Wednesday, March 25, 2015

It's hard to get into the habit of working out for better health. But an article in a recent edition of the Huffington Post not only makes sense about the habits of those who do work out regularly, it may help motivate you to take control of your health.

10 Habits Of People Who Love To Work Out


RUNNING AND SMILING
 
By Jessica Migala


You know these people: they bound out of bed in the morning ready to tackle their sunrise bike rides. They leave the office during lunch to sneak in a quick run. Or they head out of work, gym bag in hand -- and they're going to use it (not just bring it back home). They're the ones who look like they're actually enjoying themselves as they pedal furiously at Spin. Can you be more like these fitness fanatics? Experts say yes, you can teach yourself to love exercise. Get into the workout groove by mimicking their habits.

1. They Only Do Workouts They Enjoy

People who love to exercise don't waste time with activities they despise. "Too often I see people who sign up to do something like running, even though they know they hate running," says Shavise Glascoe, exercise physiologist at the Johns Hopkins Weight Management Center. Start with an activity that you're interested in or already enjoy -- it doesn't have to be what your neighbor said helped her lose weight or what the group-class trend of the moment is. What matters is that you like it. If you don't want to do it, you will make an excuse to skip it tonight (and tomorrow, and the next day).

2. They Look For Feedback

Fitness fanatics often thrive on instant feedback, says Jimmy Minardi, a former professional cyclist and personal trainer in New York City and Santa Barbara, Calif. He suggests trying out a fitness tracker that measures heart rate or calories burned, like the Fitbit Charge HR ($150; amazon.com), Withings Pulse 02 ($120; amazon.com), or the Intel Basis Peak ($200, amazon.com). That real-time feedback will help you push yourself further -- you'll always feel motivated to match or exceed your personal best -- and take your workouts to the next level. Plus, Minardi says, you'll be more connected to your training.

3. They Exercise With A Friend

running with a friend

Exercise addicts get by with a little help from their friends, says Glascoe. They're sure not to ditch their yoga buddy for an om-session even when they'd rather beeline straight home, and are excited to get out of bed for a morning run because they'll have the chance to chit-chat with their pals. Case in point: in a University of Southern California study, people said they had more fun and enjoyed working out more when they did it with a friend. Don't assume that none of your friends want to work out -- you may find one who wants to get in shape alongside you. But you could also find a workout buddy by joining a local running or biking club, or signing up for a recreational sports league.

4. They Get Back To Nature

When the weather outside is nasty, it's natural to want to take exercise inside. But if it's nice and bright out, bike along that lakefront path, run through your neighborhood early in the morning, or find an outdoor yoga class. "Nature makes you feel alive -- and when you feel great, you are more likely to want to do the workout again," says Minardi. Besides, in one 2011 study in Environmental Science & Technology, sweating outdoors was associated with a boost of energy, more engagement in the activity, and better mental wellbeing. Go ahead -- sweat, and say ahhh.

5. They Let Setbacks Slide

exercise

Sometimes life gets in the way of exercise, and that's okay, says Glascoe: "Studies show that people who have wiggle room in their mindset are more likely to maintain a regular exercise routine," she says. "Prepare yourself for potential barriers and come up with a backup plan." Glascoe has her clients plan the maximum and minimum number of days they want to exercise in a week. That way, if they miss one, there’s no "I've blown it" mentality. If you have to work late and can't hit Spin, tell yourself that tomorrow you’ll get back on track.

6. They Don't Think About How Much Weight They're Losing

"We seem to be more powerfully motivated when we look at the short-term, immediate benefits of exercise," says Gregory Chertok, a sport psychology consultant. Rather than focusing on the 20 pounds you want to lose (which, turns out, doesn't help us get off our butts and get moving, he says), think about the almost instantaneous extra energy you'll get with your kids, at work, or in the bedroom. And anyway, when you stop thinking about how your workouts are affecting your weight, you may actually start seeing the pounds melt away: Cornell University research suggests that framing your exercise as something other than calorie burning (like a break or "me time") can help you eat less after.

7. They Don't Care If It’s '"Traditional"

Exercise is exercise -- doesn't matter if it's at the gym or not. All types of activity count, so try baking your playtime into your workout time by becoming a member of the company kickball team, joining a beach volleyball league, or trying something you're curious about, like martial arts. "You're creating a lasting relationship with the activity, rather than simply showing up for classes," Minardi says. Other activities that count? Gardening, running in the backyard with your kids, and dancing (even if it's a dance party for one in your living room), adds Chertok.

8. They Crank Up The Tunes

woman holding ipod and running

There's a reason why you see so many people wearing earbuds at the gym: Music is a huge motivator, reveals research in the International Review of Sport and Exercise Psychology. "Use music to improve your results. People exercise longer and more vigorously to music, and it distracts them from fatigue," says Chertok. He recommends compiling a playlist of your favorite music. When you need motivation to get out the door, put your headphones on and get inspired to sweat.

9. They Reward Themselves

Your goal is to make exercise an automatic habit that you don't have to agonize over. (Do I really have to go to the gym after work today? Am I actually going to get up early for that run?) A way to reinforce the routine is to reward yourself for a job well done, says Chertok. One of his clients set up a checking account that he uses to deposit a set amount of money each week he successfully sticks to his fitness goals. And every time he misses them? He withdraws money. At the end of the month, he takes the money he saved and does something fun, like signing up for a cooking class or buying tickets for a show. You can also plan mini rewards, like stopping by your favorite coffee shop or juice bar post-workout. (Just don't go overboard on treats.) It's something to get you up and moving when you'd rather not.

