For many non-profits in the arts and culture sector, the past two years have been intensely transformative in terms of navigating the pandemic, keeping their doors open, supporting artists when programming was shuttered and serving the community.

At the Ashé Cultural Arts Center (ACAC) in New Orleans, the challenges were no different.

However, true to its mission to use arts and culture to support human, community and economic development, the center’s staff took a step back to consider how best they could support residents in the moment. How could artists help to address the longstanding systemic racial health disparities that became even more apparent during the COVID-19 pandemic?

Artists and healthcare providers unite

As healthcare facilities were overflowing with COVID-19 patients, the livelihood of artists and musicians was also in despair. Instead of simply standing by and watching as the pandemic ravished neighborhoods in New Orleans, ACAC partnered with several cultural institutions and health organizations to launch the Community Spread, I Deserve It! program in 2020.

Through the program, artists and culture bearers were trained as cohorts of community health workers to launch an initiative aimed at saving the lives and livelihoods of the people left susceptible in the health and wellness field. The artists were trained with expertise in maternal and child health, mental health, violence prevention, reproductive health, wellness coaching and economic empowerment.

The program’s focus areas include:

• Training and employing artists and culture-bearers as community health workers employed to work directly with residents.
• Establishing a culture-based healing space for community members to gather and engage in lifestyle wellness activities.
• Providing an equity review of New Orleans city policies and identifying those that result in disparities experienced by neighborhoods.
• Producing an equity toolkit for care providers as a model for equitable patient-provider interaction.
• Co-designing a social marketing campaign promoting solutions-based, positive health messaging.

Over the last two years, the collective has helped residents to obtain the COVID-19 vaccine, served as a liaison between patients and the public health system to coordinate appointments and follow-up care, and worked to build trust in health practitioners within a community where that trust has been broken for decades.

“Artists and culture bearers are the people most naturally positioned to care for our residents and infuse health into a community,” says Asali DeVan Ecclesiastes, Chief Equity Officer of Ashé. “They have the language to understand the barriers and translate to residents what some public health practitioners simply can’t. This is a person, as a trusted community liaison, who can connect people to the services they need and transform the challenges into solutions – with language and creative methods that feel authentic and supportive. They pretty much serve as a bridge to access.”

Leading through the pandemic

Ecclesiastes began leading Ashé in 2020 after co-founder Carol Bebelle retired. Staff had been going through the process of organizational transitioning just before the pandemic hit due to Bebelle’s retirement. Not only were they working on a new strategic plan and building trust with new leadership, but the team was also focused on enhancing the center’s innovative programming.

Ashé Cultural Arts Center offers 10,000 square feet of gallery space and 20,000 square feet of performance space, producing more than 350 events per year prior to COVID. The organization also maintains a high-value, high-profile real estate portfolio in Central City, a neighborhood where longtime residents are being aggressively displaced.

Recent data published by the National Endowment for the Arts shows the dire economic impact of COVID-19 on the arts and culture sector. Between 2019 and 2020, the U.S. arts economy shrank at nearly twice the rate of the economy as a whole. Performing arts presenters and performing arts companies were among the steepest-declining areas, according to the NEA report.

Leading a new team through the pandemic was tough, Ecclesiastes admits. But the creative ideas flowing from her team gave her the motivation to launch new programming.

“My focus was centered on how do we empower artists in this moment?” Ecclesiastes says. “The community needs artists and artists need jobs.”

“To show artists that your job doesn’t just have to be creating a work of art – it could be changing health outcomes… It could be using art as a lens inside of organizations or inside of government to create the kind of change that humanity really needs.” 

Community Spread timeline: A decade in the making

Although the Community Spread, I Deserve It! program officially launched with funding support in 2020, elements of the program have been in effect for more than a decade. Since 2011, a team of artists and creatives have been thought and implementation partners in the delivery of culture and health-infused community revitalization in the Claiborne Corridor, the commercial and social heart of the city’s historic Faubourg Tremé neighborhood.

In 2013, the New Orleans Community Health Improvement Report revealed there is a 25-year difference in life expectancy between those living in the 70112 (Tulane, Gravier, Iberville, Treme – predominantly Black neighborhoods) and 70124 (Lakeview, West End – largely white neighborhoods) zip codes. Here is an excerpt from the report, published by the New Orleans Health Department:

Throughout the assessment process we learned that poverty, particularly childhood poverty, is a major determinant of health for residents of New Orleans. The effects of poverty on the health of our citizens can be seen through lack of access to affordable housing, food, healthcare services, as well as higher rates of unemployment, infant mortality and morbidity, and obesity than the national average. In addition, there is a 25-year gap in life expectancy between residents of one of the city’s most economically depressed neighborhoods compared to those in the most affluent neighborhoods. According to the Joint Center for Political and Economic Studies’ report Place Matters for Health in Orleans Parish: Ensuring Opportunities and Good Health for All (2012), “Place matters for health in important ways, according to a growing body of research. Differences in neighborhood conditions powerfully predict who is healthy, who is sick, and who lives longer. And because of patterns of residential segregation, these differences are the fundamental causes of health inequities among different racial, ethnic, and socioeconomic groups.” Thus, examining the distributions of poverty and health at the neighborhood and community level is essential to address and eliminate health disparities.

