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.

“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.

“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.

Image: “Gogbot,” Installation at the Gogbot Media Art Festival in Enschede. By Flickr user Ineke

Happy fall television premiere week! The Fractured Atlas and Createquity teams are back with a third installment of the Createquity podcast, with a new series on television and our wellbeing.

Public conversations about television and the arts have tended to pit one against the other. If television wasn’t saving the arts by connecting them to a wide and public audience, it was killing them by advancing popular culture over ‘serious’ fare. While some celebrated the arts on television as encouraging live attendance, others worried it discouraged such attendance by serving as a substitute. From a public health standpoint, we can also be concerned by research associating heavy television-watching with conditions like obesity and early death — would we be both healthier and happier attending and participating in “traditional” art forms rather than staying home in front of the television?

Even in the age of digital communications — of broadcast and cable and wifi, oh my — we often miss the larger conversation about the box: television is culture. It conveys visual and narrative human expression, it employs and animates artists, reaches a massive audience every day, and it can even be a tool for social change. And — spoiler alert— people really enjoy watching television…a lot of television.

So what are the implications of “television as culture?” And how do they frame and inform the trajectory of artists, arts organizations, audiences, and all the others supporting and advancing artistic work? These episodes will explore the scope, scale, sources, and substance of contemporary television; consider its social, civic, and health effects; and discover it as a medium where artists and audiences find each other and even as a vehicle for artist and youth empowerment.

This follows our previous podcast: The Cost of Being Creative.

Episode 1:

Guest Louise Geraghty (bio below) provides a quick rundown of the research Createquity has done on this topic. Hear about the impact television may have on our personal health and happiness. Is heavy TV watching in the same category as soda/junk food when it comes to possibly needing some regulation?

(Click here to listen to the episode if you’re reading this via email.)

Episode 2:

Guest Qui Nguyen (bio below) talks to us about his experience in both the theatre and television worlds. Hear about how he feels the two industries interact and impact the health of the overall arts industry. Can television be a stable and even desirable form of employment for creative artists?

(Click here to listen to the episode if you’re reading this via email.)

Episode 3:

Guest Rebecca Yenawine (bio below) explains how she uses television media to engage low-socioeconomic-status youth in the Baltimore area. Hear about the impact she feels media has on the health of our communities.

(Click here to listen to the episode if you’re reading this via email.)

The Host

E. Andrew Taylor, Host
Andrew Taylor thinks (a bit too much) about organizational structure, strategy, and management practice in the nonprofit arts. An Associate Professor of Arts Management at American University in Washington, DC, he shares what he learns at “The Artful Manager.”

• Television is America’s national pastime. Adults spend an average of nearly three hours in front of the tube daily, outpacing the next most common leisure-time activity by a factor of four.
• There is surprisingly robust evidence suggesting TV watching may contribute to poor physical and cognitive health; when it comes to happiness and life satisfaction, however, the verdict is still out.
• Are people consciously choosing TV over other activities? There’s not a lot of evidence one way or another, but it doesn’t seem like most adults who watch large amounts of TV are doing so reluctantly.
• The arts are not the (obvious) antidote. People who attend exhibits and performances are no more likely to report being satisfied with their lives than those who don’t.
• We value adults’ freedom to make their own choices, so will need to see clearer evidence for an opportunity to improve wellbeing before committing to a case for change.

* * *

TV Slave – photo by flickr user Manuele Carra

In 2014, First Lady Michelle Obama broke the internet with “Turnip for What,” a vine promo for her Let’s Move! campaign. She’s appeared on the Biggest Loser. She has her own viral dance sensation–the #GimmeFive, performed to Mark Ronson’s Uptown Funk. (You know it, right?) And she’s encouraging Americans to drink more water through fun social media stunts that appeal to our egos (hello, John Legend) and a line of chic accessories from the likes of J. Crew and Rebecca Minkoff. (Not to be outdone, POTUS and VPOTUS have been known to run around the White House and drink water, too.)