10. They Dress The Part

Truth: you don't need expensive workout gear to have a great workout. But, buying new athletic apparel may be a good motivator. "We feel better about ourselves doing something athletic when we perceive ourselves as looking more athletic," says Chertok. So switch out your old, rundown pair of shoes in favor of new kicks, pick up a new sporty headband to accessorize, or spring for a pair of running shorts if you're starting to train for your first 10K.

Friday, March 20, 2015

With a background in both the fine arts and healthcare, I've always felt that the role of creativity is paramount to both. Now a new program at the University of Texas at Austin has developed a collaboration between its College of Fine Art and the Dell Medical School. I suspect the result will be a positive impact on the lives of those who experience the effort's outcomes.

The University of Texas at Austin

Design Institute for Health Brings Creativity to Health Ecosystem

March 16, 2015


AUSTIN, Texas — Two veterans of the pioneering IDEO design firm will lead the Design Institute for Health, a first-of-its-kind institution dedicated to applying design thinking and creative solutions to the nation’s health care challenges, and to integrating that perspective into medical education and community health programs.


The Design Institute for Health is a collaboration between the new Dell Medical School and the College of Fine Arts at The University of Texas at Austin. The institute will be led by two veterans of the internationally recognized design firm IDEO: Stacey Chang, IDEO’s former managing director of health and wellness; and Beto Lopez, former global lead of systems design at IDEO and a UT Austin alumnus.

IDEO is credited with a number of landmark designs that established its reputation, including the original computer mouse, the folding laptop computer and the Palm PDA device. Since then, IDEO has expanded its reach into the design of offerings as diverse as educational systems, public policy, retail spaces and children’s toys.

In announcing the institute’s creation at The Contemporary Austin – Jones Center art museum on Monday, the first day of the inaugural South by Southwest Health and MedTech Expo, Chang said there are great design opportunities in health.

Providers are moving toward a system that focuses as much on people’s lives, priorities and loved ones as on their particular maladies. The nation is more than ready, Chang said, for creative, human-centered designs that reduce waiting room times, streamline insurance payments, help people tend to their health and create a more compassionate atmosphere in hospitals and clinics.

The Design Institute for Health aims to generate designs and strategies that reinvent the ways doctors are taught and Americans get healthy and stay healthy.

“In health care, there are endless opportunities to rethink products and systems so they better serve people who need them,” said Chang, who oversaw IDEO’s health-related portfolio and will be the institute’s executive director. “The Design Institute for Health will take on these longstanding challenges in a way that’s fully integrated with the Dell Medical School’s efforts to create a vital, inclusive health ecosystem and make Austin a model healthy city.”

“This institute will systematically use design and creativity to create better health outcomes at lower costs, increase value in the health care system and improve the lives of patients and providers,” said Lopez, who will be the institute’s managing director. “We’ll examine everything from the design of health products to the architecture of the hospital to the functionality of the health ecosystem itself — it’s an incredibly exciting project.”

The Dell Medical School is the first medical school in decades to be built from the ground up at a top-tier research university. Dr. Clay Johnston, inaugural dean of the Dell Medical School, said that newness will help the school embrace novel solutions without worrying about effects on existing models and practices.

“In health care, ‘redesign’ has become such a buzz word, but few entities are using the principles of design thinking to take on these challenges,” Johnston said. “Creative, uniquely Austin solutions are required to make this a model healthy city. These guys are the creative gurus.”

Both Johnston and Douglas Dempster, dean of the College of Fine Arts, credited UT Austin President Bill Powers and Provost Greg Fenves for supporting initiatives such as the Design Institute with the potential to improve health and transform health care.

“The joint appointments of these design experts to the faculties of Fine Arts and the Dell Medical School is a first, big step in an exciting new collaboration between our two colleges,” Dempster said. “Our goal is nothing less than to redesign health care delivery in America. In the process, we are ensuring that our design program is a unifying entrepreneurial discipline at The University of Texas.”

Monday, March 16, 2015

What makes healthy individuals and does it involve healthy communities? Does having a creative society, creative economy, and creative neighborhoods have a larger impact than what we might normally consider? This article published on Grantmakers in the Arts explores just that.

From Creative Economy to Creative Society

 
A neighborhood-based strategy to increase urban vitality and
promote social inclusion

 
Mark J. Stern and Susan C. Seifert


Can a creative economy ameliorate urban poverty? The contemporary U.S. city is witness to an increasing proportion of its residents being denied active participation in the local economy, social institutions, and broader civil society. While many a metropolis has weathered the transition from an industrial to an information-based economy, most urban neighborhoods bear the persistent physical and social manifestations of economic inequality and social exclusion.

Urban policy-makers generally agree that regional economic development and job growth are the solution to urban poverty and its associated blight and pathology. Many cities have latched onto Richard Florida's argument that attracting the “creative class” to the region will generate jobs and tax revenue, a trickle down of benefits to all citizens. Unfortunately, it appears that growth of the creative economy can spark inequality and exclusion. Is the creative economy a bargain with the devil? Does a city have to accept increased economic inequality to reap the prosperity of the creative economy?

