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Quality of Life and Well-being: Measuring the Benefits of Culture and Sport: Literature Review and Thinkpiece

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CHAPTER 1.6 THE CONTRIBUTION OF CULTURE TO QUALITY OF LIFE AND WELL-BEING

Introduction

6.1 Over the past ten years research studies have attributed a wide range of social impacts to participation in cultural programmes and activities. 174 Notably, Francois Matarasso's influential 1997 report Use or Ornament? identified 50 possible impacts deriving from involvement in participatory arts and found that the majority of adult participants in the arts projects he studied, reported, (via a closed question self-completion survey) that the experience had "added greatly to their QOL". 175 As we have seen, QOL is a multi-dimensional concept and many of the broad social impacts claimed by Matarasso and others for cultural participation fall within the most common domains of QOL176. For example, as Table 6.1 shows, there are clear similarities between the categories used by Coalter in his summary of the research findings on social impact of the arts and the QOL domains found in the general literature. 177 There are also parallels between the summary of impacts identified by the Health Development Agency from arts and health projects and QOL domains. 178

6.2 Schalock's description of QOL as an "organising concept" or "unifying theme" is therefore very apt in relation to the social impact of cultural participation. 179 However, while we can construe a relationship between research into the wider social impact of cultural activities and QOL or well-being, the fact is that none of this research has explicitly aimed to investigate the effect of cultural participation on QOL. Certainly QOL and well-being are sometimes mentioned within cultural social impact research, but they are rarely defined.

6.3 Lack of research in this area is common to both QOL and cultural policy. Writing in 2004, Michalos reports that in the 63 volumes of Social Indicators Research published since the journal was established in 1974, that is, in 30 years of publication, not one article has looked at the impact of the arts on QOL, a fact that he finds surprising, "given the profoundly social impacts of the arts." 180

Table 6.1. Comparison between arts impacts and Quality of Life domains

QOL domains

Health Development Agency (2000) Impacts of arts and health projects

Coalter (2001) Impacts of arts activity

Health

Health and well-being

Health and well-being

Material well-being

Alleviating poverty

Social relationships/ well-being/ inclusion

Social cohesion

Strengthening communities, social cohesion and inclusion

Emotional well-being

Health and well-being

Increasing personal confidence and self-esteem

Work and productive activity

Economic impact and employment

Rights or civic well-being

Personal development

Changed perspective

Self-determination/ level of independence

Community empowerment/ self determination

Spiritual

Personal safety

Source: SHM Productions Ltd (2000); Coalter (2001).

6.4 The broader canvas of cultural social impact research provides the context for our concern here: the contribution of culture to QOL and well-being. The central issue for cultural social impact research remains the lack of both empirical evidence, and the lack of a theoretical basis with which to support the claims about the impact of cultural participation. 181 Notably Oakley identifies QOL (along with social capital and public value) as one of the areas in which the problem of lack of theory is "most acute" for cultural research. 182 Reporting the Urban Institute's literature review of the impact of cultural participation, Jackson also comments on how community development and social capital research have largely neglected the "unique and considerable role" of arts and cultural activity. 183

6.5 The present situation is perfectly summed up by Jackson and Herranz, talking about research into community participatory arts in North America:

"Extensive documentation exists, complete with anecdotes, stories and testimonials to the varied contributions of arts and creative activities to both individual and community development. Yet without a firm theoretical base and appropriate methods to anchor this material to that base, such narrative evidence cannot lead to generalisable conclusions."184

6.6 Pre-dating current policy interest in QOL by almost 3 decades, the report "Leisure and the Quality of Life" evaluates a series of "experiments" undertaken in Britain in the mid-1970s. With the aim of improving the quality of urban life, local cultural, recreational and sporting activities were expanded and increased in four areas: Stoke-on-Trent, Sunderland, Clywd and Dumbarton in the West of Scotland. 185 The findings pre-empt those of much later studies, confirming the important relationship between these activities and the strengthening of both self-help and voluntary organisation at community level. So how has this been taken forward? What recent research is there investigating the contribution of culture to QOL? We can divide this into two categories: research focused at individual and at community level. Some of the key studies in each area over the past ten years are reviewed below, with a particular focus on the research methodologies and the definitions of QOL used.

Studies focused on individuals

6.7 Our search produced 8 culture-related QOL studies focusing on individuals, 5 of which were North American. Four used quantitative methods alone, one used solely qualitative methods, 3 used combination methodologies and one was a longitudinal study. The authors of most of these studies have identified their work as exploratory; early attempts at testing out methodologies and of searching the way forward towards a theory of cultural impact. Four of the studies are concerned with the QOL of older people, where there is particular interest in the role of recreational or leisure activities.

6.8 Five of the studies investigated the impact on QOL of taking part in culture-related activities and 4 of these looked at the specific impact of music. These form part of a growing body of work examining the contribution of music listening and making to QOL upon which this literature review merely touches. The remainder of the studies did not have the impact of culture-related activities as their focus, but culture-related activities featured within broader studies exploring the QOL of individuals. They are included here because they provide a context for our concern with the relationship of culture to QOL, demonstrate the kind of methodologies that are being used and the different ways in which QOL is being conceptualised and measured.

Table 6.2. Culture-related Quality of Life studies reviewed: focused on individuals

Reference (date)

Discipline

Target population

Aims

Methodology

Sample

Coffman and Adamek (1999) 186
N. America

Music therapy/gerontology

Older people active in music-making

To determine the influence of wind band participation on the QOL of active senior citizen band members.

Quantitative and qualitative, incl. content analysis. Postal survey, questionnaire using both open and closed questions.

52 wind band members (96% of the band membership)

Burack et al (2002) 187
N. America

Gerontology

Older people (nursing home residents)

To investigate the effect on immediate satisfaction and global QOL of providing cognitively intact nursing home residents with music of their own choosing

Quantitative and qualitative.
Closed question survey instrument administered in face to face interviews, and structured open questions.

13 nursing home residents meeting study criteria.

Wood and Smith (2004) 188
U.K.

Human geography

Performers and audience members at live popular music concerts and events.

Live music performance as a context for exploring the "emotional content" of human affairs, specifically emotional well-being.

Qualitative, described as "experimental", including interviews, "observant listening" and "participant sensing".

Not sample based.

Michalos (2004)
N. America

Social indicators/ QOL studies

Adult residents of Prince George, Canada

To measure the impact of the arts on the perceived QOL of residents

Quantitative. Statistical analysis using step-wise multiple regression.
Postal survey : self-completion questionnaire.

315 residents representing 13% of the random sample of 2500 households to whom questionnaires sent.

Michalos and Zumbo (2000) 189
N. America

Social indicators/ QOL studies

Adult residents of Prince George, Canada

To measure the mutual influence of people's leisure time activities on their overall health or well-being, and to explain the impact of such activities and health on the perceived quality of people's lives.

Quantitative. Statistical analysis using zero order correlations and multivariate regression.
Postal survey - self-completion questionnaire

440 respondents representing 17% of the random sample of 2500 households to whom questionnaires sent.

Silverstein and Parker (2002) 190
N. America/ Sweden

Gerontology

Older people ("oldest old"

To test whether change in leisure activities over a 10 year period is associated with retrospectively assessed change in QOL among older people in Sweden

Longitudinal study. Survey questionnaire administered in 1981 and 1992. Quantitative. Statistical analysis using ordered logit procedure.

324 "oldest old" people - a nationally representative sample of individuals in the birth cohort 1906 to 1915.

Kelly et al (2001) 191
U.K.

Psychiatry/mental health

Individuals with severe and enduring mental illness

To examine the relationship between involvement in activities and self-reported QOL amongst people with severe and enduring mental illness

Quantitative. Statistical correlation tested using Kendall's tau.
Data collection face-to-face using structured interview schedule (closed questions).

92 individuals - a stratified random sample of the total population in one Health Board area identified by mental health professionals as meeting 3 criteria of severe and enduring mental illness.

Bowling and Gabriel (2004)
U.K.

HealthOlder people in BritainTo explore the constituents of perceived QOL in older ageTriangulated approach both quantitative and qualitative. Statistical analysis using multiple regression. In-depth interviews with sub-sample of respondents.999 individuals aged 65+ living in their own homes representing 77% of eligible respondents from the ONS Omnibus Survey.

6.9 In her literature review for Arts Council England, Staricoff highlights music as the most researched area of the arts and health and refers to the extensive range of studies investigating the impact of music on different healthcare specialities. 192 She cites research demonstrating the benefits of listening to music, which include the prevention of stress, a reduction in the perception and physiological consequences of pain and anxiety, diminished levels of depression and increased satisfaction with the quality of care received. 193 Michalos also refers to the sizeable literature on the use of music in therapeutic settings and reviews the very similar findings of a range of these studies. 194

6.10 Coffman makes the link between these psychological, neurophysiological and physical outcomes and QOL issues. 195 In his review of the music therapy, gerontology, medicine and music education literature, he describes a range of studies that address how listening to and actively taking part in music-making impact on two of the standard QOL domains: physical and emotional well-being. He comments that most of these studies have been concerned with the effect on mood and behaviour of passive listening to music, with very few examining the effect on well-being of music making.

