Are culturally vibrant communities healthier? Relationships between performing arts activity and health outcomes in the 500 largest US cities

Abstract

Aims:

Recent reviews have demonstrated broad links between performing arts participation (e.g. music-making; dancing; acting) and receptive engagement (e.g. listening to music; attending a dance/theatre performance) and improved health, including reduced disease and mortality risk. However, no investigations to date have interrogated the links between community-level performing arts activity (i.e. participation + receptive engagement) and health outcomes – that is, do the performing arts help create healthy communities? This study aims to address this question by examining links between performing arts activity and health outcomes across 500 cities in the US.

Methods:

Secondary analysis of demographic, health outcome, performing arts activity (estimated by annual performing arts revenue), and preventive/unhealthy behaviour data for 500 large cities in the US – data extracted from the US Centers for Disease Control 500 Cities Project, Dun & Bradstreet Hoovers Database, and US Census. Links between performing arts activity and 12 health/disease outcomes were evaluated using a series of hierarchical beta regression models which progressively controlled for demographic variables and preventive/unhealthy behaviour prevalence.

Results:

The 500 analysed US cities comprise 33.4% of the total US population and 84,010 performing arts businesses (total annual revenue $27.84 billion). No significant associations were found between performing arts activity and 9 of 12 health outcomes in fully adjusted models (p ⩾ .17). Statistically significant relationships (p < .01) between increased performing arts activity and increased prevalence of chronic kidney disease, coronary heart disease, and stroke were determined to be clinically equivocal.

Conclusions:

This study contributes to a growing body of conflicting epidemiologic evidence regarding the impact of the performing arts on health/disease and mortality outcomes, evaluated using a range of disparate methodologies. A consensus, psychometrically rigorous approach is required to address this prevailing uncertainty in future epidemiologic studies examining the effects of performing arts activities both within and across countries and communities.

Keywords

public health music dance theatre epidemiology

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References

McCrary

Redding

Altenmüller

. Performing arts as a health resource? An umbrella review of the health impacts of music and dance participation. PLoS ONE 2021;16(6):e0252956.

Fancourt

Finn

. What is the evidence on the role of the arts in improving health and well-being? A scoping review. Copenhagen: WHO Regional Office for Europe; 2020.

Verghese

Lipton

Katz

et al. Leisure activities and the risk of dementia in the elderly. N Engl J Med 2003;348(25):2508–16.

Bygren

Johansson

S-E

Konlaan

et al Attending cultural events and cancer mortality: a Swedish cohort study. Arts Health 2009;1(1):64–73.

Bygren

Konlaan

Johansson

S-E

. 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 conditions. BMJ 1996;313(7072):1577–80.

Merom

Ding

Stamatakis

. Dancing participation and cardiovascular disease mortality: a pooled analysis of 11 population-based British cohorts. Am J Prev Med 2016;50(6):756–60.

Balbag

Pedersen

Gatz

. Playing a musical instrument as a protective factor against dementia and cognitive impairment: a population-based twin study. Int J Alzheimers Dis 2014;2014:836748.

Napier

Ancarno

Butler

et al Culture and health. Lancet 2014;384(9954):1607–39.

National Endowment for the Arts. U.S. Patterns of Arts Participation: a full report from the 2017 survey of public participation in the arts, 2017. Available online at: https://www.arts.gov/impact/research/publications/us-patterns-arts-participation-full-report-2017-survey-public-participation-arts

10.

Centers for Disease Control and Prevention – National Center for Chronic Disease Prevention and Health Promotion – Division of Population Health. 500 cities project data, 2019. Available online at: https://www.cdc.gov/places/about/500-cities-2016-2019/index.html

11.

Dun Bradstreet. Hoovers, 2019. Available online at: www.dnb.com

12.

US Census Bureau. Census, 2010. Available online at: www.census.gov

13.

Wang

Holt

Zhang

et al Comparison of methods for estimating prevalence of chronic diseases and health behaviors for small geographic areas: Boston validation study, 2013. Prevent Chron Dis 2017;14:E99.

14.

American Association of Retired People Public Policy Institute. AARP Livability Index 2018. Available online at: https://livabilityindex.aarp.org/

15.