In this article, we recap current research and policy on culture and revitalization and propose a new model—a neighborhood-based creative economy—that has the potential to move the twenty-first century city toward shared prosperity and social integration.

The Creative Sector And Urban Policy

A focus on the creative economy represents the latest wave of interest in culture as a post-industrial urban revitalization strategy. Beginning with the 1983 landmark study by the Port Authority of New York and New Jersey, economic impact studies have quantified the contribution of the nonprofit cultural sector to a regional economy based on the multiplier effect of organizational and audience expenditures. In time, policy-makers realized that economic impact is magnified when bounded spatially. So the planned cultural district came into vogue, along with the development of major cultural facilities like museums or performing arts centers, as catalysts for downtown revival.

The creative economy is more than just nonprofit arts and culture. Studies by the Rand Corporation of the performing and media arts took the lead in treating nonprofit and commercial cultural firms as a single sector. Richard Florida's work—with its claims about the role of the “creative class” in global competitive advantage—encouraged the trend to treat nonprofit and for-profit firms as a single sector and expanded definitions of culture to include design and related fields as part of the creative economy.

The excitement among public and corporate executives about the creative class has overshadowed a growing literature on the community benefits of the arts and culture. Researchers studying community-building seek to integrate their findings on grassroots cultural practices and informal arts with their understanding of contemporary urban community. Economic geographers have developed a third stream of literature, which explores production-driven “cultural clusters” and the social networks underpinning productivity. It is this cultural cluster perspective that has the greatest potential to meet the dual policy goals of economic growth and social inclusion.

Social Costs of the Creative Economy

Neither the literature on the creative economy nor that on community building has focused on possible negative effects of culture-based revitalization. Gentrification remains the most common fear. A less commonly discussed drawback of culture-based revitalization, but one for which there is more evidence, is the expansion of inequality. Economic inequality—attributed to structural changes including globalization, the decline in unions, and deindustrialization—has exploded in the United States over the past thirty years.

Of particular relevance to the arts is the emergence of “winner-take-all” labor markets. Robert Frank and Philip Cook, who developed the concept, show that changes in the U.S. labor market have expanded the number of job categories in which the most skilled members reap a disproportionate share of rewards. Frank and Cook suggest that what used to be a relatively rare feature is now common in a great number of occupations and serves to accelerate economic inequality.

Within the creative economy, artists are especially vulnerable to the winner-take-all dynamic. The handful of opera singers, concert pianists, dancers, and authors seen as the best in the world garner incomes that dwarf those of gifted practitioners who are seen as less extraordinary. Indeed, the Social Impact of the Arts Project (SIAP),* in a 2005 study of artists in six U.S. metropolitan areas between 1980 and 2000, found artists consistently among the occupations with the highest degree of income inequality.

Empirical research indicates that as culture increases its share of the metropolitan economy, increased inequality is a much more significant downside than gentrification. In his 2005 work, Richard Florida acknowledged that the growth of the creative class has contributed to the rise in economic inequality and its social and political repercussions. “Perhaps the most salient of... the externalities of the creative age,” Florida noted, “has to do with rising social and economic inequality.”

Still, since its publication in 2002, Florida's The Rise of the Creative Class has been used by city officials from New York to Spokane as a how-to manual for stimulating economic growth. The realization that pursuing creative class strategies will actually exacerbate the divisions between rich and poor has been slow to sink in.

The job mix within the creative economy poses concern as well as promise for its role in promoting economic revitalization. Overall, the creative industries are dominated by jobs with high educational requirements. The expansion of both arts occupations specifically and the creative economy overall will create more opportunities for highly skilled workers than for urban residents with modest educational qualifications.

Social Benefits of Community Culture

Research conducted over the past decade across the U.S. has reshaped our understanding of the role culture plays in urban communities. We now understand that culture includes nonprofit, public, and commercial organizations as well as independent artists. In addition, we have learned that even the “informal arts” play a critical role in building social networks and connections across communities.

Much work on community culture is concerned with the inclusion of historically marginalized populations. The Urban Institute has developed a broad framework for tracking community cultural vitality—which it defines as “evidence of creating, disseminating, validating, and supporting arts and culture as a dimension of everyday life in communities.” The informal arts sector, in particular—characterized by participatory, hands-on cultural and creative activities in non-chartered groups and informal settings—is associated with people of color, immigrants, and other out-of-the-mainstream communities.

Ethnographers in Chicago and the Silicon Valley have documented the community building potential of the informal arts. A recent study, for example, found that Mexican immigrants in Chicago “use artistic and cultural practices to break down social isolation, create new social networking relationships, strengthen... bonds among group members, and ... create local and transnational ties with [outside] institutions...”

The literature, however, avoids drawing parallels between informal arts and the informal economy. The informal arts sector is not only an indicator of community cultural vitality but a symptom of the social costs of the creative economy. Many artists, particularly those operating in the informal sector, labor under difficult conditions for low wages—stringing together several jobs to make ends meet.
The vitality of informal culture, therefore, derives in part from the animating force of poverty.

Cultural engagement across the spectrum contributes to the quality of community life by reflecting and reinforcing social diversity. Urban neighborhoods that are diverse ethnically, economically, and/or by household or family structure are more likely than homogeneous communities to house cultural programs, cultural participants, and artists. Likewise, culturally active neighborhoods are more likely to maintain demographic diversity over time.