6.11 Coffman's literature review outlines the areas that have been addressed by studies to date. The physiological effects of listening to music is one of these, and Coffman suggests that further research is needed to explore the link between these effects and subjective perceptions of well-being. 196 Another focus has been on the psychological and social benefits of active music making, with a number of studies highlighting the value placed by participants on the "non-musical" benefits of music making.

"The interaction of environment with music activity and on contingent perceptions of quality of life has not been researched in any substantial way. A first step would be to identify relevant environmental factors through qualitative data gathering procedures, subsequently followed by hypothesis testing methodologies." 197

6.12 In particular Coffman highlights the literature concerned with older adults and looks specifically at the relationship between active music making and the QOL of elders, most of which is highly relevant and worth detailing here. 198

6.13 On the basis that absence of death is the most fundamental QOL, an independent study by Bygren, Konlaan and Johansson found that, after controlling for confounding variables, 199 individuals who participate in cultural activities "often had a better chance of survival" - i.e. lived longer - than those who rarely took part. 200 The study was based on a random sample of over 15,000 people aged 16 to 74 years. Of these, just under 13,000 were interviewed during 1982 and 1983 as part of the annual Swedish survey of living conditions, which, in these two years, asked detailed questions about leisure time activities - specifically, attendance at cultural events, reading books or periodicals, making music or singing in a choir. The 12,700 individuals interviewed were subsequently followed up for survival until the end of 1991 (by which time 847 had died). The findings indicated that cultural participation "may have a positive influence on survival". The authors describe this as a "fruitful line of research" and recommend a further longitudinal study with a large sample, in which confounding variables are well controlled for, to try to test the hypothesis. This is recommended by the authors as a possible way of producing empirical evidence on the effects of "cultural stimulation" on people who do not attend cultural events.

6.14 Other studies of music and QOL cited by Coffman include a study of the impact of choir membership. Clift and Hancox investigated the perceptions of choir members, using rating scales and musical background questionnaires, and identified six dimensions of perceived benefits, most of which relate to QOL domains. These are well-being and relaxation, breathing and posture, social significance, emotional significance, and heart and immune system. 201 Coffman refers to other early studies that involve the use of control groups. VanderArk et al selected a sample of nursing home residents, aged 60-95 years, and age-matched them with residents of another nursing home that had no music programme. Following exposure to 45-minute participatory music sessions, held weekly for five weeks, the residents in the experimental group had much improved ratings of "life satisfaction, attitude towards music, and music self-concept" compared with the control group. 202

6.15 Other studies discussed by Coffman concentrate on the effects of music participation on dimensions of well-being. These investigated the meanings placed by participants on music making, and, through these, found that music has both a significance, and an effect, in terms of social relationships/connectedness and self actualisation/personal development and empowerment. 203 These findings fit well with Ruud's outline of a theory on music's contribution to QOL (which, in his view, means subjective well-being or happiness) based on his own empirical research on music and identity. 204 This comprises four strands: emotional well-being, an increased ability to experience and express feelings; an increased sense of "agency", sense of purpose, empowerment, and "social competence"; strengthened feelings of "belonging" and community identity; and the development of a sense of meaning and coherence in life.

6.16 Because our search strategy used the keyword "culture" this review includes a limited selection of literature specific to individual artforms. As a result our search produced two empirical studies investigating the relationship between music and QOL. Both of these concerned older adults, one in a residential care setting. The two studies took quite different approaches, not least to conceptualising QOL.

6.17 The first, by Coffman and Adamek, investigated the influence of active participation in music making on the QOL of individual members of a senior citizen wind band. 205 The senior citizens had an average age of 70 years, and were actively committed to music-making, attending band practice twice weekly for 10 months of the year. The study objectives were achieved, first of all, by investigating the broad factors that the senior citizens themselves regarded as contributing to their QOL, and then by asking them why they chose to participate in the band, and what benefits they believed they gained personally from participation. The study investigated subjective perception of QOL, without reference to any "objective" indicators of band members' life circumstances.

6.18 The study found that many of the participants considered a desire for music making and for socialisation either "very important" or "essential" to their QOL, rating these as highly as family relationships and good health, and found that these desires were being met through band membership. The authors conclude that their findings confirm those of previous studies highlighting the importance of recreational activities to the QOL of older people, leading to concern that these opportunities are not always readily available, particular in care settings. 206

6.19 The methodology for this study raises some concerns about the scope for generalisation. The authors developed the postal survey questionnaire following a review of the research literature on QOL, incorporating both closed and open questions and rating scales. An open question asked respondents to list the factors they believed contributed to their QOL and to rate each one according to importance. Eleven 5-point scales were used to ask respondents to rate the extent of the band's influence on aspects of their social interaction and musical development. The draft instrument was peer reviewed by research experts.

6.20 The authors acknowledge some limitations to their study. The study sample was selected in order to address an under-researched area, which is the motivation of older adults involved in music making. However, the characteristics of the survey sample mean that the findings are not generalisable. The sample is representative of the membership of the band itself, but not of the general population of older people, relative to whom band members were predominantly in good health, of upper-middle class status and with a higher level of educational qualification. The authors advise that similar research into QOL using samples with a different demographic profile "may find varying results about the relative influence of music making on quality of life". 207 In other words, given the proven musical commitment of this sample it would have been surprising had music not been found important to QOL.

6.21 The second study, by Burack, Jefferson and Libow, looked at the effect of listening to music on the immediate satisfaction and global QOL of cognitively intact, nursing home residents. 208 Before and after listening to their own selection of music for half an hour, the residents were asked a structured series of closed questions about their global QOL and asked open questions about their emotional response to the music. While the respondents all expressed positive emotions of satisfaction on listening to the music, there were no statistically significant differences found between the "before" and "after" tests relating to global QOL.

6.22 The study involved a small sample (13) of residents, aged from 64 to 93 years, in a large urban nursing home, all of whom were screened to ensure that they met the study criteria. The closed questions were adapted from the Quality of Life-Alzheimer's Disease measure ( QOL- AD) specifically selected for suitability with this sample. 209 This instrument presents respondents with a list of seven items, for example, physical health, energy, interest in life, and asks them to rate their "current situation" on a four point Likert scale for each item. They were also asked to rate to what extent they currently feel "anxiety or fear" or "depression or sadness", again on a four point scale. The authors again highlight some of the limitations. First, participants were self-selected to take part and all who took part enjoyed music and felt it to be important to them. Second, the small sample size means the results are not generalisable. The authors describe this as an exploratory study, and find it "not surprising" that one 30 minute period of passive music listening had no significant effect on perceived global QOL. 210 They therefore recommend further studies to look at the effect "on overall well-being" of long-term availability of music, and of providing residents control over their own access to music. 211 Given the effect on satisfaction, the authors also felt that the scope of future research could be widened, to examine the effect of offering a range of recreational activities to nursing home residents.

6.23 The third music study took a quite different approach. Wood and Smith used the context of live music performance as a vehicle for investigating the role the emotions play within human geography - what is termed "emotional geography" or "the affective content of social life". 212 This was based on a body of empirical research that demonstrates the emotional dimension and effects of music. 213 Of relevance here, Wood and Smith set out to understand

"…the issue of whether and in what ways emotions can also work - or be worked with - to enhance social well-being and promote quality of life." 214

6.24 In doing so, they acknowledged that, as well as having a positive influence on emotional well-being, music can also have an adverse effect: it can be oppressive, invasive and stress-creating. The authors clearly defined their object as the subjective phenomenon, "emotional well-being", and, implicitly, they defined this as a contributor to overall QOL.

6.25 The methodological challenge for the authors was to develop a way to access the inner world of human emotions, and to examine "how these "work" in the practice of everyday life" i.e. in relation to material circumstances. They arrived at a study based on empirical research with both performers and audience members at live music concerts and festivals, that used a combination of different qualitative research strategies. These include interviews (using a range of styles) and methods which the authors described as "observant listening" and "participant sensing". In other words the dominant social science research model found in most studies was replaced with a quite different approach, suited to exploring the underlying processes, dynamics and relationships at work in live music performance that determine its impact on emotional well-being. 215

6.26 Wood and Smith argue that the context of musical performance - set and programme design - is intended to produce emotional effects on the audience; that for performers the act of performance is itself about emotional engagement; and that the most effective performances are those which generate a sense of intimacy, an emotional bond between performers and audiences. Their findings demonstrate that musical performance produces "an injection of resilience" and a "sense of wellness", tapping into "those emotional qualities which have the capacity to enhance people's quality of life." 216QOL is enhanced, they argue, because musical performances are "therapeutic in the broadest sense", they provide a space in which people can "immerse themselves completely" in their emotional beings and "attend to their own emotional well-being". 217 Citing research into music and both national and racial identity, they further argue that the feelings music kindles in people, "in turn… help individuals and groups shape and negotiate their identities" in both potentially positive and negative ways. 218

6.27 In conclusion they argue that,

"Neither musical encounters not kindled emotions can make poor people rich, dying people live or risky environments safe. However, musical performances do contain clues about what emotional well-being is, what happiness, contentment and hope feel like, and they show how powerful these emotions can be. This, at least, is a step towards imagining knowing, or even creating a different kind of world." 219

6.28 Our search strategy produced just one other study, by Michalos, that focused specifically on participation in culture-related activities. In the remainder culture-related activities featured within a broader range of "leisure" activities, or "activities of daily life", with the studies looking at the relationship between these broader activities and QOL or well-being.

