The Art of Humanities for Good Public Health

Authored by: Laurel Whidden

Art by: Laurel Whidden

In the global fight against disease, science can develop vaccines and treatments, but the success of public health interventions is determined by the stories we tell, the cultures we understand, and the ethics we uphold. Health humanities is a growing discipline that promotes a more inclusive, democratizing, and practical integration of the arts within healthcare, human health, and well-being [1]. Often referred to as “creative public health”, this approach values lived experience alongside professional expertise, fostering inclusion across various sectors and communities [2]. It has established a strong evidence base for improving health and has engaged cross-cultural communities worldwide, contributing to the growth of global health humanities.

A growing concern for medical educators is the decline in empathy among health professional students. Evidence suggests that this decline is driven more by structural issues within the healthcare system than by individual shortcomings [3]. This phenomenon is closely linked to what psychologists refer to as "psychic numbing," where constant exposure to suffering and stress desensitizes individuals, making them less emotionally responsive over time [4]. In healthcare or epidemiology, this can manifest with professionals becoming emotionally detached, as a defense against the overwhelming demands of their environment or disease prevalence statistics. As leading psychologist Paul Slovic, professor of psychology and president of Decision Research points out, “As the number of victims in a tragedy increases, our empathy and willingness to help reliably decrease” [4]. This detachment can extend beyond clinical settings to larger-scale public health efforts, where empathy and emotional engagement are critical to designing sustainable interventions that address the needs of diverse populations. For example, during the COVID-19 pandemic, despite the staggering mortality rates in the United States—equivalent to eight passenger jets crashing and killing everyone on board every single day since mid-March—many individuals refused to wear masks, avoided social distancing, and pushed for the reopening of businesses, schools, and venues [5]. This public refusal illustrates psychic numbing, as the overwhelming scale of the tragedy decreased emotional engagement and reduced collective action, undermining public health efforts.

 This is where human narratives, oral history, and the humanities play an essential role. Narratives spotlight the experiences of a community with shared characteristics, often underlining the collective journeys of marginalized individuals and groups [6]. These narratives can also be rooted in singular stories that reflect historical and cultural perspectives. They humanize accounts of suffering, providing a call to action that evokes empathy and emotional engagement from the public regarding public health issues. Moreover, narratives illuminate the social and structural factors that statistical data may overlook, offering a more comprehensive understanding of health challenges [7]. By expanding our understanding of complex global and public health issues, narratives create space for new questions and facilitate perspective transformation, especially in reforming healthcare policy [6].

An arts-based public health intervention, Through Positive Eyes (TPE), exemplifies this approach. This collaborative photo storytelling project, working with over 200 individuals living with HIV globally, aims to decrease stigma in public health [8]. This database allows individuals living with HIV to share their stories through powerful portraits and narratives, offering a personal, human perspective on a condition often misunderstood. The portraits, created by the “artivists” themselves, highlight their resilience and challenge harmful stereotypes, fostering empathy and connection that encourages viewers to see beyond stigma.

Similarly, anthropology can enable public health professionals to develop more inclusive and sustainable interventions by revealing local customs and social norms that significantly influence health behaviors [9]. For instance, anthropologist and physician Paul Farmer’s work in Haiti found that many Haitians viewed illnesses like HIV/AIDS and tuberculosis through lenses of poverty and spirituality, rather than solely biological factors. These understandings allowed Farmer’s team to develop culturally sensitive health interventions. Gathering oral histories in ethnography, as seen in Farmer's work, addresses enduring inequalities that affect health outcomes and ensures interventions acknowledge historical injustices.

More examples of successful culturally informed health interventions include vaccination campaigns addressing hesitancy. The "We Can Do This" campaign in the United States worked with trusted community leaders to disseminate information about COVID-19 vaccinations, encouraging nearly 22.3 million people in culturally hesitant populations to complete their vaccination between April 2021 and March 2022 [10, 11]. This outreach helped mitigate nearly 2.6 million infections, highlighting the importance of culturally sensitive public health initiatives. 

