“Music,” by Flickr user Emily Ries

Titles: (1) Music, Singing and Wellbeing in Healthy Adults; (2) Music, Singing and Wellbeing for Adults Living with Diagnosed Conditions; and (3) Music, Singing and Wellbeing for Adults Living with Dementia (three reports)

Authors: Norma Daykin, Lily Grigsby Duffy, Guy Julier, Jack Lane, Louise Mansfield, Catherine Meads, Annette Payne, Alan Tomlinson, Christina Victor (reports 1, 2, & 3); Adele Burnett, Giorgia D’Innocenzo, Paul Dolan, Tess Kay, Stefano Testoni (reports 1 & 2)

Publisher: What Works Centre for Wellbeing

Year: 2016

URL: https://www.whatworkswellbeing.org/product-category/artsculture/?filter_resource-type=full-report

Topics: music, singing, wellbeing, health, dementia, older adults, anxiety, depression, young adults

Methods: Systematic review of 145 studies exploring wellbeing outcomes of music and singing for adults, grouped into three categories: healthy adults, adults with diagnosed health conditions, and adults with dementia. (Includes empirical research published from 1996 to June 2016 and systematic reviews from 2010 to 2016.) Review of grey literature and practice reports from 2013 to 2016. Studies sourced through electronic searches. Review and analysis of data from 2,500 participants for review focusing on healthy adults; 1,364 for adults with diagnosed conditions; and 249 for adults with dementia, all from many different countries.

What it says: The authors examine the relationship between music and singing interventions and subjective wellbeing (studies that include paid professional musicians, clinical music therapy, and clinical procedures were excluded). Among healthy adults, the authors found that the evidence was strongest for the effects of music, particularly singing, for older adults on morale, mental health-related quality of life, loneliness, anxiety, and depression. Among adults with diagnosed conditions, the authors found it difficult to synthesize findings due to the heterogeneity of included studies. However, the evidence points to reductions in depression and anxiety across age groups. For adults with chronic conditions (e.g., stroke, cancer), a number of studies reported reduced stress among a range of other wellbeing outcomes. Similarly, for adults with dementia, methods used across studies were inconsistent, making it difficult for the authors to draw conclusions from studies given varying outcomes, sample sizes, and settings. Key findings across the three reports are summarized below, grouped by the quality of the evidence.

High-quality evidence:

• Among young adults, music listening alleviates anxiety and improves wellbeing
• Among older adults, regular group singing enhances moral and mental health-related quality of life and reduces loneliness, anxiety, and depression; also, singing maintains a sense of wellbeing
• Among pregnant women, structured music therapy reduces stress, anxiety, and depression
• Among college nursing students, culturally relevant music interventions decrease depression
• Among palliative care hospital patients, brief music therapy is effective in supporting wellbeing

Moderate-quality evidence:

• Among young adults, music listening for short durations enhances mood and music listening, while exercising enhances the positive effects of physical activity on state anxiety
• Among healthy adults, music listening reduces stress, negative mood, and state anxiety; among males, regular listening to a particular genre of music alleviates anxiety, stress, and depression
• Among older adults, music listening may be effective in preventing or reducing depression; participation in choirs provides positive social experiences and a vehicle for identity construction and revision later in life; and songwriting and performing contributes to happiness
• Among marginalized groups (e.g., the homeless), there is value to the therapeutic benefits of group singing and the opportunity to learn, build relationships, and engage in meaningful exchange with the broader community; among the incarcerated, listening to relaxing music alleviates anxiety and anger
• Among older people with chronic conditions in residential and community settings, culturally relevant music interventions (e.g., playing an instrument, singing) decreases depression
• Among a variety of adult populations, reported wellbeing benefits include relaxation, reduction in anxiety, spiritual uplifting, improvements in mood, emotional wellbeing, confidence, and more; also, music participation can raise awareness of the significance of music in people’s lives, which can have a positive effect on health awareness, quality of life, and behavioral change

Low-quality evidence:

• Among healthy adults, group singing fosters happiness, can enhance perceived psychological wellbeing (e.g., self-esteem, emotion, enjoyment, purpose in life, etc.) and subjective wellbeing, and supports the development of musical identity and a sense of purpose
• Among older adults, learning music may help to realize long-held ambitions and promote spiritual growth; also, motivation for music participation might be to broaden social networks and to learn
• Among marginalized groups, active music making in groups enables them to build a sense of community and share culture and heritage; among young offenders in particular, music and singing projects have a positive effect on self-esteem; among prison inmates, participatory music making, singing, and performing in public supports perceived wellbeing
• Among pregnant women, listening to relaxing music enhances wellbeing and mood
• Among people experiencing PTSD, group drumming supports reduction in related symptoms
• Among patients with Chronic Obstructive Pulmonary Disease, singing classes are associated with improvements in areas of wellbeing such as mood
• Among post-stroke patients, music therapy has a positive effect on mood
• Among adults living with chronic conditions, participation in long-term group singing improves quality of life and social and emotional wellbeing
• Among hospice patients, music therapy contributes to improved spiritual wellbeing
• Among undergraduate students, music therapy alleviates anxiety
• Among adults with dementia, listening to music enhances overall wellbeing, and for those in nursing homes, individualized music listening reduces anxiety and/or depression

Music listening accounted for over a third of interventions across studies with healthy adults, followed by under a third examining group singing. Common methodological challenges cited by the authors included small sample sizes in quantitative studies and limited theoretical analysis in some qualitative studies. It’s likely that some people with health conditions were included in some studies on healthy adults, though they were not systematically recorded, making it difficult to account for the effect of these conditions on outcomes. The authors note the following qualitative themes: enhanced personal wellbeing, characterized by happiness and other positive emotions; social wellbeing, or increased interacting and bonding with others; and identity-related benefits, associated with shared culture, past connections, self-awareness, and the perception of music as a meaningful and important part of life. Lastly, the authors conducted a meta-analysis of five studies on anxiety and six studies on depression, which revealed that music participation had no statistically significant effect on anxiety among healthy people, but that it can reduce depression.

What I think about it: Overall, this is a strong systematic review, executed mostly without flaws, though not completely. A couple of things to note which may reduce confidence include the inconsistent date ranges used to pull the grey literature, empirical studies, and systematic reviews used in the reports, as well as use of self-reported measures among participants with dementia, as noted by the authors. Another significant drawback is the potential narrowness of the search due to a focus on specific keywords like “wellbeing,” which may have led to exclusion of relevant evidence. Despite the large number of returned citations, the authors limited the scope of the review to focus on interventions with healthy adults and those with higher quality research designs. That said, findings may seem particularly robust for healthy adult populations, but really, this was just an intentional focus for the systematic review.

What it all means: This capsule review somewhat extends Createquity’s investigation on the claims to the benefits of arts participation, and the quality of evidence to back those claims, with a deeper focus on the impact of music and singing interventions on wellbeing. Notably, even with specificity around art forms, the authors note wide variation among study characteristics and outcomes, including the duration of the interventions, passive versus active forms of participation, individualized versus group experiences, as well as the range of wellbeing outcomes measured. Addressing the aforementioned methodological shortcomings would prove useful for future research in this area. To some extent, it will almost always be difficult to synthesize findings from studies on the arts and wellbeing until there is consistency in the methods employed across studies.

Nonetheless, the reports offer added value in terms of recency of studies and population breakdowns. Createquity’s investigation of the arts and wellbeing mostly cited evidence from 2014 or earlier, with a large portion of studies published before 2010. The Music, Singing and Wellbeing reports use evidence from studies published as recently as 2016, though not all (there still is publication lag). Furthermore, very few studies that Createquity came across focused on specific populations; when they did, the evidence was mixed or of lesser quality. The exception would be older adults. The strongest evidence cited in these reports focuses on older adults, similar to our findings around the benefits of participatory arts for older adults. In fact, Music, Singing and Wellbeing is an excellent supplement to that piece in particular; it includes a new large-scale randomized controlled trial of singing among older adults that was not included in our previous reviews.

Seats – photo by flickr user Ryan Wiedmaier

Build. Build. Build. So goes the unofficial mantra of arts marketers as arts organizations seek to maintain relevance in a changing society. Along with the parallel pursuit of financial stability, the goals have been clear: build demand for arts experiences to build and diversify audiences that build revenues. But the how in this seemingly linear formula – the pathways toward achieving these goals – remains less clear.

A 2016 report from the Australia Council for the Arts flips the usual script by drawing attention to the supply side of the equation. In “Showcasing Creativity: Programming and Presenting First Nations Performing Arts,” researchers Jackie Bailey and Hung-Yen Yang of BYP Group aim to understand the motivations – and the barriers – involved in presenting performances by Indigenous Aboriginal and Torres Strait Islander communities (the “First Nations” referenced in the title). In contrast to most previous examinations of audience development and diversification, this study focuses on the programs themselves, and the people curating them. How does the current performing arts landscape in Australia promote or prohibit inclusive cultural narratives? What does it take to establish a supportive, equitable infrastructure? What cultural factors get in the way?

“Showcasing Creativity” is the second study in a series of three that explore Indigenous performing arts in Australia from the perspective of audiences, the market (i.e., presenters and producers), and the creators, respectively. The sequence of studies alone suggests multiple nuanced paths toward building audiences. More notably, it contextualizes the notion of audience development by placing it within a broader framework for addressing cultural inequities in the Australian performing arts infrastructure. In other words, it paints a picture of audience development as one point of intervention among many.

Interest vs. Attendance

In a national arts participation survey from 2014, nearly two-thirds of Australians surveyed expressed interest in First Nations performing arts (i.e., works with Indigenous creative involvement, Indigenous cultural expressions, or content tied to Indigenous-related histories, groups, or politics). However, the survey revealed that only one in four actually attended First Nations arts events. Exploring this gap between interest and attendance, “Showcasing Creativity” analyzes data collected through a mixed-methods approach that includes a mapping of publicly available programs across 135 “mainstream” venues (defined as presenting works from various cultural backgrounds with no sole focus on Indigenous arts and no control or management solely by Indigenous people); a survey among 44 mainstream presenters, six Indigenous presenters, and 11 producers; and 40 interviews with presenters and producers, half conducted before the survey and the other half after.

“Showcasing Creativity” primarily focuses on shortfalls in programming and marketing that, if addressed, might improve and increase opportunities to present First Nations performing arts. An assessment of the landscape revealed a number of key findings.

• Programming: Only 2% of approximately 6,000 works programmed in 2014-15 or 2015 (depending on a venue’s season) were First Nations performing arts. Moreover, a mere 12 presenters of the 135 included in the mapping were responsible for more than a third of this programming. Nearly half of Australian presenters did not program First Nations arts at all, and more than a third of works programmed were small in scale, with less than five performers. Five works, produced by companies with known brands, accounted for almost a third of total First Nations arts programming.
• Marketing: Though audiences perceive First Nations arts as “traditional,” they are motivated to engage with contemporary works, which accounted for 84% of First Nations works presented in 2015. Only a third of presenters reported that their most recent First Nations program, on average, filled more than 75% of house capacity. Although a third of survey respondents reported that box office results failed to meet their expectations over the past two years, audience satisfaction for those who attended was high – suggesting that box office results might be attributed to limited reach in marketing, as opposed to likeability of works.

Presenters also cited several motivators for presenting First Nations arts, including opportunities to:

• engage existing audiences with new and/or challenging content
• build new audiences
• support more Indigenous works
• engage local Indigenous communities
• demonstrate breadth in artistic excellence
• meet strategic goals tied to community engagement or a broader reconciliation agenda

Perceived Barriers

What, then, comes between these motivators among decision makers and the actual implementation of programs? One such obstacle is financial risk, which can be prohibitive for some presenters and producers. Nearly half of survey respondents cited financial risk as a major obstacle, along with the price tags attached to available, brand-name works. This partially explains why presenters tend to opt for smaller, cheaper productions. Despite this perceived risk, the report highlights opportunities to grow attendance in metropolitan areas, where there are more risk-taking audiences, not to mention an existing concentration of First Nations performing arts programming.