6.29 Michalos' exploratory study attempted to measure the impact of the arts "broadly construed" on the perceived QOL, happiness and subjective well-being of adult residents in one Canadian city. 220 The "arts" rather than "culture" was chosen as the focus because the latter is such a complex and difficult term to define. Michalos defined "arts" broadly "to include things such as music, dance, theatre, painting, sculpture, pottery, literature (novels, short stories, poetry), photography, quilting, gardening, flower arranging, textile and fabric art". 221 Members of the city's Community Arts Council collaborated in the definition and in developing the survey instrument. The study used a "bottom up" model of QOL in which QOL is operationalised as reported life satisfaction, and overall perceived QOL is an aggregate of satisfaction with each of a number of specific QOL domains. 222 The study also looked at the impact on happiness, and subjective well-being, using theory-based instruments to measure these. In a postal survey, respondents were asked about the frequency and intensity of their participation in 66 arts-related activities and asked to rate, on a 7 point scale, the satisfaction gained from each one.

6.30 The findings show that, relative to the satisfaction gained from other domains of life - such as friendships and family relationships - the arts have a very small impact on QOL. Using step-wise multiple regression analysis, arts-related activities were found to explain between 5-11% of the variance in four plausible measures of perceived QOL. Arts related activities were also found to have very little influence on happiness or subjective well-being. As with other studies, the results of this research are not generalisable. The survey sample was not representative of the adult population as a whole, being skewed towards females, married people and those with a college or university level education. The survey response rate was very low (13%) which the author attributes to the low level of interest in the arts on the part of most residents. 223 Accordingly, the sample are assumed to comprise individuals with an interest in the arts, in which case the results are perhaps surprising, although the author does not offer any critical reflection on these.

6.31 The three "broader" QOL studies in which cultural participation features are all concerned with perceived QOL, that is QOL self evaluated or self reported by individuals. The subjects varied, from the general population, to "oldest old" people, to people with severe mental illness.

6.32 Michalos and Zumbo investigated the impact of people's leisure time activities on perceived QOL, which was operationalised as satisfaction with life as a whole, happiness, and satisfaction with overall QOL. 224 In a postal survey of a random sample of 2,500 households in the Canadian city of Prince George, they asked adult residents to state which of a list of 54 seasonal recreational activities they participated in, and to state which of a list of 51 possible benefits of leisure they believed they accrued. This list of activities included some culture related activities (see Figure 6.1 below) however these made up a minority (10) of the total 54 recreational activities, and the specific effects of cultural participation were not analysed. The culture related activities were incorporated into two indexes of sedentary recreational activities, but while active recreational activity was positively related to some health dimensions, sedentary recreational activities had no impact. Neither of the two indexes of sedentary recreational activity were reported as having a significant influence on life satisfaction, happiness or satisfaction with the overall QOL, although several of the 13 indexes constructed measuring the degree to which residents felt they benefited from leisure activities were found to have some explanatory power in relation to these. This study used a similar methodology to Michalos' study of the arts, 225 and as with this study the sample was not representative of the general population of adult residents of the city, being skewed towards women, married people, older people and those with a college or university education.

Figure 6.1. Cultural activities in Michalos and Zumbo's list of recreational activities

1. Listen to music
2. Watch television
3. Go to the movies
7. Dance
17. Play an instrument
31. Go to the theatre
40. Go to the symphony
41. Do arts and crafts
42. Go to the library
51. Go to concerts

6.33 A very different study by Silverstein and Parker tested whether change in leisure activities over a ten year period was associated with retrospectively assessed change in QOL amongst older people in Sweden. 226 The study involved a nationally representative sample of 324 of the "oldest old", all Swedes in the birth cohort 1906 - 1915 with an average age of 81. In 1981, and again in 1992, respondents were asked about the frequency of their participation in 15 different activities. 227 Based on previous studies, leisure activities were categorised into six domains, with cultural activities present in three of these (see Figure 6.2 below). QOL was defined in terms of the subjective perception of global life circumstances, with respondents being asked "If you think back over the last ten years, do you think your life situation has become worse, improved, or remained the same?". 228 The study found that changes in participation in leisure activities over ten years markedly influenced how older people retrospectively evaluated the quality of their lives. The findings relate to the impact of participation in activities taken as a whole, and while changes in participation between and within different types of activity were reported, the study did not measure the specific impact of cultural participation. Indeed, people who raised their levels of activity - although the type of activity engaged in might change over time - were more likely to make positive assessments of how their QOL had altered.

6.34 The authors acknowledge that their QOL definition, which they describe as "simple and subjective, and… focuses on only one of many psychological and physical manifestations of QOL" is one limitation of their study. A uni-dimensional conceptualisation of QOL is acknowledged as lacking precision and having the potential for bias. 229 Because of the distinctive cultural features of Swedish society, including the value placed on social provision, egalitarianism and the effect of good pensions on reducing income inequality, the authors do not regard their results as generalisable to other countries. 230

Figure 6.2. Silverstein and Parker - Six domains of leisure activity

Domain

Activities

Culture-entertainment

going to movies, theatre, concerts, museums and exhibits
eating out in restaurants

Productive-personal growth

reading books
participating in study circles or courses
engaging in hobbies (such as knitting, sewing, carpentry, painting, stamp collecting.

Outdoor - physical

fishing or hunting
working in the garden
going for walks

Recreation - expressive

playing bingo
dancing
playing a musical instrument

Friendship

visiting friends
having friends over to visit

Formal - group

belonging to organisations
attending religious services

Source: Silverstein and Parker (2002), p. 532.

6.35 A study by Kelly et al is another example of research where cultural participation is included as part of a focus on wider activities, in this case activities of daily living. 231 However, again, the specific impact of cultural participation was not the focus of the study and is not therefore addressed in the findings. This research explored the relationship between involvement in the activities of daily life and self-reported QOL, hypothesising that there would be a positive correlation between involvement in activities and global QOL. The study sample comprised 92 individuals, representing a stratified random sample of the entire population in one Northern Irish health board area identified as suffering from severe and enduring mental illness. In a structured interview, individuals were asked about their participation in 15 activities, 3 of which were culture-related (see Figure 6.3 below). They were also asked to rate their satisfaction with four different activities of living on a 6 point Likert scale, and an overall satisfaction score along with an "activity score" were calculated from the earlier responses.

6.36 There were very high levels of non-participation in the majority of these activities and the study found no positive correlation between taking part in activities and global perceived QOL. The median for this was 6 on a scale where 10 was the best possible life imaginable. However a stronger correlation was found between satisfaction with taking part in activities and global QOL. This is similar to the findings of Michalos and Zumbo, discussed above, in which a perception of reported benefits gained from, or satisfaction with, activities participated in appears to influence perceived QOL to some degree. In common with most of these studies, the findings relate to a population with very specific characteristics, and are not generalisable.

Figure 6.3. 15 activities of daily living

Going shopping

Going to a restaurant/café

Taking a trip in a bus or car

Going for a walk

Doing laundry

Making a meal

Reading a newspaper/magazine

Cleaning room/flat/home

Going to see a film or play

Going out to watch or play sport

Going to the library

Watching TV/listening to the radio

Going out to a social activity

Participating in a hobby

Source: Kelly (2001).

6.37 A recent study funded by the UK Economic and Social Research Council and the Medical Research Council investigated the components of perceived QOL in older people resident in the UK. 232 The research methodology involved triangulating data drawn from 3 different sources. The study used a sample of individuals aged 65 and over, recruited from the quarterly waves of the ONS Omnibus Survey (April 2000 to January 2001). These were people who had agreed to be re-interviewed for a Quality of Life Survey following participation in the Omnibus Survey. The first data source was the Quality of Life Survey, in which overall QOL was self-evaluated through closed survey items and scales. The survey questions were based on a series of theoretically derived indicators, drawn from over 20 instruments developed to measure different aspects of subjective QOL. The second source was an investigation of respondents' own definitions of QOL, based on open ended survey questions, and the third source comprised data drawn from in-depth interviews with a sub-sample of respondents about their QOL. In other words, the study used a combination of quantitative and qualitative methods, with the qualitative data providing "context and meaning" for the quantitative data. 233

6.38 The findings confirm the importance of personality effects on QOL. The "core components" of perceived QOL in older people were found to be psychological variables - examples being social expectations/comparisons and optimism-pessimism - health and functional status, and personal and external social capital. The qualitative research also emphasised the importance of financial circumstances, the effect of which may have been "flattened" out in the statistical analysis because differences in income tend to be less in older age.

