Four years later, the Swedish team followed up their 1996 study, this time to 31 December 1996. From the original random sample of 10,609 people (5,364 men and 5,245 women) aged 25–74 years, 916 men and 600 women found to have died in the intervening period. The purpose of this study was to introduce differentiation between the different types of cultural activity in which respondents had participated. In this regard, the seven independent variables were attendance at: the cinema, theatre, concerts, art exhibition, museum, church service and sporting event. Attendance at each type of event was stratified into rarely, sometimes and at least once a week. Among the potential confounders, cash buffer was used instead of income, and music-making and reading were inserted as background variables known to have a positive impact upon health.
Regarding the control variables, the same pattern was observed as before, with educational level exhibiting a more pronounced positive bias in relation to survival. Significantly, social ties were found to have a negligible effect as a confounder, irrespective of strength/quality. When checking for the effect on life expectancy of each of the cultural variables, a positive association was observed for cinema, concerts, art exhibition and museum visits but not for theatre, church or sporting attendance. The discussion drew attention to the fact that the art forms in which a positive association was observed are all nonverbal.
As the same dataset was used as in the previous study, the same weaknesses persisted. These included the lack of complexion offered by frequency measures when contemplating the qualitative cultural experience and the possible negative effects of cultural engagement. The team also confessed to not knowing which residual confounders might remain. Notwithstanding these limitations, the art form differentiation identified as lacking in the previous study was addressed.
The possible mechanisms through which arts participation might influence health were elaborated upon. Consideration was given the communicative theory of art action (which prioritises the symbolic nature of nonverbal art forms and their power in structuring feelings), the arousal theory (which supposes that art stimulates functions necessary to our survival as a species, including food, sex and death) and the psychoanalytic theory (which presumes that art offers vicarious satisfaction of sublimated desires). The neuro-immunological possibilities considered in the previous study were reiterated, and the connection between the hypothalamus, pituitary and adrenal glands (the HPA axis) and depression was elaborated, with cultural attendance thought to contribute to an enriched environment, increasing neural receptors in the hippocampus and lowering depression.
Boinkum Benson Konlaan, Lars Olov Bygren and Sven-Erik Johansson, ‘Visiting the Cinema, Concerts, Museums or Art Exhibitions as Determinant of Survival: A Swedish Fourteen-Year Cohort Follow-Up’, Scandinavian Journal of Public Health, 28, 2000, pp. 174–78.
Reproduced by permission of SAGE Publications Ltd., London, Los Angeles, New Delhi, Singapore and Washington DC.