Longitudinal Associations Between Arts Engagement and Flourishing in Young Adults: A Fixed Effects Analysis of the Panel Study of Income Dynamics

There is growing evidence on the impact of arts engagement on flourishing. However, social gradients in arts engagement and flourishing may have led to an overestimation of this impact, and there is a lack of longitudinal research in young people. We aimed to test the longitudinal associations between arts engagement and flourishing in emerging adults, accounting for observed and unobserved individual characteristics. We included 3,333 participants aged 18–28 from the Transition into Adulthood Supplement of the Panel Study of Income Dynamics. We measured flourishing across emotional, psychological, and social wellbeing, and frequency of engagement in artistic, musical, or theatrical organized activities, biennially 2005–2019. We analyzed data using fixed effects regression and Arellano-Bond methods to control for bidirectional relationships. Increases in arts engagement were associated with increases in flourishing, before and after adjusting for time-varying confounders. This relationship was driven by enhanced psychological and social wellbeing. After controlling for bidirectionality, increases in arts engagement predicted subsequent improvements in flourishing and social wellbeing. In sensitivity analyses, residential area was a moderator; arts engagement was only associated with increased flourishing in metropolitan (and not non-metropolitan) areas. Increases in arts engagement are associated with enhanced flourishing within individuals, and these associations hold across many subgroups of the population. Those in non-metropolitan areas may have fewer opportunities for arts engagement. Future work must consider how funding can be distributed to ensure that the arts are accessible across communities and geographical areas, providing all young people with opportunities to experience their potential benefits

Cross-sectional and longitudinal associations between arts engagement, loneliness, and social support in adolescence

PURPOSE: Although arts engagement holds promise for reducing loneliness and enhancing social support, previous research has focussed on older adults. We investigated whether arts engagement was associated with loneliness and social support during adolescence. METHODS: We included 11,780 adolescents aged 11–21 years from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative cohort study. We measured whether adolescents engaged in school-based arts activities (band, book club, chorus, choir, cheerleading, dance, drama club, newspaper, orchestra) at wave one (1994–1995). Loneliness and perceived social support from peers were measured at waves one and two (1996). We used logistic regression to test whether arts engagement was associated with concurrent and subsequent loneliness and social support. RESULTS: Arts engagement was not associated with concurrent or subsequent loneliness. Compared to not engaging, doing one or more school-based arts activities was associated with 59% higher odds of high social support concurrently (odds ratio [OR] = 1.59, 95% CI = 1.32–1.91). However, this cross-sectional association was attenuated after adjusting for demographic, socioeconomic, and health-related covariates (adjusted OR [AOR] = 1.16, 95% CI = 0.95–1.42). In contrast, doing arts activities was associated with 28% higher odds of reporting high social support one year later (AOR = 1.28, 95% CI = 1.03–1.59), independent of covariates and previous social support. CONCLUSIONS: Extracurricular arts activities are associated with increased odds of reporting good subsequent social support from peers. This may be because they provide opportunities for social engagement, developing friendships, and building a sense of community. Exploring these associations in more detail should be a priority, enabling better understanding of this strategy for enhancing social ties during adolescence

Associations of arts and cultural engagement with substance use trajectories in adolescence and early adulthood: a latent growth curve analysis of the Add Health cohort

