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Systematic Review
To determine the effectiveness of place-based arts interventions to improve wellbeing outcomes on healthy populations
Thee Community theme demonstrates an increase in children and young people's self-esteem, confidence, resilience (subjective), and collective self-esteem and sense of belonging (where we live) in disadvantaged youth communities. The studies use participatory art practices, particularly place-based narratives and active participation, to address heritage topics and, in one case, the use of new technologies, such as VR (duration & resources). Specialised training, hyper-local cultural leadership, professional empathy, and social networking (cultural networking & social capital) were also identified as mechanisms of success. These studies evidence how community embedded, medium- to long-term, participatory art practices have more long-lasting eudemonic effects. However, further longitudinal research would be needed 46 to corroborate these findings.The participants-centred and flexible arts interventions that draw on partnership working were particularly valuable to engage individuals from disadvantaged backgrounds and achieve positive wellbeing outcomes.
The Events theme has much more nuanced impacts. None looked at generalised trust as a wellbeing outcome, though various measures relating to community, connectiveness and belonging were explored. Both sub-themes, Music Festival and City/Capital of Culture, introduced a distinction between two typologies of art interventions: i) short-term, large-scale, aesthetically accessible, and free activities, staged in the city centre (e.g., concerts); and ii) hyper-local, co-created, intellectually challenging, expertly facilitated, longer-term and heritage focussed. These findings suggest that the former are arts interventions that can foster receptive participation (what we do) due to increased cultural offers and infrastructures, instantaneous trust between participants by celebrating together (our relationships), and improved image and identity (where we live), but without lasting effects. On the other hand, the latter, using the same mechanisms of success as the Community and Museum studies, seems to increase subjective wellbeing, active participation and volunteering (what we do) through place-based narratives, co-creation, and other participatory art practices, promoting social cohesion, community networks (our relationships and where we live), and improving skills (education and skills).
Adverse and neutral outcomes are also evidenced, namely the decline in community cohesion (where we live) and neutral impact in life satisfaction and happiness (personal) in the UK and Europe. Four studies provide evidence on how the City/Capital of Culture might exacerbate social inequalities at micro and macro levels – an increase for high-income, and a decrease for low-income residents in life satisfaction (personal) [12]; and only the developed European regions (including the UK) suffer less from hosting the ECoC.
The Museum theme provided evidence of how the museum as a heritage and community-asset can be a context for arts interventions that foster wellbeing and tackle health and social inequalities. These studies corroborate the value of social prescribing and volunteering to address social inequalities and increase active cultural participation. Studies from Museum and Community themes provide evidence of the value of medium- to long-term and heritage projects (duration & resources), artistic expertise, cultural leadership and social networking as positive enablers (cultural networking & social capital). Active participants and volunteers developed intellectually stimulating activities, creative networks and social connections with artists and other art experts, fostering social capital (our relationships). They produce artistic work through long-term participatory art practices (studies lasting up to 3 years), learn knowledgeable skills, and develop confidence in resource-rich, professional, empathic and safe environments (subjective, health, and education and skills).
Tasked with answering the question Can place-based arts interventions tackle the social determinants of health to reduce health inequalities? the review evidences that socially cohesive communities (social capital), and active cultural practice across the life course (cultural capital) are social and cognitive protective factors that enable health and wellbeing.
The museum and the community are favourable contexts for hyper-local, highly engaged, and medium- to long-term art and cultural practices. The museum is a rich heritage setting (e.g., collections, buildings, expertise) that can be a safe and stable environment to engage participants across the lifespan in medium- to long-term social prescribing programmes. The museum has the infrastructure to foster extensive (weak ties) cross-sector collaborations with health and social care, and intensive networks (strong ties) with experts, community cultural leaders, residents/participants/audiences. Museum-based volunteering was effective to develop cultural and social capital, with sustained long-term improvements in health, wellbeing, and employability.
Those interventions with community artistic expertise and cultural leadership were able to develop heritage-informed, intellectually challenging, and art co-creation activities with children and young people with historically low levels of participation in arts and culture. The medium- to long-term, hyper-local and collectively owned participatory art practices fostered complex social interactions, and sense of community, and increased active cultural participation, which developed cultural and social capital with potential sustained effects in wellbeing, community coherence, and skills. Investment in cultural infrastructure, urban regeneration and extensive event programmes fostering passive participation in cultural mega-events, with potential rerouting of public spending from other social priorities (e.g., health, affordable housing, etc.), leads to immediate and short-lived positive outcomes that can exacerbate social inequalities in the long-term.
Despite the evidence of the contribution of place-based arts interventions to alleviate the social determinants of health, caution is needed when considering their impact on the underlying causes of structural social inequalities. The review does not address the role of place-based arts interventions in the socioeconomic roots of social and health inequalities (e.g., poor housing, unemployment, food insecurity, etc.)