Crossing the Baltic Sea to Finland, this study sought to explore the relationship between leisure participation and survival. The Mini-Finland Health Survey – a two-stage cluster sample of 8,000 people aged 30–99, carried out in 1978–80 – was designed to assess health status and its determinants via a comprehensive health examination, interviews and questionnaires. Demographic questions included residential stability, socio-economic status, marital status and relations, trusting relationships, alcohol consumption and smoking. Health data related to mental health, self-reported chronic diseases or disabilities and self-rated overall health. Cultural and leisure attendance took account of: (1) clubs and voluntary societies; (2) cultural and sports attendance (including theatre, cinema, concerts, art exhibitions and sporting events); (3) religious engagement and (4) outdoor activities. The questionnaire also recorded more participatory activities such as (5) studying, (6) cultural interests (reading, listening to music) and (7) so-called hobby activities (including drama, singing, photography, painting and handicraft). The frequency of these activities was allotted a numerical value from never (0) to once a week or more (3), and a cumulative activity score was achieved by multiplying the number of leisure activities engaged in by their frequency (maximum = 21).
Since the baseline survey, the mortality of survey participants was followed up to 2002, showing 962 subjects (632 men and 330 women) to have died. Multivariable Cox proportional hazard models were applied to survival, controlling for relevant covariates. This showed that ‘68.5% of the subjects with scarce leisure participation and 84.6% of the subjects with intermediate and abundant participation were alive’ (p. 7). However, this association was found to be lacking in healthy women.
The research team acknowledged the limitations of this study, including the lack of sampling during a long intermediary period in which Finland experienced an economic recession. They also accepted that reverse causation was in evidence as ‘self-reported and self-rated health predicts survival and modifies leisure engagement’ (p. 10). Equally, participants may have had undiagnosed cancers at the time of the baseline study, which was not captured in self-rated health measures. Nonetheless, the researchers maintained that the ‘significant protective effect of the leisure activity endures. Although our findings suggest causality from leisure participation towards health, this does not rule out that leisure participation in itself may be a component of health’ (Ibid).
In this study, cultural participation is inextricably linked to social capital, using individual measures of social participation. This implies that it is the social side of cultural engagement which has an impact, with even reading and listening to music linked to social action via public libraries, and it goes some way towards explaining the gender-specific nature of these findings. A social capital approach permits a multiplicity of diverse leisure-time activities to be bunched together in the analysis, obviating any differentiation between art forms and between passive and active forms of cultural engagement. Re-interpretation of the same data with attention to art form specificity would be pertinent in the future, as would closer inspection of the biochemical measurements taken during the baseline survey.
Markku T. Hyyppä, Juhani Mäki, Olli Impivaara and Arpo Aromaa, ‘Leisure-Based Participation Predicts Survival: A Population-Based Study in Finland’, Health Promotion International, 21, no. 1, 2006, pp. 5–12.