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.

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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

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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.

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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

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“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.

“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.

“Youth” by flickr user CN

Title: Arts-Based Programs and Arts Therapies for At-Risk, Justice-Involved, and Traumatized Youths

Author(s): Development Services Group, Inc

Publisher: Office of Juvenile Justice and Delinquency Prevention.

Year: 2016

URL: http://www.ojjdp.gov/mpg/litreviews/Arts-Based-Programs-for-Youth.pdf

Topics: Arts participation, arts programs, arts therapy, youth development, at-risk youth, justice-involved youth, traumatized youth

Methods: Literature Review

What it says: This study presents a review of recent research on arts programs for three types of youth: 1)at-risk youth, or those with risk factors that increase likelihood of delinquency or other problem behaviors; 2) system-involved youth who are currently in the juvenile justice system; and 3) traumatized youth, identified based on their personal experiences. The review focuses on two types of intervention: 1) art-based programs where arts engagement are considered a type of therapy, and 2) arts therapy programs where arts approaches are part of a therapeutic process.

The review does not find clear evidence on the outcomes of arts interventions for these categories of youth in the literature, because of methodological deficiencies such as small sample sizes, lack of comparison groups, short follow-up periods, and reliance on self-reported measures. They also note that studies of programs with multiple components do not isolate the effects of each component, meaning that there is no evidence on the outcome of the arts element specifically. They conclude that more research is needed to understand the the potential impacts of these interventions, and to understand differences between the impacts of interventions using different arts disciplines.

The report does note that arts participation has been found to be associated with strong social and emotional skills among youth generally (Menzer, 2016), and that there are theoretical foundations for the efficacy of such interventions. Cognitive behavioral theory promotes changing dysfunctional beliefs, thoughts, and behaviors by helping people change the way they think. The reflective nature of many arts based approaches is well suited to this kind of therapy. Positive Youth Development theory focuses on developing the positive assets of youth by providing opportunities for pro-social involvement, such as arts programs with a social element. Additionally, multiple theoretical frameworks support the use of arts therapies with traumatized children.

The report concludes with a summary of a select number of arts-based programs that have demonstrated positive impacts on youth, including Reading for Life, Project Venture, and Cognitive Behavioral Intervention for Trauma in Schools (CBITS).

What I think about it: The authors of this review provide a useful summary of the theory and practice surrounding arts-based programs and therapies for these specific categories of youth, as well as a clear summary of the available evidence and its limitations. In spite of a lack of conclusive evidence, this research provides a good overview of how such programs are theorized to work. The review would benefit from a clearer explanation of how works were identified and included in the review, in order to provide more context for the findings.

What it all means: The positive outcomes noted in individual programs (even with the methodological problems cited), as well as the strong theoretical basis of such programs, points towards the usefulness of further research aimed at identifying specific outcomes of arts programs for at-risk, justice-involved, and traumatized youth. Such research could also help isolate the characteristics of effective programs. This knowledge could both inform program design, and help to justify spending on such programs in the future.

• The even playing field that is the Internet might be about to tilt in the favor of the powerful, in this case AT&T, Verizon, Comcast, and the like. Net neutrality is in the hands of the DC Circuit Court.
• The National Initiative on Arts & the Military has released a new advocacy white paper on arts and health in the military context, just as the NEA has announced that it will expand its Creative Arts Therapy Program through a new three-month pilot at the Department of Defense’s Fort Belvoir Community Hospital.

MUSICAL CHAIRS

• Ralph Remington is stepping down as the NEA’s Theater/Musical Theater Director to become the western regional director and assistant executive director at Actors Equity Association. He had been at the NEA since 2010.
• Los Angeles has a new mayor, and will soon have a new head of cultural affairs. Olga Garay-English, who served as Executive Director of the city’s Department of Cultural Affairs since 2007, announced she is stepping down January 4.
• Kenneth Foster, former Executive Director of the Yerba Buena Center for Arts, has kicked off his tenure leading the new Arts Leadership Program at the University of Southern California and offers some words of wisdom on how funders can best serve the performing community, and why  “best practices” aren’t all they’re cracked up to be.
• Continuing a string of recent layoffs of classical-music radio staff, Houston’s KUHA has cleaned house. The station claims that the move will actually lead to more coverage of local arts groups.

