Abstract
BackgroundAlthough there is strong advocacy for uptake of both the arts and creative activities as determinants of individual health conditions, studies evaluating causal influence of attendance at cultural events on population health using individual population data on health are scarce. If available, results are often only of an associative nature. In this light, this study investigated causative impact of attendance at cultural events on self-reported and physical health in the Polish population.MethodsFour recent waves (2009, 2011, 2013 and 2015) of the biennial longitudinal Polish household panel study, Social Diagnosis, were analysed. The data, representative for the Polish population aged over 16, with respect to age, gender, classes of place of residence and NUTS 2 regions, were collected from self-report questionnaires. Causative influence of cultural attendance on population health was established using longitudinal population representative data. To account for unobserved heterogeneity of individuals and to mitigate issues caused by omitted variables, a panel data model with a fixed effects estimator was applied. The endogeneity problem (those who enjoy good health are more likely to participate in cultural activities more frequently) was circumvented by application of instrumental variables.ResultsResults confirmed positive association between cultural attendance and self-reported health. However, in contrast to the often suggested positive causative relationship, such a link was not confirmed by the study. Additionally, no evidence was found to corroborate a positive impact from cultural attendance on physical health. Both findings were substantiated by augmentation in the longitudinal perspective and causal link.ConclusionsWe showed the relation between attendance at cultural events and self-reported health could only be confirmed as associational. Therefore, this study provided little justification to encourage use of passive cultural participation as a measure of health promotion (improvement). Our study did not confirm any identifiable benefit to physical health from passive participation in culture. Future research should investigate the causative influence of active participation in creative activities on health outcomes as, in contrast to passive attendance, it may be influential.
Highlights
There is strong advocacy for uptake of both the arts and creative activities as determinants of individual health conditions, studies evaluating causal influence of attendance at cultural events on population health using individual population data on health are scarce
Where subscript i is for the individual, t is for time, Xit is a vector of control variables, CAit is a cultural attendance indicator, ηit is a disturbance term; healthit is either selfreported health (SRH) or patient health questionnaires (PHQ-15) as two independent models are estimated; β0 represents a constant, β1 shows the individual level characteristics on health outcome and γ1 shows the effect of cultural attendance on health outcome
As mentioned previously, standard OLS estimates can yield unbiased results only when the hypothesis of lack of conditional heteroscedasticity is not rejected for the relationship between cultural participation and a health measure, i.e., having controlled for the set of covariates mentioned in section 2, respondents were identical
Summary
There is strong advocacy for uptake of both the arts and creative activities as determinants of individual health conditions, studies evaluating causal influence of attendance at cultural events on population health using individual population data on health are scarce. The commonly reported, positive relationship between the two (as in the recently published in the BMC Public Health journal paper of Hansen et al [3]) may result from the omission of unobserved individual level factors from cross-sectional (often linear or logit/ probit regression) analysis or – more importantly – the phenomenon of reverse causality. Both these issues introduce endogeneity, rendering results implausible, since they do not accommodate the problem and, disallow valid conclusion. In the presence of endogeneity, any positive influence from cultural attendance on individual health status may appear causal but ensue from the simple fact that healthier people are more likely to attend cultural events
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
