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Cultural Participation and Health: A Randomized Controlled Trial Among Medical Care Staff

From the Department of Bioscience and Nutrition, Karolinska Institute, Stockholm, Sweden (L.O.B., M.S.); Department of Community Medicine and Rehabilitation, Umeå, Sweden (L.O.B., B.B.K., A.-B.K.); Department of Cultural Geography, Umeå University, Sweden (G.W.); Department of Psychosocial Medicine, Karolinska Institute, Stockholm, Sweden (B.-M.W.); Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway (A.M.G.); Department of Public Health and Clinical Medicine, Umeå University, Sweden (S.-O.A.); and The Red Cross University College, Stockholm, Sweden (B.B.K.).

Address correspondence and reprint requests to Lars Olov Bygren, Department of Bioscience and Nutrition, the Karolinska Institute, Huddinge, S-14157 Stockholm, Sweden. E-mail: lars-olov.bygren{at}prevnut.ki.se or lars.olov.bygren{at}socmed.umu.se

Objective: Population studies demonstrate that attending cultural events is conducive to improved health when baseline health, income, education, and health habits are taken into account. Animal experiments suggest possible mechanisms. We studied the link in humans between attending cultural events and health in a randomized controlled trial.

Methods: Members of the local government officers' union in the health services in Umeå, Sweden, were invited to the experiment and 101 people registered for fine arts visits once a week for 8 weeks. They chose films, concerts, or art exhibitions visits, or singing in a choir and were then randomized into 51 cases, starting at once, and 50 controls starting after the trial. Health was assessed before randomization and after the experimental period using the instrument for perceived health, short form (SF)-36, and tests of episodic memory, saliva–cortisol and immunoglobulin. The results were analyzed using a mixed design analysis of variance.

Results: The SF-36 Composite Score called physical health improved in the intervention group and decreased among controls during the experiment (F(1,87) = 7.06, p = .009). The individual factor of the SF-36 called social functioning, improved more in the intervention group than among controls (F(1,98) = 8.11, p = .005) as well as the factor vitality (F(1,98) = 5.26, p = .024). The six other factors and the Mental Health Composite Score, episodic memory, cortisol and immunoglobulin levels did not change otherwise than among controls. Mechanisms are left to be identified.

Conclusion: Fine arts stimulations improved perceived physical health, social functioning, and vitality.

Key Words: environmental enrichment • cultural participation • choral singing • music • art • film

Abbreviations: ANOVA = analysis of variance; SF-36 = short form-36 questions; IgA = Immunoglobulin A; ELISA = enzyme-linked immunoabsorbent assay; BCA = bicinchoninic acid.