ALL ABOUT THE BENJAMINS

• Consider arts crowdfunding thoroughly kickstarted. Crowdfunding raised more than half a billion dollars for the performing and recording arts last year, almost 20% of the total money raised for all purposes through crowdfunding platforms, according to industry research. Lucy Bernholz is interested in investigating the small but increasing role U.S. foundations seem to be playing in driving this trend.
• Risë Wilson, the new Director of Philanthropy at the Robert Rauschenberg Foundation, makes the case – and offers a model – for arts grants as risk capital in an interview about the Foundation’s SEED grant program.
• Like many other downtowns, Philly’s is booming these days. But residential developer Carl Dranoff attributes the revitalization of the South Broad Street area to the Avenue of the Arts project, and insists that “anyone who says it would have happened anyway has a very short memory.”

IN THE FIELD

• In his coverage of last month’s 2013 Future of Music Summit for the Chicago Tribune, Greg Kot describes a frustrated yet resolved music industry, “Music is generating a ridiculous amount of money, none of it flowing to the people who create it.” Check out the write-ups from day one and day two.
• Nina Simon responds to the backlash that her novel programming at the Santa Cruz Museum of Art & History has generated in recent months locally and, to a lesser extent, nationally. The contention is that encouraging active participation so strongly erodes the traditional museum environment of quiet contemplation, distracting the MAH from its historical charge. Simon argues that the new approach allows for both kinds of experiences, while “balancing priorities, embracing creative tension, including diverse voices, and staying true to our mission.”

BIG IDEAS

• The ambitious Sustain Arts project aims to bring the wonders of Big Data to the cultural sector over the next three years, ultimately strengthening the nation’s cultural infrastructure. The first wave of work is happening now in the San Francisco and Detroit regions; Marc Vogl, Bay Area Field Director of the initiative, explains what he’s up to and how Bay Area folks can get involved.
• New Bonfils Stanton Foundation president Gary Steuer weighs in on the “is ‘innovation’ a nefarious buzz-word” debate (which is really the ongoing argument over how funders find the sweet spot of nurturing, not hindering, their grantees) and provides other thoughtful comments on the recent National Innovation Summit for Arts + Culture. (All 27 talks from the Summit, by the way, are now available online.)
• Google has launched Helpouts, a service that provides live on-demand chatting with experts in fields ranging from the arts to cooking and electronics. Udi Manber, VP of engineering, believes Helpouts will offer users a more “precise” mode of online learning.

RESEARCH CORNER

• WolfBrown is out with a multi-pronged report on how to engage college students in the performing arts. It includes case studies of best practices and a survey of student attitudes toward the performing arts across seven different schools.
• The Wallace Foundation has released new research on the challenges of after-school arts programs in low-income urban neighborhoods. The study draws on hundreds of interviews with young people, their families, program leaders and others to provide some answers, including ten principles for developing effective programming.
• More evidence that art therapy helps patients with Alzheimer’s.
• Elizabeth Merritt reviews a new report from European consultancy Arup on Museums in a Digital Age.
• The U.S. may be out of UNESCO, but the work continues: the international cultural agency and the United Nations Development Program have just released a Special Edition of the United Nations Creative Economy Report concluding that world trade of creative goods and services more than doubled from 2002 to 2011, to $624 billion. Unlike the 2008 and 2010 editions, many of the case studies and recommendations this time around focus on the role of culture in sustainable development at the local level, especially in poorer countries.
• So many charts, so little time! The Foundation Center has launched the eminently clickable Foundation Stats, where you can find “the answer to almost every basic statistical question about the collective work of U.S. Foundations.” Emphasis on the “basic” here, but as an added bonus the data is open and free. Meanwhile, A new report from the Foundation Center, Media Impact Funders, and the John S. and James L. Knight Foundation shows that foundations are stepping up in a big way to support traditional media organizations struggling to adjust to the digital age.
• As cultural asset mapping projects continue to gain popularity, this quick overview of where to get spatial data, and what you can do with it, is particularly timely. And speaking of cultural asset mapping, Philadelphia’s massive CultureBlocks initiative is barely six months out of the gate and there is already an academic paper on it.

Learning about programs like this, I had a hunch that partnerships between arts organizations and health organizations will be the next big thing for both groups. I thought with some research I would learn that the number of partnerships between an individual health organization and an individual arts organization has grown in the last five to ten years, and to an extent, that’s true. But some of the best, and even the fastest-growing, programs for the arts in healthcare have been around for decades. The commonality between most of these very robust programs, old and new, is they are not one partnership – they are many partnerships. Programs for the arts in healthcare appear to thrive when they are created and supported by a network of groups, each contributing their own specialty.

