Abstract
Participation in cultural activities may protect against cause-specific mortality; however, there is limited knowledge regarding this association. The present study examines the association between participation in a range of receptive and creative cultural activities and risk of cardiovascular disease- and cancer-related mortality. We also examined whether participation in such activities and influence by gender have on this association. We followed 35,902 participants of the Nord-Trøndelag Health Study (HUNT3) of Cardiovascular-Disease and Cancer Mortality from 2006–08 to 2016. Cox proportional-hazards regression was used to estimate the risk of specific mortality based on baseline cultural participation. During the eight-year follow-up, there were 563 cardiovascular-disease- and 752 cancer-related deaths among the sample (292,416 person years). Risk of cardiovascular-disease mortality was higher among non-participants in associations/club meetings (22%) and outdoor activities (23%), respectively, as well as non-attendees of art exhibitions (28%). People who engaged in music, singing, and theatre had a 27% reduced risk of cancer-related mortality when compared to non-participants. Among women, participating in associations/club meetings reduced the risk of cardiovascular-disease mortality by 36%. Men who participated in music, singing, and theatre had a 33% reduced risk of cancer mortality. Overall, a reduced risk of cardiovascular-disease mortality was associated with engaging in creative activities on weekly basis to less than twice per week. For both genders, participating in creative activities less than once a week reduced cardiovascular-disease mortality risk by 40% and 33%, respectively. For the overall sample, participating > 2 times per week in combined receptive and creative activities reduced cancer-related mortality by 29%. Participating frequently in both receptive and creative activities cultural activities was associated with lower risks of CVD and cancer-related mortality. Our data suggest that, to counteract the public health burden of cardiovascular disease- and cancer mortality, policies and initiatives to increase citizens’ participation in cultural activities should be considered.
Highlights
Non-communicable diseases (NCDs) contribute to approximately 40.5 million (71%) of all deaths globally [1], and to almost half of the disease burden in low- and middle- income countries [2]
Several creative activities lowered the risk of Cardiovascular diseases (CVDs)-related mortality; association or club meetings/activities reduced CVD-related mortality by 22%, and outdoor activities produced a reduction of 23%
While gender-specific analyses indicated similar trends for both genders in terms of risk reduction, statistical significance was found only among men who participated in creative activities every other week or less than once per week (40%; hazard ratios (HRs): 0.60; 99% confidence intervals (CIs): 0.39–0.93)
Summary
Non-communicable diseases (NCDs) contribute to approximately 40.5 million (71%) of all deaths globally [1], and to almost half of the disease burden in low- and middle- income countries [2]. Cardiovascular diseases (CVDs) and cancer are the leading causes of NCD-related deaths, accounting for 44% and 22%, respectively [1]. Interest in the association between participation in cultural activities and health outcomes has increased in recent years. Cultural activities include everyday events performed for enjoyment, entertainment, recreation, or to contribute to society [4]. Such activities can provide opportunities for social and physical engagement [5] and, may impact the population burden of major chronic diseases such as CVDs and cancer. There has been a lack of research regarding the effect cultural activities can have on population health and longevity
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