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Does Culture makes us happier – and healthier?

Scritto da Ginevra Are Cappiello il 15 Luglio 2015 in After

Introduction

 

People’s happiness and wellbeing are undoubtedly at the center of today’s modern life – we could even dare to say that our generation is obsessed with the pursuit of happiness, with finding the perfect balance between our inner desires and the lives that we actually live.
Nevertheless, we know very little about what truly makes a human being happy. We read tons of self-help books, we go to courses, and we talk to counselors. But the truth is – we very rarely dig deeper into the scientific causes behind human happiness and wellbeing. We may even be surprised to know that, in fact, there are very solid scientific causes. And among those causes, culture lists as one of the main ones.
In order to better understand this, we need first to define what we mean by wellbeing and by culture.

 

What is scientifically defined as psychological wellbeing – and more commonly referred as happiness – is a very complex, subjective feeling, made up by a series of multiple interactions and by a long list of factors: first of all, our physical and mental health, along our age, our yearly income, our profession, our education, the lifestyle that we have, our family life and many others.
If we want to make sure that communities and populations thrive, we first need to make sure that the general level of wellbeing is high. To do so, we first need to understand how much every single factor named above contributes to the general wellbeing of individuals.
To name a few, we can easily understand how lifestyle is one of the main contributors to psychological wellbeing, since unhealthy lifestyles can deeply influence the quality of our lives and therefore will influence our physical and mental health. Family life is also very important: we bring our own lives into our families, and when even one individual within a household is affected by stress, this can easily be transferred to other family members.
We can’t obviously forget about the social sphere – this is where everything converges. We can have happy populations or unhappy populations, with real waves of wellbeing affecting a specific population in a specific time.

 

And what about culture? How is culture considered when we want to understand the main factors that, together, make up an individual’s wellbeing? Well, it may be not too surprising to see that up to a decade ago culture was considered as a relatively limited factor in the long list of wellbeing determinants.
Sure, it’s difficult to deny that culture can have an impact on different spheres of our lives, such as the psychological, social and economical ones. And if taken in a broader sense, if culture can impact those spheres than it can also have an impact, in some ways, on other aspects such as our satisfaction with life.
But it is way more controversial to state with certainty that culture is really one of the most important factors when trying to understand what our wellbeing is made of.

 

Why that? Why, if compared to other relevant causes such as our level of stress, or our lifestyle, our genetic heritage, did science along the years assign a very limited role to culture? Well, this is manly due to the fact that the word “culture” is very difficult to define.

 

We can identify three main types of culture, three different meanings that in western societies are linked to this word.

 

First, we can think of culture as mix of very specific social traits that are associated to a specific time and place and to a specific human group. From this point of view, just growing up in a specific environment would imply soaking up and expressing these traits, both as an individual and social level. In order to keep these traits alive, humans have had to develop certain ways of transmitting them between each other. It’s important to mention that certain type of cultures are more prone that others to develop a high level of wellbeing among its population.
Another type of culture is the one that we, as single individuals, decide to build during our lives. Aside from our socially given traits, each individual needs to gain skills and abilities that will end up defining his/her personality and his/her role within the community. In this case “culture” is seen as a practical tool, and even if a single skill doesn’t define someone’s personal culture, all these skills together will eventually create a broader knowledge. Surprisingly or not, it has been discovered that populations that are generally identified with higher levels of this second type of culture – that is, in which individuals have a high level of education – are also characterized by higher wellbeing.

 

Finally, a third type of culture is the one we are going to refer to from now on – and it’s what most people usually mean when they talk about “culture”. In this sense, culture can be defined as a broad range of activities specifically designed to be experienced. Those are the “cultural activities” that are organized within specific social contexts. Another way to say this is that culture, from this point of view, is basically how we decide to spend our free time – in a way that is not education and is not linked to providing us with a better job, a better salary, but that it’s meant to give us pleasure and to intellectually enrich our lives.