Background

I present as informed speculation the idea that programs for the arts in healthcare work best as networks, and suggest it as an area for further exploration. My analysis is based on a subjective impression of which programs are thriving, as demonstrated by the number of patients an organization has served or visitors to an organization’s public galleries, and by an organization’s reputation within the arts or the healthcare communities. Several of these programs have received accolades or positive appraisal from external organizations. For example, CosaCosa’s Healing Art Project has been featured in Designing the World’s Best Children’s Hospitals, a publication of the National Association of Children’s Hospitals, and both NYU and Audience Focus, Inc. have conducted evaluations of New York MoMA’s Meet Me at MoMA that demonstrate the program’s effectiveness.

As the number of arts and healthcare partnerships increases, so does the number of ways the arts and healthcare interact, including therapeutic initiatives, increasing accessibility to the arts (for people whose disabilities may be a barrier), and decreasing the stigma of a disease. The Global Alliance for Arts & Health (formerly the Society for Arts in Healthcare) defines five focus areas for arts and health: patient care, healing environments, caring for caregivers, community well-being, and education. While all of these are valuable, the programs discussed here primarily relate to the first two categories (patient care and healing environments), although many of them may have other benefits.

Art therapy as a field of study originated in the late nineteenth century, as psychologists began to study the connections between art and mental and emotional wellbeing. As early as the 1930’s, psychologists used art in “milieu therapy,” encouraging patients to enjoy and create art as a part of healthy self-expression. More recently, the practice expanded from mental health to physical health. Music therapy as a discipline has followed a similar trajectory, emerging between the First and Second World Wars and first used for war veterans. These fields provide a substantial foundation for programs that combine arts and healthcare, and many healthcare organizations hire art and music therapists directly or through partnerships.

Musicians Care by Sherman Hospital on Flickr

Some of the earliest programs uniting art and healthcare were simple introductions of visual art into healthcare spaces. The British organization Paintings in Hospitals was founded in 1959 by a hospital employee who saw the positive effect that bringing the visual arts into a healthcare environment had on patients’ health and wellbeing. This type of program is still popular today, and now, many art-in-hospitals programs have blossomed into extensive networks of artists, art organizations, and hospitals. National networks such as Paintings in Hospitals and Scotland’s Art in Healthcare are thriving, and many other programs exist on a smaller scale, such as Oakwood Arts for the Spirit in Michigan. These early programs focused on improving the healthcare environment rather than giving patients opportunities to create art themselves. In the next few decades, more participatory arts and healthcare programs were created in a variety of disciplines, such as Dance Exchange’s Metlife Foundation Healthy Living Initiative program, founded in 1978.

Beginning in the 1990s, arts and healthcare partnerships have become increasingly common. Notable organizations include Dance for PD, a partnership between the Mark Morris Dance Group and the Brooklyn Parkinsons Group which has spread to over 100 communities, and Concerts in Care, which brings live music to residential care facilities across Canada. Over several decades, the concept of using the arts in healthcare has gained broad currency, as evidenced by numerous articles in mainstream medical journals and popular science periodicals (for example, this study showing that music can ease chronic pain and depression). It has also captured the attention of national policymakers.

The principle of network effects applies here; the more people who participate in a network, the more benefit users get from it. In the case of arts and healthcare partnerships it isn’t the number of people participating that makes the difference, but the number of organizations, and the people are still the ones benefiting. However, there is still a parallel. The more points of access there are for the users, with multiple healthcare organizations and multiple arts organizations participating, the more likely users are to find the program in the first place and find a part of the program that addresses their needs. Presumably, the network also creates opportunities for networking in the sense of making professional contacts, and new collaborations arising out of existing partnerships. The main drawback of having a network is that more people contributing ideas also means a more complex and often less efficient system of implementing them. For networks of organizational partnerships, having clarity and consensus around the group goals for working together as a whole can help to mitigate this drawback.

The Power of Networks

In our highly networked world, partnerships between three or more players have a lot going for them. A number of arts in healthcare programs consider their network of partnerships fundamental to what they do. For example, Shands Arts in Medicine, the hospital described in the introduction, says on its website, “An essential component of [our] mission is to create collaborations with other hospital departments, community arts organizations and hospitals around the world. These collaborations spark projects that move the message of art and wellness to a broader audience.”

A Network of Skills and Specialties

While many thriving arts in healthcare programs are organized as partnerships and networks, there is no set template that works best. In many cases, either a dedicated organization facilitates programming by reaching out to both health and arts organizations, or a healthcare organization brings in art by partnering with several different arts groups in their community. It is less common for one arts organization to partner with several health groups, but this approach seems just as effective.

