The Summit on Creativity and Aging in America

Beth Bienvenu and Gay Hanna

The following is an abridged report prepared for Grantmakers in the Arts from The Summit on Creativity and Aging in America, held in collaboration with the 2015 White House Conference on Aging on May 18, 2015, at the National Endowment for the Arts. The summit was co-presented by the National Endowment for the Arts and the National Center for Creative Aging.

In the United States, ten thousand people are turning sixty-five every day. The fastest-growing age group is those eighty-five and older, and a child born today has a high probability of living to one hundred (Wallace 2015). Life expectancy in the United States has increased from forty-five years in 1900 to seventy-nine in 2000, and people alive today have better education, nutrition, and health care (Easterbrook 2014). Economically, while there are significant levels of poverty in the older population, a large share of the wealth in the United States is held by people over age fifty. The seismic shift indicated by these facts promises dramatic and potentially positive change for American society. Old age, once considered a time of frailty and loss, is becoming a time of potential, with people living longer, healthier lives with new meaning and purpose (Cohen 2000).

The full impact of this demographic shift offered unique challenges and opportunities for consideration by the 2015 White House Conference on Aging (WHCOA). With a broad purpose to identify and advance actions to improve the quality of life of older Americans, this WHCOA provided an opportunity to review accomplishments from the past decade, including core programs such as Medicare and Social Security, and to take a comprehensive look at the next decade. The key topics examined were healthy aging, retirement security, long-term services and supports, elder justice, and innovations in product design and technology services to enable independence and enhance quality of life.

NEA and WHCOA Collaborations

In collaboration with the 2015 WHCOA, the National Endowment for the Arts (NEA) and the National Center for Creative Aging (NCCA) cohosted a one-day Summit on Creativity and Aging in America on May 18, 2015. This summit was attended by seventy-five experts in arts, aging, design, and health services, and participation was made available through social media. Grantmakers in the Arts was represented by Janet Brown, president and chief executive, and members including Ellen Michelson, president of Aroha Philanthropies, and Margery Pabst, president of the Pabst Charitable Foundation for the Arts. Attendees were assigned, based on their expertise, to smaller breakout discussion sessions, each examining one of three topic areas:

  • Age-Friendly Community Design: to focus on policies that promote excellently designed and built environments for aging populations in the United States. This includes consideration of community design (walkability, transit, access to green space, and community resources) as well as different housing typologies (single family, urban mixed, and retirement facilities).
  • Health and Wellness and the Arts: to develop policies that promote arts interventions to improve health and well-being outcomes among older adults. This includes contributions that specific art forms make to older adults’ health and well-being, how arts practitioners can partner more effectively with researchers to build evidence in support of these interventions, and (in addition to more evidence) what policy levers must be exerted to bring these interventions to older people from all sociodemographic backgrounds.
  • Lifelong Learning and Engagement in the Arts: to promote greater cognition and creativity among older adults by means of social engagement. This includes intergenerational learning, the role of older artists as social entrepreneurs, and how the arts contribute to or refashion society’s understanding of what it means to age in the twenty-first century.

A pre-summit questionnaire completed by the attendees gave foundational information to support the beginning discussions around each topic. Each group addressed three basic questions:

  • What are the biggest issues or needs in this area?
  • What are the biggest barriers to addressing those issues or needs?
  • What are viable solutions that the federal government can help with?

Feedback from each of the three topic areas was gathered to inform and be informed by the constellation of convenings held by the WHCOA throughout 2015. The participants’ discussions and findings are outlined in this report.

Please note that the report’s intent is to share the discussions and ideas presented by the convening attendees. The contents of this report do not necessarily represent the opinions or ideas of the National Endowment for the Arts.

Age-Friendly Community Design

Within the 2015 WHCOA’s focus on healthy aging, maximizing independence at home and in the community is identified as a priority. Healthy aging is defined as “continuing to live a productive, meaningful life by having the option to stay in one’s home, remain engaged in the community, and maintain social well-being” (WHCOA 2015). Age-friendly communities support independence for older adults, and age-friendly community initiatives (AFCIs) focus on “deliberately influencing social and physical environments to benefit older adults” (Greenfield et al. 2015).

Livability through universal design was a discussion track in the 2005 Mini-Conference on Creativity and Aging in America. Focused on improving quality of life for all and reducing long-term care costs, the 2005 universal design recommendations “underscored the importance of designing and creating homes, neighborhoods, and communities that support choice and livability throughout the life span” (Hanna, Noelker, and Bienvenu 2015). It is notable that of the fifty final resolutions from the 2005 WHCOA, two were in this area: “Encourage community designs to promote livable communities to enable aging in place” and “Expand opportunities for developing innovative housing designs for seniors’ needs.”