Introduction: Substance use (e.g., alcohol, marijuana, tobacco) is common during adolescence and may lead to a number of long-term negative outcomes (e.g., poor mental health). It is therefore important to explore factors that reduce the risk of engaging in these potentially harmful behaviours. Extracurricular activities (i.e., how people spend their free time) are known to be effective in reducing the risk of engaging in substance use, but the specific effects of arts and cultural engagement are less known. // Methods. Data were from the first four waves (1994-2008) of the National Longitudinal Study of Adolescent to Adult Health (ages 12-17 years). Arts and cultural engagement were measured at wave 1 (1994) by (i) the number of arts and culture groups engaged in and (ii) the weekly frequency of arts and culture related hobbies. Substance use was measured using three binary indicators of any past month alcohol intoxication, marijuana, and tobacco use measured at waves 1 to 4. Latent growth curve modelling was used to examine associations between arts and cultural engagement (group participation and weekly hobbies) at wave 1 and trajectories of past month alcohol intoxication, marijuana use, and tobacco use over waves 1 to 4. Analyses accounted for sociodemographic covariates. // Results. At wave 1, participating in more arts and cultural groups was associated with lower concurrent likelihood of being intoxicated by alcohol and using tobacco. However, longitudinally, differences in likelihoods began to narrow across waves until there was no difference by wave 4. There was no association with marijuana use. Similar results were found for engagement in hobbies; adolescents who participated in more weekly hobbies were less likely to have used any of the three substances concurrently, although over time, the differences between the groups narrowed. However, there was some evidence that the differences persisted across waves when using a less stringent (weekly) alcohol intoxication variable. // Conclusions. Overall, this research confirms associations between arts and cultural engagement and substance use at a population level amongst adolescents in the US. Actively engaging in arts and cultural activities is associated with reduced risk of concurrent substance use suggesting a potential protective relationship. However, this protection attenuates over time. As we only examined arts and cultural activities at one time point, whether sustained engagement in these activities differentially influences the risk of substance use requires further investigation

Associations between extracurricular arts activities, school-based arts engagement, and subsequent externalising behaviours: Findings from the Early Childhood Longitudinal Study

Introduction: Externalising behaviours during adolescence are associated with numerous long-term negative outcomes, although the majority of research is intervention-based as opposed to focused on risk reduction. Arts engagement has been associated with numerous beneficial factors linked to externalising behaviours, yet direct evidence linking them in longitudinal studies is lacking. / Methods: Data from the Early Childhood Longitudinal Study were used, with baseline taken at 5th grade (aged 10-11 years) and outcomes measured at 8th grade (13-14 years). Ordinary least squares regression was used to examine individual-level associations between extracurricular and school-based arts engagement (number arts classes and adequacy of arts facilities) with externalising behaviours measured using the Strengths and Difficulties Questionnaire. Poisson regression was used to examine associations between school-level arts classes and facilities with an administrator-reported index of externalising behaviours in the school. All models were adjusted for sociodemographic factors. Individual-level analyses were clustered by school. / Results: At the individual level, engaging in a greater number of extracurricular arts activities in 5th grade was associated with fewer externalising behaviours in 8th grade, although there was no association for school-based arts engagement. There were no school-level associations between arts classes or adequate arts facilities and externalising behaviours. / Conclusions: Our results suggest extracurricular arts activities may be beneficial in reducing the risk for externalising behaviours, but the relationship is seen at an individual-level of engagement rather than based on school-level provision or facilities. Ensuring extracurricular access to the arts should be considered as a cost-effective way of preventing externalising behaviours while simultaneously promoting healthy emotional, coping, and social behaviours

Associations of Social, Cultural, and Community Engagement With Health Care Utilization in the US Health and Retirement Study