Networks of program offerings, built on combining the strengths of multiple partners, allow arts organizations to leverage a set of related skills and expertise in multiple ways to target a variety of healthcare needs. For example, through a variety of partnerships the Smith Center for Healing and the Arts in Washington, DC offers different programs for cancer patients and survivors, military members and veterans, the general public, and health centers. This array of offerings and of recipients would likely be much smaller if the Smith Center limited itself to partnering with one hospital. Since the healthcare landscape is so multifaceted, the corresponding partnerships with the arts must also extend to many specialties.

Moreover, a network of partnerships can help an arts organization reach one particular audience more fully. For example, the New York Museum of Modern Art’s Meet Me at MoMA offers programs at the museum and on-site for organizations that work with individuals with Alzheimer’s. It also has a monthly interactive gallery program for individuals with Alzheimer’s and their caregivers to come independently. This combination of services, made possible by the museum’s connections to a variety of health care organizations, enables MoMA’s programming to reach people with Alzheimer’s in a variety of stages, at a variety of levels of independence, and in a variety of family and professional care situations.

Healing in the Community

The diversity networks provide helps organizations capture the best opportunities their community has to offer. For example, Snow City Arts in Chicago offers art classes to hospitalized children. While their teaching artist-in-residence program is the core of their offerings, the organization proclaims, “By working side-by-side with local arts organizations, performance groups, music ensembles, and prominent universities, we help ensure our children are learning from Chicago’s brightest artistic minds.” The program works with hospitals to bring this instruction to children who regularly miss school because of their health needs.

Artist Hein at Work by Virginia Lockett on Flickr

The advantage of networks goes in the other direction, too, helping arts and healing organizations play a more connected, more visible role in the community. In the case of COSACOSA’s Healing Art Project, this connection is intentional: “The Healing Art Project reaffirms the time-honored role of artists in sustaining the health of a community.” The project brings together children and youth of a variety of health experiences – healthy kids, kids with disabilities, and kids living in pediatric healthcare centers – to create collaborative artwork. The artwork is displayed in pediatric healthcare centers, and in some cases is an integral part of the design of these centers. Thus, the program is community-oriented both in the creation and the use of the art.

The visibility advantages of being in a network can also help a program expand and connect to the community of people it serves. For example, Dance for PD, which now has branches from Pasadena to Philadelphia to Pune, India, has been given the opportunity to participate in a number of high-profile events, such as the Parkinson’s Unity Walk in New York, which draws around 10,000 attendees.

Looking Ahead

The funding climate for this type of partnership appears to be growing friendlier as art therapy becomes more mainstream. There are several foundations and grant programs with a specific interest in bringing the arts into healthcare, such as the grants made by the Global Alliance for Arts & Health and the Metlife Foundation’s Healthy Aging grant program. Networks of partnerships have the opportunity to maximize their ability to seek support, since different funding avenues may be available to organizations on different sides of the partnership. However, networks also increase the number of variables involved, and any innovative program, especially one that is tangential to an organization’s mission or primary activities, may turn out to be a hard sell to grantmakers and donors if it appears on the surface to be riskier than traditional offerings. Organizations looking to enter partnerships should bear this in mind.

Arts organizations looking to get involved in an arts and healthcare partnership would do well to research the health and arts landscape in their area, to see whether there is an existing network they can join, and to learn what needs are not yet being met. There are a number of great resources put together by established organizations (see below); another benefit of networks is that they encourage a culture of freely sharing information. However, most of the literature out there on partnerships between the arts and healthcare is focused on providing practical guidance on what seems to work; little has been written on why it works. I am hoping to start the latter conversation with this piece, but the topic deserves more thorough attention than I am able to give it here. I envision studies that involve interviewing the leadership and staff of dozens of organizations across the country, including stand-alone projects, one-on-one partnerships, and networks. Such an effort would hopefully demonstrate whether networks are one successful model that has a lot of advantages and happens to be very popular right now, or whether they are truly the best model. The resulting lessons would equip many more organizations to unite healthcare and the arts.

Resources

• The University of Florida and UF&Shands Arts In Medicine have an online toolkit called AIM Together for organizations interested in the intersection of arts in medicine.
• The Global Alliance for Arts & Health has a basic toolkit for organizations which was created for a presentation at an event but has useful and in-depth information, and provides more resources in the members-only section of their website.
• The University of Florida also has an online toolkit specific to Arts in Healthcare for Rural Communities.
• New York’s Museum of Modern Art’s Meet Me At MoMA program provides museum programs to Alzheimer’s patients and their caregivers. MoMA provides guides for museums, care organizations, and families on how to start or engage with this type of program.
• The National Endowment for the Arts has a page on the arts in healthcare on their website.

