WARNING: Research can be bad for your health

I want to draw your attention to a new piece of research commissioned by the Scottish government which offers definitive evidence for the first time that cultural engagement is having a positive impact on the nation’s health and life satisfaction.  Janet Archer, CEO, Creative Scotland, in an address to FST/ITC Reception, 20 August 2013, Edinburgh.

I was there, unhealthily sipping my wine, when I heard Janet Archer mention this new piece research in her speech and immediately my interest was piqued.   When I was Director Centre for Cultural Policy Research (CCPR), at the University of Glasgow, we were commissioned by the (then) Scottish Executive to find the evidence of the link between arts and sports participation and quality of life and well-being.  From this we were asked to develop indicators which could be used to evaluate the effectiveness of a culture or sport intervention. Susan Galloway at CCPR reviewed the extensive literature on well-being and quality of life and we worked with Professor David Bell, an economist from Stirling University who examined the economic literature on subjective well-being.

Quality of Life and Well-being: Measuring the Benefits of Culture and Sport: Literature Review and Think-piece was published by the Scottish Executive in 2006.   In this we concluded:

‘The central issue for cultural social impact research remains the lack of both empirical evidence, and the lack of a theoretical basis with which to support the claims about the impact of cultural participation.’ (p.42)

In summary, we found that there is no evidence of a link between participation in the arts and sport and quality of life and well-being.  This does not mean that there is not one, but there is no evidence.  Moreover there are challenges in researching this area –mainly around issues of definition. What exactly is quality of life and well-being?  We concluded:

‘What this review tells us, however, is that, in the wider policy literature relating to quality of life and well-being, there is no clear definition of terms and that, the absence of such, leads to a lack of clarity in the policy focus. This, in turn, leads to a ‘back to front’ approach to enhancing quality of life and well-being in communities and for individuals: what can be measured is measured, and what is measured drives the policy. The development of new ways of measuring tends to focus on the quantitative with qualitative measures focusing on satisfaction surveys. Anything even attempting a comprehensive approach to measuring the impact on quality of life can lead to unwieldy data sets. ‘(p. 145)

This is a chunky piece of research and my summary does not do it full justice but essentially it flagged up for researchers and policy makers questions which need to be addressed when looking at the relationship between arts and sport and quality of life and well-being.  So when I heard about this new research I was intrigued to find out how they had tackled the problem of definition, methodological questions around qualitative and quantitative approaches, the issue of large datasets and what evidence was being presented.

This new piece of research, published by the Scottish Government, Healthy Attendance? The Impact of Cultural Engagement and Sports Participation on Health and Satisfaction with Life in Scotland uses the Scottish Household Survey as its data source.  Since 2009 this survey has contained questions on cultural and sports participation and on life satisfaction and self-assessed health.  The researchers analysed data from both of these to reach the conclusion that,  ‘those who participate in culture and sport or attend cultural places or events are more likely to report that their health is good and they are satisfied with their life than those who do not participate.’ (p. 5)

In our research in 2006 we said something similar:

‘In as much as culture and sport is seen to have a role in enhancing quality of life […] it appears consistently […] as one of the indicators and descriptors used in domains encompassing subjective well-being, expressed as satisfaction with life as a whole, and social inclusion/social well-being/social relationships.’  (p.137)

So in the area of ‘subjective well-being’ we too found a link. We go on:

‘This is perhaps not unexpected as it is often assumed that participation in culture and sport has a positive impact on aspects of quality of life as it relates to social inclusion. The academic literature suggests, at best, an association rather than a causal link between these. ‘(my italics) (p. 155)  And finally we are more blunt, ‘While the evidence suggests an association between cultural and sports participation and an improved quality of life, there is no evidence of a causal relationship between the two.’ (p. 155)

But then neither does this latest research claim cultural participation or attendance is the cause of good health.  Specifically they state: ‘Being cross-sectional, this study cannot determine causal relationships.’ (p. 17).  Throughout the researchers are careful to point to an association between participation and attendance in culture and sport- not that one leads to another.

What does this mean?

First, this is not the ‘definitive evidence’ policy-makers claim. We might look for associations between other activity and health benefits – for example being part of a religious group, being a volunteer in a hospital or working with refugees, having an allotment – and a myriad of other activities which are part of our social capital. Making a claim for a casual link between the health of our nation and engagement in culture is, frankly, spin.  Echoing this point, Tiffany Jenkins in the Scotsman pointed out that some art might have the opposite effect and ‘culture was not the solution to our health problems’.

And surely we have moved beyond this attempt to account for cultural spend because of non-cultural outcomes?  After all what was the Talbot Rice Gallery speech by Fiona Hyslop all about if it wasn’t underlining the importance of the arts and heritage to ‘our heart, our soul, our essence’?

But the real lesson from this research is to be found there in the Introduction:

‘Sports participation and cultural engagement levels are highest in the highest household income groups in Scotland and decline to be lowest in the lowest household income groups. Similarly, adult participation in cultural and sporting activities varies by area deprivation, with participation increasing as area deprivation decreases.’ (p. 7)

What that tells us is that not only does high deprivation bring with it poor health (which we already know from epidemiological studies in Scotland), but it also brings a reduced participation in arts and sport.  Surely this is all the evidence we need to know that more work has to be done to bridge the gap between those who have all and those who have none?  Let’s move away from making exaggerated claims for the benefit of cultural participation and attendance and focus on what really matters – creating greater access to all for all.