 

 

If we take into consideration this last type of culture, it is probably not very intuitive to think of it as a factor deeply linked to our (psychological and physical) wellbeing. Sure, the way we decide to spend our free time can impact, in some ways, the choices we do over our lifestyle. If you consider sport as a cultural activity, it’s easy to see how it could impact our wellbeing.
However, science in the last decade has assigned more and more importance to the role of culture in the development of people’s happiness and wellbeing. And the results are phenomenal and groundbreaking.

 

 

A number of international studies highlighted a very clear virtuous circle in which participation to cultural activities – that is, a clever use of our free time – definitely enhances people’s psychological wellbeing. Culture helps to lower our stress and helps us maintain a better mental health level, which results in an enhanced physical health and, along with it, a longer a somehow happier life.

 

 

Let’s take a deeper look into some studies that have revealed culture’s true benefits for our health.

 

Studies on culture and wellbeing

 

 

The Northern European region has been one of the most productive and pioneering areas for research on the theme of “culture and health. The main aim of these initial researches was to find out if there was a correlation between high levels of cultural consumptions and people’s chances of survival – not necessarily related to wellbeing.

 

 

Indeed, one of the very first studies was conducted by Byrgen at al. already in Sweden in 1996. In this observational study (that is, a study in which the researchers do not interfere with the way subjects behave and in which they simply observe the status of things) a total of 12675 individuals have been interviewed over a period of 9 years.
Bygren and the other researchers aimed at examining the relationship between cultural experiences (such as attending cultural events, reading books or newspapers, creating music or singing in a choir) and the probability to develop cancer. What they found is that those who only rarely or moderately experiences such cultural activities had higher chances of dying of cancer compared to frequent attendees, showing for the first time that consumption of culture can have a positive impact on people’s survival.
Following up on Bygren’s study, and partially using the same sample, another Swedish study is a cross-sectional one (that is, an observational study that involves the analysis of data collected from a population, or a representative subset, at one specific point in time) carried on by Konlaan et al in 2000. With this 14-year long study, Konlaan and his colleagues found a higher risk of mortality for people that rarely attended to movies, concerts and museums compared to those that visited regularly those venues. Lesser effects were found concerning visits to theaters, religious functions or sport events, and no impact at all arising from reading or playing music. Their conclusions involved assessing that the consumption of some specific types of cultural events has a beneficial impact on people’s longevity.In 2006, Hyppa found similar results in his observational longitudinal study of a sample of 8000 residents of Finland, which he followed up over a period of over 20 years. Again, while trying to discover if cultural consumption could have been considered a cause for survival, Hyppa was able to observe that people who participated in a lot of cultural activities had a lower risk of mortality.

 

 

Another set of studies tackled the relationship between culture and individual wellbeing.
In 2007, Wilkinson et al published a study that referred directly to the other studies carried on in Sweden by Bygren and Konlaan. While trying on understand the relationship between participation to cultural activities and people’s self-reported health, Wilkinson interviewed a sample of 1244 individuals. The results showed that there is a significant relationship between the two factors taken into consideration, and that the more cultural activities people reported to take part into, the higher was their level of self-reported health.
Among other studies, Daykin et al. in 2008 performed a critic analysis of the literature to figure the impact of visual arts on the youth. They found significant proof of positive impact, specifically in the behavior, interaction and social skills of subjects at risk. In another study, Hacking et al. also found that participation improved mental health and social inclusion indicators.

 

 

Even with so many studies that support the theory that culture has a high impact on people’s individual wellbeing, this relationship seems more complex and faceted than one could assume and not all studies found positive evidence.
In another two studies, Michalos and Michalos and Kalhke, in 2005 and 2008, measured the impact of arts on quality of life and ended up with very controversial results. In the first study, a survey identifying 66 culture-related activities was sent to 315 residents of Prince George, British Columbia who voluntarily decided to take the survey. Analyzing the results, the researcher discovered that arts and culture seemed to have only a very limited impact on people’s quality of life.
In the second study, a similar survey was delivered to more than 10,000 households in five British Columbia communities, and obtained comparable results.

