Can spending more time engaging with the arts, such as visiting galleries, museums, singing or painting, really lead to a longer and healthier life? It’s certainly an appealing idea. And it’s not implausible.
Stress is bad for your health, and spending your free time doing something engaging, like visiting an art gallery, seems like a good way to reduce stress. But there’s a big difference between a plausible idea and an established scientific fact. And if scientists like me want to advise people on how to spend their time, we need to be confident that our advice is based on solid evidence.
A recent study, published in the journal Innovation in Aging, offers a case in point. The study, led by a team of researchers from UCL, reported that those who engaged in arts and cultural activities more often, and in a wider range of such activities, appeared to be ageing more slowly according to certain biological clocks.
Unfortunately, determining whether arts engagement truly improves your health and slows your ageing is very difficult. There are three main challenges.
First, you need to distinguish whether arts engagement causes slower ageing or whether accelerated ageing (and poorer health) simply makes it harder to engage in the arts (an issue known as “reverse causation”).
Second, you need to account for the fact that the people who spend more time engaging with arts are generally very different to those who don’t; that is, they’re typically wealthier and living healthier lifestyles (an issue known as “confounding”).
And finally, you need to account for the fact that those who spend more time engaging in the arts may simply have more leisure time. This means being very clear about what you are comparing the time spent engaging with the arts against.
It seems plausible that visiting a gallery would be better for reducing stress than caring for a dying relative. But is it better than going for a walk? Or spending more time sleeping? Without a clear comparison, it’s impossible to tell whether spending time engaging with the arts is any better than any other leisure activity.
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So how might we clearly study the causal effect of, say, spending time visiting galleries versus spending the same time watching TV on subsequent health and ageing?
The classic approach would be to conduct an experiment. Take a large enough group of people and randomly assign them to one of two groups, with one encouraged to visit galleries and the other to watch TV.
The snag is how exactly you would encourage people – and would it work?
You could pay them. But whatever effect you observed would not then represent the effect of freely visiting a gallery versus freely watching TV.
The more popular option is to study patterns in people taking part in long-running research studies. But to do this well would require repeated and detailed data on how people spend their time and their changing health, ageing indicators and other characteristics. In theory, this would allow you to study how an increase in, say, gallery attendance versus TV watching changed subsequent health or ageing indicators, after carefully accounting for everything mentioned above.
What does the research actually show?
Alas, most studies examining the effect of arts engagement on health and ageing fall well short of these requirements. The recent UCL study offers a textbook example. It examined the effect of arts and cultural engagement on biological ageing without stating a comparison.
So, at best, it studies the effect of having more time to spend on arts and cultural engagement. And it’s probably not that either, because of the other problems of reverse causation and confounding.
Since the study only had single-timepoint measures of arts engagement and ageing, there’s no way to distinguish the effects of arts engagement on slower ageing from the effects of accelerated ageing (and poorer health) on arts engagement.
The study did account for some of the differences in the profile of those engaging in more and less arts activities. But only partially, with several factors ignored – such as wealth, childhood circumstances and disease – and others overly simplified (employment was represented by a simple yes/no variable).
Several of the most important lifestyle factors, like smoking, alcohol use and body mass index (BMI) were also only examined as a secondary concern. When these were accounted for, the apparent effects shrank by 30-80%. And, again, these were all overly simplified. For example, only smoking status, not amount of smoking, was considered.
In the resulting media coverage, the researchers said the effects of more versus less arts engagement were “comparable to the difference between smokers and those who have given up smoking”, and the lead author suggested arts engagement should be promoted “just like we promote 10,000 steps a day or five-a-day of fruits and vegetables”. If you’re a smoker, I’m afraid visiting a few museums is unlikely to offer the same life-changing benefits as giving up smoking.
For everyone else, by all means spend more time visiting museums, galleries, singing, or painting. Your life will probably be richer for it. But if you want to live a longer, healthier life, then there’s probably no substitute for increasing your physical activity, improving your diet and reducing your alcohol intake.
The authors of the study on arts and ageing were offered the right of reply. Here is their response:
Researching arts engagement is indeed challenging as it’s a complex human behaviour. We used the same methods previously used to identify other behaviours related to biological ageing, like exercise, and are currently using the findings to design experiments.
We examined many confounders, selecting those that influence arts engagement most strongly (e.g. household income and neighbourhood deprivation, which are highly correlated with wealth). Lifestyle factors can both influence and result from arts engagement (e.g. festivals can encourage substance use, while dancing can reduce BMI) – that’s why we compared results with and without them. Without lifestyle factors, biological age was 0.8 years lower among arts participants. With lifestyle factors, it was 0.65 years lower.
Experimental studies on other health outcomes suggest benefits arise not just from leisure time, but the emotional, cognitive, physical and social elements of the arts. We don’t advise substituting arts for other health-promoting behaviours, but experiments show that adding arts on top of these behaviours can lead to even greater improvements in health and wellbeing.
Peter Tennant is director and majority shareholder of Causal Thinking Ltd, which provides research and training in causal inference methods. He has no financial interest in the outcome of research on arts engagement.