What is the evidence on the role of the arts in improving health and well-being?

#artenquarantaine, #musicforhealth, #artforhealth, #artisgood, #shareculture, #lockdownart,…

Have you ever crossed such hashtags on social networks? In view of the situation, the International Yehudi Menuhin Foundation wishes to highlight the evidence – for there is – that art is good and necessary for our health and well-being all the more so at the present time. We therefore wish to encourage awareness that these sectors are essential and not secondary, promote arts engagement at the individual, local, national and international levels as well as insist on the need to further acknowledge and act on the growing evidence base.

Then, what is the evidence on the role of the arts in improving health and well-being? This article presents the scoping review by the World Health Organization. The main findings of the report are based on the results from over 3000 studies and identified a major role for the arts in the prevention of ill health, in the promotion of health and in the management and treatment of illness across the lifespan.

This report has mapped the evidence on the potential value of the arts in the promotion of good health, the amelioration or prevention of a range of mental and physical health conditions, and the treatment or management of acute and chronic conditions arising across the lifespan.

Studies have covered a diverse range of arts activities and explored programmes delivered in a range of different locations from hospitals to primary care to the community to the home.

A number of themes can be drawn from this research. First, there is a substantial body of evidence on the health benefits of the arts. Research designs included a spectrum from uncontrolled pilot studies to randomized controlled trials, from small-scale cross-sectional surveys to analyses of nationally representative longitudinal cohort studies, and from individual case studies to community-wide ethnographies. Overall, the findings from this review lend credibility to the assertion that the overall evidence base shows a robust impact of the arts on both mental and physical health.

A second theme in the identified research was a focus on conditions for which no complete solutions are available. Here, the arts hold promise in tackling difficult or complex problems for which there are not currently adequate solutions such as cancer, diabetes or respiratory diseases.

Additionally, this review identified how the arts can provide a holistic lens to view conditions that are often treated primarily as physical; this approach fits with current trends in health towards giving parity of esteem to mental health and also towards situating health problems within their social and community context.

A third theme was that the evidence base did not just show efficacy of arts interventions but also showed economic benefits, with some arts interventions showing equivalent or greater cost–effectiveness to possible health interventions. The theoretical framework used for this report focused on the multimodal aspect of arts activities as this is likely to underlie the benefits. Arts interventions can provide multiple health-promoting factors within an activity (e.g. supporting physical activity and with components that support mental health); consequently, they may be more efficient for certain health conditions than the co-prescription of a physical activity intervention and a mental health intervention.

Further, the aesthetic component of the arts and the ability to tailor them to have relevance to individuals from different cultural backgrounds means that they can be a route to engaging minority or hard-to-reach groups, who can have higher risks of poor health and concomitantly generate higher health-care costs. Arts enhance social cohesion and bonding and prevent inequities and inequalities by leaving no one behind. There is wide literature on the impact of the arts on child development, from language and expression to education attainment.

However, there is a clear need for more economic evaluations of arts interventions within health to quantify the benefits and support the business cases for funding and commissioning.

Policy recommendations

A number of considerations can be derived from the evidence mapped in this report; these target both the cultural and the health and social care sectors.

Acknowledge the growing evidence base for the role of the arts in improving health and well-being by:

Supporting the implementation of arts interventions where a substantial evidence base exists, such as the use of recorded music for patients prior to surgery, arts for patients with dementia and community arts programmes for mental health;

Sharing knowledge and practice of arts interventions that countries have found effective in their context to promote health, improve health behaviours or address health inequalities and inequities;

Supporting research in the arts and health, particularly focusing on policyrelevant areas such as studies that examine interventions scaled up to larger populations, or studies that explore the feasibility, acceptability and suitability of new arts interventions.

Recognize the added health value of engagement with the arts by:

Ensuring that culturally diverse forms of art are available and accessible to a range of different groups across the life-course, especially those from disadvantaged minorities;

Encouraging arts and cultural organizations to make health and well-being an integral and strategic part of their work;

Actively promoting public awareness of the potential benefits of arts engagement for health;

Developing interventions that encourage arts engagement to support healthy lifestyles. Note the cross-sectoral nature of the arts and health field through:

Strengthening structures and mechanisms for collaboration between the culture, social care and health sectors, such as introducing programmes that are cofinanced by different budgets

Considering the introduction, or strengthening, of lines of referral from health and social care to arts programmes, for example through the use of social prescribing schemes

Supporting the inclusion of arts and humanities education within the training of health-care professionals to improve their clinical, personal and communication skills.