In 1986, the Finnish Institute of Occupational Health (an independent research institute linked with the Ministry of Social Affairs) invited the 12,173 workers at Enzo Guzeit – a major employer in the forestry industry, which accounted for 80–90 percent of income in Finland at that time – to participate in a survey. This was open to employees of all grades, from cleaners to managers, although the majority of the eventual sample (of whom 1,681 were women and 5,864 men) was comprised of blue-collar employees. Linking to national registers, participants with cardiovascular disease, cancer-related and alcohol-related diseases and psychological conditions (including suicidal behaviour) were excluded from the study. The questionnaire solicited information about engagement in socially shared arts and cultural activities, associations and societal action, as compared with individual engagement via reading and studying. Frequency was self-rated from low (a few times a year) to high (daily or near daily) with an intermediate category of once a week or twice a month. The original cohort was re-surveyed in 1996 and 2000 and followed up for survival until 2004 (using the National Death Registry data kept by Statistics Finland). Associations between cultural engagement and various types of mortality were assessed using Cox proportional hazard models. Account was taken of socio-demographic factors (including age, marital status, educational level, social contact, smoking, alcohol consumption, exercise), stress, diabetes and hypertension.
After adjusting for socio-demographic, biological and social factors and stress, the risk of all-cause mortality and deaths from cardiovascular and external causes (such as suicides, accidents and violence-related deaths) was found to be reduced for those regularly engaging with culture. After taking account of behavioural risk factors, this association remained for external-cause mortality (including the primary external causes of accidents and suicides) but it was significantly diminished for cardiovascular mortality. From this, the researchers concluded that there was a ‘robust link between cultural activities and the reduction in deaths from external causes’. Possible reasons given for this were previously reported links between cultural engagement, health status and morale, combined with the fact that engagement with non-risky cultural activity might insulate people from life-threatening situations while providing routes to better psychological health and diminishing the risk of suicide. Within this, solitary cultural activities seemed to be related to all-cause and cardiovascular mortality while socially shared cultural activity generally pertained to death from external causes, but this association was lost when adjusting for socio-economic status and behavioural risk factors. This led to the speculation that readers might be better informed about health risks, while mental health might be improved through socio-cultural engagement.
Arts and cultural activities were included as a catch-all category in the survey, alongside a range of other activities from gardening to housework. In future studies, it would be useful to have more differentiation between types of arts and cultural activities. As the distinction between collective and solitary participation was foregrounded in this study, it would also be beneficial to acknowledge the difference between (social) attendance at arts events and (individual) participation in the making of artwork. This would add complexion to the persistent debate around (passive) attendance and (active) creation.
Ari Väänänen, Michael Murray, Aki Koskinen, Jussi Vahtera, Anne Kouvonen and Mika Kivimäki, ‘Engagement in Cultural Activities and Cause-Specific Mortality: Prospective Cohort Study’, Preventive Medicine, 49, 2009, pp. 142–47.