IMPORTANCE: There is growing evidence for the health benefits associated with social, cultural, and community engagement (SCCE), including for supporting healthy behaviors. However, health care utilization is an important health behavior that has not been investigated in association with SCCE. OBJECTIVE: To examine the associations between SCCE and health care utilization. DESIGN, SETTING, AND PARTICIPANTS: This population-based cohort study used data from the 2008 to 2016 waves of the Health and Retirement Study (HRS), a longitudinal panel study using a nationally representative sample of the US population aged 50 years and older. Participants were eligible if they reported SCCE and health care utilization in the relevant HRS waves. Data were analyzed from July to September 2022. EXPOSURES: SCCE was measured with a 15-item Social Engagement scale (including community, cognitive, creative, or physical activities) at baseline (frequency) and longitudinally over 4 years (no, consistent, increased, or decreased engagement). MAIN OUTCOMES AND MEASURES: Health care utilization was assessed in association with SCCE within 4 overarching categories: inpatient care (ie, hospital stays, hospital readmissions, length of hospital stays), outpatient care (ie, outpatient surgery, physician visits, number of physician visits), dental care (including dentures), and community health care (ie, home health care, nursing home stays, nights in a nursing home). RESULTS: A total of 12 412 older adults (mean [SE] age, 65.0 [0.1] years; 6740 [54.3%] women) were included in short-term analyses with 2 years of follow-up. Independent of confounders, more SCCE was associated with shorter hospital stays (incidence rate ratio [IRR], 0.75; 95% CI, 0.58-0.98), greater odds of outpatient surgery (odds ratio [OR], 1.34; 95% CI, 1.12-1.60) and dental care (OR, 1.73; 95% CI, 1.46-2.05), and lower odds of home health care (OR, 0.75; 95% CI, 0.57-0.99) and nursing home stays (OR, 0.46; 95% CI, 0.29-0.71). Longitudinal analysis included 8635 older adults (mean [SE] age, 63.7 [0.1] years; 4784 [55.4%] women) with data on health care utilization 6 years after baseline. Compared with consistent SCCE, reduced SCCE or consistent nonparticipation in SCCE was associated with more inpatient care utilization, such as hospital stays (decreased SCCE: IRR, 1.29; 95% CI, 1.00-1.67; consistent nonparticipation: IRR, 1.32; 95% CI, 1.04-1.68) but lower levels of subsequent outpatient care, such as physician visits (decreased SCCE: OR, 0.68; 95% CI, 0.50-0.93; consistent nonparticipation: OR, 0.62; 95% CI, 0.46-0.82) and dental care utilization (decreased SCCE: OR, 0.68; 95% CI, 0.57-0.81; consistent nonparticipation: OR, 0.51; 95% CI, 0.44-0.60). CONCLUSIONS AND RELEVANCE: These findings suggest that more SCCE was associated with more dental and outpatient care utilization and reduced inpatient and community health care utilization. SCCE might be associated with shaping beneficial early and preventive health-seeking behaviors, facilitating health care decentralization and alleviating financial burden by optimizing health care utilization

Cross-sectional and longitudinal associations between arts engagement, loneliness, and social support in adolescence

Objective: Although arts engagement holds promise for reducing loneliness and enhancing social support, previous research has focussed on older adults. We investigated whether arts engagement was associated with loneliness and social support during adolescence. / Method: We included 11,060 adolescents aged 11-21 years from the National Longitudinal Study of Adolescent to Adult Health. The number of school-based arts activities engaged in (band, book club, chorus/choir, cheerleading/dance, drama club, newspaper, orchestra) was measured at wave one (1994-1995) and loneliness and perceived social support were measured at waves one and two (1996). We used logistic and linear regression to test whether engagement was associated with concurrent and subsequent loneliness and social support. / Results: Arts engagement was not associated with concurrent or subsequent loneliness. In contrast, each additional arts activity engaged in was associated with an increase of 0.20 points in social support, concurrently (coef=0.20, 95% CI=0.02-0.38, p=0.03) and longitudinally (coef=0.20, 95% CI=0.02-0.38, p=0.03), independent of confounders. However, evidence for the longitudinal association was attenuated after adjusting for previous social support (coef=0.08, 95% CI=-0.07-0.23, p=0.30). This was likely due to the consistency of social support scores between waves one and two. / Conclusion: Extracurricular arts activities are associated with higher social support, which may be because they provide opportunities for social engagement, developing friendships, and building a sense of community. However, given the lack of association with changes in social support over time, exploring these associations in more detail should be a priority, enabling better understanding of this strategy for enhancing social ties during adolescence

Receptive and participatory arts engagement and subsequent healthy aging: Evidence from the Health and Retirement Study