Other perceived obstacles that are less tangible but equally significant include:

• tokenism, as indicated by the third of mainstream presenters that programmed only one Indigenous work in 2015
• concerns about the receptiveness of conservative audiences to the seriousness of themes in First Nations works
• fear of wrongly selecting, presenting, and marketing Indigenous works in the absence of those with lived experiences and/or cultural knowledge that might otherwise inform decision-making
• systemic racism, which manifests through discriminatory practices and programming decisions that favor dominant, Western cultural paradigms

Also worthy of note: although the majority of First Nations arts programming (59%) takes place in larger Australian cities, they represent only 2% of total performing arts in those cities. By contrast, these percentages are higher in remote and regional parts of Australia (7% and 3%, respectively), despite deep-seated racial tensions that may cause non-Indigenous audiences to be less receptive to such works. This section of “Showcasing Creativity”  offers a rich trove of qualitative data that paints a highly revealing picture of the race anxieties of Australian audiences and programmers alike. As one interviewee suggests, “Living in a very European community it is hard to get audiences to engage with Indigenous work. People see it as earnest, preachy and not fun.”

Multiple Pathways

What does all of this mean? Readers may recall Createquity’s August 2016 feature, “Making Sense of Cultural Equity,” which sifted through a number of visions that emerged throughout the decades-old history of cultural equity advocacy in the United States. The big takeaway was that the four distinct visions that were parsed out – diversity, prosperity, redistribution, and self-determination – were not mutually exclusive, as one often had implications for another, despite differences in desired outcomes.

It’s no coincidence, then, that “Showcasing Creativity” similarly suggests multiple pathways for addressing inequities in the Australian performing arts infrastructure. One such pathway is the development of alternative presenting opportunities – such as Blak Lines, a touring initiative highlighted in the report that presents contemporary First Nations dance and theatre through a consortium of venues across Australia. This type of initiative – most aligned with the diversity vision for cultural equity, addressing homogeneity within mainstream institutions – holds promise in its ability to develop relationships between presenters, audiences, and Indigenous artists and communities, while providing leeway for targeted, localized marketing.

Another pathway might be increased opportunities for Indigenous people to help maintain creative control and integrity of First Nations works. As an example of the self-determination vision – which centers communities’ ownership of cultural life – this would include greater opportunities to involve Aboriginal and Torres Strait Islanders in non-performer roles, where there is further underrepresentation. These include producer, technical, or administrative roles that often entail greater decision-making responsibilities.

There is also something to be said about how presenters find First Nations works. Nearly three-fourths of survey respondents indicated that prior relationships and peer networks with artists, producers, and community members are most important in this context. Similarly, in building capacity to deal with cultural sensitivities, peer-to-peer learning and long-term community engagement activities help to establish the meaningful relationships needed to foster in-depth, cross-cultural exchange. Ultimately, social networks and relationship building become central to addressing the intangible obstacles above.

“Showcasing Creativity” highlights the varying, simultaneous efforts needed to address cultural inequities, encouraging us to move away from any singular path and toward more coordination to effect and sustain infrastructure-wide change. The report’s section on barriers to programming First Nations work, in particular, offers a new and valuable contribution to the literature that is remarkable for its candor. As noted in this report, additional research about learning and training opportunities for technical and administrative roles might prove useful in understanding what barriers exist for Indigenous populations beyond performer roles. We would also love to see more research examining how these kinds of cross-cultural programming challenges play out in other national contexts.

Each year, our field generates tons of research about critical issues in the arts, on topics ranging from the impacts of arts participation to issues of access and equity to what drives organizational performance. Arts research is an expansive domain, and we wanted the scope of eligibility to reflect that. However, to be considered for the Createquity Arts Research Prize, publications had to meet a few criteria. On a logistical level, they needed to have been first released in 2016, written in English, and available to the public (journal articles counted as long as they were accessible through standard library subscriptions). And in terms of content, they needed to be either focused primarily on the arts or have been written with an arts audience in mind. Historical, biographical, or aesthetic analyses of single or small groups of artists’ work were not eligible; nor were cultural criticisms focusing on specific artworks.

We found candidates for the prize from a number of sources. We started with our own Newsroom columns, which contain a section each month featuring “New Research of Note” taken from the 200+ blogs, newsletters, and social media feeds that we collectively follow. We combed a handful of research “aggregators” including the UK’s CultureCase and Canada’s Arts Research Monitor. We issued an open call for nominations, which yielded 18 eligible submissions from readers like you (thank you!). The majority of the content, however, came from academic journals. We dug through the following, reviewing articles published in 2016 for each:

• Artivate
• Arts Education Policy Review
• Creativity Research Journal
• Cultural Trends
• International Journal of Art and Design Education
• International Journal of Arts Education
• International Journal of Arts and Technology
• International Journal of Arts Management
• International Journal of Cultural Policy
• International Journal of Design Education
• International Journal of Education and the Arts
• International Journal of Education through Art
• International Journal of Music Education
• Journal of Cultural Economics
• Journal of Learning Through the Arts
• Medical Problems of Performing Artists
• Research in Dance Education
• Research in Drama Education: The Journal of Applied Theatre and Performance
• The Arts in Psychotherapy
• The European Journal of Philosophy in Arts Education
• The International Journal of the Arts in Society
• The Journal of Arts Management, Law, and Society
• Youth Theater Journal

Once we had collected all of this material in one place, we embarked upon three rounds of review. First, screeners extracted crucial information about each study, including a summary of the research questions or hypotheses being explored and the methods employed to pursue that exploration. Screeners were also free to offer a recommendation about whether the piece should or should not be set aside for deeper review. Second, Createquity’s founder Ian David Moss and Research Team Leader Rebecca Ratzkin scored each study on the basis of its relevance to Createquity’s interest in “the most important issues in the arts and what we can do about them,” the rigor of the methodological approach, and the added value it offers above and beyond existing literature. (You can read a more detailed description of these criteria here.)

This rating process yielded a total of eight finalists for the prize, which we’ve now put in front of an external panel of research experts to rank. In addition to the criteria above, the expert panel will consider as “tie-breaker” factors the inventiveness and transparency of the research, as well as the boldness of the topic or approach and the extent to which the Prize would represent a significant opportunity for the author(s) or publisher. This year’s panel includes Norman Bradburn, an esteemed scholar who is a former professor and provost at the University of Chicago and currently senior fellow at NORC at the University of Chicago; Carlos Manjarrez, director of the Office of Data Governance and Analysis at Legal Services Corporation and formerly founding research director for the Institute of Museum and Library Services; and Michael Rushton, director of strategic planning for Indiana University and formerly director of the arts administration program within the university’s School of Public and Environmental Affairs. These distinguished individuals join Createquity’s Moss and Ratzkin on the expert panel.

This process has pushed us to standardize our approach for processing and synthesizing research. As a result, we’ve built a comprehensive database of arts research published in 2016 – a pretty amazing thing. Our hope is to build upon this database each year as new research is released.

This is the first time Createquity (or anyone else, to our knowledge) has attempted to review arts research at anything approaching this level of comprehensiveness, and there were some limitations to our process that we’ll look to improve on in any future efforts. For instance, because of differing levels of access to academic databases among our team members, in some cases we relied solely on abstracts for initial screening. This would have biased us towards studies that included methodological descriptions in their abstracts, and may have led us to disregard some valuable studies this time around. We also didn’t use keyword searches to find relevant articles in journals that we don’t follow regularly, which means we probably missed a lot of medical literature, as well as other publications featuring arts-inclusive research from a non-arts disciplinary perspective. And of course, there’s the language limitation – we restricted ourselves to English-language sources for feasibility reasons, which is likely more of an issue for gray literature than academic literature. Even so, we likely missed a fair amount of English-language gray literature from outside the U.S.

Still, despite the imperfections, this was quite a feat for us here at Createquity, and we’re confident the selection process has been much more robust than those that, for example, rely solely on nominations. And we think we’re off to a great start filtering through the untapped potential in arts research. We hope this brings the field a step closer to more fully engaging with arts research, including understanding how to make sense of all the research that’s out there, and how best to use findings in decision-making. We plan to make the big announcement in the coming weeks, so stay tuned!

“2012 Olympic Games” by Flickr user Republic of Korea

Title(s): Quantifying the Social Impacts of Culture and Sport; Quantifying and Valuing the Wellbeing Impacts of Culture and Sport (two reports)

Author(s): Daniel Fujiwara, Laura Kudrna, and Paul Dolan.

Publisher: UK Department for Culture, Media & Sport

Year: 2014

URL: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/304896/Quantifying_the_Social_Impacts_of_Culture_and_Sport.pdf

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/304899/Quantifying_and_valuing_the_wellbeing_impacts_of_sport_and_culture.pdf

Topics: cultural engagement, sports participation, social outcomes, subjective wellbeing, cost savings

Methods: Regression analysis of survey data gathered between 2010 and 2011 among a nationally representative sample of 40,000 UK households (Understanding Society, Wave 2). Additional data in analysis drawn from British Household Panel Survey (Understanding Society survey predecessor with smaller sample size but more detailed income-related data).

What it says: The authors examine the relationship between sports and cultural participation and 1) various social outcomes, specifically measures of health, education, employment, and civic participation; and 2) subjective wellbeing (i.e., life satisfaction). They also estimate cost savings and financial values associated with the social and wellbeing impacts of sports and cultural engagement, which was defined by the following variables: participation in arts and cultural activities; attendance at arts and cultural events; participation in team and individual sports; and museum, heritage site, and library visitation.

Examining impacts on self-reported health, the authors found that those who participate in sports are 14 percent more likely to report good health than those who do not, whereas only 5 percent of art goers are more likely to report good health. Unlike arts attendance, arts participation (i.e., active modes of engagement) was found to have a negative association with health, although researchers suggest this could be attributed to reverse causality: the possibility that unhealthy people may be more likely to actively engage in the arts. Overall, the impacts of sports and culture on health were constant across gender, age, income, and geography, except the the impact of team sports on health was greater for younger people, and arts participation had more of an effect on health for older adults.

In terms of education, the authors examined the reported likelihood of 16- to 18-year-olds going into higher education (sample size of 900). There was a 14 percent increase in likelihood for those who participate in the arts, generally, and a 7 percent increase in likelihood for those who participate in swimming, which was the only sports variable to have a significant effect. There was a 13 percent increase in likelihood for those who attended dance events, and a smaller 8 percent increase in likelihood for those who actively participate in music. Given the smaller sample size, the authors did not examine distributional impacts across age, gender, etc.

The authors also examined the effects of sports and culture on job satisfaction and job search behavior. They found that participation in team sports is associated with an increase in job satisfaction, although this association only exists among people with high income. They found that participation in any sport is associated with an 11 percent increase in the likelihood of having looked for a job in the last four weeks. This figure was fairly similar for engagement in the arts (12 percent). The increase in the likelihood of looking for a job was slightly higher for people who participate in drama (11 percent) versus those who were members of an arts audience (8 percent). Those who participate in individual sports and those with higher incomes were 9.5 percent less likely to have looked for a job.

For civic participation, the authors examined correlations between sports and arts engagement and frequent volunteerism and charitable giving. They found that sports engagement is associated with a 3 percent increase in frequent volunteerism (defined as once every two weeks) whereas arts engagement (that is, both attendance and participation) is associated with a 7 percent increase. Participation in drama was more strongly correlated with frequent volunteerism (8 percent) than the next highest associated arts-related activity – attending an exhibition (3 percent). Increased charitable giving was twice as high among those who engage in the arts (£50 increase; although effects are modified by gender, with more charitable donations among men) versus those who engage in sports (£25 increase). Participation in drama was most strongly correlated with increased charitable giving (£83) than the next highest arts-related activity – attendance at dance events (£35).

As for wellbeing, the authors found that sports engagement, arts participation, and arts attendance all had a significant, positive association with life satisfaction. In particular, team sports and swimming had the greatest effect of all sports activities; drama and crafts produced the greatest effects within the arts participation category; and attending musical events and plays and visiting libraries were most effective of all attendance activities. Conversely, the researchers found that fitness and performing music had negative associations with life satisfaction. While there were few significant differences among different population groups, the report indicates that arts participation and individual sports’ positive effects on life satisfaction were larger for people over the age of 46.

