Conclusions and future research questions
People viewing "Paris Street; Rainy Day, 1877" by Gustave Caillebotte, Art Institute of Chicago; Flickr
In conclusion, this study suggests that receptive arts engagement could have independent longitudinal protective associations with longevity in older adults. This association appears to be partly explained by differences in factors such as cognition, mental health, and physical activity among those who do and do not engage in the arts, but seems to be independent of these factors. This study did not compare the relative effect size of arts and other known predictors of mortality, but other factors such as socioeconomic status, physical health, and health behaviours undoubtedly have a larger bearing on mortality risk.
This study raises a number of future research questions. Firstly, we focused on receptive arts activities but were unable to assess the potential overlap with active participation in arts activities (such as making music, painting, and dancing) because no suitable questions were included in ELSA (Editor's Note: The English Language Skills Assessment). So how receptive arts activities compare with active arts activities remains to be explored.
Secondly, we assessed receptive arts engagement at a single point in time, but future studies could consider how life trajectories of receptive arts engagement are related to mortality. This study is important because of the current focus on schemes such as “social prescribing” and “community service referrals” that are being used to refer people (including older adults) to community arts activities in a number of countries. In addition to other literature that explores the benefits of such engagement for specific mental and physical health conditions, our results suggest that cultural engagement is associated with longevity. A causal relationship cannot be assumed, and unmeasured confounding factors might be responsible for the association. Nevertheless, our results highlight the importance of continuing to explore new social factors as core determinants of health.
*BMJ 2019;367:l6377
** E-value is a parameter that describes the number of hits one can "expect" to see by chance when searching a database of a particular size. It decreases exponentially as the Score (S) of the match increases. Essentially, the E value describes the random background noise.
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