SIAP's research on Philadelphia neighborhoods has documented links between cultural engagement, social diversity, and community capacity-building. Residents who participate in the arts and culture also tend to engage in other types of community activities. Moreover, the presence of cultural organizations in a neighborhood stimulates local community participation overall. This kind of community cross-participation helps stabilize heterogeneous communities as well as enhance overall community capacity.

SIAP has documented a connection between community culture and child welfare: low-income neighborhoods with high cultural participation rates were more than twice as likely as comparable low-participation neighborhoods to have very low truancy and delinquency. These child welfare indicators reflected not the number of kids in arts programs but rather the relationship of cultural engagement to “collective efficacy,” a term used by public health researcher Felton Earls to explain why some poor neighborhoods are safer than others—that is, “social cohesion among neighbors combined with their willingness to intervene on behalf of the common good.”

The Regeneration Potential of Cultural Clusters

Urban policy makers, using consumption-driven models, have focused on using culture to draw tourists, conventioneers, and suburbanites downtown. However, production-driven “cultural clusters,” which occur at both neighborhood and regional scales, may be the best fit between the needs of declining cities and the cultural sector.

Clusters are geographic concentrations of inter-connected companies, specialized suppliers, service providers, and associated institutions in a particular field. According to Michael Porter, economic clusters increase productivity by driving the direction and pace of innovation. “A cluster allows each member to benefit as if it had greater scale,” according to Porter, “without requiring it to sacrifice its flexibility.”

In a study of the craft, fashion, and cultural products industries of Los Angeles, Allen Scott observed that clustering is a critical feature for cultural producers to improve the quality of work produced and benefit economically from the work. L.A.'s small-scale, labor-intensive crafts firms cluster in dense industrial districts throughout the inner city and region to reduce costs through “agglomeration economies.” Moreover, the spatial proximity of individuals and firms facilitates intense social networks that spur a cross-pollination of ideas and innovation. Manuel Castells calls this organizational structure a “network enterprise” and the location where proximity generates synergy a “milieu of innovation.”

Community arts researchers have found direct connections between culture and revitalization. In a study of ten Chicago neighborhoods, Diane Grams and Michael Warr identified social networks as a key mechanism by which community arts contribute to neighborhood improvement. By developing social networks, low-budget arts programs leverage local and non-local assets that result in direct economic benefits for the neighborhood—new markets, new uses of existing facilities, new jobs for local artists—as well as broader community engagement.

SIAP has developed empirical methods to measure the arts' impact on the broader socio-economic processes of urban neighborhoods. Indeed, SIAP's research on Philadelphia shows a strong and long-standing relationship between cultural assets and neighborhood regeneration. During the 1980s and 1990s, low-income neighborhoods with many cultural providers or participants were three to four times more likely to revitalize—that is, to gain population and reduce poverty—than other at-risk areas. Between 2001 and 2003, distressed neighborhoods rich in cultural assets were more likely to see a dramatic improvement in their housing markets.

How might we explain a connection between cultural engagement and the decline of poverty? SIAP's analyses of metropolitan Philadelphia demonstrate that cultural production and participation reinforce one another, both within communities and across the region. Cultural providers (nonprofit and for-profit), individual artists, and participants tend to locate in similar communities. Moreover, communities rich in cultural resources send participants to programs throughout the city as well as draw outsiders into their own neighborhoods. Even among small grassroots arts centers, nearly four-in-five participants come from other neighborhoods. Unlike most community activities, culture builds bridges across the divides of geography, ethnicity, and social class. By building social networks within and between neighborhoods, cultural engagement fosters collective capacity, especially in low-wealth communities.

SIAP's findings demonstrate a clear correlation between cultural engagement and community well-being, but several empirical holes remain. We have yet to:


  • measure directly the link between cultural partici-pation and neighborhood change—the “collective efficacy” hypothesis;

  • collect comparable data on other forms of community engagement to assess the relative effectiveness of culture in promoting neighborhood revitalization; or
  • sort out the temporal relationship between cultural engagement, civic vitality, and neighborhood regeneration.

In addition, it would be useful to do case studies of neighborhood cultural clusters—what SIAP calls “natural” cultural districts—to look at the social and spatial dynamics of cultural production and participation and their implications for neighborhood revitalization.

A New Model: a Neighborhood-Based Creative Economy

Can the creative economy expand economic opportunity and social inclusion without generating the inequality and displacement that its critics have noted? The answer, we suggest, lies in linking threads from the creative economy, community-building, and cultural cluster literature into an alternative model, which we call a neighborhood-based creative economy. The three perspectives share an interest in moving beyond traditional nonprofit models of the arts and focusing on a community's assets rather than its deficits. All view cultural organizations not in isolation but as “network enterprises” in which their connections to wider systems are more important than their internal organization.

The creative cluster literature highlights that creativity is a collective process. The productive and revitalization potential of the creative sector depends upon an infrastructure of social and spatial networks. A neighborhood-based creative economy would build the social and spatial networks of creativity from the bottom up.