ART AND THE GOVERNMENT

• Never afraid to speak his mind, Rocco Landesman shares a few more words about his experience as NEA head, this time with the Public Theater’s Public Forum Podcast.

MUSICAL CHAIRS

• Ken Corbin, a 27-year IRS veteran, will take over as acting head of the IRS’s exempt organizations division amid the recent controversies at the agency.

ALL ABOUT THE BENJAMINS

• The Knight and Gates Foundations are now teaming up to fund the Media Impact Project, which will develop tools for measuring the impact of online media.
• Controversy over public-private partnerships is as hot as ever, this time appearing in the provision of public space. The Atlantic discusses the equity, efficiency, and quantity implications.
• Former hedge funder John Arnold and wife Laura have opened a controversial, highly data-driven foundation in Houston with promising results already in the areas of hunger and criminal justice, Philanthropy News Digest reports.
• Andy Warhol’s eponymous foundation is struggling with a serious institutional crisis in which leaders created perverse incentives for their art authenticators and salespeople, according to Richard Dorment’s crackerjack reporting for the New York Review of Books.
• A new fund to help young London theater producers is making a big splash, the Guardian reports.

IN THE FIELD

• Ever wonder how arts therapy works for victims of trauma? ARTSblog has a fantastic pithy explanation in their article on the use of art therapy with members of America’s armed forces. More on arts and the military from Americans for the Arts can be found here.
• In an evolving sharing culture, copyright has become a major challenge for museums attempting to make social connections with audiences. Carolina A. Miranda explains how this works today in a detailed article for ARTnews.
• Curation is an evolving artform. Erin Roos-Brown, a Program Manager for the Creative Campus Initiative at Wesleyan University’s Center for the Arts, argues in her article on the topic that curation used to require an insulated academic and is now quickly becoming a social, entrepreneurial role.
• A fascinating New York Times report on using art to launder money explains how the culture around buying famous artworks makes it one of the best ways to hide your tracks–if you’re a criminal.
• Vancouver theater producer Caleb McMullen is boldly offering a guarantee on the price of the ticket for his company’s production of Proof. The Globe and Mail lays out the whys, hows, and whos.
• A judge has allowed composer Nathan Currier’s lawsuit against the Brooklyn Philharmonic to proceed, thus extending the saga of the most bizarre concert experience ever experienced into its 10th year. -IDM

CONFERENCES AND TALKS

• The Australian breaks down the takeaways from the Aspen Institute’s meeting on the future of museums in a new brief summary.

BIG IDEAS

• Createquity’s Talia Gibas has a brief summary at ARTSBlog covering how to get into the weeds of what the STEM to STEAM movement is really trying to accomplish.
• Fast Company’s always enterprising online outfit FastCoLabs has been experimenting with a new part-long form, part-live blog format that has (thus far) had a remarkably positive impact on their analytics.
• The Atlantic’s Emily Badger challenges the virtues of the advancing personalization of Google Maps in her piece The Potential Problem With Personalized Google Maps. Her argument speaks to the potential for idiosyncratic exposure to reduce quality of life.
• Students all over the country are being told to purse their passion, but what if they don’t have one? Economists try to answer this question in this piece by Planet Money’s Chana-Joffey Walt.
• Artful improvisation is a useful tool for managers. Keith Sawyer explains what leaders should glean from jazz improv in particular in his review of Yes to the Mess by Frank J. Barrett.
• Congratulations to the lucky dozen who made the Barry’s Blog Dinner-vention guest list! The event will be held September 6 at the Djerassi Resident Artist Program, and will be recorded for posterity. -IDM

RESEARCH CORNER

• Arts Education Partnership has released Preparing Students for the Next America, a new report in which they detail how arts education improves work readiness and enriches the lives of community members.
• D5, a coalition of funders, community activists, and thought leaders, have a new report on diversity in the philanthropy sector, how to improve it, and why it matters.
• The Lilly Family School of Philanthropy at Indiana University has a new report out on the use of program-related investments (PRIs) as a philanthropic tool over the past twenty years.
• Foundations still have a long way to go on the road to transparency, according to a new report from the Center for Effective Philanthropy, and the President and CEO of the James Irvine Foundation adds his thoughts on how to make transparency a priority in the boardroom.
• A new model of concert attendance published in the International Journal of Research in Marketing provides evidence for a number of counter-intuitive findings, including an indifference point in terms of attendance between contemporary and less-known romantic-period works.