Regarding cost savings and financial impacts, the authors looked at the association between self-reported health and use of medical services. Per person cost savings were highest for those who participate in sports (£98) versus those who attended arts events (£37). Arts participation had negative cost savings (-£32). It is important to note that these preliminary estimates do not consider other behavioral factors that may offset health benefits, such as quitting smoking, which may lead to weight gain. The authors then roughly estimated increases in lifetime earnings associated with sports and cultural engagement, which was highest for dance attendees (£56,400) and lowest for swimmers (£26,800). The authors also estimated monetary values (i.e., how much money one would need to derive wellbeing impacts) for arts and sports-related variables with statistically significant wellbeing impacts. The highest values were attributed to participation in dance (£1,671, per person, per year), swimming (£1,630), and library visits (£1,359). Assuming a twice-per-week engagement in sports, the authors estimate an annual value of £1,127 and a per-activity value of £11. For the arts, based on average engagement of 15 to 20 times-per-year, they estimate an annual value of £935 and per-activity value of £47.

What I think about it: The authors control for as many factors as possible using regression analysis, but acknowledge that they cannot fully attribute causality. Prior to conducting these analyses, the authors conducted a literature review to 1) ensure there was existing evidence of positive associations between sports and culture and, for example, improved health outcomes and volunteerism; and 2) determine what to control for in their analyses, which was fairly comprehensive. Also, the analyses seem particularly strong given the large, representative sample. It is important to note that the income data from the British Household Panel Survey and data from the Understanding Society survey come from different time periods, so impacts that may have changed over time are not accounted for in these analyses. In addition, Understanding Society data does not indicate the frequency of respondents’ participation in specific sports and cultural activities (e.g., fitness, swimming, music, dance). Rather, they derive a per-activity value for sports and cultural engagement, generally. In actuality, these values may vary based on the specific activity.

What it all means: Both reports indicate there are strong correlations between sports and cultural engagement and social impact – e.g., arts attendance and improved health; arts participation and volunteerism – and life satisfaction. Although these are not causal relationships, the analyses are useful for determining appropriate policy interventions, including estimating the costs and benefits associated with such changes and in comparison to other areas of leisurely engagement. Indeed, these reports could be helpful in allowing government to determine how best to allocate public dollars. The wellbeing valuation seems more fitting than use of market data (or preference-based valuation) since it examines the impact of a range of factors on wellbeing, including the income needed to achieve particular impact. As the researchers suggest for the future, issues of causality should be addressed through use of experimental methods, such as random assignments for sports and culture engagement, to single out effects and perhaps establish a control group with which to compare results.

Methodology for Rating Evidence

We use the following definitions for placement on the graph and for describing benefits in the document.

Does the evidence indicate that the benefit exists?

• Yes: the majority of the available evidence supports the claim
• No: the majority of the available evidence opposes the claim
• Mixed: neither of the above conditions is true

How strong is the quality of the evidence?

• High: multiple studies with causal designs (experimental or quasi-experimental)
• Medium: a single study with a causal design, or multiple studies that otherwise make a compelling case for causal interpretation in the judgment of our team
• Low: neither of the above conditions is met

In cases where the supporting, mixed, and opposing evidence is of differing strength, the stronger evidence is given more weight in determining whether the evidence supports the claim.

In the body of the article, we use the qualifier “probably” to describe effects in the Yes/Medium cell of the matrix, “may” to describe effects in the Yes/Low, No/Low, and all Mixed cells of the matrix, “probably not” to describe effects in the No/Medium cell of the matrix, and “does not” to describe effects in the No/High cell of the matrix.

Note: in general, we support methodological diversity, and are not dogmatic about valuing “gold standard” study designs such as randomized controlled trials at the expense of all other types of research. However, in practice, studies with causal designs tend to be much rarer than descriptive and case-study-based research, and therefore more valuable due to their scarcity and the fact that they are typically more challenging to conduct. In addition, given that the questions explored in this review are inherently causal in nature – can we trust that an activity or intervention makes some kind of benefit more likely – it is appropriate to privilege designs that make a convincing attempt to rule out alternative hypotheses for any observed effects. Our rating of evidence strength takes these considerations into account.

Full Bibliography

Below is a full list of resources which informed this research investigation. Much of our research focused on literature reviews or meta-analyses, and we have included here works that were consulted directly, as well as resources that were encountered within a review and factored into our findings. Works that received a thorough review from Createquity are marked with an asterisk (*).

Arts Council England. (2006). The Power of Art. Visual arts: evidence of impact. Part 2. London. Retrieved from www.artscouncil.org.uk/media/uploads/ documents/publications/phpOCmaHq.pdf

Arts Council England. (2014). The Value of Arts and Culture to People and Society: An Evidence Review. Retrieved from http://www.artscouncil.org.uk/sites/default/files/download-file/Value_arts_culture_evidence_review.pdf

Arts Midwest, & Metropolitan Group. (2015). Creating Connection: Research Findings and Proposed Message Framework to Build Public Will for Arts and Culture. Retrieved from http://www.artsmidwest.org/sites/default/files/ArtsMidwest_BPWReport.pdf

Asbury, C. H., & Rich, B. (2008). Learning, arts, and the brain: The dana consortium report on arts and cognition. Dana Press.

Bakhshi, H., Freeman, A., & Higgs, P.. (2013). Dynamic Mapping of The UK’s Creative Industries. NESTA. Retrieved from www.nesta. org.uk/publications/dynamic-mapping-uks-creative-industries

Baxter, C., Tyler, P., Moore, B., Morrison, N., McGaffin, R., & Otero-Garcia, M. (2005). Enterprising Places: Sustaining Competitive Locations for Knowledge-Based Business. Cambridge, UK: Cambridge–MIT Institute.

BOP Consulting. (2011). Edinburgh Festivals Impact Study. Final Report. London. Retrieved from www.eventscotland.org/ resources/downloads/get/56.pdf

*Brown, A. (2006). An Architecture of Value. GIA Reader, 17(1). Retrieved from http://www.giarts.org/article/architecture-value

Brown, E. D., & Sax, K. L. (2013). Arts enrichment and preschool emotions for low-income children at risk. Early Childhood Research Quarterly, 28(2), 337–346.

Bygren, L. O., Johansson, S.-E., Konlaan, B. B., Grjibovski, A. M., Wilkinson, A. V., & Sjöström, M. (2009). Attending cultural events and cancer mortality: A Swedish cohort study. Arts & Health, 1(1), 64–73.

Carnwath, J. D., & Brown, A. S. (2014). Understanding the Value and Impacts of Cultural Experiences: A Literature Review. WolfBrown and Arts Council England. Retrieved from http://www.artscouncil.org.uk/media/uploads/pdf/Understanding_the_value_and_impacts_of_cultural_experiences.pdf

CASE programme: understanding the drivers, impacts and value of engagement in culture and sport. (2010). Retrieved from https://www.gov.uk/government/publications/case-programme-understanding-the-drivers-impacts-and-value-of-engagement-in-culture-and-sport

CEBR. (2013). The contribution of the arts and culture to the national economy. London. Retrieved from www.artscouncil.org.uk/media/uploads/pdf/CEBR_economic_ report_web_version_0513.pdf

Clarke, E., DeNora, T., & Vuoskoski, J. (n.d.). Music, Empathy, and Cultural Understanding. 2014: Arts & Humanities Research Council.

Clawson, H. J., & Coolbaugh, K. (2001). The YouthARTS Development Project. Juvenile Justice Bulletin. Washington, D.C.: Department of Justice, Office of Juvenile Justice and Delinquency Prevention. Retrieved from http://eric.ed.gov/?id=ED454130

Clift, S, Hancox, G, Morrison, I, Hess, B, Stewart, D, & Kreutz, G. (2008). Choral Singing, Wellbeing and Health: Summary of Findings from a Cross-national Survey. Sidney De Haan Research Centre for Arts and Health, Canterbury Christ Church University. Retrieved from https://www.canterbury. ac.uk/health-and-wellbeing/sidney-de-haan-research-centre/ documents/choral-singing-summary-report.pdf

Clift, S., Skingley, A., Coulton, S., & Rodriguez, J. (2012). A controlled evaluation of the health benefits of a participative community singing programme for older people (Silver Song Clubs). Sidney De Haan

*Crossick, G., & Kaszynska, P. (2016). Understanding the Value of Arts and Culture: The AHRC Cultural Value Project. United Kingdom: Arts & Humanities Research Council. Retrieved from http://www.ahrc.ac.uk/documents/publications/cultural-value-project-final-report/

Research Centre for Arts and Health, Canterbury Christ Church University, Folkestone, Kent, UK. Canterbury Christ Church University, Folkestone, Kent, UK: Retrieved from http://www. Ahsw. Org. uk/userfiles/Other_Resources/SSCRCTsummaryreportOct12. Pdf

Daykin, N., & Byrne, E. (2006). The impact of visual arts and design on the health and wellbeing of patients and staff in mental health care: A systematic review of the literature. University of the West of England.

Development Services Group, Inc. (2016). Arts-Based Programs and Arts Therapies for At-Risk, Justice-Involved, and Traumatized Youths. Washington, D.C.: Office of Juvenile Justice and Delinquency Prevention. Retrieved from http://www.ojjdp.gov/mpg/litreviews/Arts-Based-Programs-for-Youth.pdf

Education Endowment Foundation. (2016). Hallé SHINE on Manchester: Evaluation report and executive summary. Retrieved from https://educationendowmentfoundation.org.uk/our-work/projects/shine-on-manchester/

Everitt, A., Hamilton, R., & White, M. (2003). Arts, health and community: A study of five arts in community health projects. University of Durham.

Falck, O., Fritsch, M., & Heblich, S. (2011). The phantom of the opera: Cultural amenities, human capital, and regional economic growth. Labour Economics, 18(6), 755–766.

Feldman, A. F., & Matjasko, J. L. (2005). The Role of School-Based Extracurricular Activities in Adolescent Development: A Comprehensive Review and Future Directions. Review of Educational Research, 75(2), 159–210. https://doi.org/10.3102/00346543075002159

Fujiwara, D. (2013). Museums and Happiness: The Value of Participating in Museums and the Arts (The Happy Museum). Retrieved from http://www.happymuseumproject.org/wp-content/uploads/2013/04/Museums_and_happiness_DFujiwara_April2013.pdf

*Fujiwara, D., Kudrna, L., & Dolan, P. (2014a). Quantifying and Valuing the Wellbeing Impacts of Culture and Sport. Department for Culture, Media and Sport. Retrieved from https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/304899/Quantifying_and_valuing_the_wellbeing_impacts_of_sport_and_culture.pdf

*Fujiwara, D., Kudrna, L., & Dolan, P. (2014b). Quantifying the Social Impacts of Culture and Sport. Department of Culture, Media and Sport. Retrieved from https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/304896/Quantifying_the_Social_Impacts_of_Culture_and_Sport.pdf

Garrod, B. (2014). Investigating the role of Eisteddfodau in creating and transmitting cultural value in Wales and beyond. Arts & Humanities Research Council.

Gerry, D., Unrau, A., & Trainor, L. J. (2012). Active music classes in infancy enhance musical, communicative and social development: Active music classes enhance development. Developmental Science, 15(3), 398–407. https://doi.org/10.1111/j.1467-7687.2012.01142.x

Giordano, P. C., Cernkovich, S. A., & Rudolph, J. L. (2002). Gender, crime, and desistance: Toward a theory of cognitive transformation1. American Journal of Sociology, 107(4), 990–1064.

Graham, G., Chattopadhyay, S., & Lakhanpal, J.R. (2014). Using New Metrics to Assess the Role of the Arts in Well-Being: Some Initial Results from the Economics of Happiness. The Brookings Institute. Retrieved from https://www.arts.gov/sites/default/files/Brookings-Final-Report.pdf

Greene, J. P., Kisida, B., & Bowen, D. H. (2014). The educational value of field trips. Education Next, 14(1).

Grodach, C., Foster, N., & Murdoch III, J. (2014). Gentrification and the artistic dividend: the role of the arts in neighborhood change. Journal of the American Planning Association, 80(1), 21–35.