 

 

However, two of the most peculiar studies ever in this field show, once again, that indeed culture and wellbeing are positively related to each other.
One of them is the only randomized controlled trial carried out so far in the field of culture and health. A randomized controlled trial is a type of scientific experiment where the subjects being studied are randomly allocated one or other of the different treatments under study, and is more often used in the medical and clinical fields. This study, carried on again by Bygren and his colleagues, has been conducted over a sample of 101 public service workers in the city of Umea, in Sweden, who made themselves available to an 8-week experiment in which they had to take part in cultural activities. A first group started immediately to take part in several cultural activities, while the second group served as a control group.
Through a survey tool called SF-36 the author measured people’s health status before and after the experiment. The results have shown that in the first group (the one that was taking part in cultural activities) people’s physical health increased, and that in the control group, in which people were not taking part in any cultural activity, physical health decreased.

 

 

Finally, the most comprehensive – and one of the most recent – studies in this field is the one by Cuypers et al. published in 2011 and named the “HUNT Study”. This Norwegian research wanted to analyze the relationship between cultural activities and perceived health, anxiety and depression level and life satisfaction in both genres. In the study, more than 50.000 adults individual residents of Norway have been interviewed through surveys. Results showed that the participation to cultural activities – both passive and active ones – is significantly correlated with a good health status, a good satisfaction with one’s life and a low anxiety and depression levels in both genres.
Particularly for the male gender, passive/receptive cultural activities – more than the active ones –shown to be correlated with all health-related factors.

 

 

In addition to these international studies, some interesting researches have been carried on in Italy. In 2008, 3000 Italian citizens have been interviewed as representative sample of the Italian population in a study carried on by Grossi et al. The study, very unique and peculiar both in Italy and in Europe, aimed at giving a comprehensive picture of the relationship between cultural consumption and people’s psychological wellbeing, trying to highlight the impact of culture in the quality of life of individuals. More specifically, the research wanted to better understand the role that different types of cultural experience have on determining people’s psychological wellbeing.

 

 

To measure the subjective psychological wellbeing, the Italian researchers used tool that has been scientifically validated during over 30 years of scientific research and that is probably the most reliable one to the knowledge of who is writing. This tool is called the Psychological General Wellbeing Index, or PGWBI.
The PGWBI has been developed as a specific tool to measure how people self-report different emotional and interpersonal states of mind, that can be mirrored into a general sense of subjective wellbeing or, in the contrary, of discomfort. In other words, the PGWBI is able to reflect “peoples’ subjective wellbeing perception”.
The original PGWBI consist of 22 questions that explore different areas of people’s emotions: anxiety, depression, positive wellbeing, self-control, vitality and general health. Each area gets a score and the maximum score that an individual can get is 110 points, which may be describe as a state of “beatitude”.
On the other hand, an additional survey has been distributed to the 3000 people’s sample in order to measure cultural consumption, asking people to rate the frequency and intensity with which they take part in 15 different types of cultural activities (as a reminder, with cultural activities we mean ways with which people decide to fruitfully spend their free time).

 

 

Once again, the results are very interesting and in line with the ones from International studies. The research showed that people who have no access to cultural activities have an average PGWBI score that is statistically lower than the one of people who enjoy a higher consumption of culture, and way lower than the one of people of experience a lot of cultural activities in a given year.
Moreover, and here is the somewhat shocking revelation, in the Italian study cultural consumption has been shown to be the second most important factor in determining people’s psychological wellbeing, right after the physical health status. Some specific types of cultural activities ended up being linked than others to higher levels of psychological wellbeing, such as musical concerts and sport practice.
Finally, this study clearly showed that there is a very big difference between the wellbeing of people who have zero access to cultural activities and the one of people who have very high levels of cultural consumption, compared to the levels of wellbeing of people who only have a moderate cultural experience.

