From Evidence to Action: How can Policymakers Realise the Potential of the Arts to Support Public Health?
Rosie Dow, Katey Warran
Researchers from the Social Biobehavioural Research Group, University College London discuss how arts are shown to improve public health
Here at UCL, we’ve been conducting clinical trials for several years to explore how the arts can help to address specific health challenges. As well as showing positive health benefit from targeted creative activities such as singing for postnatal depression or magic for hemiplegia in young people, we’ve also analysed large population datasets (cohort studies) to uncover links between more general arts engagement and better health across the lifespan, and indeed longevity. Our findings – and others’- have spurred the World Health Organization in the past few years to call on governments to invest in more equitable access to arts and culture for public health, as well as arts projects to support more specific health outcomes. This is particularly pertinent as we recover from the COVID-19 pandemic and its lasting effects on public health.
As we continue our research, we believe it’s important to track how policymakers are responding to this globally, so we recently mapped over 130 international policy documents published since 2017. Our analysis of these documents, just published in Lancet Public Health, shows that there is indeed lots of interest in this area internationally, with many innovative policies aimed at realising the potential of the arts for public health. However, the exercise also highlighted that much more could still be done by health and cultural policymakers. Here, we summarise some of our observations from this work and share our calls to action for policymakers:
1) Protect funding for arts and culture:
The temptation to say ‘we can’t afford the arts when health systems are in crisis’ may be understandable to some on the surface, but in fact the reverse is true: given the links between arts engagement and better long-term health outcomes it seems we can’t afford not to invest in the arts. So, governments need to be aware that cuts to ‘general’ arts and culture may be a false economy when it comes to public health. Indeed, investing in the arts within our communities may help to take the pressure off health systems during challenging times.
2) See the links between geography, health inequality and the arts
Our research shows that geography and socioeconomics often dictate who is benefiting from access to arts and culture. People of lower socioeconomic groups, people in more deprived areas, and those with mental and physical health needs, often have lower levels of engagement in the arts and will therefore be missing out on the potential social and health benefits of culture. To avoid exacerbating health inequalities, policymakers must therefore give special focus to people who currently have the least access – both nationally and locally.
3) We need more equal commitment, and more collaboration, from health and arts policy makers
Our search suggested that arts policymakers may be more ready to recognise the link between arts and health than their health counterparts. Just 13 of 130 documents published 2017-2022 were from health bodies, compared to 35 from arts bodies. Possible reasons may include health partners perceiving a lack of evidence of the clinical effectiveness of the arts, seeing limited infrastructure for commissioning arts in health initiatives, or having little capacity to explore emerging and complex areas, especially right now. However, we believe the aim here is rather for health partners to work with arts partners on innovative approaches to their current crises, thus sharing the load of responsibility and giving them new resources to draw on. Two great examples are Greece and Wales, where health and arts agencies have published memoranda of understanding which commit them to (for example) supporting arts posts in health settings and social prescribing initiatives. These examples highlight that positive benefits to people and health systems can be achieved if bureaucratic boundaries can be overcome.
4) Balance local and national policymaking to make it real
Beyond these national imperatives, different geographical areas will have varying public health priorities. Since culture and the arts are also inherently local and place-based, we would like to see more national commitments to empowering (and investing in) local governments to respond to their own priorities for culture and health. A useful blueprint may be Finland, where local ‘cultural wellbeing plans’ have been published across multiple regions concurrently. Each municipality has identified key target groups (e.g., older people) and modes of arts applications in health (e.g., cultural prescriptions from GPs), with detailed delivery plans across these areas. This also allows grassroots cultural movement for health and wellbeing to flourish and flex as local areas’ priorities and populations change.
5) Look at the ecosystem
Of course, policy is only one part of the picture. Having lots of policies mentioning arts and health doesn’t necessarily mean more innovation is happening, and vice versa, a country may have a thriving arts and health movement without any real policy recognition. Policymakers therefore need to consider their role in this ecosystem. As others have commented, simply saying something about addressing equity of access to arts and culture is not enough. Yes, it’s about investment, but it’s also about valuing collaboration, creativity and wellbeing in our societies. About having a localised approach in practice, backed up by national and international commitments, even and especially in times of crises in public health systems. And finally, developing infrastructures and systems for culture and public health so that policies can translate into real change on the ground. We hope the examples we found can provide inspiration for policymakers towards a healthier and more creative future.
To read the full article, visit: https://doi.org/10.1016/S2468-2667(22)00313-9
To find our arts and health policy mapping tool, visit https://map.sbbresearch.org/