Abstract
SummaryObjectivesTo investigate the association of participation in arts and cultural activities with health behaviours and mental well-being in low-income populations in London.Study designCross-sectional, community-based observational study.MethodsData were taken from the cross-sectional baseline survey of the Well London cluster randomized trial, conducted during 2008 in 40 of the most deprived census lower super output areas in London (selected using the English Indices of Multiple Deprivation). Multiple imputation was used to account for missing data in the Well London survey. Descriptive statistics and regression analyses were used to examine the association between participation in arts and cultural activities and physical activity (meeting target of five sessions of at least 30 min of moderate-intensity physical activity per week), healthy eating (meeting target of at least five portions of fruit or vegetables per day) and mental well-being (Hope Scale score; feeling anxious or depressed).ResultsThis study found that levels of arts and cultural engagement in low-income groups in London are >75%, but this is well below the national average for England. Individuals who were more socially disadvantaged (unemployed, living in rented social housing, low educational attainment, low disposable income) were less likely to participate in arts or cultural activities. Arts participation was strongly associated with healthy eating, physical activity and positive mental well-being, with no evidence of confounding by socio-economic or sociodemographic factors. Neither positive mental well-being nor social capital appeared to mediate the relationship between arts participation and health behaviours.ConclusionThis study suggests that arts and cultural activities are independently associated with health behaviours and mental well-being. Further qualitative and prospective intervention studies are needed to elucidate the nature of the relationship between health behaviours, mental well-being and arts participation. If arts activities are to be recommended for health improvement, social inequalities in access to arts and cultural activities must be addressed in order to prevent further reinforcement of health inequalities.
Highlights
The use of arts and creative activity therapies in clinical settings, for a range of medical conditions related to both physical and mental health, is supported by the Department of Health for England.1e3 Such interventions can include visual arts, drama, music, movement-based arts and dance, and creative writing
Levels of arts and cultural engagement in low-income groups in London are high, with three-quarters of individuals participating in a creative activity or attending a cultural event at least once a year
This study found different sociodemographic patterns of arts participation in the Well London population compared with the national Taking Part survey; in both surveys, individuals who were more socially disadvantaged were much less likely to have participated
Summary
The use of arts and creative activity therapies in clinical settings, for a range of medical conditions related to both physical and mental health, is supported by the Department of Health for England.1e3 Such interventions can include visual arts, drama, music, movement-based arts and dance, and creative writing. Whilst the benefits of arts and creative activities are well researched and widely used in the clinical medical field,[9,10] there is less evidence about the benefits of these activities for maintaining health or preventing ill health. There is strong advocacy for, and substantial use of, arts and creative activities to address social and cultural drivers of poor health[11] and for conveying health promotion messages.12e14 As yet, there have been few high-quality controlled evaluations of such interventions.15e20. The aims of this study were: to assess the prevalence of creative activity participation and cultural event attendance in low-income groups in London, and compare them with the national population in England; to investigate the association of receptive and active participation in arts and cultural activities with healthy eating, physical activity, and mental health and well-being; and to assess the evidence that social capital or mental health might mediate the relationship between arts participation and health behaviours
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