Engagement in cultural activities and cause-specific mortality: Prospective cohort study

Abstract

Objective To determine the relation between engagement in cultural activities and main causes of mortality among full-time employees. Methods Finnish industrial employees ( N = 7922) completed a questionnaire about engagement in cultural activities (arts and culture, activities in associations, societal action, reading literature, and studying) in 1986 and were followed-up for mortality rates until 1986–2004. Results High engagement in cultural activities was independently associated with decreased all-cause mortality (hazard ratio 0.71, 95% CI 0.57–0.88) and external causes of death (hazard ratio 0.46, 95% CI 0.24–0.90) after adjustment for socio-demographic factors, socio-economic status, work stress, social characteristics, diabetes, and hypertension. High engagement was also associated with a reduced risk of cardiovascular mortality after controlling for socio-demographic factors and stress (hazard ratio 0.68, 95% CI 0.49–0.95). The associations with all-cause mortality and deaths from external causes remained after further adjustment for behavioral risk factors. Of the forms of engagement, solitary cultural activities were related to all-cause mortality while socially shared cultural activities were more closely linked to external mortality. Conclusion Better overall survival of culturally engaged employees is largely attributable to their lower risk of death from external causes.