RATIONALE: Arts engagement is associated with prolonged longevity, but it remains unclear whether it is also associated with increases in the portion of people's lives for which they remain healthy. We investigated whether receptive and participatory arts engagement were associated with healthy aging two and four years later. METHOD: We included 1269 older adults from the Health and Retirement Study (HRS), a longitudinal study of individuals aged 50 and above in the United States. Participants who completed the HRS 2014 Culture and the Arts Module and who were alive in 2016 and 2018 were eligible. We measured the number of participatory arts activities engaged in (e.g., crafts, dancing) and frequency of receptive arts engagement (e.g., going to a gallery or performance) in the past year. Healthy aging was a binary outcome, conceptualized as no major chronic diseases, no cognitive impairment, good physical functioning, and good mental health. RESULTS: In logistic regression models, doing receptive arts once a month or more was associated with higher odds of healthy aging four years later compared to never engaging (odds ratio [OR] = 1.80, 95% CI = 1.10, 2.96). However, this evidence was attenuated after adjusting for demographic and socioeconomic covariates (adjusted OR = 1.44, 95% CI = 0.84, 2.46). The number of participatory arts activities engaged in was not associated with healthy aging two or four years later. In sensitivity analyses, there was some evidence that receptive engagement was associated specifically with higher odds of good physical functioning four years later. CONCLUSIONS: The lack of consistent associations between receptive and participatory arts engagement and healthy aging was unexpected given previous evidence for links between arts engagement and each of the four domains of healthy aging. Our findings highlight key methodological issues that should be explored in further research with larger nationally representative samples, longer follow-ups, and more detailed measures of arts engagement

Associations between participation in community arts groups and aspects of wellbeing in older adults in the United States: a propensity score matching analysis

Objectives: There is a social gradient in both arts engagement and wellbeing that may have led to an overestimation of the impact of arts engagement on wellbeing. We tested whether participation in community arts groups was associated with wellbeing after removing confounding by demographic, socioeconomic, and health-related factors. Methods: Using propensity score matching, we analyzed data from 12,055 older adults in the Health and Retirement Study. We measured community arts groups participation and concurrent life satisfaction (evaluative wellbeing), positive and negative affect (experienced wellbeing), and purpose in life, constraints on personal control, and mastery (eudaimonic wellbeing). Results: After matching, arts group participation was associated with higher positive affect (average treatment effect on the treated [ATT] = 0.18, 95% CI = 0.12–0.24), life satisfaction (ATT = 0.09, 95% CI = 0.04–0.15), purpose in life (ATT = 0.07, 95% CI = 0.02–0.13), and mastery (ATT = 0.07, 95% CI = 0.01–0.14) than not participating. Participation was not associated with negative affect or constraints on personal control. In sensitivity analyses, these associations were maintained four years later. Conclusion: Arts group participation was associated with the positive elements of evaluative, experienced, and eudaimonic wellbeing. Facilitating participation in community arts groups could help to promote healthy aging, enabling a growing segment of the population to lead more fulfilling and satisfying lives

Arts and Cultural Engagement, Reportedly Antisocial or Criminalized Behaviors, and Potential Mediators in Two Longitudinal Cohorts of Adolescents

Arts and cultural engagement is a potential strategy for reducing or preventing reportedly antisocial or criminalized behaviors (those previously and problematically termed as "delinquent") in adolescence. However, most research to date has focused on arts-based interventions and has not tested arts and cultural engagement in large population-based longitudinal studies. This study investigated whether arts and cultural engagement reduced reportedly antisocial or criminalized behaviors in two large nationally representative cohorts, the National Longitudinal Study of Adolescent to Adult Health (n = 10,610; 50% female, 72% White, age range = 11-21 mean = 15.07) and the National Education Longitudinal Study of 1988 (n = 15,214; 50% female, 73% White, age range = 13-16 mean = 14.38). Structural equation modelling also allowed exploration of two potential mechanisms that might link arts and cultural engagement to reportedly antisocial or criminalized behaviors (self-control and attitudes towards these behaviors). More arts and cultural engagement was associated with fewer reportedly antisocial or criminalized behaviors, better self-control scores, and fewer positive perceptions of reportedly antisocial or criminalized behaviors concurrently and one to two years later. Arts and cultural engagement may provide opportunities for adolescents to realize positive developmental outcomes, reducing their risk of reportedly antisocial or criminalized behaviors