Grossi, E., Blessi, G. T., Sacco, P. L., & Buscema, M. (2012). The interaction between culture, health and psychological well-being: Data mining from the Italian culture and well-being project. Journal of Happiness Studies, 13(1), 129–148.

Guetzkow, J. (2002). How the Arts Impact Communities: An introduction to the literature on arts impact studies. Presented at the Taking the Measure of Culture Conference, Princeton University: Princeton University Center for Arts and Cultural Policy Studies. Retrieved from https://www.princeton.edu/~artspol/workpap/WP20%20-%20Guetzkow.pdf

Hacking, S., Secker, J., Spandler, H., Kent, L., & Shenton, J. (2008). Evaluating the impact of participatory art projects for people with mental health needs. Health & Social Care in the Community, 16(6), 638–648.

Hancock, M. R. (1993). Character journals: Initiating involvement and identification through literature. Journal of Reading, 37(1), 42–50.

Hervas-Olivier, J., & others. (2011). The Importance of Creative Industries Agglomerations in Explaining the Wealth of European Regions. DRUID. Retrieved from http://druid8.sit.aau.dk/acc_ papers/3u3ov4ld8gx1uvxa4pgddeivjeg5.pdf

Hesmondhalgh, D., & Pratt, A. (2005). Cultural industries

Hetland, L., & Winner, E. (2001). The arts and academic achievement: What the evidence shows. Arts Education Policy Review, 102(5), 3–6.

Holden, J. (2006). Cultural value and the crisis of legitimacy. Demos London.

Hyyppä, M. T., Mäki, J., Impivaara, O., & Aromaa, A. (2006). Leisure participation predicts survival: a population-based study in Finland. Health Promotion International, 21(1), 5–12.

Ings, R., Crane, N., & Cameron, M. (2012). Be Creative Be Well. Arts, wellbeing and local communities. An evaluation. London: Arts Council England. Retrieved from www.artscouncil.org.uk/media/uploads/pdf/BCBW_final.pdf

*Jackson, M. R., & Herranz, J. (2002). Culture Counts in Communities: A Framework for Measurement (Research Report). The Urban Institute. Retrieved from http://www.urban.org/UploadedPDF/310834_culture_counts.pdf

*Jackson, M. R., Kabwasa-Green, F., & Herranz, J. (2006). Cultural Vitality in Communities: Interpretation and Indicators. The Urban Institute. Retrieved from http://www.urban.org/projects/cultural-vitality-indicators/publications.cfm

John S. and James L. Knight Foundation. (2010). Soul of the Community – Overall Findings. Retrieved from http://www.knightfoundation.org/sotc/

Jones, S. (2010). Culture shock. London: Demos.

Kattenstroth, J.C., Kalisch, T., Holt, S., Tegenthoff, M., & Dinse, H. R. (2013). Six months of dance intervention enhances postural, sensorimotor, and cognitive performance in elderly without affecting cardio-respiratory functions. Frontiers in Aging Neuroscience, 5, 5.

Kay, A. (2000). Art and community development: the role the arts have in regenerating communities. Community Development Journal, 35(4), 414–424.

Kay, A., & Watt, G. (2000). The role of the arts in regeneration. Scottish Executive.

Kidd, D. C., & Castano, E. (2013). Reading literary fiction improves theory of mind. Science, 342(6156), 377–380.

Konlaan, B. B., Bygren, L. O., & Johansson, S.-E. (2000). Visiting the cinema, concerts, museums or art exhibitions as determinant of survival: a Swedish fourteen-year cohort follow-up. Scandinavian Journal of Public Health, 28(3), 174–178.

Lambert, C. (2014). The Value of Live Art: experience, politics and affect. Arts & Humanities Research Council.

Lobo, Y. B., & Winsler, A. (2006). The effects of a creative dance and movement program on the social competence of head start preschoolers. Social Development, 15(3), 501–519.

Lowe, S. S. (2000). Creating community art for community development. Journal of Contemporary Ethnography, 29(3), 357–386.

Manchester, M, & Pett, E. (n.d.). Teenage Kicks: Exploring cultural value from a youth perspective. Arts & Humanities Research Council.

*Mark J. Stern. (2007). Culture and Urban Revitalization: A Harvest Document. University of Pennsylvania. Retrieved from https://www.reinvestment.com/wp-content/uploads/2015/12/Culture_and_Urban_Revitalization_A_Harvest_Document-Report_2007.pdf

*Markusen, A., & Gadwa, A. (2010). Arts and culture in urban or regional planning: A review and research agenda. Journal of Planning Education and Research, 29(3), 379–391.

Martin, A. J., Mansour, M., Anderson, M., Gibson, R., Liem, A., & Sudmalis, D. (2013). The Role of Arts Participation in Students’ Academic and Nonacademic Outcomes: A Longitudinal Study of School, Home, and Community Factors. ResearchGate, 105(3), 709–727. https://doi.org/10.1037/a0032795

*Matarasso, F. (1997). Use or Ornament? The Social Impact of Participation in the Arts. Comedia. Retrieved from http://www.feisean.org/wp-content/uploads/Use-or-Ornament.pdf

*McCarthy, K., Ondaatje, E., Zakaras, L., Brooks, A., & RAND. (2004). Gifts of the Muse: Reframing the Debate About the Benefits of the Arts. RAND. Retrieved from http://www.rand.org/content/dam/rand/pubs/monographs/2005/RAND_MG218.pdf

McLean, J., Woodhouse, A., Goldie, I., Chylarova, E., & Williamson, T. (2011). An evidence review of the impact of participatory arts on older people. Edinburgh: Mental Health Foundation. http://baringfoundation.org.uk/wp-content/uploads/2011/04/EvidenceReview.pdf Luettu, 16, 2013.

Medeiros, K. de, & Basting, A. (2014). “Shall I Compare Thee to a Dose of Donepezil?”: Cultural Arts Interventions in Dementia Care Research. The Gerontologist, 54(3), 344–353. https://doi.org/10.1093/geront/gnt055

Medvedeva, M., Novak-Leonard, J., Brown, A,. (2011). Audience Impact Study: Literature Review. WolfBrown and the National Endowment for the Arts. Retrieved from http://arts.gov/sites/default/files/Audience-Impact-Study-Literature-Review.pdf

*Menzer, M. (2015). The Arts in Early Childhood: Social and Emotional Benefits of Participation. National Endowment for the Arts. Retrieved from https://www.arts.gov/sites/default/files/arts-in-early-childhood-dec2015-rev.pdf

Morley, E., & Winkler, M.K.. (2014). The Validating Arts & Livability Indicators (VALI) Study: Results and Recommendations. Urban Institute. Retrieved from http://arts.gov/sites/default/files/VALI-Report.pdf

*National Endowment for the Arts. (2012). How Art Works. Retrieved from http://arts.gov/sites/default/files/How-Art-Works_0.pdf

National Endowment for the Arts. (2013). The Arts and Aging: Building the Science.

Newman, M., Bird, K., Tripney, J., Kalra, N., Kwan, I., Bangpan, M., & Vigurs, C. (2010). Understanding the impact of engagement in culture and sport: A systematic review of the learning impacts for young people. Retrieved from http://eprints.ioe.ac.uk/16334/1/Understanding_the_impacts_main_report.pdf

Nicolopoulou, A., Barbosa de Sá, A., Ilgaz, H., & Brockmeyer, C. (2009). Using the Transformative Power of Play to Educate Hearts and Minds: From Vygotsky to Vivian Paley and Beyond. Mind, Culture, and Activity, 17(1), 42–58. https://doi.org/10.1080/10749030903312512

Niemi, L. (2014). The Arts & Economic Vitality: relationships between the Arts, entrepreneurship, & innovation in the workplace (working paper). Washington, DC: NEA. Retrieved from http://arts.gov/sites/default/files/Research-Art-Works- BostonCollege.pdf

*Noice, T., Noice, H., & Kramer, A. F. (2013). Participatory Arts for Older Adults: A Review of Benefits and Challenges. The Gerontologist, gnt138. https://doi.org/10.1093/geront/gnt138

Pajaczkowska, C. (n.d.). Empathy by Design. Arts & Humanities Research Council. Retrieved from https://www.academia.edu/12247924/Empathy_By_Design

Petrie, K. J., Fontanilla, I., Thomas, M. G., Booth, R. J., & Pennebaker, J. W. (2004). Effect of written emotional expression on immune function in patients with human immunodeficiency virus infection: a randomized trial. Psychosomatic Medicine, 66(2), 272–275.

Putnam, R. D. (1994). What makes democracy work? Review-Institute of Public Affairs, 47(1), 31.

Reynolds, J, Hetherington, J., O’Sullivan, A, Clayton, K, & Holmes, J.. (2014). The story of Lidice and Stoke-on-Trent: towards deeper understandings of the role of arts and culture. Arts & Humanities Research Council.

Ritblatt, S., Longstreth, S., Hokoda, A., Cannon, B.-N., & Weston, J. (2013b). Can music enhance school-readiness socioemotional skills? Journal of Research in Childhood Education, 27(3), 257–266.

Roger Tym & Partners. (2011). Economic Impact of the Liverpool Arts Regeneration Consortium. Manchester. Retrieved from www.larc.uk.com/wp-content/ uploads/2011/10/LARC-Economic-Impact-Final-Report.pdf

Sacco, P.L. (2013, October). Culture 3.0: the impact of culture on social and economic development, & how to measure it. Presented at the Scientific Support for Growth and Jobs: cultural and creative industries conference, Brussels.

Särkämö, T., Tervaniemi, M., Laitinen, S., Forsblom, A., Soinila, S., Mikkonen, M., … others. (2008). Music listening enhances cognitive recovery and mood after middle cerebral artery stroke. Brain, 131(3), 866–876.

Schellenberg, E. G. (2004). Music Lessons Enhance IQ. Psychological Science, 15(8), 511–514. https://doi.org/10.1111/j.0956-7976.2004.00711.x

Scottish Government, S. A. H. (2006, January 20). Quality of Life and Well-being: Measuring the Benefits of Culture and Sport: Literature Review and Thinkpiece [Research Publications]. Retrieved January 24, 2015, from http://www.scotland.gov.uk/Publications/2006/01/13110743/0

See, H. B, & Dimitra Kokotsaki, D. (2016). Impact of arts education on the cognitive and non-cognitive outcomes of school-aged children. Durham University and the Education Endowment Foundation. Retrieved from https://educationendowmentfoundation.org.uk/public/files/Publications/Arts_Education_Review.pdf

*Sheppard, S.C, Oehler, K., Benjamin, B., & Kessler, A.. (2006). Culture and Revitalization: The Economic Effects of MASS MoCA on its Community (No. C3 D Report NA3.2006). North Adams, MA: Center for Creative Community Development. Retrieved from http://web.williams.edu/Economics/ArtsEcon/library/pdfs/NA%20Economic%20Impacts%2032006.pdf

*Staricoff, R. L. (2004). Arts in health: a review of the medical literature. Arts Council England London. Retrieved from http://www.artsandhealth.ie/wp-content/uploads/2011/08/AHReview-of-Medical-Literature1.pdf

*Stern, M. J., & Susan C Seifert. (2013). Cultural Ecology, Neighborhood Vitality, and Social Wellbeing – A Philadelphia Project. University of Pennsylvania Social Impact of the Arts Project (SIAP). Retrieved from https://www.arts.gov/exploring-our-town/sites/arts.gov.exploring-our-town/files/SIAP%20CULTUREBLOCKS%20REPORT%20DEC2013%20V1.pdf

Taylor, P, Davies, L., Christy, E, Cooley, E., Taylor, A., Jones,R, Dumas, V. (2015). The Social Benefits of Engagement with Culture and Sport. London: DCMS. Retrieved from https://www.gov.uk/government/uploads/ system/uploads/attachment_data/file/416279/A_review_of_ the_Social_Impacts_of_Culture_and_Sport.pdf

*Tepper, S. (2014). Artful living: Examining the relationship between artistic practice and subjective wellbeing across three national surveys. The Curb Center for Art, Enterprise, and Public Policy at Vanderbilt University. Retrieved from http://arts.gov/sites/default/files/Research-Art-Works-Vanderbilt.pdf

The Cultural Learning Alliance. (2011). Key Research Findings: The Case for Cultural Learning. Retrieved from http://www.culturallearningalliance.org.uk/images/uploads/Key_Research_Findings.pdf

The National Endowment for the Arts. (2011). The Arts and Human Development. Retrieved from https://www.arts.gov/sites/default/files/TheArtsAndHumanDev.pdf

Tooby, J., & Cosmides, L. (2001). Does beauty build adapted minds? Toward an evolutionary theory of aesthetics, fiction, and the arts. SubStance, 30(1), 6–27.

