The art of life and death: 14 year follow-up analyses of associations between arts engagement and mortality in the English Longitudinal Study of Ageing

Objective: To explore associations between different frequencies of arts engagement and mortality over a 14 year follow-up period. Design: Prospective cohort study. Participants: English Longitudinal Study of Ageing cohort of 6710 community dwelling adults aged 50 years and older (53.6% women, average age 65.9 years, standard deviation 9.4) who provided baseline data in 2004-05. Intervention: Self reported receptive arts engagement (going to museums, art galleries, exhibitions, the theatre, concerts, or the opera). Measurement: Mortality measured through data linkage to the National Health Service central register. Results: People who engaged with receptive arts activities on an infrequent basis (once or twice a year) had a 14% lower risk of dying at any point during the follow-up (809/3042 deaths, hazard ratio 0.86, 95% confidence interval 0.77 to 0.96) compared with those who never engaged (837/1762 deaths). People who engaged with receptive arts activities on a frequent basis (every few months or more) had a 31% lower risk of dying (355/1906 deaths, 0.69, 0.59 to 0.80), independent of demographic, socioeconomic, health related, behavioural, and social factors. Results were robust to a range of sensitivity analyses with no evidence of moderation by sex, socioeconomic status, or social factors. This study was observational and so causality cannot be assumed. Conclusions: Receptive arts engagement could have a protective association with longevity in older adults. This association might be partly explained by differences in cognition, mental health, and physical activity among those who do and do not engage in the arts, but remains even when the model is adjusted for these factors

Factors influencing self-harm thoughts and behaviours over the first year of the COVID-19 pandemic in the UK: longitudinal analysis of 49 324 adults

Background: There is concern that the COVID-19 pandemic and its aftermath will result in excess suicides by increasing known risk factors such as self-harm, but evidence on how pandemic-related risk factors contribute to changes in these outcomes is lacking. // Aims: To examine how different COVID-19-related experiences of and worries about adversity contribute to changes in self-harm thoughts and behaviours. // Method: Data from 49 324 UK adults in the University College London COVID-19 Social Study were analysed (1 April 2020 to 17 May 2021). Fixed-effects regressions explored associations between weekly within-person variation in five categories of adversity experience and adversity worries with changes in self-harm thoughts and behaviours across age groups (18–29, 30–44, 45–59 and 60+ years). // Results: In total, 26.1% and 7.9% of respondents reported self-harm thoughts and behaviours respectively at least once over the study period. The number of adverse experiences was more strongly related to outcomes than the number of worries. The largest specific adversity contributing to increases in both outcomes was having experienced physical or psychological abuse. Financial worries increased the likelihood of both outcomes in most age groups, and having had COVID-19 increased the likelihood of both outcomes in young (18–29 years) and middle-aged (45–59 years) adults. // Conclusions: Findings suggest that a significant portion of UK adults may be at increased risk for self-harm thoughts and behaviours during the pandemic. Given the likelihood that the economic and social consequences of the pandemic will accumulate, policy makers can begin adapting evidence-based suicide prevention strategies and other social policies to help mitigate its consequences

Do predictors of adherence to pandemic guidelines change over time? A panel study of 22,000 UK adults during the COVID-19 pandemic

In the absence of a vaccine, governments have focused on behaviour change (e.g. social distancing and enhanced hygiene procedures) to tackle the COVID-19 pandemic. Existing research on the predictors of compliance with pandemic measures has often produced discrepant results. One explanation for this may be that the determinants of compliance are context specific. Understanding whether this is the case is important for designing public health messaging and for evaluating the generalisability of existing research. We used data from the UCL COVID-19 Social Study; a large weekly panel of UK adults from first five months of lockdown in the UK (n = 22,625). We tested whether the extent to which demographic, socio-economic position, personality traits, social and pro-social motivations, and the living environment predict compliance changed across the pandemic using multilevel regression modelling. Low compliance was strongly related to younger age and also to risk attitudes, empathic concern, and high income, among other factors. The size of some of these associations was larger in later months when less stringent lockdown and household mixing measures were in place. The results showed that compliance was lower and fell faster across some groups, suggesting the importance that public health communications adopt a plurality of messages to maximize broad adherence