At the core of the model is a view of the community cultural sector as an ecosystem. An ecosystem perspective highlights how the capacities and impacts of the sector as a whole are greater than the sum of its parts. The community cultural ecosystem includes many agents—nonprofits, commercial cultural firms, individual artists, and informal groups—that operate both within communities and across metropolitan areas. An ecosystem perspective views the connections and flows between agents and resources—their institutional and social networks—as more important than individual entities.

An effective revitalization strategy should be both place- and people-based; that is, it should be grounded in a given locale but have active connections with other neighborhoods and economies throughout the city and region. A neighborhood-based ecosystem approach to the creative economy is a way to integrate urban neighborhood residents with the regional economy and civil society.

From Creative Economy to Economic Opportunity

The concept of the community cultural ecosystem fits uneasily with current interest in the creative economy. At least in its American manifestations, the creative economy is thoroughly market-oriented. The profit motive is the change agent, and cultural and social arrangements are expected to respond accordingly.

Creative Class Myopia.

Florida's work is based on a reasonable and important insight—that the role of creativity has become a central element of a region's comparative economic advantage. But there is a dark side to the creative class argument. As Saskia Sassen noted years ago, the global economy tends to “valorize” particular jobs while it “devalorizes” others that are equally important to the overall functioning of the economy. In his enthusiasm for the role of the truly creative in stimulating economic growth, Florida places a high value on particular workers—typically high-wage, well-educated workers—which has the effect of devaluing those who make a less visible contribution. But if we make life better for the creative class, in a world of limited resources, we make life worse for the less “gifted.” In his latest book, Florida bemoans that creative places have high levels of social and economic inequality. Yet, it is difficult to see how his conceptualization of creativity could have any other consequence.

The unhappy denouement of the creative class raises a provocative implication that has been largely unexplored. In his seminal work, Art Worlds, sociologist Howard Becker challenged the image of the artist as a genius existing outside of any social organization. Individual creativity—even in its most idiosyncratic form—is tied to patterns of organization of social activity that allow the genius to play that role. “Works of art,” Becker explains, “are not the products of individual makers, ‘artists’ who possess a rare and special gift... [They] are, rather, joint products of all the people who cooperate via an art world's characteristic conventions to bring works like that into existence.” Artists are indispensable, but they are not the whole show.

Like Sassen, Becker is as likely to believe that the stagehand, the printer, or the violin string maker is as critical to art as the famed actor, author, or singer. Once we see creativity as a collective process, we need to pay attention to everyone who contributes to the process, not just the creative class.
Much recent work on the creative economy and creative class turns Becker's insight on its head. Where Becker showed that art requires the contribution of many people with different skills and aptitudes who coordinate their activities, creative class advocates take the classic idea of the artist—a genius with unique vision and skill—and generalize it to all creative workers. Where Becker sought to demystify creativity, many writers on the creative economy seek to generalize the artists' aura to encompass stockbrokers, lawyers, and even university professors!

A Creative Sector Workforce Development Strategy.

Could the creative economy have implications for an urban workforce development strategy? What if we turn Howard Becker's insight back on its feet and give the creative economy new legs? If the sector's success is based on the social organization of many people with different skills and aptitudes, the creative economy might provide the foundation for a variety of new jobs and skills not covered by current definitions of creative workers. Someone has to lay the fiber optic cable for the web designer, someone has to sew the costumes for the dancers, and someone has to create the drawings for the architect. From this perspective, the creative economy could provide opportunities for young adults who have not been successful in pursuing traditional academics.

In fact, using a narrow definition in valuing the creative class flies in the face of a profound reorganization of work life that emerges at the beginning of the twenty-first century. The organization of work during the twentieth century followed a trajectory that separated mental and manual work. During the course of industrialization, the restructuring of work was devoted to removing knowledge from the “hands” who did the work and giving it to the engineers and managers who oversaw and directed the process.

By the end of the century, however, the pendulum had begun to swing back. In sector after sector, information technologies permitted a reduction in the division of labor and a reintegration of manual and mental labor. Indeed, the reintegration of mental and manual work that is required for creative and cultural production provides a fertile ground for examining opportunities for an urban workforce.

To do so we have to identify the range of skills that, while not creative in the conventional sense, are critical to the social organization of the creative industries. With the digitization of audio and video production, for example, it has become almost impossible to distinguish where the “technical” work stops and the “creative” work starts.

Digital media production presents only the most obvious illustration. Philadelphia's Charter High School for Architecture and Design has developed a curriculum that combines traditional academics with design skills and hands-on training in carpentry, building trades, and structural systems. Across the creative sector, we need a thorough inventory of the actual work involved and the paths for entering these occupations.

From Economic Opportunity to Social Citizenship

Can a neighborhood-based creative economy contribute to both shared wealth and social inclusion? Can cultural engagement foster an open society? Can we tie a creative economy to a creative society? Yes, but not if we avoid the lessons of past experience.

The Limits of Trickle-down Prosperity.

Much of the literature on culture-based revitalization focuses on large-scale projects and districts as a means of reanimating downtowns. Significant public investment in culture is directed at high-income patrons and visitors—tourists, conventioneers, downtown residents, and suburbanites. The case for benefits to residents of modest means is typically the creation of service-sector employment and the trickle-down of economic advantages to the region.