Dun Bradstreet. Firmographic code tables – SIC 8-Digit Code, 2019. Available online at: https://www.dnb.com/utility-pages/dnb-demographic-firmographic-code-tables.html

16.

Kaplan

Pamuk

Lynch

et al Inequality in income and mortality in the United States: analysis of mortality and potential pathways. BMJ 1996;312(7037):999–1003.

17.

National Center for Health Statistics. Health, United States, 2015: With special feature on racial and ethnic health disparities. Hyattsville, MD: National Center for Health Statistics; 2016.

18.

Ferrari

Cribari-Neto

. Beta regression for modelling rates and proportions. J Appl Stat 2004;31(7):799–815.

19.

Clark

Gelfand

. Hierarchical modelling for the environmental sciences: Statistical methods and applications. Oxford: Oxford University Press; 2006.

20.

US Office of Management Budget. Revised delineations of metropolitan statistical areas, micropolitan statistical areas, and combined statistical areas, and guidance on uses of the delineations in these areas, 2020. Available online at: https://www.whitehouse.gov/wp-content/uploads/2020/03/Bulletin-20-01.pdf

21.

US Census Bureau. Delineation files, 2020. Available online at: https://www.census.gov/geographies/reference-files/time-series/demo/metro-micro/delineation-files.html

22.

Babyak

. What you see may not be what you get: a brief, nontechnical introduction to overfitting in regression-type models. Psych Med 2004;66(3):411–21.

23.

Hair

. Multivariate data analysis. Upper Saddle River, NJ: Prentice Hall; 2009.

24.

Grimes

Schulz

. False alarms and pseudo-epidemics: the limitations of observational epidemiology. Obstet Gynecol 2012;120(4):920–7.

25.

Ioannidis

. Why most discovered true associations are inflated. Epidemiology 2008;19(5):640–8.

26.

Young

Karr

. Deming, data and observational studies: a process out of control and needing fixing. Significance 2011;8(3):116–20.

27.

Konlaan

Bygren

Johansson

S-E

. Visiting the cinema, concerts, museums or art exhibitions as determinant of survival: a Swedish fourteen-year cohort follow-up. Scand J Public Health 2000;28(3):174–8.

28.

Løkken

Rangul

Merom

et al Are playing instruments, singing or participating in theatre good for population health? Associations with self-rated health and all-cause mortality in the HUNT3 study (2006–2008), Norway. In: Bonde

Theorell

(eds) Music and public health. Cham: Springer; 2018. pp. 33–54.

29.

Hughes

Chang Vander Bilt

Ganguli

. Engagement in reading and hobbies and risk of incident dementia: the MoVIES project. Am J Alzheimers Dis Other Demen 2010;25(5):432–8.

30.

Salimpoor

Benovoy

Longo

et al The rewarding aspects of music listening are related to degree of emotional arousal. PLoS ONE 2009;4(10):e7487.

31.

Lynar

Cvejic

Schubert

et al The joy of heartfelt music: an examination of emotional and physiological responses. Int J Psychophysiol 2017;120:118–25.

32.

Grewe

Nagel

Kopiez

et al Emotions over time: synchronicity and development of subjective, physiological, and facial affective reactions to music. Emotion 2007;7(4):774–88.

33.

Chapin

Jantzen

Kelso

et al Dynamic emotional and neural responses to music depend on performance expression and listener experience. PLoS ONE 2010;5(12):e13812.

34.

Nakahara

Furuya

Obata

et al Emotion-related changes in heart rate and its variability during performance and perception of music. Ann NY Acad Sci 2009;1169:359–62.

35.

Grewe

Nagel

Kopiez

et al Listening to music as a re-creative process: physiological, psychological, and psychoacoustical correlates of chills and strong emotions. Music Percept 2007;24(3):297–314.

36.

Barisic

Leatherdale

Kreiger

. Importance of frequency, intensity, time and type (FITT) in physical activity assessment for epidemiological research. Can J Public Health 2011;102(3):174–5.

37.

Rhodes

Janssen

Bredin

et al Physical activity: health impact, prevalence, correlates and interventions. Psychol Health 2017;32(8):942–75.

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