*Topos Partnership for the Fine Arts Fund. (n.d.). The Arts Ripple Effect: A Research-Based Strategy to Build Shared Responsibility for the Arts. Retrieved from http://www.theartswave.org/sites/default/files/pdfs/The-Arts-Ripple-Report-January-2010.pdf

Trüby, J., Rammer, C., Müller, K., & others. (2008). The role of creative industries in industrial Innovation. ZEW-Zentrum für Europäische Wirtschaftsforschung/Center for European Economic Research. Retrieved from https://ideas.repec.org/p/zbw/zewdip/7499.html

Verghese, J., Lipton, R. B., Katz, M. J., Hall, C. B., Derby, C. A., Kuslansky, G., … Buschke, H. (2003). Leisure activities and the risk of dementia in the elderly. New England Journal of Medicine, 348(25), 2508–2516.

Vlismas, W., Malloch, S., & Burnham, D. (2013). The effects of music and movement on mother–infant interactions. Early Child Development and Care, 183(11), 1669–1688.

Wolf, D. (2016). Why Making Music Matters: WolfBrown and Carnegie Hall’s Weill Music Institute. Retrieved from http://www.carnegiehall.org/uploadedFiles/Resources_and_Components/PDF/WMI/WhyMusicMatters.pdf

*Wali, A., Severson, R., & Longoni, M. (2002). Informal Arts: Finding cohesion, capacity, and other cultural benefits in unexpected places. The Chicago Center for Arts Policy at Columbia College. Retrieved from http://www.americansforthearts.org/sites/default/files/Informal_Arts_Full_Report.pdf

Weinberg, M. K., & Joseph, D. (2016). If you’re happy and you know it: Music engagement and subjective wellbeing. Psychology of Music, 305735616659552. https://doi.org/10.1177/0305735616659552

*What Works Centre for Local Economic Growth. (2016). Evidence Review 3: Arts and Culture. Retrieved from http://www.whatworksgrowth.org/public/files/Policy_Reviews/16-06-15_Culture_and_Sport_Updated.pdf

Wheatley, D., & Bickerton, C. (2016). Subjective well-being and engagement in arts, culture and sport. Journal of Cultural Economics, 1–23. https://doi.org/10.1007/s10824-016-9270-0

Winter, T. (2014). A Somatic Ethnography of Grand Gestures Elders Dance Group (Project Report No. AH/L005638/1). Sunderland: University of Sunderland. Retrieved from http://sure.sunderland.ac.uk/5820/.

Zeilig, H. (2014). The arts in dementia care – A critical review of cultural and arts practices in dementia care in the UK. Arts & Humanities Research Council.

“Catalog” by Flickr user Beyond DC

The platitudes are on the lips of every arts supporter, ready to be recalled at the first sign of a public hearing or potential funding cut. “The arts are essential – a necessity, not a luxury.” “The arts help kids learn.” “The arts are the foundation of the knowledge economy.” It feels good to say those things, especially if you’re someone who has spent a life in the arts. But are they actually true? Are we pulling a fast one on ourselves and our audience by saying them? Or are we doing a service to the world by spreading the good news?

Over the past half century, hundreds of researchers have spent thousands of hours and millions of dollars grappling with these questions. And while the literature still has a ways to go before we can consider the answers definitive, it is becoming clear in at least several arenas that it’s not just our imagination: arts participation really does improve lives. In particular:

• Participatory arts activities help to maintain the health and quality of life of older adults. As discussed in our previous feature, singing improves mental health and subjective wellbeing; taking dance classes bolsters cognition and motor skills; dancing and playing a musical instrument reduce the risk of dementia; and visual arts generate increases in self-esteem, psychological health, and social engagement.

• Arts therapies contribute to positive clinical outcomes, such as reduction in anxiety, stress, and pain for patients. Music interventions tend to dominate studies in this area, mostly characterized by passive forms of participation (e.g., listening to music).

• Arts participation in early childhood promotes social and emotional development. For example, teachers report fewer instances of shy, aggressive, and anxious behavior among preschoolers taking dance classes, and toddlers receiving music instruction demonstrate increased social cooperation with other children.

• Student participation in structured arts activities enhances cognitive abilities and social skills that support learning, such as memory, problem-solving, and communication. (While arts participation may improve academic attainment as well, any effects are fairly small.)

We’ve catalogued these and other benefits in an interactive graphic we’ve created – the first of its kind – that explores the various benefits claimed for arts participation along with the strength of evidence backing those claims. See how the benefits stack up against each other at a glance, or zoom in to read what the research has to say about specific questions. (Read about our methodology here.) We recommend viewing in full-screen mode for best results.

Before we dive in further, a little context-setting is in order. The first thing to note is that what you’re going to read below is a work in progress. The literature on the effects of arts participation is vast and of highly uneven quality. To arrive at the conclusions we express here, we’ve relied heavily on existing literature reviews and meta-analyses on the topics in question, which means that any errors of interpretation or questionable judgments in those reviews are likely repeated here. Over time, we intend to get to know the underlying studies and publications and fill in gaps or make corrections as needed. In addition, new research on these topics comes out on a regular basis, and sometimes it challenges conclusions that we had previously drawn about a topic. For both of these reasons, you can expect that we will make tweaks both to the interactive and the content below as we gain access to new information going forward.

Second, it’s important to remember that the focus of this review is quite broad, and looks for general effects on a general population. It’s likely that in practice, there is quite a bit of variation between disciplines, between different modes of artistic participation, and between participants (e.g., different personality types). We can already say, for example, that music is both the most-studied intervention and the one that seems to have the most robust evidence behind it. As we get to know the literature better via the process described above, we’ll be able to identify these kinds of nuances with more precision.

Readers interested in the details behind the evidence in the article are encouraged to take a look at our capsule reviews on participatory arts for older adults, cultural arts and dementia, arts and early childhood, and arts and at-risk youth, all of which are based on in-depth literature and systematic reviews conducted by others and outline common methodological shortcomings and recommendations for future research. Of particular note is our capsule review on the Cultural Value Project (CVP), which shares the results of the UK-based Arts and Humanities Research Council’s three-year investigation into the value of culture. While the full bibliography to this article is far more extensive, our investigation relied heavily on the above sources.

Feelin’ Good: Physical and Mental Health

Of the four broad areas of arts impact that we identified in our review, the most robust research has taken place in the areas of education and personal development and physical and mental health. In fact, the evidence underlying the benefits of the arts for older adults is so compelling that we decided to write a whole separate article about it. A variety of participatory arts activities improve older adults’ mental and physical health, and in some cases, lessen the likelihood of developing dementia later in life. For instance, weekly singing has been shown to decrease anxiety and depression; weekly dance has been shown to improve cognition and attention, posture and balance, and hand and motor skills; and lifelong engagement with music, particularly playing an instrument, is correlated with improved memory among older adults. The arts also play a role in improving the overall quality of life for older adults more generally, such as attitudes toward social life.

While this was some of the most compelling evidence uncovered by our review, older adults aren’t the only beneficiaries. Arts therapies have been shown to improve clinical outcomes among patients. For example, a 2004 review of more than 400 pieces of literature exploring the arts’ and humanities’ relationship to healthcare and the arts’ effects on health identified a number of impacts for arts therapies. This includes visual art and music helping to reduce anxiety and depression among cancer patients undergoing chemotherapy, an association between music and reduction in anxiety and blood pressure in cardiovascular care, and reduction in use of pain medicine following surgery. Music tends to dominate these studies, with a generally positive effect on anxiety, stress, and pain reduction among patients. Another strain of studies has explored the related claim that visual art and design may help to improve the quality of healthcare settings, thus improving patient satisfaction and clinical outcomes. While the methodological quality of the evidence in this area is considerably weaker than that described above, initial results support the claim..

The arts may also generate health impacts beyond dedicated healthcare settings. We found that community arts activities probably contribute to healthy living habits and improved understanding of health. Using a mixed-methods approach that included a community-randomized design, an evaluation of 100 small participatory arts projects across impoverished parts of London found increases among participants in healthy eating, physical activity, and positive feelings. Similarly, a 2003 mixed-methods evaluation of the Wrekenton Lanterns Project, a community arts project drawing attention to coronary heart disease, suggested that arts activities contributed to healthy personal development, including healthy eating and mothering, mental health improvements, and increased absorption of health information. In the absence of longitudinal studies, however, it is difficult to know if participants sustained these habits over time.

The strongest and most consistent evidence for the health impacts of the arts relate specifically to mental health: in particular, reductions in depression and anxiety. It should come as no surprise, then, that arts participation is associated with subjective wellbeing, or one’s perceived quality of life. Over the past several decades, growing scholarship on wellbeing has sought to address just how well a person thinks they’re doing, with ongoing development of indicator systems that, in more recent years, have begun to incorporate measures related to arts, culture, and creativity. Createquity has been interested in the connection between arts participation and subjective wellbeing for some time. In our own analysis of data from the 2012 General Social Survey, we found no relationship between having attended an exhibit or performance in the past year and one’s satisfaction with life. However, a subsequent research spotlight revealed that among a large sample of Americans, more active forms of cultural participation including playing a musical instrument, gardening, and craft-making were positively associated with life satisfaction.

Our current review of the literature suggests that while causal attribution remains difficult to pin down, arts and cultural participation probably improves self-reported happiness or life satisfaction. A 2010 study of 1,500 randomly selected Italians analyzed two data sets on general wellbeing and cultural participation, yielding surprising results: cultural experiences – in this instance, passive modes of participation such as cinema, theatre, concert, and museum going – were the second most important determinant of psychological wellbeing, second only to the incidence of diseases, and ranking above factors like job, income, and education. And while not all arts participants are necessarily “doing well,” there is some evidence that unhappy people might be worse off it not for their cultural activities. For instance, a 2008 study of 1,124 choral singers in England, Germany, and Australia found that among respondents who scored on the lowest third of the psychological wellbeing scale, singing in a choir had a significant impact on their ability to cope with physical and mental health issues, among other personal challenges. There is some work being done to explore these issues in the US, but existing data sets on wellbeing and arts participation are not as easy to cross-reference. For instance, a 2014 study found an association between arts participation and wellbeing, but the study design made it difficult to determine if it was indeed attributed to arts participation and not other factors.

From Jungle Gyms to Jobs: Education and Personal Development

Although some of the strongest evidence we’ve come across speaks to the value of participatory arts for older adults, one doesn’t have to be a senior citizen, or for that matter even an adult at all, to benefit. On balance, the evidence suggests that the impact of arts and culture on psychological wellbeing is consistent across the lifespan, as far back even as early childhood.

A recent NEA literature review found ample evidence that arts participation in early childhood (birth to eight years) promotes social and emotional development. For example, a 2013 randomized controlled trial of 102 toddlers found that those participating in classroom-based music education were more likely to increase their level of social cooperation, interaction, and independence (as reported by their teachers) than a control group that did not receive a music education program. Similarly, a 2006 study of 40 preschoolers found that those that met with a dance group for eight weeks had stronger improvements in social skills and showed noticeable reductions in shy, anxious and aggressive behavior compared to a control group.

For slightly older kids, student participation in structured arts activities enhances cognitive abilities and social skills that support learning (e.g., memory, problem-solving, and communication). A 2010 systematic review of the Culture and Sport Evidence (CASE) database in the UK concluded that participation in “structured arts activities” could increase young people’s performance on a range of indicators of cognitive and social ability. Perhaps even more importantly, there is good reason to believe that arts education programs are disproportionately impactful for lower-income children. The NEA literature review on early childhood mentioned above includes a Head Start arts education experiment with 88 preschoolers from low socioeconomic status families. Those who participated in music activities showed improved cognitive abilities and increased ability to pay attention than children in the control group that received regular Head Start instruction. According to the NEA literature review, other specific benefits to lower-income youth include increases in confidence, student behavior and social skills. These findings are consistent with those from the well-known randomized controlled trial to measure the impact of field trips to the Crystal Bridges Museum of American Art. Benefits such as enhanced critical thinking skills and improved measures of tolerance were two or three times higher for children attending schools in rural areas or that served predominantly low-income households.