The development potential of a regional creative economy is characterized more by intriguing possibilities than proven facts. By comparison, the social benefits of the arts are persuasive and relatively well-documented. Virtually all social impact studies find a consistent set of positive neighborhood effects associated with community arts and culture. They bridge long-term barriers of class and ethnicity as well as differences in age and gender. They foster social and institutional connections both within and between neighborhoods. They animate public spaces. They create value in the form of physical amenities and the quality of the built environment. SIAP's research provides evidence that the social benefits are connected to wider trends in community capacity-building and economic well-being.

Under the right circumstances, large-scale cultural projects can generate significant economic return, but the bulk of these benefits accrue to high-wealth populations. By contrast, small-scale projects entail modest investments and yield modest direct economic return. However, clusters of even low-budget arts and cultural resources generate significant spillover effects that contribute to the quality of community life, which in turn can trigger long-term economic benefits.

Creative Economy as Social Inclusion Strategy.

To succeed on social—and economic—justice grounds, a neighborhood-based creative economy must integrate economic opportunity and social inclusion. For the creative economy to become a creative society, we need to see people as more than cogs in the economy. We need to see them simultaneously as workers and citizens and to develop an approach that recognizes both.
The starting point would be a political ideology that acknowledges, rather than denies, the potential for exclusion. The British experience might be a guide to reassessing the social and economic value of culture-based development. The priority given to social inclusion, by Creative London, for example, is an attempt to combine market principles with social purposes.

If a successful creative economy is based on social organization, as Howard Becker suggests, then a strategy of social inclusion should identify opportunities for social mobility and wealth-creation across the economy, not just at its top. Such a strategy would have implications for education and training and would create a virtuous cycle of orienting urban kids toward jobs that really exist and re-valuing those jobs within the creative economy.

A social inclusion strategy would support urban neighborhood-based creative businesses and sole proprietors. For the Los Angeles craft industries, Scott and Rigby recommended a policy framework that would “not involve ‘picking winners’ [but rather would be] based on a bottom-up and industry-wide approach directed toward improving localized external economies [by] stimulating the entrepreneurial and creative capacities of all local firms.” We should invest in collaborative networks of producers and providers to enhance their institutional infrastructure and social capital. Scott and Rigby “envisage the creation of communities of firms, workers, and public agencies engaged together in reconstructing the collective competitive advantages of the region's craft industries.”

In any case, we need a hardheaded strategy that takes both market realities and the very real human, social, and cultural impacts of the arts into consideration. Such a strategy would likely be characterized by smaller investments, smaller risks, and more gradual change than what's found in the strategies that drive most cultural facility and district plans. As importantly, however, a social inclusion strategy must also have a bigger vision and commitment to the integration of all local residents with the regional economy and civil society.

“Natural” Cultural Districts as Anchors of Neighborhood-based Creative Economy

The picture of a community cultural ecosystem described above suggests a neighborhood-based approach to the use of culture to stimulate both community revitalization and regional economic development. The model illustrates the interdependencies of cultural producers, providers, and participants and the way networks are woven between community and regional entities.

UK cultural planner Chris Murray recognizes neighborhoods as cultural entities that are both sustained by and sustaining of the contemporary urban economy. He writes:
Provision for cultural needs helps to develop and sustain communities, but local communities also have a function in sustaining and developing the culture of societies as a whole. It is at the margins that innovation often occurs: the blending of culture, the expression of individual identity, alternative lifestyles.
All urban neighborhoods have the potential to become “cultural hubs,” says Murray, but not without coordinated action. He advocates an approach that engages both artists and citizens in planning and design processes and that provides for community appropriation and ownership of space. “Artists tend toward flexible, open-minded approaches; innovation; critical and questioning methods; and people-centered solutions.”

While all urban neighborhoods have the potential to become cultural hubs, some have the potential to become “natural” cultural districts. Many low-wealth neighborhoods possess a critical mass of cultural assets—cultural firms and organizations, workers and participants, artists and creative entrepreneurs. As an alternative to top-down planned cultural districts or as a complement to local community development, planners and developers could identify these grassroots nodes as leverage points for public, private, and philanthropic investment. In this model, “natural” cultural districts would be centers of social and economic development and would serve as neighborhood anchors for the creative economy.

Artists' centers, in particular, appear to be generative in terms of stimulating creative work and careers as well as neighborhood and regional economies. Regional economist Ann Markusen, based in Minnesota, found that dedicated spaces for artists to work and convene “help to maximize artistic spillover” within a local community. Artists' centers enable residents to interact with artists and participate in the creative process; contribute to the social, cultural and commercial lives of local neighborhoods; and “pay economic dividends for the region.”

A neighborhood-based creative economy, anchored by a network of “natural” cultural districts, provides an inclusive vision of an expanding urban economy. The concept addresses three types of market failure that are intrinsic to the creative economy and contribute directly to inequality and exclusion: one, growth of winner-take-all artist and creative-class labor markets; two, proliferation of informal arts (although a source of energy and innovation, they are also a symptom of a low-wage and insecure economy); and, three, neighborhood displacement of residents and entrepreneurs who have initiated revitalization.

Ultimately, we have no choice. If we don't work on economic equality and social inclusion, the creative economy unabated will accelerate inequality and exclusion. Florida highlights the pressures “hindering the rise of a more fully creative society,” including increased inequality, declines in housing affordability, uneven regional development, sprawl, and ecological decay. Ironically, policy-makers cite Florida in promoting the creative economy as a strategy for urban regeneration and regional competitive advantage. Given their narrow focus, these policies, if successful, will feed broader social dislocation.