The Age-Friendly Community Design discussion track addressed policy issues and barriers to promoting excellently designed and built environments for aging populations in the United States. A diverse group of participants from architecture, real estate, interior design, landscape architecture, aging, funding, and local government engaged in three focused discussions covering a variety of topics including transportation, housing, health care, and land use.

The following solutions were offered:

  • Leverage resources across federal agencies to promote creative financing tools for age-friendly home designs and renovations, as well as community design, transportation, and way-finding, with the goal of giving older people and their families access to affordable options for aging in the communities of their choice.
  • Fund innovations in design through research within federal agencies (DARPA, NSF, NEA, etc.).
  • Appoint a White House spokesperson on aging to start a federal campaign against ageism, and to promote healthy longevity through quality design for individuals and the communities in which they live, work, and play.
  • Start a government-wide conversation on design as a key tool for creating all-inclusive communities regardless of socioeconomic status in order to promote good health, education, and generativity across generations.

Health and Wellness and the Arts

A major shift is occurring in health care, and the arts and aging community is playing a key role in this transformation. A move from a medical model of aging applied at a time of functional loss to an approach focused on the whole person’s strengths and abilities is fertile ground for creativity and the arts. This holistic approach helps foster optimal health and wellness, with particular awareness of the person’s physical, mental, emotional, and spiritual needs (Thornton 2013). Successful prevention efforts depend on this awareness.

During the 2015 WHCOA/NEA summit, the assembled group of twenty-two experts in the Health and Wellness and the Arts track used these developments and related feedback as a springboard toward developing priorities and language that could connect to policy. The participants focused on policy issues and barriers related to the promotion of arts interventions to improve health and well-being outcomes among older Americans. Topics included the contributions that specific art forms make to older adults’ health and well-being, how arts practitioners serving these populations can partner more effectively with researchers to build evidence in support of these interventions, and (in addition to more evidence) what policy levers must be exerted to bring these interventions to older Americans from all sociodemographic backgrounds.

The following solutions were offered:

  • Identify key federal agencies that can utilize the arts to solve critical health issues; help replicate and sustain evidence-based program services across health care systems and community services; and expand and infuse the arts through existing systems at the federal, state, local, nonprofit, and for-profit levels.
  • Create public awareness by acknowledging and naming the artistic contributions integral to other areas within health care systems, including environmental design, workforce development, and patient satisfaction.
  • Expand the federal Interagency Task Force on the Arts and Human Development with virtual interprofessional mentorships in order to break down the silos between disciplines, encourage collaboration, and integrate psychological and social sciences as allies in the arts and humanities.
  • Establish a national arts, health, and well-being research network with best practice sharing (map out who funds what and under what parameters). This solution is not exclusive to aging-related concerns.

Lifelong Learning and Engagement in the Arts

“Learning is important across the life span for us to continue to be generative throughout our entire lives. Arts education is not only for children and youth, but for all of us,” said William Benson, moderator of the summit and managing principal of Health Benefits ABCs. “Lifelong learning” is defined by Collins Dictionary online as “provision or use of both formal and informal learning opportunities throughout people’s lives in order to foster the continuous development and improvement of the knowledge and skills needed for employment and personal fulfillment.” A large portion of the adult population of the United States is enrolled in some type of lifelong learning program.

At the summit, the Lifelong Learning and Engagement in the Arts track focused on policy issues and barriers related to the promotion of greater cognition and creativity among older adults by means of arts engagement. Topics included the arts as a conduit of intergenerational learning, the role of older artists as social entrepreneurs, and how the arts contribute to or refashion society’s understanding of what it means to age in the twenty-first century. The Lifelong Learning and Engagement in the Arts participants included invited leaders from the arts, education, and aging communities, who represented government, for-profit and nonprofit organizations, and foundations.

The following solutions were offered:

  • Actively work to eliminate ageism across all federal policies in the arts, health care, education, and community design.
  • Catalyze increased public/private funding by convening funders and developing innovative funding models based on earned income and public/private partnerships.
  • Collaborate across federal, state, and local governments to collect data, map the ecosystem, and leverage the potential of successful programs in order to build a sustainable supply to meet the growing demographic demand.
  • Promote and fund research on cost-effectiveness and outcomes of lifelong learning for career development and life enrichment, including intergenerational programs and services.
  • Increase visibility and support of individual older artists and provide support for programs that enhance their quality of life and work.
  • Promote workforce development to build a broad and diverse community of teaching artists to work across community settings, including education, vocational and avocational, health care, parks and recreation, senior centers, and arts organizations of all disciplines.