6.39 Of most interest to us, sport and cultural activities featured in a variety of solo and social activities subjectively perceived by respondents as enhancing their QOL, shown below. 234 However sport and cultural activities are just a few of a very wide range of reported activities which, in themselves, form part of just one domain (social relationships) out of 10 constituent domains of QOL as perceived by older people. 235 (The other 9 domains are home and neighbourhood, psychological well-being, other activities done alone, health, financial circumstances, independence, other/miscellaneous, and society/politics). Nevertheless the results of the qualitative research show that, in evaluating their QOL, older people place a high importance on both social activities and solo activities, in which cultural activities figure (80% and 93% of respondents respectively described these as "good things that give my life quality"). 236

6.40 By demonstrating how multi-faceted the concept of QOL is, this research gives us a valuable insight on the challenge involved in isolating and empirically measuring the effect on QOL of cultural participation alone. These findings also demonstrate how the importance placed on different dimensions of QOL varies according to population demographics and how the dimensions of perceived QOL may therefore shift over time, according to changing circumstances, or changing life stage. This raises important questions. Can we hypothesise that cultural activity will have the same importance to or influence on QOL for all people? Are there particular life stages or life circumstances in which cultural activity is most likely to have a positive impact on perceived QOL?

Figure 6.4. Summary of older people's models of quality of life 237

Social relationships (good only): (italics added)

Social roles and social activities

  • Helps friends, family, neighbours
  • Does voluntary work
  • Committee member of local group
  • Performs in arts, drama, music group, choir
  • Attends local events/meetings/education classes
  • Attends age related clubs
  • Has holidays/weekends away
  • Goes on outings/day trips/shopping with someone else
  • Has meals/drinks out
  • Gambles ( e.g. horses, bingo)
  • Goes to cultural events ( e.g. theatre/concerts/cinema)
  • Attends place of worship
  • Mental pursuits to keep mind alert (evening classes, quizzes, bridge)
  • Does sport/exercises/dancing activities
  • Solo pursuits ( e.g. crafts, cooking, TV, crosswords, gardening)
  • Walking dog - helps to meet others/caring for pet

Solo activities (alone) - mostly good:

  • Crafts, including woodwork, embroidery, sewing, restoring antiques, knitting, crochet, painting, flower arranging
  • Hobbies including stamp, coin, book other types of collecting
  • Maintaining cultural interests in art/theatre/architecture
  • Technical hobbies including photography
  • Home improvement activities ( DIY)
  • Cooking, eating new foods, diet
  • Having a drink at home
  • Watching sport on TV
  • Listening to music on audio-cassettes/radio; watching TV/videos
  • Playing a musical instrument alone ( e.g. piano, organ)
  • Reading books, poetry
  • Reading newspapers
  • Mental pursuits including crosswords, jigsaws, competitions, writing
  • Gardening or allotment
  • Watching wildlife ( e.g. feeding and watching birds, badgers, squirrels etc)
  • Doing (solo) physical activities, exercise, keeping fit, walking, jogging, walking the dog for exercise

Summary of studies focused on individuals

  • In summary, very few studies have investigated the impact of cultural participation on the QOL and well-being of individuals. With the exception of Michalos' recent work, the subject has been neglected by academics studying QOL. However a body of literature exists that looks specifically at the contribution of music making and listening to QOL, and this may benefit from a dedicated literature review 238.
  • Of the studies that look specifically at the relationship between cultural participation and QOL just one found evidence of a substantial contribution, and this was in a sample of committed musicians. The other studies either found no effect on the QOL of subjects, or evidence of a very small contribution to QOL.
  • The studies that have been undertaken are often exploratory in nature and most investigators have stressed the need for further research in order to test the findings. In the majority of cases (5 out of 7) the findings were not generalisable to a wider population, most commonly because of the unrepresentative-ness of the sample used, small sample size, or for reasons of cultural specificity. Investigators recommended a variety of measures to rectify these issues, including larger sample sizes and longitudinal studies.
  • It is interesting to contrast the different ways in which QOL is defined and measured in these studies. Coffman notes how gerontological studies examining the social benefits of music making and listening often use other concepts interchangeably with QOL, including "life satisfaction, meaning of life, meaning in life, sense of purpose, successful ageing, well-being (mental, emotional, social, spiritual) and wellness". 239 Referring back to the earlier discussion of QOL measurement, several of the studies reviewed here used uni-dimensional or multi-dimensional single scale measures of QOL.
  • Whether explicitly or implicitly, these studies defined QOL as subjectively perceived well-being and operationalised this in terms of satisfaction either with life as a whole, or as satisfaction with a series of aspects or domains of life, asking respondents to rate on a scale their level of satisfaction with each one. Some studies used both of these. 240 For example Michalos operationalised QOL as satisfaction with particular domains of life, and satisfaction with life as a whole, while also including measures of overall happiness, and subjective well-being, using established instruments to measure each of these. 241 The domains of life with which respondents were asked to rate their satisfaction were pre-determined by the researchers, although in most cases using theoretically grounded instruments.
  • Few of the studies discussed the way in which they had defined and operationalised QOL or gave any critical assessment of this, for example acknowledging that they were conceiving of QOL in a limited way, in terms of subjective perceptions only. 242 In view of the widely accepted lack of correlation between subjective and objective dimensions of QOL, one has to question whether the use of satisfaction alone is a helpful way of defining and measuring QOL, and perhaps ask whether researchers should admit that they are investigating determinants of life satisfaction rather than QOL.
  • In contrast to this approach, two of the studies used a multi-dimensional definition of QOL and involved respondents in the identification of QOL domains, which they were asked to rank in order of importance. 243 One of these studies combined this approach with a wide range of measures of subjective QOL, but which did not include "straight" life satisfaction. 244
  • Bowling and Gabriel's study is of particular significance because it allows us to consider the role of cultural participation within the context of the multiplicity of socio-economic variables influencing QOL.
  • In short, this is an area of research in its infancy: there are very few studies and those that exist have limitations. The empirical evidence for culture's contribution to the QOL of individuals is very thin. In a nutshell, this is the fundamental problem encountered in attempts to develop cultural indicators of QOL or well-being at community level, to which we now turn.

Studies focused on communities and cultural indicatiors

6.41 At a policy level, throughout the English speaking world, the concept of QOL is currently intertwined with those of sustainable development and community well-being, reflected in efforts to measure and track the well-being and QOL of communities using indicators. 245 Oakley describes the policy focus on "quality of life", "public value" and "social capital" as "struggling to express a notion of "economic growth…plus", the "plus" being variously environmental or social sustainability, combined with some notion of happiness or quality of life." She predicts that cultural research "will increasingly become embedded in and part of these larger research efforts". 246 This certainly appears to be the case, with a body of research emerging in the past few years focused on the development of "cultural indicators." 247

6.42 Occasionally, but increasingly, cultural indicators 248 are being included as part of broader frameworks of socio-economic indicators measuring the QOL/well-being/sustainability of communities. 249 However, to a large extent, culture has been off the policy radar when it comes to these broader policy issues, and many indicator systems are only, belatedly, redressing this situation. 250 An example is the Federation of Canadian Municipalities' Quality of Life Reporting System, which, when first published in 1999, did not include cultural or leisure indicators. An independent evaluation subsequently recommended these be developed for inclusion. 251 Community cultural indicators are also being developed "in their own right", attempting to monitor the QOL/health/well-being of communities through measures of the "vitality" of local cultural activity, often as part of a "cultural planning" approach. As we shall see, much of this work is being developed in North America.

6.43 As seen from the general QOL literature, these approaches are not "new", but draw on a tradition of social indicator research spanning over 30 years. Efforts to develop frameworks of cultural statistics at national and international level, involving UNESCO, the EU, etc have a similar time span. These are now catching a new policy "wave" as pressure to develop cultural indicators has emerged from a number of directions. Baeker has identified three of these as being, first, pressure on governments to provide evidence of effective investment; second, pressure on institutions, public bodies and local authorities to evaluate progress towards policy goals; and, third, "to build an evidence base related to the benefits of cultural development to communities". 252 Most of the recent "cutting edge" cultural policy research internationally has been in this area, clearly driven by national and local government policy interest, and some, although a minority, of this work on cultural indicators overlaps with issues of QOL and well-being. 253 Our interest is with this subset of cultural indicators work, and we will briefly review some of the key work in North America and the UK, considering the approaches and methods adopted.

6.44 Table 6.3 gives an overview of the 9 articles considered. Seven of these are North American and seven are concerned with the development of cultural indicators, either at community, city or local authority level.

