What Business Gets Wrong About Health

Before the Civil War, Natchez, Mississippi housed the second-largest market of enslaved people in the American South. Today, Natchez is emblematic of much of this region: a beautiful place still grappling with its past while reaching toward an uncertain future.

Being from Appalachia, this is a paradigm I understand. In 2014, the arts nonprofit I co-founded, IDEAS xLab, was invited to Natchez by a large health insurance company to design creative placemaking activities for the launch of a community health initiative. The company had produced a glossy strategy report and hired marketing firms from Chicago and New York to promote the event. Fun runs, outdoor Zumba classes, and healthy cooking demonstrations were planned. Banners and t-shirts emblazoned with corporate logos abounded.

Launch morning arrived. As everything was being set up in the heart of this little Mississippi town, I noticed an older African American lady sitting on a park bench watching all the activity. I spent the next couple of hours talking with her about life, family, and the history of this place. As we neared the end of our visit, I gestured toward all the goings-on and asked her, “What do you think about all this?”

A knowing grin came across her face. “Those are nice people,” she said. “It’s clear they believe they are getting ready to do something important. But I don’t think any of that’s going to work.”

She went on to tell me about her most prized possession: a recipe card. Torn and stained from years of use, the card was written in her grandmother’s handwriting. The first ingredient was two cups of lard.

I remember her saying something like, “Just because those people’s numbers say I need to eat a piece of kale and walk around the block a time or two doesn’t motivate me to change anything. They don’t understand that I’m not just making food when I cook my grandmother’s recipe. I’m connecting to my roots, my heritage, my identity. That recipe card reminds me of who I am and where I come from. It is an act of celebration, passed down through generations of strong, creative, skilled Black women in my family.”

“I get that it’s not the healthiest thing to eat,” she said. “But change can’t ever be about just one thing, like how much I weigh or my cholesterol. If change is not about everything, and at the same time, most people won’t embrace it.”

She was talking about culture: how we create meaning in life and share that meaning with others.

I knew she was right. My own granny—who is 100 years old and lives in the place my people have called home for generations, southeastern Kentucky’s Breathitt County (one of two communities profiled in J.D. Vance’s Hillbilly Elegy)—has had this same conversation with me many times. Culture is the soil in which we plant our dreams and cultivate our meaning.

Numbers alone may move businesses and markets to act, but culture is the operating system that guides a community. More than almost anything else, culture shapes our notions of wellbeing. Wellbeing includes objective health measures, like blood pressure and rates of disease. But more importantly, it also encompasses subjective measures, like feelings of hope, trust, and belonging.

Individual Change vs Culture Change

Let’s be honest. One of the primary reasons business leaders care about employee wellbeing is that it impacts their bottom line. Historically, much of the business community’s approach to improving employee wellbeing has focused on getting people to change their personal health behaviors: the things that an individual is doing “wrong.” Phrases like “Need to eat healthier?” and ”Need to get more exercise?” are often used. This is an approach that defines people by their perceived deficits relative to a fictional standard of what is “best” that’s based on a quantitative algorithm developed to control cost.

Many times, these behavior change efforts are undergirded by unintentional, unspoken messages that a person’s own identity is their biggest stumbling block. “If only Latoya were more like Becky, she would be healthier and happier.” There is a LOT to unpack between the lines of such statements! But, let’s just say for now that these are certainly not inclusive messages that build trust and collaboration among diverse groups in the workplace or in society.

Research suggests that culture influences wellbeing more than almost anything else. This is why I believe that artists, creatives, and other culture-bearers—when trained and supported properly—are linchpins for unlocking human potential in America’s innovation economy.

I still believe that our nation has the potential to be a place where everyone can have a fair chance to become their best self. For us to realize this potential, however, public, private, and nonprofit sector interests must become better aligned. In a growing plural society with competing value systems, what is “good” cannot be a one-size-fits-all standard determined by for-profit businesses. Forging the path ahead is fundamentally a cultural challenge in which we must all take part.

Enter the Center for Creative Placehealing

The World Health Organization has repeatedly identified the systemic neglect of culture as the single greatest barrier to the advancement of the highest standard of health worldwide.[1] According to this definition, health is more than the absence of disease: it is a state of wellbeing that allows people to contribute their full creative potential to the communities they love. This interaction helps us manifest a personal sense of hope, trust, and belonging. Culture is the result of how communities make and share meaning. It is the “why” of both people and business.

In 2018, I joined the faculty of the University of Louisville School of Public Health & Information Sciences. In January 2019, our school launched the Center for Creative Placehealing (CCP), which promotes a framework for connecting creatives with evidence-based research and development support to drive a culture of health through business. Cultural wellbeing is our tangible, measurable goal. You can read more about our vision, mission, and values on our website.

In January 2020, CCP will launch the Cultural Wellbeing 2020 initiative. This comprehensive initiative will involve multiple corporations within the Louisville business community, an interdisciplinary team of researchers and creatives, and experts in public and economic policy.

Cultural Wellbeing 2020 will use creative placemaking techniques and public health research to address the deeply entrenched challenges faced by businesses, including how to create cultures where people feel safe and supported and are able to rise to their highest potential. Cultural Wellbeing 2020 will make Louisville the first city in the country to scientifically measure and manage cultural wellbeing in the corporate sector, using the Cultural Wellbeing Index© that we developed.

The fact that we are launching this initiative in Kentucky makes it even more important. Companies face heightened operational and reputational risks when they do business in places like this, where the legal and/or social atmosphere makes it difficult for African Americans, people of color, and LGBTQ+ individuals to bring their “whole self” to work out of fear of discrimination.

We hope this initiative will help to formalize the concept of “cultural wellbeing” as a core component of regional economic development strategies; support the development of inclusive workplaces; and, in concert with creative industries, promote public health research as a driver of economic and entrepreneurial ecosystem growth.

What’s Next

Over the next three blog posts in this series, I will outline CCP’s Theory of Change and suggest ways that creative placemaking practitioners across the U.S. can benefit from and adapt our work for their own use with the businesses that call their area home.

When business is combined with the energy and power of arts and culture, a new way forward emerges: a way that supports wellbeing in society. A way of hope, trust, and belonging that is not small or isolated. A way that reveals “a bigger us.” As James Baldwin wrote, this is the precise role of the artist: “to illuminate that darkness, blaze roads through that vast forest, so that we will not, in all our doing, lose sight of its purpose, which is, after all, to make the world a more human dwelling place.”

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Theo Edmonds is an artist, cultural futurist, champion clog dancer, and health innovator. He is an Assistant Professor at the University of Louisville School of Public Health & Information Sciences, where he also serves as Founding Director of the Center for Creative Placehealing. He is co-founder of IDEAS xLab and Vice President of CIVITAS, a regional LGBTQ Chamber of Commerce. Theo was named by Southern Living magazine as one of 50 People Changing the South.