ABH Guest Post: Epistles from a Public Health Metaphysician - Art and Public Health
The following is a reshared post from Dr. Ed Ehlinger’s Substack. Dr. Ehlinger is a long-time Fellowship mentor and the founding president of our previously named organization, Twin Cities Medical Society. His wisdom and advocacy in the public health space is a continuous source of hope and inspiration.
“It is difficult to get the news from poems yet men die miserably every day for lack of what is found there.”
Edward P. Ehlinger, MD, MSPH
In his Introduction to Psychology class at the University of Wisconsin, Professor Harry Harlow lamented how the field of psychology had failed to properly study the notions of love and affection. He admitted that “So far as love or affection is concerned, psychologists have failed in their mission. The little we know about love does not transcend simple observation, and the little we write about it has been written better by poets and novelists.” He also referenced Karl Weierstrass, the 19th Century "father of modern analysis" in mathematics, who said, “It is true that a mathematician who is not somewhat of a poet, will never be a perfect mathematician.”
So, what does that have to do with Public Health?
While Harlow's experiments with chimpanzee mothers and babies showed how love and affection profoundly shape health outcomes, his comments about poets raise a broader question about the role of the arts and humanities. Could they help us better understand the complex public health issues we face? Could our public health information be “written better by poets and novelists”? Could it be true that “a (public health worker) who is not somewhat of a poet, will never be a perfect (public health worker)”?
The Arts as Health Determinants
Our understanding of what creates health has expanded significantly. We now realize that health is determined by far more than medical care and personal choices. It's profoundly influenced by the social and economic circumstances in which people live, work, worship, and play. These conditions are dramatically affected by the presence or absence of music, art, theater, dance, and literature. This makes these art forms powerful public health tools and artists part of the public health workforce.
The Institute of Medicine expanded the public health workforce by defining public health as: “what we do collectively to assure the conditions in which (all) people can be healthy.” This definition doesn’t mention doctors, nurses, hospitals, or even health departments. That's because public health is not a specific place or profession; it's a philosophy that people bring to their daily activities. Anyone working to create the conditions for health is part of this collective action. And, according to the World Health Organization, these conditions include: Income, Education, Employment, Food, Housing, Physical Environment, Inclusion, Peace, and Health Services – the Social Determinants of Health (SDOH).
Since that list was generated 20 years ago, we've learned that community design and quality of life have a huge impact on the SDOH. Healthy communities build social capital, foster social cohesion, and provide a sense of inclusion and belonging, which we now know are major health determinants. Musicians, artists, dancers, and writers are essential architects in building healthy communities. As poet Wendell Berry said, “A proper community is a commonwealth: It answers the needs, practical as well as social and spiritual, of its members - among them the need to need one another.”
Arts in Real-World Public Health
Consider how writers and musicians have expanded our view of relationships, physical and social environments, housing, peace, politics, and the importance of community. Their influence is all around us:
Imagine the peace, civil rights, women’s rights, and environmental movements of the 1960s and 1970s without the soundtrack provided by Spirituals, the songs of Bob Dylan and Pete Seeger, Gospel music, and the infectious tunes of Motown.
Ponder the emotions and the questions raised by stimulating works of classical, modern, and street art within and outside of galleries.
Contemplate the expanded understanding of culture transmitted by music, dances, and dancers in our cities and rural communities and from around the world.
Consider how Langston Hughes’ poem Harlem (Dream Deferred) influenced the dream of Dr. Martin Luther King, Jr., or how the inauguration poems of Amanda Gorman ("The Hill We Climb") or Maya Angelou (“On the Pulse of Morning”) captivated the nation with their calls for unity, diversity, resilience, and hope.
Reflect on the questions raised about our place in the world by theatrical works like “Death of a Salesman” and “A Raisin in the Sun.”
Just envision the sterility and blandness of a world without the ability of people to creatively express and share their joys, sorrows, fears, hopes, and dreams.
Impact of the Arts on Health
The arts, by themselves, can be a therapeutic and illness-preventing intervention, particularly for mental hygiene. Here are just a few examples:
Mental Health
Dance and music programs significantly improve mental health, creativity, and quality of life for students, with measurable reductions in anxiety, depression, and stress.
Participating in cultural events supports cognitive development, stress reduction, pain management, and social connection.
Art therapies (e.g., music, dance, and writing) reduce anxiety, support pain management, and foster emotional expression for patients in hospitals and underserved populations.
Doctor-prescribed museum visits, dance, or community arts participation show promise in improving mental health and reducing medical visits.
Non-Mental Health Impacts
Arts-based campaigns, such as youth spoken-word interventions, have improved understanding of things like climate change and health inequity, and increased civic engagement.
Community music and theater projects help strengthen social capital, build trust, reduce isolation, and foster civic engagement, aligning closely with social determinants of health.
Art, music, poetry, and dance are often seen as independent external tools or interventions for promoting health. But what if they were embedded in the professionals themselves? How would a physician-artist view the picture a patient is painting as she explains her symptoms? How would a hydrologist-dancer interact with the flow of creeks and rivers through agricultural landscapes? How would an epidemiologist-photographer frame the study of a disease outbreak? How would a public health information officer-musician harmonize the message about a multi-sector health emergency? How would a pediatrician-poet articulate a child development message for a parent? It might be true that “a public health worker who is not a poet, will never be a perfect public health worker.”
A Final Plea for Art in Public Health
Literature, art, music, dance, and theater significantly influence the conditions in which people live, work, and play. Their influence underscores the need to include them in our work to advance health equity and optimal health for all – as both external tools and internalized principles.
The arts broaden our thinking and help us see the reality of other people’s lives. They allow us to imagine how the lives of our fellow citizens can be improved. They enhance our ability to connect with and help individuals and communities.
The profound everyday impact of these creative forms of expression gives credence to the physician-poet William Carlos Williams’ statement. We must recognize that "news from poems" is not a luxury, but a life and death necessity. By embracing the arts, we don’t just treat symptoms; we create the conditions for a more compassionate, connected, and ultimately healthier society.