 

 

Another interesting research is the one that took place during fall 2010 in the city of Milan, always carried on by Grossi et al. Up to that moment, there had been a very small number of studies that focused on the contribution of culture in the wellbeing of individuals who lived in a large metropolitan area. Similar to the Italian study, the Milan one’s aim was to explore the relationship between cultural access and individual psychological wellbeing, trying to provide with a sort of scale of the specific impact of specific cultural experiences.
1000 Milanese citizens have been interviewed for this research, using again the PGWBI as a main tool in combination with the survey to assess their level of cultural consumption.
In the results, not only Milan’s citizens seem to experience more cultural activities than what measured in other parts of Northern Italy (only 5% of the population declared to not take part in any cultural activity, a very low percentage if compared to the one in other parts of Italy), but they also have a higher general state of psychological wellbeing (an average of 80.6 in the PGWBI scale, while the Italian average measured in the previously mentioned study was of 78).
In this study it was made clear once again how specific leisure activities – that is, certain cultural experiences, sport included – are among the highest factor when we try to predict an individual’s wellbeing.
The study highlighted how the more cultural activities people experience, the more their wellbeing enhances; this seemed particularly true for the female gender, which in this study is shown to benefit more from cultural consumption than the male one. A reinforcement to the results shown in the first Italian study in the Milan’s study culture ended up being, once again, the second factor that influences people’s general wellbeing, right after physical health and followed by family status, profession and level of education.
But which are the cultural experiences that enhance our wellbeing the most? Well, in the Milan’s study case, practicing frequent sport activities and going often to museums showed up at the most beneficial experiences, while as we have seen in the Italian study experiencing musical concerts was ranked as one of the most beneficial activities (always accompanied by the regular practice of sport).

 

 

 

Conclusion

 

 

As mentioned, in the last 20 years or so science has been dedicating more and more energies to discovering if arts and culture – meant as a pleasurable, clever and meaningful use of people’s free time – play a more or less significant role in enhancing the wellbeing and the health of individuals. And as we have seen in the review of the international studies on the field of culture and health named above, the majority of these studies found a positive link between those factors. Even if some of the results can be slightly controversial, and not all the findings have been strong enough to be considered groundbreaking, researches now all agree that taking part in cultural activities is beneficial for our health – psychological and physical one alike.
The two studies carried out in Italy bring this results to another level and go as far as stating that, on a scale of the most relevant factors for the psychological wellbeing of people, culture ranks second. If we are not too surprised by the fact that culture comes immediately after the absence of diseases, it is somehow very interesting that it is considered more relevant than factors such as age, income, education, gender and occupation that historically received a greater attention in comparable literature when trying to discover the main factors beneficial to people’s wellbeing.

 

 

Recognizing this positive influence and the significant impact of cultural access on personal wellbeing can lead to new and original research pathways. Still, the relationship that so many researches found to be true may become suddenly elusive and not so clear if we were to analyze it through different and more conventional statistical instruments.
Why so? As we have seen, culture itself can have very different meanings depending on what we consider “culture”, and different populations may have an indeed different idea about what culture is. Moreover, cultural habits are diverse, and people (specifically the most avid cultural consumers) tend to distribute their time among several activities and forms of culture, which may also vary over time. In other words, culture is an extremely complex and somehow vague concept. In the scientific and medical field, such complexity would normally require to avoid simpler statistical models with limited variables such as the ones that have been used in the researches summarized above (observational and cross-sectional studies among others).
An intricate concept such as culture would really benefit from further researches that favor more statistically significant models such as randomized control trials or real field experiment (similar to the one carried on by Cuypers), which allow the consideration of dynamic interactions among several variables. Such studies would really help the scientific (and humanistic) community to give the appropriate relevance and direction to the relationship between culture and wellbeing, but setting up a similar study would obviously require very specific conditions, long time frames and higher research costs.