Current research has explored how arts-based murals influence social perceptions of public health issues, challenge stigma, and promote awareness. A local arts-based intervention in Ithaca, New York, led by Tompkins County Whole Health (TCWH) and Ithaca Murals, recently unveiled a mural honoring COVID-19 victims and celebrating public health efforts. The mural includes visual elements from the pandemic and reflects the resilience of the Tompkins County community while emphasizing vaccinations' role in preventing illness [12]. Similarly, the Porch Light Program, engages underprivileged urban areas across the U.S., focusing on social issues such as homelessness, housing inequality, immigration, and social injustice. Assessed by the Yale School of Public Health Education, this program has been shown to enhance empathy, social trust, and community perceptions in lowering stigma around mental health issues while inspiring local activism [13].

As we move forward, it is fundamental to continue integrating humanities in public health, as it fosters empathy, cultural understanding, and inclusivity. From combating misinformation, cultivating trust, and unearthing the stories of marginalized populations that embody health inequity, the humanities can redefine public health for a sustainable future.

References 

1. Crawford, P. (2020). Introduction: Global Health Humanities and the Rise of Creative Public Health. In The Routledge Companion to Health Humanities. Routledge https://www.taylorfrancis.com/chapters/edit/10.4324/9780429469060-1/introduction-paul-crawford 

2. Tinner L. Reflections on the benefits and challenges of using co-produced artistic workshops to engage with young people in community settings. Res Involv Engagem. 2024 Jun 3;10(1):51. doi: 10.1186/s40900-024-00575-1. PMID: 38831355; PMCID: PMC11149207. 

3. Guidi C, Traversa C. Empathy in patient care: from 'Clinical Empathy' to 'Empathic Concern'. Med Health Care Philos. 2021 Dec;24(4):573-585. doi: 10.1007/s11019-021-10033-4. Epub 2021 Jul 1. PMID: 34196934; PMCID: PMC8557158.

4. Slovic, P. (2007). If I look at the mass I will never act: Psychic numbing and genocide. In The new humanitarianism: A new approach to humanitarian action (pp. 1-10). Oxford University Press. 

5. Paul Slovic observes the ‘psychic numbing’ of COVID-19. (n.d.). Https://Www.Apa.Org. Retrieved December 1, 2024, from https://www.apa.org/members/content/covid-19-psychic-numbing

6. Fadlallah R, El-Jardali F, Nomier M, Hemadi N, Arif K, Langlois EV, Akl EA. Using narratives to impact health policy-making: a systematic review. Health Res Policy Syst. 2019 Mar 5;17(1):26. doi: 10.1186/s12961-019-0423-4. PMID: 30836972; PMCID: PMC6402129.

7. Niederdeppe, J., Bu, Q. L., Borah, P., Kindig, D. A., & Robert, S. A. (2008). Message design strategies to raise public awareness of social determinants of health and population health disparities. The Milbank quarterly, 86(3), 481–513. https://doi.org/10.1111/j.1468-0009.2008.00530.x 

8. Through Positive Eyes. (n.d.). Through Positive Eyes. Retrieved [Date], from https://throughpositiveeyes.org 

9. Foucault, M. (1994). Society Must Be Defended: Lectures at the Collège de France, 1975-76. Picador.

10. Gollust, S. E., Nagler, R. H., & Fowler, E. F. (2021). The Role of the Public Health Campaign in Addressing COVID-19 Vaccine Hesitancy. Health Affairs, 40(7), 1177-1186.

11. Affairs (ASPA), A. S. for P. (2024, May 6). COVID-19 Vaccination Public Education Campaign Saved Thousands of Lives, Billions of Dollars [News Release]. https://www.hhs.gov/about/news/2024/05/06/covid-19-vaccination-public-education-campaign-saved-thousands-lives-billions-dollars.html 

12. Tompkins County Whole Health. (2024). Tompkins County Whole Health unveils mural celebrating public health efforts and honoring lives lost to COVID-19. Tompkins County, NY. https://www.tompkinscountyny.gov/health/tompkins-county-whole-health-unveils-mural-celebrating-public-health-efforts-and

13. Tang, Y. (2019). The Impact of Mural Programs on Minority Communities in the United States (Doctoral dissertation, Drexel University). doi: https://doi.org/10.17918/aj57-ak87