No, she’s not trying to be the next pop star. (Though we would totally buy her record.) She has a mission, and that’s to stem the obesity epidemic in the United States. The situation is, by all accounts, dire: 17% of children and almost 35% of adults are currently considered obese, and those numbers are worse among individuals with lower incomes and less education (so-called “low-SES” populations). Almost one in eleven adults has type 2 diabetes, and many more have prediabetes. Obesity is bad for our wallet: the US spends an estimated $147 billion in obesity-related healthcare expenses annually. It’s bad for the environment, too: cars are burning nearly a billion more gallons of gasoline a year than if passengers weighed what they did in 1960.

FLOTUS is but one character in the ongoing obesity saga. The Food and Drug Administration appeared in 2014 with new rules requiring establishments to post the calorie content of food on their menus. It went even further in 2015, when it required front-of-package labeling. Former Mayor Mike Bloomberg led a movement in New York to reduce soda consumption by limiting the sale of jumbo sugary drinks, which re-ignited the debate around the so-called sin tax. For more than a decade, public schools have battled youth junk food consumption with all sorts of methods: removing vending machines, imposing strict guidelines for school nutrition, and the Hail Mary move of banning birthday cupcakes.

Let’s Move Day – photo by flickr user Phil Roeder

The junk food hullabaloo raises interesting questions about choice, and whether individuals can or do make good choices for themselves. Here, the work of leading psychologists, economists and neuroscientists provides useful context: it is now widely accepted that most people make sense of the world by simplifying it, and the ways our brains are wired to simplify things can cause us to make judgments that are contrary to our best interests. There are a few reasons we might tend towards the simplify trap: hyperbolic discounting, which is our tendency to value immediate pleasure (or pain) over future consequences; loss aversion, or the fact that we dislike losing more than we like winning, which can make us risk-averse; or our tendency to focus only on what we know and what’s familiar. The combination of these factors makes low-risk, familiar propositions offering immediate satisfaction very hard to turn down. If we grew up with juice boxes and oreos as a school snack, and the closest grocer is a corner bodega stocked with chips and soda, and, well, sugar and salt and fat are so good, then of course we’d reach for cookies over carrots.

At this point, dear reader, you might be wondering why we have spent the first four paragraphs of an article about television and the arts talking about obesity. Well, as it turns out, TV (probably) makes you fat too.

TUNE IN, DROP OUT

Jamie K. is a 36-year-old from Fort Wayne, IN. She has a GED, and is unemployed. She likes to make jewelry and work on home improvement projects in her free time, which isn’t much, since she has three teenagers. She doesn’t go to arts events, because she doesn’t “have friends that are cultured, and it’s hard to go to things that [she] would find interesting by [herself].” She actively watches 10 hours of TV a day. Sonja B., a 57-year-old from Chicago, IL who is also unemployed, doesn’t attend arts events because they are usually in the evening, and she “wouldn’t want to go by [herself.]” She works out, and watches an average of 15 hours of TV, daily. Shantell T. is a 33-year-old administrative assistant from Washington DC. She watches 12 hours of TV on a typical day, and doesn’t consider herself to be a very “artsy” person.

In May of 2015, Createquity published Why Don’t They Come?, the first of many deep dives into the question of disparities of access to the benefits of the arts. The article looked closely at arts participation patterns among poor and less educated individuals, and considered obstacles to attendance including logistical reasons, such as cost and access to transportation or childcare, as well as other factors like feeling excluded and not having a friend to take along. (It is worth noting that many of the logistical reasons cited as obstacles to arts attendance are barriers to healthy eating as well. Cost and access in particular are blamed with the widening food gap between rich and poor.)

What we discovered in the course of our research surprised us. While the aforementioned obstacles were certainly barriers, a lack of explicit interest was far and away the dominant factor keeping low-SES populations away from arts events.