Associations between singing to babies and symptoms of postnatal depression, wellbeing, self-esteem and mother-infant bond

Introduction: There is growing research documenting the psychological benefits of singing. However, it remains unknown whether singing to new babies is associated with enhanced maternal mental health. This study had two aims: (i) to explore whether these associations exist, and (ii) to compare the effects of singing to babies with listening to music in order to explore whether the sound of music alone or the physical act of singing might be responsible for effects. Methods: Multiple linear and logistic regression models were used to analyse cross-sectional data from 391 new mothers, exploring associations between both singing to babies and listening to music, and symptoms of postnatal depression, wellbeing, self-esteem and self-rated mother-infant bond. Results: Singing to babies on a daily basis was associated with lower symptoms of postnatal depression and enhanced wellbeing, self-esteem and self-reported mother-infant bond. Listening to music was associated with lower depression and enhanced wellbeing but effects were attenuated by confounding variables involving other arts engagement. Discussion: These data suggest that the specific act of singing could support the mental health of new mothers. The correlations found in this study raise questions as to whether maternal singing to babies can causally improve maternal mental health and wellbeing and as such whether singing could be recommended to new mothers as a positive parenting practice, or whether supportive community singing interventions could be developed

Community group membership and multidimensional subjective well-being in older age

BACKGROUND: It has been highlighted as a public health priority to identify ways of supporting well-being in older age to allow people to lead healthy and integrated lifestyles. This study explored whether membership in eight different sorts of community groups was associated with enhanced experienced, evaluative and eudemonic well-being among older adults. METHODS: We analysed data from 2548 adults aged 55+ drawn from the English Longitudinal Study of Aging. We used multivariate logistic and linear regression models to compare change in well-being between baseline and follow-up 10 years later in relation to membership of different community groups while controlling for potential confounding variables. RESULTS: Membership in two types of community groups was associated with enhanced well-being: attending education, arts or music classes was longitudinally associated with lower negative affect (OR 0.73, CI 0.57 to 0.92) and life satisfaction (β 0.55, CI 0.02 to 1.08) while church or religious group membership was longitudinally associated with lower negative affect (OR 0.79, CI 0.65 to 0.98) and higher positive affect (OR 1.54, CI 1.25 to 1.90). There was no evidence of reverse causality through cross-lagged analyses. However, just 17.4% and 24.6% of older adults were found to engage in these two types of community groups, respectively, and several demographic factors were identified as barriers to participation. CONCLUSIONS: Overall, this study suggests that education, arts or music classes and church or religious groups may support well-being in older age. Programmes to encourage engagement could be designed for older adults who may not normally access these community resources

Could listening to music during pregnancy be protective against postnatal depression and poor wellbeing post birth? Longitudinal associations from a preliminary prospective cohort study

Objectives: This study explored whether listening to music during pregnancy is longitudinally associated with lower symptoms of postnatal depression and higher well-being in mothers post birth. Design: Prospective cohort study. Participants: We analysed data from 395 new mothers aged over 18 who provided data in the third trimester of pregnancy and 3 and 6 months later (0–3 and 4–6 months post birth). Primary and secondary outcome measures: Postnatal depression was measured using the Edinburgh Postnatal Depression Scale, and well-being was measured using the Short Warwick-Edinburgh Mental Well-being Scale. Our exposure was listening to music and was categorised as ‘rarely; a couple of times a week; every day <1 hour; every day 1–2 hours; every day 3–5 hours; every day 5+hrs’. Multivariable linear regression analyses were carried out to explore the effects of listening to music during pregnancy on depression and well-being post birth, adjusted for baseline mental health and potential confounding variables. Results: Listening during pregnancy is associated with higher levels of well-being (β=0.40, SE=0.15, 95% CI 0.10 to 0.70) and reduced symptoms of postnatal depression (β=−0.39, SE=0.19, 95% CI −0.76 to −0.03) in the first 3 months post birth. However, effects disappear by 4–6 months post birth. These results appear to be particularly found among women with lower levels of well-being and high levels of depression at baseline. Conclusions: Listening to music could be recommended as a way of supporting mental health and well-being in pregnant women, in particular those who demonstrate low well-being or symptoms of postnatal depression

