This presentation was delivered by Sandra Kirkwood, Occupational Therapist, on October 22, 2011, at the Australian Society for Performing Arts Healthcare Conference, which was held at Sydney University.

1. EQUITY, DIVERSITY AND ACCESS
TO PERFORMING ARTS
Managing Social Inclusion in New Frontiers of
Healthcare
Sandra Kirkwood
B. Occ.Thy, B.Music, M.Phil.
Music Health Australia

2. “Health encompasses the social,
emotional, spiritual and cultural
well-being of the whole community"
National Aboriginal Health Strategy (2002)

3. Social Ecology of Performing Arts
Personal Professional Political

4. RIGHT OF PARTICIPATION & HEALTH
• “Everyone has the right freely to participate in
the cultural life of the community, to enjoy the
arts and to share in scientific advancement and
its benefits.” Article 27, Universal Declaration of
Human Rights (1948).
• "the enjoyment of the highest attainable
standard of health is one of the fundamental
rights of every human being...” WHO Constitution
• Australian Human Rights Framework 2010
• The Australian Charter of Health Rights 2008

5. Personal Perceptions
Personal ethnographies:
• What are activity limitations?
• What are barriers?
• Experiences of discrimination
• Restrictions to participation?
• Access to services?
• Health literacy – access to information,
technology, and resources in suitable formats

6. Do you believe that PWD are given
equal opportunities in P. Arts?
• Not given equal access to performance spaces
(physical access, and Braille scripts)
• Parts for PWD are given to able-bodied people
• Not much discrimination in writing music,
designing sets and scenery, or editing visual
recordings, and backstage stuff.
• Not many plays written for deaf. They could be
translated. A lot of disabilities are not seen.
• They go for looks. Not many opportunities in
mainstream. But there are groups for PWD.

7. Professional
• Mapping current demographics
• Understanding state-of-the-art ethics
• Auditing and critical reflection on practice
• Building capacity of services to address need
• Training in legislation/conventions
• Policy of continuous quality improvement
• Charters with social inclusion, diversity ideals
• Comprehensiveness of evidence-based practice

8. Professional
Professional Code of Ethics:
• “Occupational therapists shall not
discriminate in their professional practice, on
the basis of ethnicity, culture, impairment,
language, age, gender, sexual preference,
religion, political beliefs or status in society”
(OT Australia, 2001, p. 4).
World Federation of Occupational Therapists,
2006 Position Statement on Human Rights.

9. Burden (DALYs) by broad cause
Queensland Health, 2006
Percentage
Cancers 19%
Cardio-Vascular 16%
Mental 14%
Nervous12%
Chronic respiratory 7%
Diabetes 7%
Unintentional injuries 5%
Musculoskeletal 4%

10. Social Determinants of Health
• Rural and remote – Geographic distribution
• Cultural diversity – Social inclusion
• Poverty – Equity in health service provision
• Environmental deprivation – Access education
• Promoting healthy lifestyles to reduce chronic
disease
• Target minority groups - employment
• Status of women

11. Political

12. Analysis - Political
(a) What are characteristics of the
conflict/cooperation situation?
(b) Who are the actors (occupational beings)?
(c) How do actors conduct themselves? What
are their aims, interests and motives?
(d) What are their means?
(e) What does the political landscape look like?
(f) And what is the broader context wherein
conflict and cooperation manifest themselves?
Kronenberg & Pollard (2006) OT without borders

13. MULTI-SECTORIAL STUDY
HIGHER
INTERNATIONAL NATIONAL
EDUCATION
PERFORMING
WORKPLACE HERITAGE &
ARTS
RELATIONS CULTURE
HEALTHCARE

14. What do we think we might find?

15. Performing Arts sex comparison
100%
90%
80%
70%
60%
Females
50%
Males
40%
30%
20%
10%
0%
Sound recording Music & theatre Recorded media Film & video Employment across
studios product'n manu/pub production state

16. Performing Arts–Age distribution
35
30
25
20
Film/video prod'n
Music/theatre prod
15
Sound record'g studios
10
5
0
15-24 25-34 35-44 45-54 55-64 65 plus

17. LITERATURE REVIEW
• Saxon (1987) noted poverty as an issue that could
impact on performing artists’ access to private
medical insurance
• Hamilton (1994) investigated the impact of
occupational stress in ballet across different
cultural backgrounds
• Brodsky’s (1995) USA study of “Blues Musicians’
Access to Health care.”
• Lubet (2002) Disability Studies and Performing
Arts Medicine; and Brandfonbrener editorial.

18. LITERATURE REVIEW
• Ralph Manchester, MD from New York
(2006), editorial: “Diversity in Performing Arts
Medicine.”
• John Hadok (2008) The few hardy souls who are
scattered through the nonmetropolitan regions and
the interior suffer isolation and a form of cultural
famine. We are faced with considerable challenges --
the geographical difficulties interplaying with the
social, cultural and professional fabric — that must
be addressed… artists living and working in rural and
remote places and those who tour there have no
access to health care that takes especial cognizance

19. RESEARCH METHODS
• Literature & Website Review
• Telephone interviews, e-mail inquiry
• Collating findings into database
• Field observations (work, study, recreation)
• Demographic Analysis, mapping services
• Prevalence of health conditions – certain groups.
Reports from consumers.
• Thematic Analysis: clustering of issues
• Reflection on Practice: Community of Inquiry

20. RESEARCH AIM & OBJECTIVES
To explore and inform performing arts and
health professionals about the latest
access, equity and diversity initiatives.
Key Research Question:
“How do we ensure equitable participation in
the performing arts for all citizens?”
To improve access and build capacity of services
To facilitate continuous quality improvement

21. RECOMMENDATIONS
• A self-audit tool for performing arts is needed
• A National Database of Equity and Diversity
support services for performing arts is needed
• Details of key contacts and resources
• Multi-dimensional strategic planning is
needed around how to manage
equity, diversity, unmet needs and gaps in
services.
• Working party to prioritise initiatives.

22. 2011 Conference
Sandra Kirkwood presented this paper at the
Australian Society for Performing Arts Health
Care Conference at Sydney University on 20
October, 2011.
Music Health Australia is a network of people
interested in Music Health, and also an
organisation that provides Occupational
Therapy and Music services.
www.musichealth.com.au