That’s What You Think – photo by flickr user Robert Couse-Baker

Of all these statistics, one in particular stood out to us. Virtually alone among the activities we studied, television attracted more participation from poor and less educated adults rather than less. And on top of that, our analysis of GSS data suggested that even within low-SES groups, adults who don’t attend arts events watch even more TV than those who do. It seems possible that, whatever sustenance people are seeking from live arts attendance, the folks who don’t go are getting it (at least in part) from the small screen.

Given the tendency to be distrustful of television, we were curious: are people going to be worse off on average watching TV instead of engaging in other, potentially more enriching, activities? Should this be an area of concern for our work here at Createquity? Is there an opportunity here to improve wellbeing through the arts?

SMALL SCREEN, BIG CONSEQUENCES

“It’s kind of a waste,” admits one of our interviewees. “I’m not really doing anything when I’m sitting and watching TV.”

As it turns out, sitting and not really doing anything when you’re watching TV doesn’t bode well for your physical wellbeing. There is compelling evidence that increased hours spent watching television is associated with obesity, in part because of the sedentary lifestyle it promotes by crowding out time that could be spent on exercise. SA Bowman looked at data from the USDA’s Continuing Survey of Food Intakes by Individuals (CSFII), and found that men and women across demographic groups, including race, income, and educational status, were more likely to be overweight as their average hours of television viewing per day increased. Women who watched more than two hours of TV per day were 41.4% more likely to be obese than women who watch less than one hour a day. For men, that figure was 90.29%. And it’s not just sitting that’s the problem: even among healthy Australian adults who exercise at least 2.5 hours per week, watching TV is straight up bad for the waistline, with more hours watching TV per day was associated with increased blood pressure, waistline, and cholesterol levels. (Note 2)

Research has indicated that TV affects physical health in other ways as well⏤even to the point of shortening your lifespan. One team’s analysis of the 2008 General Social Survey-National Death Index dataset reveals that each hour of TV watched per day is associated with a 4% increase in mortality risk, amounting to an overall reduction of 1.2 years in total life expectancy due to television viewing in the US. A 2010 paper found an increased likelihood of all causes of mortality with more than 2 hours of television watched per day. Yet a third paper finds that, compounding psychological factors aside, TV may lend itself to an increased likelihood of smoking (and we all know where the shoe drops there).

Watching Zoolander – photo by flickr user Vincent Diamante

Are you doing some math in your head? (Your Favorite TV Shows x Total Viewing Hours) / Hours Watched Daily = Life Expectancy Reduction and Loss of Cognition? We did some math too, because there’s more to the brain than cognition. We ran a regression analysis on television and wellbeing using data from the 2012 General Social Survey. After controlling for variables including health, income level, education level, gender, age, and the frequency with which people interact with their friends and relatives, we found that increased hours of watching television is negatively associated with overall life satisfaction for people in the top three income quartiles, albeit only by a little bit. (Interestingly, we did not an association between television viewing and happiness for people with household incomes less than $25,000 per year). With a small sample and effect size and no ability to infer the direction of causality, we have to be careful not to push these results too far. Still, this descriptive analysis doesn’t do the case for TV any favors.

Others have investigated the relationship between watching a lot of television and one’s overall satisfaction with life (sometimes framed or referred to by scientists as subjective wellbeing). In their analysis of individual responses to the World Values Survey, which includes data from 80 countries, researchers Luigino Bruni and Luca Stanca found that television “crowds out” other, more social, activities–such as volunteering or spending time with friends and family–that are associated with higher life satisfaction. In the same study, they also suggest that increased hours spent watching television causes people to want higher incomes, which in turn creates unhappiness and low life satisfaction. According to Bruni and Stanca, TV is a part of a “relational treadmill” that induces people to measure their increase in happiness against that of their neighbors, instead of against their own experiences. Television, they argue, makes people want to consume more, inspired by both advertising and program content; unfortunately, by this metric, individuals will never achieve a real increase in happiness that corresponds to their increase in buying power. Some take issue with the way Bruni and Stanca classified countries in their methodology (see here), and at least one set of researchers note that when considering heterogeneity within countries, people who watch television report higher levels of wellbeing than people who do not watch any television at all. Still, we likely can all point to an example of being sucked into the “relational treadmill” of consumption thanks to TV.