Table 6.3. Culture related QOL studies reviewed: community level

Reference (year)

Title

Type

Funders

Jackson and Herranz (2002); Jackson et al (2003) 254
N. America

Arts and Culture in Community Building Project ( ACIP) est.1996 Urban Institute

Development of cultural indicators for inclusion in community indicator systems to assess QOL

Rockefeller Foundation

Stern and Seifert (1998) 255
Stern and Seifert (2002) 256
N. America

Social Impact of the Arts Project ( SIAP) est. 1994 University of Pennsylvania
Culture Builds Community
Cultural Participation in Philadelphia

An affiliate of ACIP and involved in the above project.
Research focus on cultural participation and social capital/community building

Rockefeller Foundation
Pew Charitable Trusts
William Penn Foundation

Knight Foundation et al (2001) 257
N. America

Listening and Learning: Community indicator profiles of Knight Foundation communities and the nation

Culture as part of community indicators

Knight Foundation

Cultural Initiatives Silicon Valley (2003) 258
N. America

Cultural initiatives Silicon Valley - Creative Community Index

Cultural indicators at community level

Knight Foundation

Swain (2005) 259
N. America

2004 Quality of Life Progress Report
Jacksonville Community Council Inc

Culture as part of community QOL indicators

Jacksonville CCI, City of Jacksonville, United Way of Northeast Florida

Essex County Council (2003) 260
UK

Creative Consequences: the Contribution and Impact of the Arts in Essex
Colin Mercer, Consultant

Cultural indicators at local authority level,

Essex County Council

Morris Hargreaves McIntyre (2005) 261
UK

The value of culture - Shropshire County Council
Morris Hargreaves MacIntyre

Culture indicators at local authority level

Shropshire County Council
C

Kopczynski and Hager (2003) 262
N. America

Denver Performing Arts Research Coalition
The Urban Institute

Cultural indicators at city level

The Pew Charitable Trusts

Center for Arts and Public Policy, Wayne State University (1996) 263
N. America

Arts & Culture and the Quality of Life in Michigan, Part I: The Influence of the Arts and Michigan's Anchor Organisations

Arts impact study linked to QOL

Michigan Council for Arts and Cultural Affairs

6.45 Our review of these community level studies begins with two key questions. What does the community cultural indicators research tell us about culture's contribution to QOL? Has it advanced either the theory or the empirical evidence for culture's impact on QOL?

6.46 In North America, charitable foundations - in particular the Knight Foundation and the Rockefeller Institute - have played a major role in funding the development of culture-related QOL indicators.

6.47 The Urban Institute's Arts and Culture Indicators in Community Building Project ( ACIP) was established in 1996 in collaboration with the Urban Institute's National Neighbourhood Indicators Partnership ( NNIP). 264NNIP aims to assist with the development of neighbourhood indicators systems around the United States, the aim being to monitor QOL at community level. ACIP is funded by the Rockefeller Foundation to investigate how arts and culture-related measures can be integrated into these neighbourhood indicator systems.

6.48 At the start of the project the key issue confronting ACIP was the lack of theory relating cultural participation to QOL. Consequently developing a "grounded theory" of cultural impact, with which to underpin community cultural indicators, has been a central concern of ACIP's endeavours. ACIP describes arts, culture and creativity as:

" 'essential factors in community building processes' but acknowledges that the precise impacts on community building 'are not well documented or understood…' ". 265

6.49 The early years of the project involved a literature review of cultural impacts, and a phase of extensive fieldwork to both investigate and map what communities themselves recognise and understand as cultural activity and to observe in detail community arts and community building practices. In doing this ACIP has worked in close collaboration with community builders, artists and arts administrators in its affiliated organisations in seven US cities: Boston, Chicago, Los Angeles, San Francisco Bay Area, Providence, Washington DC and Philadelphia. The project has utilised predominantly qualitative methods: in the first two years of the project 140 face-to-face interviews and 23 focus group discussions were conducted in mostly moderate and low income communities. A range of research projects exploring different methodologies within many different types of arts project and communities have been undertaken by affiliates focused on:

"building grounded theory, developing data collection instruments, and actually collecting data about the potential contributions of cultural participation to various aspects of community life". 266

6.50 Amongst other things this has resulted in a list of "potentially important impacts" - both direct and indirect - that community cultural participation may have including:

  • supporting civic participation and social capital
  • catalyzing economic development
  • improving the built environment
  • promoting stewardship of place
  • augmenting public safety
  • preserving cultural heritage
  • bridging cultural/ethnic/racial boundaries
  • transmitting cultural values and history; and
  • creating group memory and group identity 267

6.51 At each stage ACIP has reviewed, discussed and debated its findings with its affiliates, refining and distilling these into a framework for arts and culture research and measurement. The framework is intended as a guide for organisations wishing to develop cultural QOL indicators within their own communities. The framework (see Figure 6.5 below) comprises four "guiding principles" and the mapping of four "domains of inquiry and dimensions of measurement". 268

6.52 According to ACIP the four principles give:

"an indication of the possible breadth, depth and value of the arts and cultural participation in neighbourhoods. They make it easier to see the possible connections between cultural activity and community building processes. Moreover they suggest categories of measurement." 269

6.53 Firstly, ACIP emphasise the need for a very broad definition of cultural participation using a "bottom up" approach rooted in the community. Secondly, they stress that "the concept of cultural participation includes a wide array of ways in which people engage in arts, culture and creative expression" beyond consumerism or being an audience member. What follows is the need to "map" and develop inventories of forms of cultural activities within communities. 270 The third principle emphasises that, in practice, cultural activities are not only valued within communities for aesthetic reasons but because they are "embedded in or tied to other community processes", and therefore valued because they engender things such as community pride. Finally, ACIP stresses the many different types of organisation at community level involved in supporting cultural activity, many of which are not arts or culture specific, for example churches, children's and youth organisations, charities etc.

6.54 The findings of their fieldwork suggest that not only is cultural activity in its many diverse forms part of the social fabric of communities, contributing to its social capital, but there is a complex relationship between cultural and other types of organisation and activity within communities. ACIP highlights the lack of theoretical models describing and explaining the complex systems of support for arts and cultural activity within communities and this is one line of research they have been developing further with the help of affiliates. 271

Figure 6.5. ACIP's Framework for Arts/Culture Research and Measurement

Guiding principles

Domains of inquiry and dimensions of measurement

1. Definitions depend on the values and realities of the community

Presence
Identification, documentation and measurement of art or creative expressions that are defined and valued by a given community as cultural assets

2. Participation spans a wide range of actions, disciplines, and levels of expertise

Participation
Identification, documentation and measurement of the ways in which people participate in cultural activity (as creators, teachers, consumers, supporters etc)

3. Creative expression is infused with multiple meanings and purpose

Impacts
Identification, documentation and measurement of impacts or the relation of arts and cultural participation to various community outcomes such as creation of neighbourhood pride, stewardship of place, inter-racial and inter-ethnic tolerance or acceptance, improved public safety etc.

4. Opportunities for participation rely on arts-specific and other resources

Systems of support
Identification, documentation and measurement of a community's capacity to support art and cultural opportunities - the resources (financial, in-kind, organisational and human) required to bring opportunities for participation to fruition.

Source: Jackson et al (2003), p. 4.

6.55 Drawing on their experience to date, ACIP raises some highly pertinent issues for researching the impact of cultural participation on QOL, succinctly described by Jackson:

"There are two main theoretical and methodological challenges to documenting arts/culture/creativity impacts. The first is having definitions that are either too narrow to capture what we are looking for or too broad for policy use. The second is trying to establish simple causal relationships in an area that is inherently complex - with many interacting forces and about which not enough is yet known to justify efforts to build formal causal models, even complex ones." 272

6.56 In other words, while their extensive community based research has concluded on the need for a very broad definition of cultural participation and for an understanding of the complex way in which cultural activities mesh within communities:

"…the very broadness of ACIP's definition - combined with the fact that arts, culture and creativity are operating in an environment in which many other factors are operating simultaneously - vastly complicates the task of pinpointing the contribution of arts-related activities to the overall impacts observed." 273

6.57 These are the key challenges posed for the design of research aimed at measuring impact on QOL. But Jackson goes further. Public policymakers world-wide require research that demonstrates causal relationships between cultural participation and desired policy outcomes, and for these to be single-cause relationships. ACIP's research findings to date suggest that reality is quite different from this - these demands may therefore be based on an incorrect understanding or conception of cultural activity at community level. Jackson writes,

"Such overemphasis on single-cause relationships can derail inquiries that may more appropriately identify ways in which cultural participation contributes, along with other social and economic dynamics, to particular outcomes". 274

6.58 Finally, ACIP has concluded that one of the key barriers to developing the type of data collection and research activity needed to underpin theoretical development in this area is the lack of funding available to cultural organisations for this purpose. It recommends that practitioners ("community workers, arts administrators and artists") be acknowledged as key players in these efforts, and that:

"policymakers and funders must acknowledge and facilitate this component of a practitioner's job, by incorporating resources to support theory development and data collection into grants for practitioners and program guidelines." 275

6.59 The ACIP research project continues, and a number of research publications reporting on more recent work are due to be published in Autumn 2005.