An earlier systematic literature review of 188 studies, the landmark 2001 Reviewing Education and the Arts Project (REAP) study, offers another perspective on the evidence base for non-arts academic outcomes of arts education. After comparing 275 effect sizes across groups of comparable studies, the researchers found strong causal evidence for the impact of music listening on spatial-temporal reasoning; learning to play music on spatial reasoning; and classroom drama instruction on verbal skills. However, the evidence was weaker in several other areas, including most effects on reading and math performance.

Indeed, one puzzle embedded in the extensive literature on arts education is how little the aforementioned benefits to learning and cognitive capabilities seem to translate to traditional measures of academic attainment such as standardized tests. Evidence from a wide body of literature suggests that even if there is a positive effect, it is so small as to be practically meaningless. The CASE systematic review cited above found that overall, participation in structured arts activities only improved attainment in high-school-aged students (as measured by standardized tests) by one to two percent. Similarly, a review from the Education Endowment Foundation in the UK concluded that arts participation had “positive but low” effects on academic learning in English, math, and science.

A major drawback within this literature is a lack of longitudinal studies. Short-term experimental designs that assign some students to an arts program and others to a control group are useful for isolating the effects of that particular program, but they usually only measure temporary effects on participants. Both the NEA’s early childhood literature review and the Cultural Value Project note the dearth of research that might isolate the long-term effects of arts participation in childhood over a lifetime.

Arts as Economic Engine, Sort of

In contrast to the health and educational literature described above, research on the economic and social impacts of the arts does not paint as straightforward a picture of benefit to society. In some cases this is because the available research simply is not very robust (unsurprising, given that measuring effects at a community level is far more difficult than doing so at an individual level); in others, it is because the evidence is conflicting, or the implications of it unclear.

Arguably the most convincing case to be made here is that cultural assets (organizations, venues, etc.) probably contribute to higher real estate values at a neighborhood level, but this insight is complicated by questions around the potential negative impacts of gentrification. For instance, a 2013 study on how cultural districts reshape neighborhoods found evidence that cultural districts “have significant impacts on property values,” although the evidence of effects on poverty, education, and families was weaker. A 2006 case study of MASS MoCA and its surrounding neighborhood in rural Massachusetts found significant increases in property values following the opening of the contemporary art museum. Similarly, between 2006 and 2008, a multi-pronged investigation by Mark Stern and Susan Seifert’s Social Impact of the Arts Project (SIAP) revealed a relationship between concentrated cultural assets and rising real estate values. It remains unclear, however, whether this effect generates benefits for existing, non-property-owning residents, like rising income levels or job prospects, or alternatively, brings potential harm through disruption of existing population dynamics. Perhaps surprisingly, there is a general lack of evidence that the arts contribute to concrete negative neighborhood revitalization impacts like displacement, but little attention has been devoted to “fuzzier” outcomes like feeling a loss of ownership.

Another common type of research in cultural economics is the much-touted (and much-criticized) economic impact study. If you work in the arts, chances are you’ve seen a press release at some point in the past decade announcing that the arts generate some large dollar amount in revenue and impressive number of jobs in your community. Claims of this nature may be true in a literal sense, but are usually far less meaningful than they first appear. Sure, the arts industry creates jobs, but so does literally every other industry. The more relevant question is this: “do the arts spur spending in the economy that wouldn’t have happened otherwise?” Evidence for that more ambitious proposal is mixed. For example, a review of 36 studies by the UK-based What Works Centre for Local Economic Growth found that the effects of large-scale facilities on local employment are limited at best; however, the review included both cultural and sports facilities, and was heavily weighted toward the latter.

Speaking of employment, one of the few studies that examines the longer-term effects of arts and cultural participation suggests that cultural participation may contribute to capacity for innovation within the workforce. In an analysis of the 1979 National Longitudinal Survey of Youth, Laura Niemi compared more than 7,000 Americans’ history of arts participation as children to their career history as adults. Niemi found a strong association between interest in the visual arts in adolescence and later innovation and entrepreneurship, which held true even when controlling for personality traits associated with innovation (like a willingness to take risks) and educational attainment. Family income, however, was not tested as a control factor.

If the arts help produce more innovative individuals, it stands to reason that the presence of arts and cultural activities and creative industries in a region may contribute to increased productivity and innovation in other industries in that region. For example, a 2015 empirical study of 2,000 creative enterprises in Austria found evidence to support three theories for how creative industries affect an economy’s overall innovation performance: being a major source of innovative ideas, products and services; offering services that lend themselves to innovative activities in other enterprises; and using new technologies to encourage further development in tech production. Do creative industries similarly make a region wealthier? Maybe: a 2011 study examining the relationship between manufacturing, service, and creative industry agglomerations and the wealth of 250 European regions found that for every percent increase in employment in the creative industries, there is a little over a half-percent increase in GDP. As with much of this literature, though, including that seeking to test Richard Florida’s hypothesis that creative industries draw talented workers and employers to a region and increase wealth that way, causation and correlation are difficult to tease out.

Come Together: On the Arts and Social Cohesion

The state of the evidence is even muddier when it comes to the impact of the arts on the social fabric between and among communities. As with economic vitality, evidence in this arena suffers from a lack of experimental and quasi-experimental designs that would help us better understand the social benefits of the arts. However, much of the difficulty is also rooted in the theoretical complexities that complicate coming to a shared definition of terms in this area. Social benefits of the arts have been described by many names, including social capital, social wellbeing, social inclusion, arts for social change, and more. We even struggled with what label to use to describe benefits in this area, and consider “social cohesion” to be a preliminary designation.

One of the better-studied research topics in this area is the relationship between participation in the arts and pro-social or civic behaviors like voting, volunteering, or attending community meetings. A 2014 Arts Council England evidence review found “growing evidence that children and young people’s engagement with arts and culture has a knock-on impact on their wider social and civic participation.” More specifically, based on British and American systematic reviews, high school students who participate in the arts “are twice as likely to volunteer than those that don’t…and 20 percent more likely to vote as young adults.” However, the major problem with research of this nature is that it does not test the very plausible counter-hypothesis that a common personality trait or set of values drives both arts engagement and civic behavior. Experimental work in this area would be extremely valuable for answering that question.

What about the relationship between arts assets and indicators of social wellbeing at a neighborhood level? The best work on this front has been conducted by SIAP’s Stern and Seifert, who attempted in a recent project to analyze multiple dimensions of economic and social wellbeing in Philadelphia. Their investigation, however, failed to find correlations between cultural assets and most indicators of social wellbeing after controlling for race and economic vitality, casting significant doubt on this effect.

Can the arts help increase trust and understanding between people of different backgrounds through dialogue or creating spaces for storytelling? In the United States, Animating Democracy and SIAP have both conducted qualitative and descriptive research into this phenomenon. However, the literature is almost entirely bereft of control groups, making it difficult to draw firm conclusions. One of the few exceptions is the aforementioned Crystal Bridges study on field trip attendance, which reported an increase in tolerance and “historical empathy” among students who attended the museum compared to students who didn’t. It’s difficult to know, however, how meaningful the proxy measure used in this study is in practice. Furthermore, one of the problems for this area of research is that it seemingly matters a lot what messages are being communicated through the artwork when it comes to building bridges across social divides, complicating attempts like this one to assess in general terms whether this type of intervention “works.”

What It All Adds Up To

Last year, Createquity explored the literature on wellbeing and quality of life in general, and noted that culture is often missing from frameworks that seek to capture a holistic definition of wellbeing. This investigation, and the ongoing work that will flow from it, demonstrates how and where the arts fit most naturally into such a framework.

• Arts participation contributes directly to quality of life by increasing self-reported happiness and life satisfaction. This is probably the case for the population in general, and is almost certainly true for the subset of that population that pursues sustained engagement in arts activities over time. In addition, robust effects of arts participation on reducing anxiety and depression have been demonstrated for people in healthcare settings and older adults, two potentially vulnerable populations. This research validates Createquity’s thematic focus on ensuring equitable access to opportunities to participate in the arts across society as a whole.
• Arts participation contributes indirectly to wellbeing via, at a minimum, its effects on education and personal development (particularly the development of emotional and social skills in early childhood, and the development of cognitive capabilities and communication skills in later childhood), and physical health (particularly in healthcare settings). Other indirect effects to wellbeing may exist as well, but the research is not yet at a place where these can be demonstrated conclusively.

This review likewise highlights where additional investments in research would be especially productive. Experimental and quasi-experimental designs are extremely rare in the research on the economic and social impacts of the arts; initiatives to fill this gap, though likely expensive and difficult to implement, would prove enormously helpful in resolving many of the causation vs. correlation conundrums that currently pervade this literature. Even in the health and education areas where these techniques are more common, however, there remains considerable room for further research and greater methodological ambition. There is a strong need in these areas for studies that examine the effects of arts participation over a long period of time, and for randomized controlled trials that use larger sample sizes.

As stated in the beginning of this article, both the research literature itself and our understanding of it are works in progress. We will continue to update and adjust the infographic describing benefits as new research comes to light in the months and years to come. As we learn more about how the arts benefit lives, the knowledge will inform our ongoing inquiry into the most important issues in the arts and what we can do about them.

“Loring Park Art Fair” by flickr user m01229

Title: Understanding the Value of Arts & Culture

Author(s): Geoffrey Crossick & Patrycja Kaszynska

Publisher:Arts & Humanities Research Council

Year: 2016

URL: http://www.ahrc.ac.uk/documents/publications/cultural-value-project-final-report/

Topics: Art, culture, cultural value, economics, community development, arts education, health and wellbeing

Methods: Literature Review

What it says: This report represents the culmination of the Cultural Value Project (CVP), a three-year initiative undertaken by the Art and Humanities Research Council (AHRC) of the UK into understanding the value of culture. It draws upon a body of original work made possible by the following research grants administered by the AHRC:

• 46 Research Development Awards to carry out original research,
• 19 Critical Review Awards to undertake reviews of the literature in a particular area, and
• 7 Expert Workshop Awards to organize intensive discussions amongst specialist academics and practitioners.

This original work was supplemented by additional literature review by the project’s leaders to trace the historical and current boundaries of how we conceive of cultural value, make recommendations for moving forward, weigh in on the methodologies used by arts researchers, and present the available understanding of how culture creates value in several key areas: reflective individuals; engaged citizens; communities, regeneration and space; the economy; and health, aging, and wellbeing (the report also includes a “note” about arts education).

The final report’s historical discussion of cultural value explores the tension between concepts such as intrinsic and instrumental benefits, excellence and access, and quality and expansion. The project conceptualizes cultural value as a broad framework of different values, each evaluated by or demonstrated with appropriate and differing methodologies (in the process, rejecting what the authors describe as a hierarchy of methodologies that privileges quantitative evidence over qualitative). The project also sought to expand beyond what it saw as a narrow focus on publicly funded art, and focus on the commercial sector as well as amateur arts and cultural practices. The goal was to put the art experience of the individual at the center of the research.

The following is an overview of findings from key benefit areas.