TV and your brain: Turin street art – photo by flickr user mermaid

THE TWIST

You would think with all this talk of obesity, mortality, and dissatisfaction with life, people would reach for the off button. The fact that they don’t suggests they must be getting something out of it.

Could it just be that people who watch large amounts of TV lack self-control? That could explain some of these findings; for example, there is research that indicates unhappy people in general tend to watch more TV, suggesting that depression might be the culprit in some cases. But that doesn’t seem to be the whole story. There is an emerging body of research on television and addiction, but people are still trying to understand it, how many people are affected, and how it relates to other addictions that might be more disruptive to daily life. We have not found evidence tying television addiction to income level, even though people with lower incomes tend to watch more TV.

TV Man in the Autumn – photo by flickr user sualk61

Then there’s the fact that, for many, watching television is a meaningful social experience. Kawanda C. lives in New Orleans, where she doesn’t have a car. She’s 31 and didn’t finish high school. She works as a cashier, and spends a lot of time getting to and from work. She watches on average eight hours of TV a day, and loves to watch with her kids. Sonja B. also opts for companionship when taking in her favorite shows: “It’s always fun to watch TV with someone else because they might have a different perspective.” Indeed, in contrast to to Bruni and Stanca’s findings about television crowding out social activity, researcher Nele Simons’s interviews with TV watchers show that they socialize around the television they watch. She even suggests that people watching television at different times can create new opportunities for TV and socializing. In Simons’s telling, the classic mid-century meme of a traditional family unit gathered around to watch I Love Lucy or the Ed Sullivan Show continues, only today it’s football at your uncle’s place, or Game of Thrones at your corner dive bar.

Family watching television. Evert F. Baumgardner, ca. 1958 – from the National Archives and Records Administration.

It does seem that qualitative methodologies tend to paint a more positive picture of the effects of television. A set of interviews with Dutch adults aged 65-92 published last year explored the question of whether their television viewing habits are more often part of a selection strategy–that is, a conscious choice made to maximize wellbeing–or a compensation strategy, a choice that is made to fill time or otherwise compensate for some kind of loss or diminishment. While there were certainly examples of compensation strategies among their interviewees, the researchers more often found that people were watching TV with no regrets.

But the TV-is-good-for-you case is more than anecdotal; there’s a small but growing body of quantitative research that paints a more positive side to the medium as well. Recall that our aforementioned analysis of the General Social Survey found that among the lowest income quartile, which is also the segment that watches the most TV, more television is not associated with lower life satisfaction. One hypothesis to explain this comes from a paper by Bruno S. Frey et al. analyzing data from the European Social Survey. Frey et al. found that people with a lower opportunity cost of free time, like unemployed people or those with very fixed working hours, were less likely to report decreased life satisfaction as their TV hours increase, while the opposite was true of individuals with a high opportunity cost of their free time. If people with lower incomes tend to have a lower opportunity cost of their free time, this might explain why television at the bottom income quartile does not seem to harm life satisfaction.

While we haven’t encountered research showing positive effects of television content on adult viewers, there are some success stories for children and teens. In one study, researchers Kearney and Levine looked at the MTV franchise 16 and Pregnant–a series of reality TV shows including the Teen Mom sequels–and determined that the shows ultimately led to a 5.7% reduction in teen births in the 18 months following their introduction, which is about one third of the reduction in teen births during that period. In a follow-up, Kearney and Levine found that preschoolers who lived in areas where they could watch Sesame Street were 14% less likely to fall behind when they got to elementary school, and that this effect was much more pronounced for kids who grew up in areas with higher levels of economic disadvantage.