Findings of the Summit at Large (including Social Media Participation)

The three topic area groups presented their findings to the full body of summit attendees, including those participating through social media. The summit at large discussed these findings and addressed the most important issues, needs, barriers, and solutions in the three areas. These principal findings of the summit discussions are outlined below.

The Role of the Arts in the WHCOA Convenings

WHCOA Regional Forums

The White House held regional forums in Tampa, Seattle, Phoenix, Cleveland, and Boston in February and March 2015, and creativity and arts engagement played an important role throughout. Intergenerational programs that utilize the arts as equalizers between participants (including people with memory loss) were explored. For instance, WHCOA representatives visited the Intergenerational School of Cleveland, Ohio, an award-winning charter school that engages people with early-stage Alzheimer’s to mentor high-risk youth, helping them achieve high scores on standardized tests and graduation. The artwork of older artists was celebrated in each location. The WHCOA regional forums collaborated with state arts agencies and regional arts organizations, leveraging and highlighting the important arts infrastructure that the NEA has nurtured across the country. For example, the Arizona Commission on the Arts assisted in the planning and production of the Phoenix forum, and other state arts commissions assisted in finding older artists and related visual arts exhibitions.

Recommendations for the Field

The NEA gathered and analyzed the comments and findings covered throughout summit discussions and has distilled them into a set of recommendations that the NEA would submit for consideration by the leadership of the creativity and aging field.

  1. Launch a national campaign to reframe arts services to address the reality and benefits of longevity, combat ageism, and promote intergenerational programs and services. This national campaign would tie into the related efforts of AARP, PBS Second Avenue, and other national advocates. Led by a public/private partnership, the campaign would not only generate arts engagement throughout the older population, it would also provide new revenue to arts organizations and jobs for teaching artists and other art service providers.
  2. Build a leadership council of arts, aging, health, and community services organizations (including age-friendly/dementia-friendly advocates) to promote collaborations in policy development, research, and funding. This council would operate in a similar way as the Leadership Council of Aging Organizations and other advocacy and policy groups. Regularly scheduled meetings would be held to pool resources in promoting and tracking legislative efforts that encourage creativity and arts participation for older adults; these would involve the arts, design, health, and aging service fields.
  3. Convene a summit of social entrepreneurs in technology and community service from the nonprofit and private sectors with the goal of helping arts products and services go to scale. Following models established by AARP and the Gerontological Society of America and using public/private funding, the field of creativity and aging would gather innovators to assist in bringing evidence-based products and programs to scale to meet the growing demand by individuals and communities for high-quality services. A series of webinars would disseminate findings to the field.
  4. Establish a research network to build an evidence base to support funding and policy development for arts and design products and aging services. At this time there is no coordinated effort to identify, promote, or encourage evidence-based research, which is in demand by institutional service providers across the spectrum of community and health services. A network coordinated by research leaders in the fields of arts, design, health, and aging services would enable researchers to find needed support and build collaboration. There would be competition for funding innovative projects that would enhance the development and utilization of products and services (including age-friendly communities and universal design).

Conclusion

This year marks the fiftieth anniversary of both the establishment of the National Endowment for the Arts and the enactment of the Older Americans Act, Medicare, and Medicaid. This legislation, passed as part of President Lyndon Johnson’s Great Society initiative, assured all Americans of the potential to be healthy and to pursue happiness across their life spans. Creativity and the arts have been recognized as being part of the intrinsic fabric of humanity and key assets in building the American Dream into robust realities. Therefore, the coming together of the NEA and WHCOA in 2015 is historic and has given the field of arts and design an opportunity to be visionary in building innovations to support age-friendly communities for the twenty-first century.

It is no surprise to anyone that the new longevity of older adults presents unparalleled challenges, but the opportunities are surprising and equally unprecedented. The NEA has launched, as part of its fiftieth anniversary, an initiative called “Creativity Connects,” which will explore how the arts contribute to the nation’s creative ecosystem and how they connect with other sectors that want and utilize creativity. In addressing our country’s seismic demographic shift, the arts are uniquely suited to meet challenges and open up an array of opportunities for all Americans. Across all ages, through innovations that support both individual life enhancement and community development, creativity in the arts and design serves our many cultures, economic levels, and life preferences. The next fifty years have the potential to be a new renaissance for the arts and design in support of the flourishing of four generations within their homes and in the broad expanse of urban and rural communities. Grantmakers in the Arts has an important visionary role to play in opening access to the arts across the life span and in encouraging communities everywhere to embrace this new longevity and the contributions of all people in making America a vibrant place to live, work, and grow older.