Economics alone won't get us to inclusion. If we see the creative sector only as a market, the logical result will be an increase in inequality and exclusion. We need a vision that possesses a social and political, as well as an economic, rationale.

Culture can foster social inclusion, but it isn't automatic. With political will and coordinated action, we can channel the promise and prosperity of the creative economy toward innovative economies, remunerative employment, social citizenship, and dynamic communities—toward a creative society.

Mark J. Stern and Susan C. Seifert are principals in the
Social Impact of the Arts Project (SIAP) at the University of Pennsylvania.

Monday, March 9, 2015

A study of identical twins demonstrates that it's not all about identical DNA, but that physical activity can play a major role in differentiating both physical appearance and amount of gray matter. In other words, genetics aside, exercise can be the difference maker.

 Well - Tara Parker-Pope on Health

One Twin Exercises, the Other Doesn’t




 


Identical twins in Finland who shared the same sports and other physical activities as youngsters but different exercise habits as adults soon developed quite different bodies and brains, according to a fascinating new study that highlights the extent to which exercise shapes our health, even in people who have identical genes and nurturing.

Determining the precise, long-term effects of exercise is surprisingly difficult. Most large-scale exercise studies rely on questionnaires or interviews and medical records to establish the role of exercise. But these epidemiological studies, while important and persuasive, cannot prove that exercise causes health changes, only that people who exercise tend to be healthier than those who do not. 

To prove that exercise directly causes a change in people’s bodies, scientists must mount randomized controlled trials, during which one group of people works out while a control group does not. But these experiments are complicated and costly and, even in the best circumstances, cannot control for volunteers’ genetics and backgrounds. 

And genetics and upbringing matter when it comes to exercise. Genes affect our innate endurance capacity, how well we respond to different types of exercise, and whether we enjoy working out at all. Childhood environment also influences all of this, muddying the results of even well-conducted exercise experiments. 

All of this makes identical twins so valuable. By definition, these pairs have the same DNA. If they were raised in the same household, they also had similar upbringing. So they can provide a way to study the effects of changes in lifestyle among people with the same genes and pasts. 

Some past studies had found that older identical twins whose workout habits had diverged over the years tended to age differently, with greater risks of poor health and early death among the sedentary twin. 

But no studies had looked at young twins and the impacts of different exercise routines on their health. So for the new study, which was published this month in Medicine & Science in Sports & Exercise, researchers at the University of Jyvaskyla and other institutions in Finland turned to that country’s extensive FinnTwin16 database, which contained twins’ answers to questionnaires about their health and medical conditions, beginning when the pairs were 16 and repeated every few years afterward.

The researchers were looking for young adult identical twins in their early- to mid-20s whose exercise habits had substantially diverged after they had left their childhood homes. These twins were not easy to find. Most of the pairs had maintained remarkably similar exercise routines, despite living apart. 

But eventually the researchers homed in on 10 pairs of male identical twins, one of whom regularly exercised, while the other did not, usually because of work or family pressures, the researchers determined. 

The dissimilarities in their exercise routines had mostly begun within the past three years, according to their questionnaires.

The scientists invited these twins into the lab and measured each young man’s endurance capacity, body composition and insulin sensitivity, to determine their fitness and metabolic health. The scientists also scanned each twin’s brain. 

Then they compared the twins’ results. 

It turned out that these genetically identical twins looked surprisingly different beneath the skin and skull. The sedentary twins had lower endurance capacities, higher body fat percentages, and signs of insulin resistance, signaling the onset of metabolic problems. (Interestingly, the twins tended to have very similar diets, whatever their workout routines, so food choices were unlikely to have contributed to health differences.)

The twins’ brains also were unalike. The active twins had significantly more grey matter than the sedentary twins, especially in areas of the brain involved in motor control and coordination. 

Presumably, all of these differences in the young men’s bodies and brains had developed during their few, brief years of divergent workouts, underscoring how rapidly and robustly exercising — or not — can affect health, said Dr. Urho Kujala, a professor of sports and exercise medicine at the University of Jyvaskyla who oversaw the study. 

Of course, the study was small and not a formal randomized trial, although it involved identical twins. 

But Dr. Kujala said he believes that the results strongly imply that the differences in the twin’s exercise habits caused the differences in their bodies. 

More subtly, the findings also point out that genetics and environment “do not have to be” destiny when it comes to exercise habits, Dr. Kujala said. For these particular twins, whether their genes and childhoods nudged them toward exercising regularly or slumping on the couch, one of the pair overcame that legacy and did the opposite (for better and worse). 

The rest of us can do likewise, Dr. Kujala said. Even if the input from our DNA and upbringing urges us to skip the gym, we can “move more,” he said, and, based on this study, rapidly and substantially improve the condition of our bodies and brains.

Monday, March 2, 2015

How many times have you heard the story of the patient that gets exploratory surgery only to have an unknown cancer spread rapidly right afterwards? While our healthcare system tries most often to "fix it," are there times when nothing should be done but to wait and see? A New York Times essay explores how we might look at health risks and decide to ignore some of them.

