Arts & Health

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Following an earlier special issue of this journal focused on music and health (Clift, 2002), I welcome the opportunity to bring together a wider spectrum and commentary and research on arts and health in this special issue and a second planned for early 2006. Health educators and health promoters have long understood the value of theatre and music as media for communicating health messages, but increasingly it is recognised that active participation in the arts has considerable potential in directly promoting key aspects of individual health and wellbeing – enjoyment, positive social relationships, self-esteem and empowerment. As a context for the specific contributions in the special issues, I felt it was useful to outline some of the recent key developments and publications in this exciting field, which together point to considerable interest and activity in arts and health since the late 1990s. A key turning point in the recent history of arts and health in the UK was the Windsor Conferences (1998/1999) organised under the auspices of the Nuffield Trust to explore the potential of the arts in contributing to health care and therapy, health professional training, hospital design, and the promotion of healthy communities. Following these conferences, the Nuffield Trust published valuable reports giving an overview of debates and developments in the field (Philipp, 2002; Coates, 2005). The National Network for the Arts in Health was launched shortly after the Windsor Conferences in 2000, and membership has shown consistent growth over the last five year to its current level of 165 individuals and 274 organisations across the country (Lara Dose, personal communication, 19 April 2005). The National Network not only has provided a valuable information service of its members – on resources, research and funding sources, it has undertaken advocacy for the role of the arts in health – helping to persuade and enthuse. The last five years has also seen over 60 major national and regional conferences with a specific focus on arts and health – and this interest shows little signs of abating, with two major conferences on arts and mental health due to take place in May this year: “Arts for Life’s Sake: Creativity and mental health” organised by the Mental Health Foundation in Glasgow, and “Mental Health and Art: Breaking down every barrier through creativity”, organised by Pavilion in Birmingham. Arts and health has also become a regular feature of mainstream public health conferences with, for example, the Faculty of Public Health conference in Eastbourne 2004 and the United Kingdom Public Health Association conference in Gateshead 2005, giving arts and health prominent attention. At the level of national policy and strategic developments – there have been some encouraging signs that government departments in the UK have begun to look favourably on the value of the arts for health – though we still await a strong central lead. It is regrettable, for instance, that the recent White Paper Choosing Health (DoH, 2004) contains no references to or case studies of arts and health projects. Nevertheless, the Minister for Public Health, Hazel Blears, highlighted in a recent speech (2003) “. . . the contribution that I know the arts and culture can – and does – make to community health and well-being.” The arts she acknowledged: . . . have made a direct contribution to health education and promotion work, helping to develop and reinforce positive empowering images to both involve and get messages across to different groups. The Department of Culture, Media and Sport (DCMS) provides more useful guidance on arts and social policy, including health, and the Department (together with the Department of Health and the National Institute for Mental Health in England) has recently commissioned research on arts and mental health by a team at Anglia Polytechnic University and the University of Central Lancashire under the direction of Professor Jenny Secker, a key aim of which is “to pull together what is already known about the benefits of arts participation” (project update, April 2005). The Scottish Executive has also produced a valuable report reviewing the evidence-base for social policy in culture, the arts and sport (Ruiz, 2004). Chapter seven of the report focuses specifically on health, and is set within a wide-ranging discussion of social impacts of the arts in the areas of regeneration, social inclusion, crime reduction and addressing prejudice – all of which are recognised as important in improving health in communities. Many local authorities, through their cultural strategies, have acknowledged the significance of culture (including the arts, leisure activities and sports) in helping to meet their statutory obligations to promote community wellbeing. Particularly fine examples of development work in this respect are provided by the Cultural Strategy for London and the efforts put into reviewing evidence on the links between culture and community health and wellbeing (London Health Commission, 2002; Cave and Coutts, 2002). The Arts Council’s position on arts and health has in recent years been consistently supportive – though issues of reorganisation and limited funding have restricted what they have been able to achieve. Nevertheless, a few of the Arts Council regions have produced important reviews and strategy documents accessible through the Arts Council web site – and currently a national strategy for arts and health is under development (Taylor, 2004), and is expected in Summer 2005. From a health service perspective, important work has been undertaken by NHS Estates around hospital design, and independent health/policy groups such as the King’s Fund have played an important role in raising the profile of arts in health settings. Currently, NHS Estates is working with the National Network for Arts in Health in undertaking a cost-benefit analysis of attention to arts and design in hospital settings (Lara Dose, personal communication, 19 April, 2005).Everyone with an interest in arts and health is exercised by the issue of “evidence”, and the need both to demonstrate the effectiveness of arts-based interventions for health and to understand the processes by which engagement in the arts and creative activity can be beneficial for health. Before its demise, the Health Education Authority commissioned a useful survey of arts and health initiatives, and similar surveys of provision have been undertaken on a regional basis (White, 2003; Clift and Vella-Burrows, 2003). Angus (2002) provides a review of approaches to evaluation in arts and health projects, and Staricoff (2004) has comprehensively reviewed the medical literature on arts in health and describes research studies that have shown “clear and reliable evidence that clinical outcomes have been achieved through the intervention of the arts” – for example, that encouraging people to attend cultural events can reduce blood pressure and reduce levels of stress hormones (Konlaan et al., 2000). Academic centres with a specific focus on arts and health, currently exist in the Universities of Durham, Manchester Metropolitan and Canterbury Christ Church, and each is actively pursuing research and evaluation. Many individual academics across the country are also engaged in researching and evaluating the health dimensions of the arts. I hope these special issues will give a valuable overview of some of the important work accomplished in the field in the last few years. The current issue begins with a valuable overview by Macnaughton et al. of the research challenge facing advocates of arts and health work, and is followed by two qualitative evaluations of local arts and health initiatives in different parts of the UK. Together these papers show the kind of qualitative approach that has generally been adopted in evaluating community arts for health initiatives – and signal the need perhaps for larger scale, longer-term and more controlled studies. The review by Marks, which follows, focuses on dance therapy and Tai Chi for people affected by arthritis and offers a possible goal for research in arts and health – to achieve a consensus on the specific health benefits of engagement in particular art forms for clearly defined groups of people or health conditions, through the careful review of available evidence. On the other hand, some might resist the view that the value of creative activities for health is something that can be researched in a controlled, quantifiable manner. This is a debate that will continue to run. Finally, Barnes, in highlighting the role of creative and arts-based activities in promoting more happiness in schools – argues that expressions on children’s faces are a key source of evidence on the health promoting character of a school. Perhaps in evaluating the impact of creative activities and the arts, researchers need to give as much attention to what they can see – as they do to what people say and what can be measured.

Stephen Clift
Sidney De Haan Research Centre for Arts and Health, Canterbury Christ Church University, Folkestone, UK

Previously published in: Health Education, Volume 105, Number 5, 2005 less

Emerald Group Publishing Limited; September 2005
80 pages; ISBN 9781845447564
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