Project HEAL (Health.Equity.Art.Learning)

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Health Impact Project

The Louisville Metro Department of Public Health and Wellness, IDEAS xLab, and the Commonwealth Institute of Kentucky conducted an HIA to examine how implementing Project HEAL could affect health in the Smoketown neighborhood of Louisville, Kentucky. Project HEAL is a community development model that uses arts and culture activities to increase civic engagement and drive equitable policy change. The HIA examined potential changes to social isolation and cohesion, civic engagement in policymaking, educational achievement, economic well-being, and the physical environment as a result of three initiatives: One Poem at a Time, an effort to limit negative advertising in low-income communities; Hero+Shero Journeys, an environmental justice program at a local middle school; and HOPEBOX (also known as Smoketown Laundry), a full-service laundromat, community center, and local business incubator for worker-owned co-ops in the health sector.

Using baseline health data from the federal Centers for Disease Control and Prevention and Center for Health Statistics, a literature review, and community feedback gathered through arts and culture activities, the HIA found that the primary health benefit of Project HEAL would be increased social cohesion and improved mental health outcomes. Other potential benefits include enhanced academic performance, better environmental health, and increased opportunities for economic well-being. 


The Project HEAL and HIA processes increased community cohesion and engagement in Smoketown, which helped ensure that the Louisville Metropolitan Sewer District (MSD)’s new 16.7 million-gallon sewer overflow basin was built underground, with a grassy park on top, rather than above-ground as originally planned. Smoketown residents wrote letters and attended public meetings for a full year encouraging MSD board members to revise the plans. The ribbon cutting was Dec. 15, 2017.

Through the One Poem at a Time initiative, inspirational pictures and quotes from Smoketown residents replaced cigarette, alcohol, and payday loan advertisements on billboards throughout the neighborhood. When those rentals ended, the Louisville Metro Department for Public Health and Wellness diabetes prevention program purchased seven billboards highlighting access to healthy foods in Smoketown. Using data from the HIA, neighborhood leaders spoke out when three new liquor stores applied for licenses within the 1.2-square-mile community, and all three licenses were denied at the local level. Two appealed to the state: One was denied, and the second changed its plans and became a grocery store. Smoketown leaders and Project HEAL representatives are continuing their discussions with the city council about ordinances to limit negative advertising and alcohol outlet density in low-income census tracts.


This Health Impact Assessment Report first appeared in The Cross-Sector Toolkit for Health. The Cross-Sector Toolkit for Health was originally developed by the Health Impact Project, formerly a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts. The creation of this resource was supported by a grant from the Health Impact Project. The views expressed are those of the author(s) and do not necessarily reflect the views of The Pew Charitable Trusts, or the Robert Wood Johnson Foundation.

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