HEARTS. The Health, Economic and Social impact of ARTS engagement: a Public Health Study

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In the past few decades, there has been a surge of international interest in the role of the arts and culture in healthcare, public health and health promotion, on an individual and community level. However, the vast majority of research studies have focused on the effects of targeted, time-limited arts interventions on particular patient groups. Yet, much of the arts and cultural engagement across the UK is not confined to specific interventions but involves a more general, ubiquitous participation that can be harder to measure through experimental studies. A select number of public health studies have found associations between cultural participation (including attending concerts, museums and galleries) and self-reported health, as well as inverse associations between cultural participation and mortality risk. However, important questions remain, and to date, there have been no large-scale public health studies examining the impact of the arts in the UK.This project is led by the Centre for Performance Science, an internationally distinctive partnership of the Royal College of Music and Imperial College London, with an extensive track record in arts, health and social research. It explores the effect of (i) activities that involve actively 'doing' (e.g. music, dance, art, photography and drama) and (ii) activities that require physical attendance (e.g. attending concerts, monuments, museums, galleries, cinemas, heritage archives and theatre); (iii) 'home-based' activities (e.g. listening to the radio, watching TV, reading, storytelling, using arts-based apps, digital arts experiences, online music co-production). Our research questions identify the impact of the arts and culture on individual, social and economic measures of health and wellbeing, as well as explore how associations vary between different socioeconomic, geographical and ethnic populations within the UK.To explore these questions, the project is organised into four work packages. Work package 1 will involve assessing existing data including undertaking a meta-analysis of previous studies and exploring a UK cohort study that includes some questions on the arts. However, recognising the limited data currently available, work packages 2 and 3 are based on a large-scale national survey to be carried out during our study. Open to all adults in the UK, the survey will target the general population as well as participants diagnosed with one of four major health conditions facing the UK: mental health, cancer, cardiovascular disease and chronic respiratory diseases. These conditions have all previously been researched in smaller arts-in-health intervention studies but not at a public health level, and their inclusion will facilitate understanding of the relationships between culture and the individual, social and economic facets of health and wellbeing. A total of 25,000 participants will be recruited to complete an anonymous online questionnaire consisting of demographic questions, validated psychological scales and economic metrics, assessments of arts and cultural participation and self-reporting of health. Work package 2 will explore the questions with a cross-sectional analysis of these data with nested case-control studies; work package 3 will monitor a sub-section of the sample as a cohort for the following year with 6-monthly updates to track longitudinal change in arts engagement. Recognising the complexity of cultural engagement and health, work package 4 will add context to the survey data, with a sub-sample of survey participants taking part in qualitative telephone interviews to explore motivations for, and experiences of, arts engagement across the UK and how this is reported to intersect with health behaviours, perceptions and outcomes.Through the extensive epidemiology methods proposed, an ambitious sample size and nested qualitative data, the findings promise to redefine the value of the arts and culture for public health in the UK.