 Well - Tara Parker-Pope on Health

Healthy in a Falling Apart Sort of Way




 


When asked on a medical form to evaluate my overall health, I invariably check “healthy.” But I sometimes wonder how accurate that is.

After all, I do have arthritis that necessitated a double-knee replacement 10 years ago, and I find it increasingly difficult to open containers designed to thwart a 2-year-old. My spine is a mess, and my back hurts from time to time. I have tinnitus and some hearing loss in one ear. I was treated for breast cancer 16 years ago. I take a statin to lower a cholesterol level that defied conservative measures of diet and exercise. And I constantly have to practice remembering people’s names.

So, at nearly 74, how healthy am I? Well, I also walk three miles and swim three-quarters of a mile nearly every day. I’ve taken over most of the chores my late husband once did. I shovel and sweep my walk, cook most of my meals, and care for an active Havanese puppy who’s walked four times a day and runs free in the park every morning.

I have yet to retire and still work part time writing a weekly column, though I’ve resisted the temptation to write another book, choosing instead to enjoy more theater, opera, concerts and grandchildren, and to train the puppy to be a therapy dog.

All of which invites the question of how one defines health.

In 1948, the World Health Organization described health as “a stage of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” By that definition, I and millions of Americans like me across the age spectrum would flunk, leaving “most of us unhealthy most of the time,” as Richard Smith noted in theBMJ blog in 2008.

But disease patterns have changed since 1948. Most people, like me, are aging with chronic ailments and disabilities, yet they continue to function independently. The old definition of health “minimizes the role of the human capacity to cope autonomously with life’s ever changing physical, emotional, and social challenges,” wrote Machteld Huber and her colleagues wrote in BMJ in 2011. And the definition fails to recognize that people are able to “to function with fulfillment and a feeling of well-being” even when they have a chronic disease or disability, they wrote.

Dr. Huber and her colleagues went on to note that the ability to continue to participate in society might be more important than measured gains in health. The ability to cope with life’s ailments might be more a more important and realistic measure of health than complete recovery.

Which leads to a sober reassessment of all we do to find and treat health problems or head them off at the pass. The widespread belief that medicine today has the potential to prevent most health problems or detect them early enough for a cure has succeeded in “medicalizing” modern life and raising the costs of medical care to unsustainable levels.

It has also prompted Dr. H. Gilbert Welch, a professor at Dartmouth Medical School, to write “Less Medicine, More Health: 7 Assumptions That Drive Too Much Medical Care.” A primary care physician and health policy wonk, Dr. Welch submits that too many people are being tested for too many things, being subjected to treatments they do not need and, in the process, being exposed to procedures that may do more harm than good.

One assumption, that all risks can be lowered, can create risks of its own. Case in point: A belief (sadly mistaken) that the measles vaccine is hazardous has sparked a mini-epidemic of a potentially life-threatening disease that had been eliminated from these shores 15 years ago.

Dr. Welch suggests focusing on reducing big risks and ignoring those that are average or lower. “Many health risks you hear about are exaggerated,” he wrote. “Interventions to reduce average risks can create as many problems as they solve.”

Another assumption, that it is always better to fix a problem than to manage it, has fostered a different epidemic: the ballooning and stenting of every coronary vessel found to have a partial blockage in patients with stable angina. However, as a randomized clinical trial showed, patients treated with medications to control blood pressure and cholesterol were no more likely to suffer a heart attack or die than those who underwent an angioplasty. Only if symptoms of cardiac pain persist is a more invasive procedure justified, Dr. Welch said.

Perhaps Dr. Welch’s most controversial “assumption” is that detecting a potential health problem early is better than waiting until it produces symptoms. The value of screening people without symptoms is perhaps the most hotly debated issue in modern medicine. Should every woman over 40 have an annual mammogram? Should every man over 45 get an annual PSA test for prostate cancer?

It makes intuitive sense that early cancer detection and treatment are lifesaving. But what if the cancer would never have become a threat to life? To this day, I don’t know if my cancer would have been deadly had I not had surgery and eight weeks of radiation. But once I knew it was there, I had little choice but to treat it.

Men with PSA readings on the rise face an even more challenging decision since definitive treatment, usually surgery or radiation of the prostate, can leave them impotent and incontinent.

Dr. Welch submits that sometimes early diagnosis does little more than turn people into patients for more years. “Action,” he wrote, is not reliably the ‘right’ choice.” Sometimes it’s best to “don’t just do something, stand there.” The problem, of course, is knowing when it is safe to just monitor a disease and treat only if it progresses.

So, if not modern medical care, what really determines how healthy people are? The W.H.O. now recognizes that the following factors can have as big an impact, or bigger, on our health than access to and use of health care services:

■ Income and social status, the higher the healthier.

■ Education, likewise the higher the better.

■ Physical environment — safe water, clean air, wholesome workplaces, safe homes and well-designed communities.

■ Social support networks, including family, friends and community.

■ Genetics, which influences life span and the risk of developing certain diseases.

■ Gender — men and women face different health risks at different ages.

■ Personal behavior and coping skills, including smoking, drinking, eating, physical activity and dealing with stress.

“One of the keys to health is not to obsess about it,” Dr. Welch said in an interview. “A lot of medical care doesn’t help people. We need to be more cautious about being medicalized when we’re well. We need to think about options and not necessarily jump to the most aggressive one, which can have the most side effects.”