A 2023 report from the Commonwealth Fund and the African American Research Collaborative exposed the persistent and troubling disparities in healthcare. According to the report, 47 percent of healthcare workers have witnessed discrimination against patients within their facilities, and 52 percent consider racism in healthcare a crisis or major problem. Moreover, 57 percent of healthcare workers have observed discrimination against patients who primarily speak languages other than English. We also know that there is a major disparity in health outcomes within communities of color compared to white communities. To cite just one jarring example, maternal mortality rates among Black women are more than twice that of white women, according to the CDC.
It is clear that we require new models that meet the needs of diverse communities who have been overlooked and failed by our current health system. This calls for the development of a human-centered process that integrates the voices of those most affected by inequitable health institutions into the transformation of care both within and beyond the clinic.
At Wagner Foundation, we are witnessing a significant shift in health institutions embracing innovative care models: hospitals are building critical infrastructure within communities to promote health, strengthening local food systems, and investing in affordable housing. Students in the emerging field of medical humanities are engaging in the study of literature, philosophy, and the arts to enrich the emotional and ethical dimensions of patient care. Doctors have even begun prescribing cultural experiences as a form of medical intervention.
This shift aligns with a growing number of initiatives across the country that recognize the powerful role artists can play as partners and catalysts in driving transformative change within health institutions. Because they are deeply embedded in their communities, artists can ask critical questions and open channels of dialogue, ultimately contributing to culturally competent care. As funders, we believe in resourcing these artists as well as accompanying medical institutions ready to adapt to the changing needs of the communities they serve.
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The role of artists as catalysts for change
Bridging the divide between community and healthcare is Convalescence, a new exhibition by Philadelphia-based artist Pepón Osorio. Sited at Thomas Jefferson University’s medical campus in Philadelphia, this bold installation is rooted in the artist’s personal experience with cancer. While undergoing treatment for the disease, Osorio was moved to begin meeting with families and individuals of color across Philadelphia who have experienced life-threatening illness, inviting them to share their own stories of healing.
In Convalescence, each participating family is represented by a hospital bed adorned with objects evoking their personal and medical histories. Video monitors display recordings of participants sharing in their own words their traumatic medical experiences and dreams for the future. The installation also includes various interventions that interrupt what is typically found in hospital lobbies: portraits of community health workers and advocates hang alongside the traditional depictions of hospital founders (mostly white men); a patient’s bill of rights takes up an entire wall; and a maquette of a neighborhood botánica joins a pre-existing model of a hospital wing expansion.
This moving installation seeks to answer the question: How can healing be understood as a creative act supporting personal and collective change? As an extension of the exhibition, Osorio is also organizing workshops and public programs with thinking partners whose lives and careers have been shaped by health injustice and who explore alternative models for community-based care.
It is important to recognize that artists such as Osorio have long been invested in questions of community care and health equity, imbuing their conceptual practice with the needs and concerns of those most affected. Born in Santurce, Puerto Rico, in 1955, Osorio moved to New York City in 1975 and began his career as a child social worker. In the 1980s, he started working more concertedly as an installation and performance artist, using everyday materials in immersive environments to represent the health, well-being, and cultural life of Nuyorican and Latinx communities in the Bronx.
These early works include Maria Cristina Martinez Olmedo, D.O.B. 3/27/89 (1989), in which Osorio placed a Black baby doll in an elaborately decorated bassinet to draw attention to the infant mortality crisis among people of color. With El Velorio (1991), a room-sized installation of coffins with testimonials to people who died of AIDS, he pointed to the silence surrounding the spread of the disease in Latinx communities. Osorio emphasizes that the audiences for his work are the populations who have shared their experiences with him, stating, “My principal commitment as an artist is to return art to the community.”
The role of human-centered institutions in systems change
In December 2020, the American Association of Medical Colleges published a report titled The Fundamental Role of the Arts and Humanities in Medical Education that urged medical schools to integrate medical humanities into their curricula. Adoption has been slow, partly due to the costs and complexity involved in successful implementation, coupled with the growing emphasis on specialized medicine driven largely by an economic model that prioritizes intervention over prevention. This narrow focus has promoted the categorization of patients as either ill or healthy, neglecting the complex, nuanced ways we experience the continuum from illness to well-being. In Convalescence, Osorio creates space for a dialogue that is too often marginalized—even absent—from conventional health education: the vital role of the spiritual and psychological aspects of the self in illness, healing, and health.
Critically, this conversation is taking place directly on Jefferson’s medical school campus, where tomorrow’s physicians are being steeped in the practices that will determine the future of healthcare. Known for its innovative medical education and research, the university offers a wide range of programs in medicine, nursing, and health sciences, with a strong focus on clinical training and interdisciplinary collaboration. Status quo organizations can be a signal of how difficult and unwieldy systems change can be, discouraging progress. In contrast, when institutions like Jefferson show they can adapt, they send a message that change is possible.
The ability and willingness for Jefferson and other health institutions to collaborate with artists like Osorio on their terms is vital to the future of medical education. Artists can be catalysts for innovation and change, but that will require traditional structures such as hospitals and universities to adapt to make it feasible for cultural workers to manage complex projects like Convalescence within institutional settings, all while staying true to the artist’s ethos and commitment to community engagement.
We all have a role to play in cultural transformation
Successful projects like Convalescence demands the ability to navigate the creative tensions between the needs and voices of artists and activists, the resources necessary for experimentation, and the ability to foster support and buy-in from institutional leaders. It also requires funders to invest in these intersectional projects. At Wagner Foundation, we saw a clear connection between our efforts to advance health equity and supporting the critical role artists play in advancing dialogue about what makes healthy communities thrive. Philanthropic capital can be key to allowing these projects to unfold, from providing the flexibility to experiment with bringing in artists to supporting institutional leadership and communities in their learnings.
The organizing team behind the Convalescence exhibition was a critical component of its success. Megan Voeller, director of humanities at Jefferson, is a curator, writer, and educator whose research focuses on how contemporary artists engage with concepts and practices of health, healing, and medicine and on the reciprocal role of the arts and humanities in medical training. Voeller’s track record in leading public- and patient-centered initiatives laid the groundwork for their ability to successfully navigate the institutional dynamics required to bridge traditional divides between art and medical education. Partnered in this project is curator Rob Blackson, who has collaborated with Osorio for a number of years. Blackson’s work over the past decade has illustrated a shift in the way artistic programs can be crafted to build a healthy mutuality of poetic and practical social purpose.
We all have a role to play in truly healing our healthcare systems. To evolve, we must continue to challenge conventional models and embrace the transformative potential of arts and culture in systems change. Institutions, funders, artists, and community leaders alike can advocate for the integration of artistic practices and institutional collaborations that honor our collective humanity.
November 3, 2024
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