• Reflective Individuals. The report finds that cultural engagement helps to improve understanding of oneself and others. Evidence for the latter centers around the ability to empathize, which one study defines as the ability to understand others’ difference while maintaining a strong sense of self. Findings are based mostly on self-reported changes following participation in arts and cultural experiences. Two case studies discussed in the report reference literature focused on distinct populations: ex-offenders and caregivers/healthcare professionals. For ex-offenders, the literature pertains to the arts’ contributions to self-reflection and the ability to imagine alternate paths, although the relationship to re-offending is not clear given compounding factors. For caregivers and healthcare professionals, the literature relates to humanizing patients and individualizing their experiences. The report notes that longitudinal studies, help to distinguish between affective and cognitive dimensions of cultural experiences, and their differing effects on reflection over time. However, more of this type of research is needed to further discussion and understanding of affect.
• Engaged Citizens. The report cites a body of evidence that affirms an association between cultural participation and pro-social behaviors such as voting or volunteering. This evidence is largely derived from United States-based studies that analyze existing data sets, and findings echoed by additional work conducted in Europe. The mechanism or cause of this association is not as well understood. The report also singles out a framework from the work of Stern and Seifert which posits three theories of action for how the arts influences patterns of civic engagement: didactic (instructing or persuading), discursive (providing settings for discussion and making connections), and ecological (creating spillover effects that increases engagement and social capital). The report posits that the arts provide “spaces within which alternative ways of thinking, imagining and acting may take shape.” These reviews draw on case studies in the areas of climate change, as well as healing after armed conflict to develop this idea.
• Community Development. The report draws on research that identifies three ways that cultural activity is thought to be linked to urban regeneration: development of cultural and creative industries, raising the public profiles of cities, and improving social circumstances in urban areas. The report finds that these propositions lack clear definitions, making it difficult to find evidence to support claims. In particular, there are several areas in which longer-term effects are not as well understood – for example, measurement of the ongoing benefits of investment in large-scale cultural facilities beyond an initial boost to tourism or public profile, or the long-term stability of neighborhoods in which creatives and other residents are often quickly priced out as an experience-based economy supplants production-based economic activities. The report cites initial work highlighting the potential for small-scale cultural assets in neighborhood social development (most notably in work by Stern and Seifert, and Grodach), and calls for more research in this area.
• Economy. The report highlights two areas of research which move beyond frequently used economic impact approaches, and looks at the arts and creative industries as a growth vector in the wider economy. The first is the potential for the arts to draw investment and skilled workers to a region: research using self-reported data demonstrates that businesses and skilled workers report placing some value on cultural assets in their decisions on where to locate, though authors note that the actual level of effect on investment and movement of skilled laborers is not as well-defined, and more research is needed. The second area of inquiry highlighted in the report is on spillover effects from the creative industries to other sectors, most notably related to increased innovation. The report cites European studies that have found correlations between interactions with creative industries and indicators of innovation in other sectors, although identifying causality and mechanism of such an effect requires more research. The report also discusses more traditional economic impact research because, as the authors point out, economic impact has become the principal way that advocates demonstrate the economic value of the arts. The authors discuss methodological questions in regards to determining spending measurements, highlighting methods that adjust for concepts like displacement and deadweight (i.e., spending that has been pulled away from another sector, or that would have happened anyway) as promising tools for more accurate understanding of economic impact. They also discuss satellite accounts designed to measure the economic footprint of creative industries and the arts in the long term, and point out that these accounts may prove most valuable as efforts to define and track the creative industries to enable future research. The report also discusses econometric valuation methods, used to determine the value people assign to non-market goods, usually by asking them to self-report that value in some way. The authors see promise in developing this approach within the cultural sector, based on initial project research which explored and developed an econometric valuation methodology.
• Arts Education. The authors draw from a body of research on the effects of both arts education and arts participation, to determine that there is little evidence that they have a significant effect on educational attainment via test scores. However, there is evidence of positive effects on skills associated with learning, such as cognitive abilities or pro-social behaviors and motivation. The authors also report some evidence that these effects may be greater among children of low socioeconomic status. The authors conclude from this that the role of arts in education would be better presented as contributing to skills and behaviors that provide a platform for greater learning, as opposed to directly leading to higher attainment in all disciplines. They also caution against a hierarchy of disciplines, which privileges gains in certain subjects like math and science, as opposed to valuing achievement and/or learning within arts disciplines themselves.
• Health and Wellbeing. The report draws from a varied body of research about health and wellbeing, based mostly on existing literature. Researchers note five areas in which the arts help to improve health and wellbeing: clinical outcomes, such as reduction in anxiety, stress, and pain among patients (music programs dominated these studies); quality of health care settings and contribution to patient satisfaction; healthy living habits and improved mental health outcomes (developed through community-based, health-related arts activities); subjective wellbeing; and maintaining good health and quality of life of older adults. The report points to a number of shortcomings in the research, including: difficulty in isolating variables and attributing effects to specific arts interventions; prioritization of quantitative methods such as randomized control trials, which may not be suitable for evaluating arts interventions but are typically relied upon in clinical drug trials; the relative absence of longitudinal studies; and non-standardization of theoretical underpinnings and rigor of research design across studies. Concerns about contested understandings of wellbeing were also noted.

With regard to methodologies, the report primarily discusses the limitations of quantitative data in research about cultural value. It notes that controlled experimental studies sit at the top of the conventional hierarchies of evidence, but do not always adequately capture the context, particularity, and depth of arts and cultural experiences, for which alternative methods may be better suited. Many of the funded projects that were part of the CVP employed methods and analytical approaches like ethnography, network analysis, economic valuation, arts-based and hermeneutic techniques (suited for capturing nonverbal data), phenomenological approaches, and narrative inquiry. In particular, the report recommends qualitative data as a means of understanding much of the subjective meaning-making and significance attached to cultural experiences, and cautions against prioritizing standardization for the purpose of comparison in all cases. The report notes the value of experimental and quasi-experimental research design in testing art and culture’s effects, particularly in the arts and health fields. However, given the difficulty in isolating variables in cultural experiences, the report suggests augmenting this approach with rigorous qualitative research, which might be characterized by multi-modality, scalability (extrapolating from case studies), and iterability. It also calls for more attention towards formative and participatory evaluation, rather than the more common summative evaluations used for accountability and advocacy purposes. The report concludes with recommendations for future research, including equal consideration of informal, publicly-funded and commercial arts and culture, and more extensive insight into the effects of distinct cultural forms, collaborative vs. individual experiences, and the psychological effects of cultural engagement.

What we think about it: This project offers value to the field of arts research, most notably in summarizing and advancing theoretical conversations about how to conceptualize and investigate the value of arts and culture. The overall body of work created by the project’s research awards and workshops is also immensely valuable, and a capstone report synthesizing the overall findings of multi-year, multi-project research engagements should become common practice in the field.

Most of the report’s major theoretical decisions (emphasizing individual experience as opposed to works of art, using a broad definition of arts and culture, drawing on wellbeing and the capability approach, and moving beyond a strict defense of the current landscape of public support for the arts to map value more broadly) feel simultaneously landmark and inevitable for this type of research. The researchers’ methodological work is also valuable, but isn’t as convincing. Although the authors argue for dismantling a “hierarchy of evidence” which privileges experimental design above all else, the report falls short of providing the necessary context and examples of rigorous qualitative designs that would more firmly establish how that recommendation translates to practice. As opposed to abolishing hierarchy within arts research, it might be more productive to develop a detailed working model that explores how different methodologies fit together and complement each others’ strengths and weaknesses. This would shed light on the important role of qualitative analysis in an overall process while maintaining clear standards of evidentiary rigor.

The report does offer some direct findings on major areas of benefit of the arts and culture, but much of the analysis of the funded works seems more focused on plumbing the depths of specific research questions and methodologies than building toward an overall understanding of value in the arts. We wish the authors had done more to sketch out how the findings from the research grants and the supplemental literature review add up to a cumulative understanding of the mechanisms through which the arts improve lives, and how that understanding might be useful in decision-making contexts.

What it all means: The Cultural Value Project final report accelerates shifts in arts research that have been years in the making: expanding definitions of arts and culture, paying more attention to relationships between different parts of an arts and cultural ecosystem, foregrounding inequality and inequity, and moving beyond a narrowly defined understanding of cultural value. The report’s methodological suggestions could also yield value to the field. But there is still much work to be done, especially in understanding cultural value in academically rigorous ways, and connecting that understanding to the myriad decisions facing the arts sector around the globe.

“Human Brain Sections” by flickr user GorissenM

Title: “Shall I Compare Thee to a Dose of Donepezil?”: Cultural Arts Interventions in Dementia Care Research

Author(s): Kate de Medeiros and Anne Basting

Publisher: The Gerontologist, 54(3)

Year: 2013

URL: http://gerontologist.oxfordjournals.org/content/early/2013/06/07/geront.gnt055.full.pdf

Topics: Arts participation, older adults, dementia, arts therapy

Methods: Literature review (of systematic reviews)

What it says: This article reviews 27 systematic and integrative reviews of pharmacologic, psychosocial and cultural arts interventions in dementia care for older adults. (The authors use philosopher Susanne K. Langer’s 1966 definition of cultural arts as “the practice of creating perceptible forms expressive of human feeling,” accounting for the role of imagination more so than the outward senses.) Although individual studies of cultural arts interventions demonstrate positive outcomes, most are excluded from systematic reviews due to weaknesses in research design, such as small sample sizes and the lack of randomization or control groups. Only reviews published in English between January 2000 and September 2012 were included. Studies that didn’t involve humans or focused on biological aspects of dementia were excluded.

The authors grouped results of pharmacologic, psychosocial and cultural arts interventions into three categories: 1) cognition; 2) problematic behaviors or symptoms, such as agitation, anxiety or apathy; and 3) quality of life. Drug trials involving donepezil led to improvements in cognitive function and self-reported quality of life for people with mild to moderate dementia. Otherwise, pharmacologic interventions demonstrated minimal benefit in dementia care compared to psychosocial and cultural arts interventions. Psychosocial interventions involving cognitive training and stimulation led to improvements in cognition, and those involving reminiscence led to improvements in autobiographical memory. A wide variety of psychosocial interventions such as aromatherapy, group validation, and reminiscence were most effective in reducing problematic behaviors such as wandering, irritability, and disruptiveness, respectively. Some also led to improvements in quality of life, as reported by people with dementia and their caregivers.

There were no cultural arts interventions included in the studies that adequately measured changes in cognition. Some music therapies led to reduction in problematic behaviors such as irritability, aggressiveness, agitation, and inappropriate vocalization, although application of the therapies varied widely. One study involving visual arts interventions distinguished between individual and group activities, noting higher levels of fear and verbal agitation for people with dementia assigned to individual art projects compared to those in weekly art classes. Results regarding improvements in self-reported quality of life varied widely for cultural arts interventions, with many facing methodological limitations. Those involving dance/movement therapy found increases in communication and quality of life as reported by participants and their caregivers, however, no validated assessment tools were used. One study involving storytelling similarly demonstrated improvements in communication and “expressions of pleasure,” but no significant change in wellbeing. Although lacking standardized outcome measures, visual arts interventions demonstrated similar improvements in participants’ expressions of pleasure. Music interventions also had positive outcomes, such as increases in self-reported quality of life, but with limitations in sample sizes, non-validated measures, and poorly defined outcomes.

The authors note that reviews were selected for inclusion based on topic, so the quality of individual studies was not evaluated. In addition, the authors clearly indicate inconsistencies amongst reviews, such as definitions of key outcomes, variability in measures used, and the level of detail offered in each study. Based on their review, the authors conclude that the quality of a study should be based on what is being measured and how, rather than its adherence to randomized controlled trial designs, since the latter does not necessarily capture changes in affect or meaningfulness. The authors also call for the consideration of the individual nature of cultural arts, noting that outcomes may differ significantly from person to person, but also note the importance of including the larger social network of people with dementia that play a role in improving their social connectedness.

What I think about it:

Although measures vary widely and findings are not suitable for direct comparison, this review is helpful in situating arts interventions among a broader pool of interventions for treating dementia, most of which are medically oriented. Much like other studies investigating the health impacts of arts and cultural participation, the authors point to the need for improved research designs. Perhaps the most notable takeaway from this review is the recommendation to move away from interventions that fall into the boundaries of traditional arts disciplines, and towards better understanding what the actual activities comprise, how they’re delivered, and to whom specifically. In other words, the priority should not be to determine which art form is most effective but instead, seeking clarity around what exactly it is that the arts offer in this realm that non-arts interventions with similar characteristics do not.