6.60 The Social Impact of the Arts Project ( SIAP) at the University of Pennsylvania is an affiliate of ACIP. Since 1994, with the aid of funding from a range of charitable foundations, it has undertaken a range of research projects investigating the role of culture in metropolitan Philadelphia and its suburbs. Most recently it has been involved in the Benchmark Project, a "multi-year" study of cultural participation in two neighbourhoods of Philadelphia, funded by the Knight Foundation, which aims to "broaden, deepen and diversify resident participation in arts and cultural activities". 276 Some of the findings of this benchmark study confirm those of the ACIP project, particularly regarding the very broad way in which cultural activity is conceived at community level; the multiple meanings, values and significance with which cultural activities are imbued; and the strong inter-relationship between community cultural activity and non-cultural organisations, particularly religious ones. 277

6.61 An earlier SIAP project was a long-term evaluation of the William Penn Foundation's Culture Builds Communities ( CBB) initiative that ran between 1997 and 2002. The initiative aimed to test a variety of strategies to increase cultural participation and strengthen community cultural organisations. To this end, 29 projects involving 38 organisations were funded towards a range of objectives, including "expanding cultural opportunities, enhancing artistic quality, or fostering community-based collaborations with a focus on young people". 278SIAP's evaluation of the initiative assessed, amongst other things, whether it had achieved its objectives in terms of "improving the role of cultural organisations in building community". 279 The first major part of its evaluation strategy therefore involved researching "the nature of the community cultural system and its connection with other institutional and demographic features of neighbourhoods" and, thereafter, looking at whether the initiative had any impact upon this. 280 This ties neatly with one of the key lines of research enquiry highlighted above in the ACIP research.

6.62 SIAP chose to focus on the ecology of the local cultural system rather than the traditional focus on cultural institutions, because it allowed them to understand more clearly the "relationships and networks" in operation, and not just the "individual agents". 281 They argue that

"this perspective is particularly important when studying the arts because of the strong relationship between level of cultural engagement and other measures of the quality of life of urban neighbourhoods". 282

6.63 Based on field research SIAP mapped a neighbourhood cultural ecology populated by a variety of agents including non-arts community based organisations, for-profit community cultural firms, non-profit community cultural institutions, cultural participants, artists, funders and resource networks, regional cultural institutions and regional cultural audiences and described the complex network of relationships by which these are connected. 283 It emphasises that many of the links between organisations are at the level of individual members or participants, and organisational leaderships may not even be aware of them.

6.64 By mapping a time series of cultural data against other indicators of QOL, they claimed a correlation at neighbourhood level between:

  • presence of cultural organisations over time and both decreasing levels of poverty, and stable or increasing population;
  • amongst disadvantaged neighbourhoods, higher levels of cultural participation and lower rates of juvenile delinquency and truancy;
  • cultural participation and subjective perception of community QOL as "excellent"
  • presence of cultural organisations over time and neighbourhood "diversity" (including ethnic diversity and household type) and used this as evidence that community cultural systems "build social fabric and community capacity" and "contribute to neighbourhood revitalisation". 284

6.65 To evaluate whether the Culture Builds Community ( CBB) initiative had helped build community capacity/social capital, SIAP collected data against three indicators, selected on the basis of published research findings (a) cross-participation - community residents who took part in both cultural and other types of local activities; (b) networks and contacts between community institutions, and (c) the views of non-arts community-based organisation leaders towards those cultural organisations receiving project grants from the CBB Initiative. 285 Research methods included questionnaire surveys of resident participants and community organisations and interviews with leaders of organisations.

6.66 The findings showed that:

  • On "cross-participation" - considered by previous research as being one of the critical ways in which culture contributes to community capacity building 286- people involved in cultural activities were found to be more likely to be involved in their community in other ways, most commonly in religious services (50% of respondents), home-and-school associations (33%), recreational activities (30%), and libraries (28%), with at least 10% involved in civic associations, continuing education and special interest groups (although whether this had changed over time, as a result of the initiative, was not reported).
  • There was a clear relationship between cultural participation and satisfaction with the QOL of the community
  • Networks between community institutions grew rapidly during the CBB initiative, from 1,124 relationships in 1997 to 1,729 in 2000. One quarter of all relationships with non-arts institutions were with educational establishments.
  • The network of institutional relationships maintained by grantees grew stronger as it grew larger, with a distinct shift from passive to active relationships, as collaborators on projects.
  • The network of institutional relationships shifted from a hierarchical to a flatter, more democratic structure, as the number of links between organisations grew to encompass all levels of the organisation.
  • In terms of how cultural organisations are regarded, the study found that while they are considered an asset, they are not seen as important in terms of community development. 287

6.67 One of the strengths of this research was that the evaluation was built into the design of the initiative from the outset. Secondly, the initiative took place over a number of years, and the evaluation team was therefore able to assess impact over a far longer period of time than is usually available. This proved extremely important as Stern and Seifert note that,

"building cultural participation, community partnerships, and community capacity are incremental, interdependent processes requiring a long-term commitment" and that "some of the outcomes of the initiative were not visible until its third year". 288

6.68 The John S. and James L. Knight Foundation has supported a Community Indicators project, helping to develop social indicators for each of the 26 "Knight communities" 289 across the United States. The Knight Foundation itself acknowledges that this is one of around 200 indicators projects ongoing in the United States, "varying in size, scope and topic focus". 290 The first Knight Foundation social indicators report, published in 2001, uses a number of terms inter-changeably including civic health, community vitality, well-being and QOL, without offering an explicit definition. The report highlights the factors affecting the "civic health" of communities and comments on how the Foundation hopes the social indicators will be used by communities. It is based on thousands of interviews with residents, and draws together quantitative data from official and un-official sources.

6.69 The Knight Foundation indicators include a focus on "the vitality of cultural life" as one of six areas of civic life considered to have a key influence on community QOL. (The other areas are well-being of children and families, housing and community development, civic engagement, education and community conditions (demographic and socio-economic profiles)). These areas were selected explicitly because they relate most closely to the Foundation's interests and objectives, expressed in its mission statement, "investing in the vitality of the 26 communities". 291 The Foundation's social indicators start from the explicit premise that culture "improves our lives and enriches our communities" citing its investment of over $100m in arts and cultural activities over the past 50 years, including funding for projects that promote civic engagement and tackle racial prejudice. 292

6.70 The quantitative indicators selected to reflect the vitality of cultural life are shown below.

Figure 6.6. Knight Foundation indicators - current community conditions - vitality of cultural life

Indicator Area

Indicators

Types of arts and cultural organisation
These indicators "provide a measure of the size and variety of the arts sector" in an area and therefore differences in "opportunities to participate" between geographic areas.

  • Numbers of arts and culture organisation
  • Types of organisations identified
  • % of organisations with $500,000 or more in annual expenses
  • Numbers of arts and culture organisations per 10,000 residents
  • Assets of arts and culture organisations per capita

Finances of arts and culture organisations
These indicators "provide quantitative measures of the stability and financial capacity of the arts sector".

  • % of arts and culture organisations reporting a deficit
  • Median deficit of arts and culture organisations
  • Median surplus of arts and culture organisations

Table based on John S and James L Knight Foundation et al (2001), pp.136-141.

6.71 In addition, for the 2001 report, a residents survey was carried out in each of the 26 communities to gather data about a range of other culture-related indicators of community QOL. The report claims, without supporting references, that "community support of nonprofit arts and cultural organisations is often considered an important dimension of overall community health". 293 The survey asked a series of questions about satisfaction with the level of cultural provision in the local area, use of and satisfaction with these cultural services, attendance at nonprofit arts and cultural events, barriers to attendance and participation, and attitudes towards cultural activities, involvement in nonprofit cultural organisations (through volunteering, donations etc).

6.72 Significantly, the Knight Foundation survey sample was sufficiently large to allow findings to be compared between groups within most communities, something not often achieved by social surveys or residents' surveys at community or local authority level in the UK. An important finding was that race or ethnicity has a "profound effect" on how individuals view the availability of cultural resources within the community. Even controlling for other socio-economic variables, dissatisfaction with levels of cultural provision was high amongst Afro-Caribbean and other non-white ethnic groups compared with white Americans. Non-white ethnic groups were also far less likely to attend the type of cultural events asked about in the survey. 294 These findings were strongly associated with responses to the attitudinal question "If you are looking for a cultural event to attend, how important is it that the event reflects your ethnic or racial background?". 295 Those who felt this was important were least likely to attend cultural events on offer, and more likely to be dissatisfied with levels of cultural provision in their area.

6.73 In its most recent Social Indicators report, Listening and Learning, published in 2004, the indicators of cultural vitality have been revised and consist of the following:

Figure 6.7. Listening and Learning Indicators of Cultural Vitality

Indicator Area

Indicators (based on administrative records)

Access to arts organisations
Description:
"a measure of the access of community members to arts or cultural activities".

Number of arts organisations per 10,000 residents

Financial well-being of arts organisations
Description:
"a measure of the stability of the arts sector"

Assets of arts and cultural organisations per capita

Indicators Area

Indicators (based on community surveys)

Concern about the lack of arts and cultural activities
Description:
"a measure of concern about the issue"

Percent of residents who say that the level of availability of arts or cultural activities is a "big problem"

Attendance at arts or cultural activities
Description:
" a strong indicator of the vitality of the cultural life of a community"

Percent of residents who say that they attended a movie, a live music event, a play, dance, or other theatre performance, an art museum or a symphony in the past 12 months

Giving back to the arts and cultural life
Description:
"one measure of community support for the arts"
"one measure of community engagement in arts and cultural activities"

Percent of residents who say that they donated money or personal belongings to an arts or cultural organisation in the past 12 months

Percent of residents who say they volunteered their time to an arts or cultural group in the past 12 months

Source: John S and James L Knight Foundation, American Institutes for Research, and Princeton Survey Research Associates International (2004) Listening and Learning 2004: Community Indicator Profiles of Knight Foundation Communities and the Nation. Miami: John S and James L Knight Foundation, p.106.

