This area of assessment is one that needs further work, as it is currently a knowledge gap. This is particularly exacerbated by a lack of clarity about what we mean by culture. Furthermore the inherent value of culture is, in part, a philosophical assertion that can’t be measured in numbers. This is very much an area of well-being assessment that presents some challenges to understanding and quantifying the topic.

There is a paucity of hard evidence about the value and impact of culture on well-being, particularly at the local level. In order to understand the importance of a thriving culture for the well-being of the area and gauge how well we are doing we need to know a number of things for which we have limited (or even absent) information as they are not currently measured or monitored. Amongst other things we need to know:

• what do we ascribe as culture / cultural activity
• what cultural assets or provision do we currently have?
• where is it, what is it, who is it experienced by or delivered to, who is providing it?
• are these the right places / people / types of provision?
• what counts as a ‘good’ standard of provision?
• how do we measure the impact of culture?

There has been some secondary research on the subject, however. In a 2014 report ^[i] the Arts Council for England states that:

“..art and culture make life better, help to build diverse communities and improve our quality of life. Great art and culture can inspire our education system, boost our economy and give our nation international standing.”

The report lays out some of the positive impacts that access to and participation in arts and cultural events can have on:

Individual well-being

• Those who had attended a cultural place or event in the previous 12 months were almost 60 per cent more likely to report good health, compared to those who had not, and theatre-goers were almost 25 per cent more likely to report good health.
• Research has evidenced that a higher frequency of engagement with arts and culture is generally associated with a higher level of subjective well-being.
• Engagement in structured arts and culture improves the cognitive abilities of children and young people.
• A number of studies have reported findings of applied arts and cultural interventions and measured their positive impact on specific health conditions which include dementia, depression and Parkinson’s disease.
• The use of art, when delivered effectively, has the power to facilitate social interaction as well as enabling those in receipt of social care to pursue creative interests. The review highlights the benefits of dance for reducing loneliness and alleviating depression and anxiety among people in social care environments.

Community well-being

• There is strong evidence that participation in the arts can contribute to community cohesion, reduce social exclusion and isolation, and/or make communities feel safer and stronger.
• Culture and sport volunteers are more likely than average to be involved and influential in their local communities.
• High-school students who engage in the arts at school are twice as likely to volunteer as those who don’t engage in the arts and are 20 per cent more likely to vote as young adults.
• Employability of students who study arts subjects is higher and they are more likely to stay in employment.

Education

• Taking part in drama and library activities improves attainment in literacy.
• Taking part in structured music activities improves attainment in maths, early language acquisition and early literacy.
• Schools that integrate arts across the curriculum in the US have shown consistently higher average reading and mathematics scores compared to similar schools that do not.

The economy

• Arts and culture can boost local economies through attracting visitors; creating jobs and developing skills; attracting and retaining businesses; revitalising places; and developing talent.
• Businesses in the UK arts and culture industry generated an aggregate turnover of £12.4 billion in 2011.
• For every £1 of salary paid by the arts and culture industry, an additional £2.01 is generated in the wider economy through indirect and induced multiplier impacts.

Religion and spirituality

In the past decade or so, researchers across a range of disciplines have started to explore and acknowledge the positive contribution spirituality can make to mental health ^[ii] . Service users and survivors have also identified the ways in which spiritual activity can contribute to mental health and wellbeing, mental illness and recovery.

Depression is the most common mental health problem in the UK and has been the focus of much of the research exploring the relationship between spirituality and mental health. The evidence shows a positive association between attendance at a place or worship and lower levels of depression amongst adults, children and young people. It also shows that belief in a transcendent being is associated with reduced depressive symptoms.

Similar research has examined the relationship between spirituality and anxiety or stress. Quantitative research demonstrates reduced levels of anxiety in a number of populations, including medical patients in later life, women with breast cancer, middle aged people with cardiac problems and those recovering from spinal surgery. Qualitative research also demonstrates that yoga and meditation are also associated with improvements in mental health and reductions in anxiety.

There is an emerging literature examining the association between spirituality and post-traumatic stress disorder (PTSD). One review found 11 studies that reported links between religion, spirituality, and trauma-based mental health problems. They found that religion and spirituality are usually, although not always, beneficial to people in dealing with the aftermath of trauma.

[i] The value of arts and culture to people and society: an evidence review, Arts Council England, 2014 http://www.artscouncil.org.uk/sites/default/files/download-file/Value_arts_culture_evidence_review.pdf

[ii] The Impact of Spirituality on Mental health, Mental Health Foundation 2006

The impact of culture on well-being is highlighted by the Chief medical Examiner for Wales’ annual report. Social prescribing is a non-medical health and well-being based approach that expands the range of options available to primary care clinicians and patients to improve healthy life behaviours, for example services such as choirs, gardening and walking clubs, debt advice, volunteering networks and befriending. The social prescribing approach can improve self-esteem, mood and self-efficacy, social contact and the development of transferable skills to help the management of chronic conditions. Demand for health services can be decreased where the medical model of care is not the most effective solution.