What it all means:

Given the relative weakness of drug interventions in this review, overall findings begin to suggest that cultural arts and psychosocial interventions may be viable alternatives to drug treatment. It offers a broad perspective of promising outcomes for people with dementia, and asks important questions about whether or not the clinical trial model suits arts interventions. This is consistent with the methodological limitations cited in the Cultural Value Project, namely its recommendation to better understand where rigorous qualitative methods, which are often more suitable for arts interventions, might fit within traditional hierarchies of evidence that prize RCTs. An appropriate next step would be to design research studies that begin to answer the what, how, and who questions previously outlined by de Medeiros and Basting.

“Sculpture by Ron Mueck – Two Women 2005” by flickr user Lance

Title: Participatory Arts for Older Adults: A Review of Benefits and Challenges

Author(s): Tony Noice, Helga Noice, and Arthur F. Kramer

Publisher: The Gerontologist, 54(5)

Year: 2013

URL: http://gerontologist.oxfordjournals.org/content/early/2013/12/10/geront.gnt138.full.pdf+html

Topics: Arts participation, older adults, creative aging, quality of life, health benefits, cognition

Methods: Literature review

What it says: This article reviews literature on the health benefits of active arts participation among older adults ages 60 and older in good general health. Arts activities include dance, expressive writing, music (singing and instrumental), theater, and visual arts. The review included a combination of 31 experimental and correlational studies conducted between 1985 and 2013. The following were excluded: case studies; studies with small sample sizes (n < 8); reports in non-peer-reviewed journals; articles not written in English; and studies focusing on arts therapies to treat those with illness, trauma, or other life challenges.

Overall, the studies demonstrate positive cognitive, affective, and quality-of-life outcomes. The review categorizes findings based on art forms

• A number of dance studies using quasi-experimental designs demonstrated cognitive and physiological improvements (e.g., increased attentional control). Dancers also scored higher on self-assessments of general health and subjective wellbeing compared to control groups. One of the studies suggests that cognitive benefits might be attributed to dance’s aesthetic qualities, rather than aerobic exercise, as no significant improvement in cardiorespiratory fitness among study groups (dancers and non-dancers alike) was observed.
• Studies related to expressive writing include evidence of improved processing, speed, attention, verbal learning, and memory, although this may be moderated by participants’ educational level and interest in writing. One study revealed psychological benefits, indicated by improvements of scores on a standard depression scale. The authors note that studies involving expressing writing were the only ones where a professional artist was not involved. This is a notable distinction because it may 1) point to why effects were likely moderated by participants’ level of educational attainment, or existing interest in writing, and 2) shed light on the value of formal arts instruction, which is likelier to draw sustained engagement (and produce substantive effects) than one-off attendance at events or other modes of passive engagement in the arts.
• Music-related studies produced a wide variety of results. For singing, there were self-reported decreases in doctor visits, falls, and use of over-the-counter medicine, decreases on a standard depression/anxiety scale, as well as improvements in overall health and involvement in activities and statistically significant improvements in emotional wellbeing, quality of life, and knowledge of singing;increases in self confidence were marginally significant. As for playing a musical instrument, results include: decreased levels of anxiety and depression, increases in the human growth hormone (associated with higher energy and improved memory and sex function), significant improvements in cognitive processes, and perceived favorable effects on health, and to a lesser extent, on social relationships and personal development. In some cases, positive outcomes did not persist over the longer term following music participation,unless, instrumentalists had trained or practiced over an extended period of their lives.
• Theater studies produced positive evidence, mostly related to increases in memory, comprehension, creativity, problem-solving, and personal growth. A study on improvisational drama yielded positive changes in anxiety, and another demonstrated improvements in wellbeing and physical measures, but not psychological health.
• Lastly, visual arts studies using qualitative methods revealed increases in social engagement, sense of empowerment, psychological health, skills development, ability to set new challenges, and identity preservation. One study using a randomized controlled trial yielded positive outcomes measures for anxiety, affect, and self-esteem.

The authors acknowledge the limitations of the research: the total number of studies reviewed is relatively small; a variety of instruments were used to measure change; and not all experiments were well controlled. To improve consistency across future research, they propose standardizing measures, vocabulary, and behavioral outcomes to assess effectiveness of interventions across art forms. They also recommend consistent use of pre/post design, and including control groups, where appropriate, as well as pursuing more meaningful sample sizes, more diverse populations, and longitudinal studies that measure effects over a long period of time.

What I think about it: The review offers a useful overview of health benefits associated with older adults’ arts participation. Some of the claims that were summarized had no indication of statistical significance, which may be a result of authors’ attempt to succinctly summarize findings from studies that used a wide variety of research designs. Nonetheless, the summary chart prepared by the authors is useful in showing the breadth of methods, sample sizes, and outcome measures used across arts interventions among older adults.

What it all means: Noice, Noice, and Kramer’s review was published the same year that NEA released The Arts and Aging: Building the Science, a report summarizing findings from its public workshop exploring research gaps and opportunities for understanding the relationship between the arts and health and wellbeing among older adults. A preliminary version of this review was prepared as a paper for the workshop, so this is a useful, evidence-based supplement to the mostly anecdotal findings in the NEA’s summary. The two combined – in addition to the NEA’s 2011 white paper on the arts and human development, which has a chapter on arts, health and wellbeing among older adults – show that there is growing momentum in the field of creative aging. The health focus and population specificity of this field offers a unique opportunity to lay the groundwork for developing more rigorous research designs for arts inventions broadly. In doing so, researchers can begin to identify the specific benefits of aesthetic engagement. In addition, researchers and advocates can use this evidence to gain support not only from public arts agencies, but also from non-arts agencies serving aging populations.

• Singing improves mental health and subjective wellbeing (i.e., perceived quality of life)
• Taking dance classes bolsters cognition and motor skills, and even lessens the likelihood of developing dementia later in life
• Playing a musical instrument has myriad positive effects, including dementia risk reduction
• Visual arts practice generates increases in social engagement, psychological health and self-esteem

Just how the arts benefit society is one of the most studied topics in arts research, to the extent that multiple literature reviews, most notably the RAND Corporation’s decade-old landmark Gifts of the Muse, have sought to compile our collective knowledge on the subject. In recent years, several important initiatives and publications have added to this evidence base, including the final report earlier this year from the UK-based Arts and Humanities Research Council’s Cultural Value Project and National Endowment for the Arts’s 2011 literature review on the arts and human development. Over the past few months, Createquity has been reviewing these and other publications with an eye toward creating a continually-updated catalogue of demonstrated impacts for arts activities. What are all of the ways in which the arts contribute to or detract from wellbeing, and how strong is the evidence supporting each of those claims?

Our review of the literature addressing these questions yielded a surprising result: the most compelling evidence of the value of the arts revolves around improving the lives of older adults. Better understanding the relationship between the arts and aging may help to identify areas for improvement in future research into wellbeing, as well as opportunities for investing in the quality of life of older individuals.

Painter — photo by Flickr user M-n-M

The global population is aging in unprecedented numbers and living longer than ever. Between 1980 and 2010, a period marking most of millennials’ present lifetimes, the number of U.S. centenarians increased by nearly two-thirds! Longer lifespans bring immediate implications for many and eventual implications for us all, if we’re lucky. While extending the so-called golden years can be a blessing, challenges include deteriorating health, social isolation, loss of loved ones, and life transitions.

Fortunately, research shows that arts-related interventions can help (in some cases, more so than traditional Western medicine). In particular, there is substantial causal evidence that participatory arts activities help to maintain the health and quality of life of older adults. These benefits, detailed below, include improvements in cognitive and tactile abilities, subjective wellbeing, and dementia risk reduction (although the effects on managing dementia are less clear).

Jamming and Grooving Towards Better Health

The literature on the effects of participatory arts engagement within aging populations is significant not only for the breadth of demonstrated benefits to older adults, but also the relatively high quality of evidence supporting these claims.

Most of the literature we encountered involved making music, although a number were focused on dance. Music and movement activities (playing instruments, singing, dancing) have been shown to improve mental and physical health among older adults. In a randomized controlled trial of 212 British adults over the age of 60, those who participated in weekly singing groups over three months were found to have had improved mental health (decreased anxiety and depression) compared to those who didn’t. These health effects were mostly sustained over a period of at least three months after the weekly singing ended. By contrast, the positive effects of instrument playing do not always persist over the longer term following participation, unless participants have trained or practiced over an extended period of their lives. This might explain why lifelong engagement with music, particularly playing an instrument, is correlated with improved memory among older adults ─ and why some older musicians, like Herbie Hancock at a solid 76, still perform with as much gusto now as they did in their prime. Despite a smaller sample size, another randomized controlled trial of 35 adults aged 60 and over suggested health benefits of dance for older adults. Those who took weekly dance classes over a six-month period showed improved cognition and attention, posture and balance, and hand/motor skills like steadiness and aim in comparison to the control group.

Other research points to the role of the arts in improving overall quality of life for older adults more generally, such as attitudes toward social life. For example, an evaluation of a different, yearlong weekly singing program for adults aged 60 and over revealed marked improvements in emotional wellbeing, especially for those who had been widowed. A mixed-methods study of the effects of painting lessons among older adults in the same age range documented similar improvements in both mental health and social wellbeing. After having participated in these professionally conducted lessons, participants noted increases in social engagement, their sense of belonging, and self awareness and understanding. Likewise, a randomized controlled trial of 50 older adults who participated in 12 visual art sessions over a month showed improvements in self-esteem and anxiety reduction. No wonder your grandmother was always in a good mood after watercoloring class, treating you to ice cream when you picked her up!

Doses of Art to Stay Lucid?

Every 66 seconds, an American develops Alzheimer’s disease. It is the sixth leading cause of death in the United States, and kills more people than breast cancer and prostate cancer combined. As the population ages, millions will be affected: the number of Americans with the disease will double between 2015 and 2050. With soaring diagnoses come soaring costs ─ financial, emotional, and social ─ for patients and their caregivers. Establishment of accessible and cost-effective methods of delaying Alzheimer’s disease and other dementia-related illnesses is crucial.

A 21-year longitudinal study of 469 older adults aged 75 and over published in 2003 found that playing an instrument, reading, and playing board games were strongly associated with lower incidence of dementia. In fact, those who scored in the highest third on the study’s cognitive-activity scale had a 63 percent lower risk of dementia than those in the lowest third. Dancing was the only physical activity to show similar effects.

Arts engagement also seems to benefit older adults who already have dementia, providing improved communication, cognitive function, self-esteem and social participation. TimeSlips, a creative storytelling program for people with dementia, appears to promote engagement, alertness and social interaction among participating adults, as well as improved attitudes among caregivers towards their patients. On the other hand, a 2013 report from the National Endowment for the Arts cites a review of 24 studies that presents a more mixed picture of the evidence, with music interventions leading to both positive and negative outcomes for individuals in severe stages of dementia-related illness. It’s also important to note that methodological challenges abound in this area of research, including confounding external factors related to social context, interrelated variables, and inconsistent outcome measures, all of which makes drawing firm conclusions difficult.

In fact, a separate literature review by Tony Noice et al. notes similar shortcomings in a broader set of research on participatory arts for older adults. As a general rule, research on the benefits of the arts lags behind the level of rigor frequently encountered in the broader universe of scientific research. So while the evidence described above is quite strong by arts research standards, it nevertheless has limitations. Other opportunities for improvement, according to Noice et al., include introducing more standardized assessment of interventions across art forms and measuring effects over a longer period of time. Though the work to date has been promising, until studies on the effectiveness of arts interventions for older adults more consistently meet rigorous standards, their ability to shape perception of the value of such programs will remain limited.

Music has powers — photo by Flickr user Jinx McCombs

As mentioned earlier, we discovered this wealth of literature on arts and aging as part of a larger inquiry into the benefits of the arts in general. That inquiry, in turn, extends a longer-term initiative on Createquity’s part to reconcile the benefits of arts and culture with broader theories of wellbeing (or quality of life), such as the capability approach. Our next article will explore some of the other areas of benefit that have been claimed for arts participation, along with an assessment of the evidence backing up those claims.

In the meantime, rest assured knowing the older people in your life who participate in the arts are not just pursuing a silly pastime. For some, it might just be the key to a worry-free life or a still-taut mind ─ all the more reason to encourage them to channel their inner Aretha, Baryshnikov, or Picasso.