 

 

So for now we are left with a (still high and promising) number of less experimental but very positive studies, which agree that experiencing culture is beneficial for us. If we are to trust the results of these studies, we must realize that the link between culture and wellbeing paves the way to breakthrough public policy strategies. As the evidence examined show that cultural access is a key determinant of wellbeing, policies aimed to promote its accessibility (as well as physical activity) should be considered as health-related policies, with significant implications.
Governments, corporations and other institutional entities should recognize, when considering art- and culture-related investment, the considerable economic and social upsides provided to their constituencies. These benefits aren’t as subtle, generic and diluted in time as one may think; accounting for them properly on the basis of empirical results could lead the way to more rational (and pleasing) criteria for the development of our cities, workplaces and communities.

 

 

 

 

References

 

 

1) Bygren LO, Konlaan BB, Johansson SV (1996) Unequal in Death.
Attendance at Cultural Events, Reading Books or Periodicals, and Making Music or Singing in a Choir as Determinants for Survival: Swedish interview survey of living condition.BMJ 1996;313:1577-1580

 

2) Konlaan BB, Bygren LO, Johansson SE (2000) Visiting the Cinema, Concerts, Museums or Art Exhibitions as Determinant of Survival: A Swedish Fourteen-Year Cohort Follow-up. Scandinavian Journal of Public Health, 28:174-178

 

3) Hyppa MT, Maki J, Impivaara O, Aromaa A (2006) Leisure Participation Predicts Survival: A Population-Based Study in Finland. Health Promotion International, 21:5-12

 

4) Michalos AC (2005) Arts and the Quality of Life: An Exploratory Study. Social Indicators Research, 71:11-59

 

5) Bygren LO, Johansson SV, Koonlaan BB, Grjibovski AM, Wilkinson AV, Sjostrom M (2009) Attending Cultural Events and Cancer Mortality: A Swedish Cohort Study. Arts & Health, 1:64-73

 

6) Bygren LO, Weissglas G, Wirkstrom BM, Konlaan BB, Grjibovski A, Karlsson AB, Andersson SO, Sjostrom M (2009) Cultural Participation and Health: A Randomized Controlled Trial Among Medical Care Staff. Psychosomatic Medicine 71:469-473

 

7) Cuypers K, Krokstad S, Holmen TL, Knudtsen MS, Bygren LO, Holmen J (2011) Patterns of Receptive and Creative Cultural Activities and their Association with Perceived Health, Anxiety, Depression and Satisfaction with Life Among Adults: The HUNT Study, Norway. Journal of Epidemiol Community Health Aug;66(8):698-703. Epub 2011 May 23.

 

8) Grossi E, Tavano Blessi G, Sacco PL, Buscema M (2012) The Interaction Between Culture, Health and Psychological Well-Being: Data Mining from the Italian Culture and Well-Being Project. Journal of Happiness Studies 13: 1. 129-148

 

9) Grossi E, Sacco PL, Tavano Blessi G, Cerutti R (2011) The Impact of Culture on the Individual Subjective Well-Being of the Italian Population: An Exploratory Study. Applied Research Quality Life 6: 387-410

 

10) Dupuy HJ (1990) The Psychological General Well-being (PGWB) Index. In: Wenger NK, Mattson ME, Furburg CD, Elinson J (Eds.) Assessment of Quality of Life in Clinical Trials of Cardiovascular Therapies. Le Jacq Publishing, New York: pp. 170-83.

 

11) Grossi E, Groth N, Mosconi P, Cerutti R, Pace F, Compare A, Apolone G (2006) Development and validation of the short version of the Psychological General Well-Being Index (PGWB-S). Health and Quality of Life Outcomes 4: 88- 96

 

 

 

 

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