REPORT CREDITS

This report was prepared by Gay Hanna, lead author, with coauthors and note takers Tobi Abramson, Janice Blanchard, Paula Cleggett, Ace Everett, Judith-Kate Friedman, Linda Noelker, and Judy Rollins from the National Center for Creative Aging.

The Summit on Creativity and Aging and the report were sponsored in part by Americans for the Arts, Aroha Philanthropies, DSM, The Pabst Charitable Foundation for the Arts, The Rosalinde and Arthur Gilbert Foundation, and Phyllis Cohen and Walter Goldstein.

REFERENCES AND RESOURCES

Braveman, P., and L. Gottlieb. 2014. “The Social Determinants of Health: It’s Time to Consider the Causes of the Causes.” Public Health Reports 129: 19–31.
Cohen, G. 2000. The Creative Age: Awakening Human Potential in the Second Half of Life. New York: Avon Books.
———. 2005. The Mature Mind: The Positive Power of the Aging Brain. New York: Basic Books.
———. 2006. The Creativity and Aging Study: The Impact of Professionally Conducted Cultural Programs on Older Adults. Center for Aging, Health & Humanities, George Washington University. http://cahh.gwu.edu/arts-aging-study.
———. 2009. “New Theories and Research Findings on the Positive Influence of Music and Art on Health with Ageing.” Arts & Health: An International Journal for Research, Policy and Practice 1(1): 48–62.
Easterbrook, G. 2014. “The New Science of Old Age.” The Atlantic, 314(3): 60–72.
Gottlieb, L., M. Sandel, and N. Adler. 2013. “Collecting and Applying Data on Social Determinants of Health in Health Care Settings.” JAMA Internal Medicine 173(11): 1017–20.
Greenfield, E., M. Oberlink, A. Scharlach, M. Neal, and P. Stafford. 2015. “Age-Friendly Community Initiatives: Conceptual Issues and Key Questions.” The Gerontologist 55(2): 191–98.
Hanna, G., L. Noelker, and B. Bienvenu. 2015. “The Arts, Health, and Aging in America: 2005–2015.” The Gerontologist 55(2): 271–77.
Harrell, R., J. Lyonott, and S. Guzman. 2014. “What Is Livable? Community Preferences of Older Adults.” AARP Public Policy Institute. http://www.aarp.org/ppi/issues/livable-communities/info-2015/what-is-livable-AARP-ppi-liv-com.html.
Larkin, M. 2015. “Arts Colonies Offer a Creative, Whole Person Wellness Alternative for Independent Living.” Journal on Active Aging, May/June.
Lindland, E., M. Fond, A. Haydon, and N. Kendall-Taylor. 2015. Gauging Aging: Mapping the Gaps between Experts and Public Understandings of Aging in America. Frameworks Institute. http://www.frameworksinstitute.org/pubs/mtg/gaugingaging/index.html.
National Association of Area Agencies on Aging. 2014. Making Your Community Livable for All Ages: What’s Working. http://www.n4a.org/files/n4aMakingYourCommunityLivable1.pdf.
National Association of Area Agencies on Aging. 2014. Trends and New Directions: Area Agencies on Aging Survey. http://www.n4a.org/files/AAA%202014%20Survey.pdf.
National Endowment for the Arts. 2013. The Arts and Aging - Building the Science. https://www.arts.gov/publications/arts-and-aging-building-science.
National Endowment for the Arts. 2011. The Arts and Human Development: Framing a National Research Agenda for the Arts, Lifelong Learning, and Individual Well-Being. https://www.arts.gov/publications/arts-and-human-development-framing-national-research-agenda-forthe-arts-lifelong.
Sherman, A. 2006. “Toward a Creative Culture: Lifelong Learning through the Arts.” Generations 3(1).
Super, N. 2015. Presentation by Nora Super (Executive Director, 2015 White House Conference on Aging) to the Leadership Council of Aging Organizations, October 7, 2015.
Thornton, L. 2013. Whole Person Caring: An Interprofessional Model for Healing and Wellness. Indianapolis: Sigma Theta Tau International.
Wallace, N. 2015. “The Aging of America.” Chronicle of Philanthropy 27(13): 8–13.
Welch, P., ed. 1995. Strategies for Teaching Universal Design. Boston: Adaptive Environments.
White House Conference on Aging (WHCOA). 2015. “Healthy Aging.” http://www.whitehouseconferenceonaging.gov/2015-WHCOA-Final-Report.pdf#page=11.