6.74 In association with Americans for the Arts, the Knight Foundation has also funded pioneering work in communities to develop quantitative indicators of "the health and vitality" of their arts and culture sectors. 296 One of these involved Cultural Initiatives Silicon Valley ( CISV) and resulted in a Creative Community Index for the Santa Clara region. As with the original Knight Foundation study, the explicit premise of this indicators project was that culture and creativity is a key determinant of QOL, thus, the "basic tenet" of the project was:

"…to insure the future prosperity, vitality and overall quality of life of our region, we must intelligently leverage (sic) our most valued assets of creativity and cultural participation.". 297

6.75 Motivating the project was the concern that although the region was home to thousands of highly skilled creative industries workers from around the globe, the "social connectedness" of its communities was very poor. A comparative study of 40 metropolitan areas of the US ranked Silicon Valley at or near the bottom of a variety of measures of social capital. 298 The aim was therefore to use the creativity of the resident workforce as a tool to build both a sense of community and community social capital, thereby improving QOL.

6.76 The first step in the indicators project was the development of a theoretical model of how the region's arts and cultural sector works and how it interacts with broader community life. A conceptual framework was established "based on a causal theory of the impact of the cultural sector on a community". 299 This is presented as a research hypothesis about the impact of arts and culture, which the Creative Communities Index is designed to test:

The "assumptions" and "beliefs" that underpin the framework are outlined in detail (see below). The report refers to "what we know" about creativity, connectedness, cultural participation and social capital, and "contribution" on the basis of existing cultural research in these areas, a variety of which is cited.

"Assumptions underlying the Framework

  • The vision of Silicon Valley is that of a creative, connected, contributing region with a prosperous economy and an attractive QOL
  • Cultural participation is a key element of Silicon Valley's general QOL
  • Participation in cultural life can enhance people's connections to each other and to place
  • Creativity is important to Silicon Valley's future. Cultural participation can enhance creativity.
  • Silicon Valley should aspire to contribute to the world, going beyond its contributions in technology. Cultural participation can produce new ideas and expressions that contribute to global well-being.
  • Twenty-first-century Silicon Valley will define "desired outcomes of cultural life differently than other regions and generations." 300

6.77 The Creative Community Index report is exemplary in presenting the theoretical framework in which its indicators have been selected, and from which they gain significance and meaning. The indicators have been chosen to test the validity of the hypothesis that arts and cultural participation impact positively on creativity, contribution and connectedness, as defined in the report, and are presented in four categories: outcomes, participation, assets and levers. The indicators themselves draw on data from 3 different sources: an interview-based residents' survey, a survey of local arts and cultural organisations, and official data. In terms of content, the indicators cover fairly familiar ground. Creativity indicators include participation in cultural and creative activities and how people view the importance of this, as well as trends in patent activity. Indicators of contribution relate to the activities of local arts organisations, measures of participation in arts and cultural activities, residents' views and opinions. The indicators also cover areas such as community cultural assets, venues and facilities, civic aesthetics, creative education, leadership, policies and financial investment. While the indicators are all quantitative, CISV report that they have initiated a complementary programme of qualitative sociological field research into more informal participatory arts in the region, looking at how people get involved, and the impact on their lives. 301

6.78 The format of the Creative Communities Index, which has a strong "advocacy" feel to it, unfortunately does not lend itself to critical reflection on the approach and methodology. There is therefore no assessment of whether the hypothesis is proved or disproved by the indicators. Instead, findings are reported that illustrate and support the underlying assumptions of the proposed model.

6.79 One of the earliest attempts to develop community QOL indicators in the US was in Jacksonville, where the Community Council Inc ( JCCI) and Chamber of Commerce established a project twenty years ago using quantitative measures to systematically track the QOL of the community. 302 Over the years the indicators framework has expanded, as have the range of institutional sponsors, which now include the local authorities. Many other communities within the US have used it as a model. The 2004 Jacksonville Quality of Life Progress Report describes the indicators as measures of QOL, which it defines as

"a feeling of well-being, fulfilment or satisfaction resulting from factors arising in the external environments". 303

6.80 It acknowledges that personal relationships play a determining role in QOL for many people, but clearly states that it is taking a "community perspective" by choosing to focus on external factors. The results of the annual Quality of Life Progress Report are used to identify issues for examination by community research projects that may seek, for example, to understand the causes or processes behind changes in the indicators.

6.81 Thus 119 indicators are presented within the framework of 9 "external environments": education, economy, natural environment, social well-being and harmony, arts, culture and recreation, health, government, transport and community safety. The indicators are drawn from secondary sources - administrative records and official data - and from an annual survey of residents' opinions, conducted by telephone interview. The selection of indicators is explained not in relation to an underlying theory of QOL, but in relation to a set of criteria guaranteeing (amongst other things) the meaningfulness, validity, reliability and timeliness of the measures chosen. In the absence of any explicit theoretical basis, the inclusion of arts and culture appears to be on the basis of the assumption or belief that these are "a good thing" and important external contributors to QOL. Significantly, the report acknowledges that some important dimensions of QOL are omitted from the report because quantitative measures are not available, suggesting that the selection of indicators is, to some extent, "data driven". The arts and culture indicators, shown in Table 6.4 below, appear to reflect this, and bear a resemblance to local authority performance indicators, or at least indicators of public service provision.

Table 6.4. Jacksonville Community Council Inc 2004 Quality of Life Progress Report. Enjoying Arts, Culture and Recreation - indicators

Indicator

Why is it important?

Number of public performances/events at selected facilities

"Opportunities for entertainment and cultural enrichment are essential ingredients in the quality of life of the community"

Public and private support per person for the arts

"Most arts organisations rely on a combination of public funding and private financial support in order to provide art and cultural services to the community"

Public-park acreage per 1,000 people

"The availability and ease of access to public parks provide opportunities for relaxation and community recreation"

Number of participants in sports activities at parks and pools

"Supervised sports activities provide opportunities for youth recreation, build character, and decrease the risk of youth involvement in delinquent activities"

Attendance at musical shows per 1,000 people

"Increased attendance at musical performances is evidence of strength in performing arts in the community"

Attendance at sports facilities per 1,000 people

"Attendance at sports events provides a shared sense of community among fans"

Attendance at selected events per 1,000 people

"Participation in community events strengthens the sense of place and quality of life of a community"

Library use (as measured by circulation per person)

"Public libraries provide an opportunity for all residents to enjoy free use of books, videotapes, CDs, and other materials"

Recreation expenditures for activities/maintenance

"While money itself does not guarantee improved service, increased funding for activities and maintenance is an indicator of priorities and commitment to quality"

Boat ramps per 100,000 people

"The river and ocean are natural assets in Jacksonville, and the community benefits from access to these assets"

Source: Swain (2005), pp. 47-51.

6.82 The approach of using indicators as a tool to develop an evidence base showing the linkages between culture and other policy areas has been attempted recently in the UK. The local authorities in Essex worked with consultant Colin Mercer, using survey methodology originally developed by Francois Matarasso of Comedia, to produce an "ongoing knowledge base about the economic and social impact of the arts" in the county. 304 In particular, the local authorities wished to evaluate the contribution of cultural provision to "the cross-cutting policy agendas of social inclusion, health, crime, education, regeneration, and quality of life". 305 The report, Creative Consequences: the contribution and impact of the arts in Essex: 2001/02, specifically identifies "quality of life" as the most useful organising principle for understanding the contribution of culture to other policy and planning fields but makes clear that:

"What we are dealing with here, then, is not just the 'warm and fuzzy' sense of well-being produced by access to, and participation in, culture and the arts but also - in joined up mode - the connections between culture, social and economic development and, quite simply, sustainability". 306

6.83 The study acknowledges the necessity of measuring QOL using both objective, quantitative, and subjective, perceptual indicators, and developed a methodology that combined both types. Data collection was organised through three types of survey activity. A comprehensive database of arts organisations was compiled, and all 881 of these organisations were surveyed to collect quantitative data about inputs and outputs. A survey of participants in arts projects and workshops collected data on both quantitative and qualitative outcomes, and an audience survey captured "value judgements" from audiences at arts performances and events. 307

6.84 Data from the organisational survey was analysed in order to map the scale and depth of activity by arts organisations at small area level. Data was presented relating to the diversity and volume of cultural production, consumption - numbers of people attending or participating in cultural activity, organisational longevity, cultural employment, voluntary work, organisational size, staff training and development, work experience, financial turnover, income by type, sources of public funding, and partnership activity.