TV time – photo by flickr user Blake Danger Bentley

I WILL CHOOSE FREE WILL?

TV makes us fat. It dumbs us down. Too much TV makes us unhappy. Not enough TV makes us unhappy. TV makes us laugh. It keeps us informed. It keeps us from more social activities. It’s an opportunity for family time. It’s dangerous: for our feeling of self worth, for our capacity to understand right from wrong. At the end of the day, there’s plenty of evidence to suggest that TV is both good and bad for us, depending on who we are, how we define good and bad, and how we go about asking and answering the question.

To be sure, not all of this evidence is created equal. If we were to pit the “TV is good” and “TV is bad” hypotheses against each other in a contest of methodologies, bad would probably win out. But how bad is bad? What exactly is the threshold of evidence of harm that would warrant taking the position that TV requires an intervention?

Here, the case of junk food provides us with a useful comparison. The impact of junk food consumption on public health has generated enough concern among reasonably-minded policy wonks to motivate multiple attempts at intervention by the state. And yet even for junk food, that movement to change behaviors has not come without controversy. The FDA, under intense pressure from Congress (and the National Restaurant Association) was forced to delay nation-wide implementation of menu labeling requirements until after the upcoming Presidential elections. (NYC implemented these same rules in 2006, and it took a full two years for them to become reality.) This past November, NYC passed a law requiring restaurants to indicate highly salted dishes; it was challenged immediately. Bloomberg’s famous soda ban was struck down, suffering from a backlash from the very people it was intended to help. Richmond, CA took a different approach, introducing a soda tax rather than a size limit, but it, too, failed.

What’s more, many of these well-meaning attempts to regulate the health of Americans don’t seem to be working: menu labeling has not been shown to change eating habits (and at least one study suggests it leads to greater caloric intake.) Kids denied in-school vending machines often end up consuming extra junk food. One year after Berkeley, CA became the first city in the US to successfully pass a soda tax, a study of its effectiveness reveals that, as the price increase has been largely assumed by distributors, the intended effect on consumers is negligible.

The no free-will bus campaign – photo by flickr user Travis Morgan

While there are certainly aspects of the effect of TV on physical, cognitive and subjective wellbeing that are concerning and deserve further exploration, given how dicey it is to seek to intervene in adults’ choices, our instinct is to exercise caution. For us to move forward in pursuing a case for change with respect to TV, we would need to see clearer evidence for an opportunity to improve wellbeing.

For us, the question of wellbeing ultimately comes down to opportunity and choice. Our definition of a healthy arts ecosystem draws inspiration from the “capability approach,” a widely adopted philosophical framework developed by Amartya Sen and Martha Nussbaum that defines wellbeing in terms of freedoms. According to the capability approach, whether or not people take advantage of the opportunities they have, their capability to make decisions about how they pursue their lives is vital to wellbeing, and having the capability to achieve various states is more important than whether or not one chooses to exercise that capability.

Frances T. talks about the impact of TV on her life

It seems like a whole lot of people are making the choice to reach for the remote. For some, this undoubtedly isn’t the best choice they could make. For others, maybe it is. And it’s really hard for us, or anyone else, to tell the difference. Tempting as it might be to judge people who spend eight hours a day in front of the TV, many of us spend that much time or more each day in front of a different sort of small screen. We can only hope that everyone who does so is as enthusiastic about it as Frances T., who confidently declared when we asked her whether TV affects her wellbeing, “it is my own wellbeing to watch TV.”

Liked this article? Two things. First, we’ll be hosting a #CreatequityAsks Twitter chat to discuss the implications of this work on Wednesday, March 9 from 4-5pm Eastern time. Second, we’re conducting a reader poll to help us determine what we should investigate next. Please take 5 minutes to share your opinions! Thanks so much.