Do socio-demographic factors predict children's engagement in arts and culture? Comparisons of in-school and out-of-school participation in the Taking Part Survey

There is evidence on the health, social and developmental benefits of arts and cultural participation for young people. While there is a known social gradient across adult arts participation where socially advantaged individuals are more likely to engage in the arts, it remains unclear whether socio-economic factors also affect child participation either in school or out of school. This study analysed cross-sectional data from 1,986 children aged 11–15 in the Taking Part Survey interviewed from 2015–2018. It focused on three aspects of children‘s participation: (i) performing arts activities, (i) arts, crafts and design activities, and (iii) cultural and heritage engagement. Results show a social gradient across all three activities for out-of-school engagement, but not for in-school engagement. Arts and cultural activities provided by schools are therefore important to ensuring universal access to the arts amongst young people

How is patient activation related to healthcare service utilisation? Evidence from electronic patient records in England

Background: There is increasing awareness of the importance of patient activation (knowledge, skills, and confidence for managing one’s health and health care) among clinicians and policy makers, with emerging evidence showing higher levels of patient activation are associated with better health outcomes and experiences of health care. This study aimed to examine the association between patient activation and a wide range of specific types of healthcare service utilisation in England, including GP and non-GP primary care, elective and emergency hospital admissions, outpatient visits, and attendances at the Accident and Emergency department. Methods: Data were derived from linked electronic patient records collected by primary and secondary healthcare providers in North West London between January 2016 and November 2019. Our analyses focused on adults (18+) with a valid Patient Activation Measure (PAM). After excluding patients with missing data, we had an analytical sample of 15,877 patients. Data were analysed using negative binomial regression and logistic regression models depending on the outcome variable. Results: Patients had a mean activation score of 55.1 and a standard deviation (SD) of 17.7 (range: 0–100). They had an average of 5.4 GP visits (SD = 8.0), 26.8 non-GP visits (SD = 23.4) and 6.0 outpatient attendances (SD = 7.9) within a one-year follow-up. About 24.7% patients had at least one elective admission, 24.2% had one or more emergency admissions, and 42.3% had one or more A&E attendance within the follow-up. After accounting for a number of demographic and health factors, we found a linear (or proximately linear) association between patient activation and the number of GP visits, emergency admissions and A&E attendance, but a non-linear relationship between patient activation and the number of non-GP visits, the number of outpatient attendance and elective inpatient admission. Conclusions: This study has provided strong empirical evidence from England linking patient activation with healthcare service utilisation. It suggests the value of supporting patient activation as a potential pathway to ease the burden of healthcare system

The interaction between social factors and adversities on self-harm during the COVID-19 pandemic: longitudinal analysis of 49 227 UK adults

BACKGROUND: Little is known about which factors exacerbate and buffer the impact of coronavirus disease 2019 (COVID-19)-related adversities on changes in thinking about and engaging in self-harm over time. AIMS: To examine how changes in four social factors contribute to changes in self-harm thoughts and behaviours over time and how these factors in turn interact with adversities and worries about adversities to increase risk for these outcomes. METHOD: Data from 49 227 UK adults in the UCL COVID-19 Social Study were analysed across the first 59 weeks of the pandemic. Fixed-effects logistic regressions examined time-varying associations between social support quality, loneliness, number of days of face-to-face contact for >15 min and number of days phoning/video calling for ≥15 min with self-harm thoughts and behaviours. We then examined how these four factors in turn interacted with the total number of adversities and worries about adversity and how this affected outcomes. RESULTS: Increases in the quality of social support were associated with decreases in the likelihood of both outcomes, whereas greater loneliness was associated with an increase in their likelihood. Associations were less clear for telephone/video contact and face-to-face contact with outcomes. Social support buffered and loneliness exacerbated the impact of adversity experiences on self-harm behaviours. CONCLUSIONS: These findings suggest the importance of the quality of one's social support network, rather than the mere presence of contact, for reducing the likelihood of self-harm behaviours in the context of COVID-19 pandemic-related adversity and worry