Following the release of the report, Ashé Cultural Arts Center began to envision the Community Spread program, which was called “I Deserve It!” at the time because the Ashé team learned that even with access to healthcare, many Black and Brown people didn’t always feel like they received the best care. However, when they first tried launching the program, they couldn’t get funding support. 

“For artists to address a 25-year difference in life expectancy – that doesn’t seem quite coherent, right? Unless you know the ability of artists. We are uniquely positioned to make deep, impactful changes in ways that policy makers and scientists cannot.”

Avis Gray, ACAC Leader of Health Equity, oversees the Community Spread collective. Gray retired from the state health department as a nurse before joining Ashé.

“Poor health outcomes in BIPOC communities are not simply the result of defective character traits or willfully destructive decision making by residents,” Gray says. “Centuries of federal, state, local and private sector policies have created an environment that is destined to lead to poor outcomes, no matter their character or choices.”

“People in poverty don’t expect that they should be well and are accordingly more passive about their health outcomes,” she added. “Some rarely feel empowered to investigate their options or control their interactions with healthcare providers.”

If residents are in prevention or crisis mode, Community Spread collective can guide them to what they need and provide follow-up support.

Listen to an interview with Avis Gray

 Community partners spread messages of health equity

The Community Spread, I Deserve It! collaborative’s structure consists of several partnering organizations. Ashé Cultural Arts Center is the lead convener charged with designing and overseeing the program, ensuring project compliance, providing partner coordination, and recruiting, hiring and managing artists as community health workers.

New Orleans East Hospital (NOEH) – the only hospital owned by the city and one of four  hospitals in the country where President and CEO Takeisha Davis is a Black woman – partners with the collaborative to provide care to residents with an intentional focus on racial equity and a reduction in racial health disparities. Dr. Davis is a New Orleans native and spent the last 10 years at the Louisiana Department of Health and Hospitals (DHH) where she served as the Director of the Center for Community and Preventive Health, Medical Director and Assistant State Health Officer for the Office of Public Health (OPH).

“Her commitment to this program is on a different level. She’s more aware of the zip code disparities and sees them play out in our communities in the most horrific ways,” Ecclesiastes says.

Through the hospital partnership, a group of physicians meet bimonthly with the community health workers to ensure there is ongoing dialogue on how hospitals can deliver equitable care. NOEH led the co-creation of a model for equitable patient-provider interaction that has been scaled through its membership in the LCMC Health System (Louisiana Children’s Medical Center), a nonprofit network of healthcare providers in Southern Louisiana whose members include academic centers, acute care facilities and research hospitals.

The Tulane School of Public Health & Tropical Medicine co-created an 80-hour curriculum tailored to artists and culture bearers. The curriculum is focused on addressing health equity challenges facing BIPOC residents and includes principles of public health, a community health assessment, and compassionate resilience training.

The Institute of Women & Ethnic Studies joined the collaborative to address the influence of interpersonal and societal dynamics on behaviors and lifestyle choices. The organization is currently developing a social marketing campaign focused on enhancing wellbeing and promoting a wellness vocabulary centered on self-empowerment.

Additional partners include the New Orleans Health Department and the Ujamaa Economic Development Corporation, which has led the project’s community engagement strategy.

“This program has created new norms for residents’ views of health, shifting those elements of our culture that promote disease into ones that promote wellness,” Gray says. “This is an approach that is continual rather than episodic; that respectfully engages community stakeholders, and one that supports compassionate, trauma-informed care focused on the roles of both patients and providers.”

For those who are still not convinced of the critical role artists and creatives play in dismantling unjust health systems, Ecclesiastes shared this final thought:

“Artists are the best of humanity, and they can reflect the best of humanity. Artists teach us how to have transparency and engagement. They teach us how policy can be rooted in the most inhumane ways, but then they find creative solutions that are also highly data driven and analytical. They give us the permission to dream and create – even inside of poor policy – beyond what’s comfortable and safe. They teach us how to push boundaries with creativity.”