Evaluating arts and health

 “Art is an irreplaceable way of understanding and expressing the world. There are some truths about life that can be expressed only as stories, or songs, or images. Art delights, instructs, consoles. It educates our emotion.”

These words from American poet Dana Gioia (2007) allude to the unique and emotive qualities of art in expressing and sharing human narratives and experiences.

I think intuitively we all know, understand and value the role arts play in society and in our lives.  My experience of the arts is that they can make you feel things, experience a range of emotions as intended or otherwise by the artist. Importantly the arts can be shared and experienced with friends and loved ones and can also enable you to meet new people and become part of new communities.

I’m not sure that the impacts of the arts can ever truly be measured. The arts or a particular art form are unique in the mind, senses and heart of the individual experiencing it. Art is surely a diverse, multidimensional, experiential and emotionally-driven phenomenon. Then, of course, there is the distinction between directly participating in the arts and broader attendance. Whether you are playing in an orchestra or listening to it, both forms of engagement are valuable.

Arts and society

In recent years the perception of the role arts can play in society has changed somewhat. Increasingly the arts have been utilised as a vehicle for delivering social regeneration – to engage and strengthen communities, to address damaging social behaviours and to enhance social capital and employability. All of which has the potential to improve the health and wellbeing of the community members involved. With the arts being used in this way within communities, funding bodies are applying greater scrutiny to assess the impacts of such investment.

The tension between just ‘knowing’ that the world would be a paler version of itself without art versus the need to ‘measure’ the arts is one I feel on a daily basis although I am drawing closer to reconciling this tension. I am privileged to lead the evaluation of Sistema Scotland. Sistema Scotland delivers arguably Scotland’s highest profile social intervention.

Through its ‘Big Noise’ programme Sistema Scotland believes that children from disadvantaged backgrounds can gain significant social benefits by playing in a symphony orchestra which may lead to better life outcomes and opportunities, including improved health and wellbeing.

I recall clearly Sistema Scotland’s chair Richard Holloway being very challenging regarding this inherent tension in the GCPH attempting to measure Sistema’s work. Richard’s challenges at the outset of the evaluation were entirely justified and have spurred us on (as I’m sure they were intended to do!).

As evaluators, we must reach higher and do everything we can to ensure we deliver a robust evaluation of impacts and outcome. But we must also deliver an evaluation which enables the ‘beautiful language’ which Sistema speaks to be heard. An evaluation which recognises the ‘essence’ of this collective art form; as well as articulating the ethos and workings of this dynamic organisation. The first evaluation report of the Sistema evaluation will be published in April 2015.

The evaluation process

However there will be a range of evaluation outputs and an important first step in the evaluation process is to assess the current evidence concerning the arts and health. With a particular focus on the evidence required to inform the evaluation of Sistema, three distinct systematic literature review work packages were commissioned by the GCPH:

• WP1: The impact of art attendance and participation on health and wellbeing
• WP2: ‘Arts and smarts’ – assessing the impact of arts participation on academic performance during the school years
• WP3: Community-based music programmes, and health and inequalities – the impact on children/adolescents and their families 

The commissioned systematic reviews assess the quality of evidence in each work package using a traditional view of the evidence hierarchy. This does mean a disciplined and restrictive view of evidence, but this approach is helpful at the outset of the evaluation in order to highlight studies which have yielded high-quality findings and significant results.

Equally valuable is the consideration of the theorised pathways between the arts and health, and potential mechanisms of change - as well as highlighting gaps in evidence across the three work packages. This is important to ensure that the Sistema evaluation contributes new insights to these evidence bases and is utilised in supporting recognition of the wider impacts of the arts and in the design and delivery of community-based arts programmes as social interventions.

Importantly the three systematic reviews are not a summary of every piece of evidence ever relating the arts to health. The reviews consider evidence over a ten-year period from 2004 to 2014 and thus provide an overview of recent evidence, methodologies and commentary. 

As for me, while I still wrestle with the challenges of measuring the outcomes of what Sistema does I take a degree of comfort from knowing that we are approaching this evaluation in the right way; with unequivocal methodological rigour and yet an eye for the subtle and intangible, for the essence and beauty of what Sistema does.

I also remind myself that if this evaluation goes to plan then my colleagues and I will have played a part in broadening the societal understanding of the role the arts can play in social interventions and in reducing inequalities in health, wealth and opportunity.