6.85 The surveys of participants and audiences aimed to "quantify the benefits gained by people participating in the arts and the experiences of arts audiences" through self-report via a questionnaire tool. These provided quantitative evidence of impact, so avoiding the often-criticised, "anecdotal", case study approach often used to gauge social impact. The authors acknowledge some of the limitations of their methodology, which include reliance upon the subjective perception of respondents, with no attempt to "externally verify" this through the use of objective measures. Second, they acknowledge that the outcomes of arts participation may not be immediate, and therefore may not be possible to detect at this stage. Thirdly there is the problem of establishing cause and effect. Arts participants may perceive positive outcomes, but how do we know that these are the result of the arts intervention and not other influences? Despite these constraints, the authors maintain that the "consistent and undeniable message" of the survey evidence is of positive association between arts participation and beneficial outcomes. 308

6.86 The participants' and audience survey questionnaires each contained a series of questions using a combination of closed multiple-choice and open-ended questions. The participants survey was designed to capture outcome measures in three areas: human capital, social capital, and attitudes towards the Essex arts sector, with a section covering demographic background. The audience questionnaire was designed to capture value judgements relating to levels of satisfaction with events attended, and attitudes towards the Essex arts sector relating to value for money, accessibility and other aspects of service quality, as well as the importance of the arts to local QOL, again with a series of demographic questions.

6.87 This is a far-sighted and pioneering piece of work by a UK local authority, which paves the way for others to follow. The report critically reflects on its methodology and proposes a number of changes for the future. With specific reference to cultural QOL research a number of observations can be made. First, the findings are presented as a step towards meeting the need for "integrated and sophisticated cultural QOL indicators". However elsewhere in the report it is clear that this is not the only impetus behind the research. To this is added the need for advocacy to justify spending on what are, in England, still discretionary services (with the exception of libraries), the need for greater accountability as part of the modernising government agenda, and the need to develop a performance framework. One suspects that, in practice, these other considerations may have dominated the research agenda. Although the concept of QOL has been skilfully used to frame the findings, the research objective was to "provide a statement of the diversity, sustainability, economic and social impact of the arts". 309

6.88 The study appears to begin from the premise that the positive impact of the arts in society are a given. The selection of measures is not presented in relation to an explicit theory of impact, nor is the stated aim to test a hypothesis. We have to deduce that the survey questionnaires were designed to capture data about assumed areas of impact. This is particularly evident in relation to QOL, of which the report does not offer an explicit definition. In its key findings under the heading "quality of life and social capital" the report quotes survey evidence that since taking part in arts activities 83% of participants have developed a more active social life, 75% have decided to start some training or a college course, and 81% have become involved in other community projects. 310 This suggests a partial conception of how cultural participation might affect QOL, yet the report does not acknowledge or discuss this aspect of the research design.

6.89 In the report, Mercer describes how local authorities are ideally placed to tap into "how and why and on what terms people actually engage with culture. These are indicators which local government, because of its proximity to people's daily lives, can develop on a special and privileged basis." 311 At the same time, the pressure on local authorities to focus on their own service provision and performance results in a conception of culture in these terms. As we observed with some of the US research, there is always the possibility of excluding aspects of cultural involvement recognised by communities within the population of Essex, but which do not figure within local authority supported provision.

6.90 Lastly, consultants Morris Hargreaves McIntyre have developed for Shropshire County Council a methodology that allows them to measure the impact of cultural provision on QOL, community safety and healthy lifestyles. 312 Shropshire already monitors QOL more broadly and was one of the pilot authorities in the Audit Commission's national QOL indicator project. However culture was a neglected area within the existing QOL monitoring. The council wished to redress this, but to do so in a way that related to both central and local government policy agendas and to the many varying needs for Performance Indicators. The main challenge in developing indicators and measures to assess cultural impact on QOL was therefore that the council needed a framework,

"capable of embracing the complex ecology of varied definitions of quality of life and multiple aims and objectives from central government, local government and NDPBs." 313

6.91 The resulting methodology is therefore very much policy- rather than theory-based. The indicators and measures proposed for culture are rooted in the definitions and themes of QOL identified in national and local policy documents, including the Government's seven "Shared Priorities for Central and Local Government". It places the measurement of cultural impact within the council's framework of performance information and management systems. Where possible existing performance indicator data has been incorporated into the measures of impact, and, in turn, the measurement system devised is intended to meet the PI needs of the local authority, Non Departmental Public Bodies ( NDPBs) and central government.

6.92 The "Outcome Measurement Framework" has four tiers: it establishes the context in which cultural services operate, and then monitors: inputs (the investment of labour, finances etc), outputs (what is actually delivered) and outcomes. The importance of the inter-relationship between these four factors is emphasised. The outcomes, the difference cultural services make to individuals and communities, are described as the key and the outcome indicators and measures are shown in Table 6.5 below. The main report details the range of ways in which culture contributes to each of the QOL themes. The basis for these claims is not explained in the report, but these appear to summarise the wide range of suggested impacts outlined in the existing body of research and advocacy on cultural social and economic impact, which was reviewed as part of the research programme.

6.93 Data for the measures is to be drawn wherever possible from existing performance indicators. But a range of new measurement tools will also be developed including questionnaires for user/attenders of cultural events, participants in activities, cultural organisations, and group/group leaders, each to be administered in separate surveys. 314

6.94 While the indicators and measures in this study are based on assumed areas of impact, a strength of this indicator framework, at least at a conceptual level, is that it links the quality of inputs, including funding and resources, and outputs - the quality of the cultural experience - to the outcomes/impacts. However, in practice, it is not clear how the quality of cultural provision - including participatory projects - can be evaluated and incorporated within this quantitative framework.

Table 6.5. Shropshire County Council Outcome Measurement Framework

Outcomes: what difference did the services make to individuals and communities?

Indicators

Measures

Achieve potential

Feel achieved potential
Achieved QOL
Have aspirations
Realise can make a difference
See the world differently

Stimulation

Aesthetic pleasure Enjoyment
Inspiration Escapism
Creativity

Economic impact

Direct/indirect Raised profile
Employment created Value for money
Leverage Cultural tourism motivated
Spend/multipliers
Economic/business development

Education, experience, learning, skills

Learning assisted
Skills developed/increased/preserved
Excellence
Learning aspirations and action
Career aspirations and action
Enabling
Human capital

Esteem

Self-esteem - feel good about self
Self-confidence - increased self-confidence
Sense of achievement
Feel in control - made choices
Influences decisions/effected change
Feel valued and respected

Community cohesion and well-being

Social capital - value and trust between communities
Inclusion for all
Diversity - cultural inclusion/celebration
Sense of identity/history/place
Interaction with others/reduced isolation
Community group development and capacity building

Safety

Increased awareness Feeling safer
Changed perceptions Reduction in fear of crime
Safer communities

Mental and physical health

Changes/progression in activity/behaviour
Improved physical and mental health
Increased sense of physical and mental well-being
Contribution to prevention - action taken

Natural environment

Knowledge and understanding of the natural world
Understanding of environmental impact
Ownership/empathy with the natural environment
Changed behaviour

Built environment

Increase in knowledge/understanding of built environment
Change in attitudes or values to the built environment
Feel culture has contributed to quality of built environment
Ownership/empathy with the built environment

Source: Morris Hargreaves McIntyre (2005), appendix 1, p. 7.

6.95 Finally, separate to the work on indicators, there are examples of studies that have looked in different ways at the impact of culture on QOL or aspects of QOL.

6.96 These include studies that have attempted to measure the effect of arts or culture on the global QOL of communities, often as part of work with a wider research focus. These often use uni-dimensional, single scale instruments to measure the subjective perception of individuals in a given community.

6.97 One example is the research carried out by the Urban Institute on behalf of the Denver Performing Arts Research Coalition ( PARC). 315 The research was part of a three-year project to investigate the level of participation and support for the arts in 10 communities across the US. One aspect of this was a household survey conducted by telephone interview in five communities: Denver, Alaska, Cincinnati, Pittsburgh and Seattle. The survey aimed to look at the wider social and economic contribution of the performing arts. It therefore looked not only at attendance at and participation in the performing arts, but sought householders' attitudes towards the value of the performing arts to their personal lives and to their community. Of particular interest to us, the results were analysed by key demographic characteristics.

6.98 The survey found that Denver residents had even more positive opinions about the value of the performing arts to their community than about the value to their own lives. More than half of respondents strongly agreed that the performing arts "improve the quality of life in the greater Denver area", with a further 32% "somewhat" agreeing. Denver residents with higher levels of education, frequent attenders, and those with no dependent children at home were more likely to agree, and those under 25 years were less likely to agree. 316 The survey also found a strong relationship between attending live performing arts events frequently and volunteering in community organisations. 317

6.99 Another example is the study Arts and Culture and the Quality of Life in Michigan which similarly used survey questions to gauge perception of the contribution of culture to community QOL. 318 The study uses a range of methodologies including secondary data analysis, literature reviews, a residents' survey and case studies. It focuses on three areas in which the arts are credited with "a substantial measurable effect on quality of life issues", these being education, crime and social cohesion. 319 However the approach to each of these areas is largely descriptive. The section on education and achievement, for example, reviews the literature linking creativity to educational achievement and skills development, and supports this with anecdotal evidence from Massachusetts based educationalists and case study descriptions of education-based initiative involving local arts organisations.

6.100 In addition, an attitudinal survey was carried out on two groups: a sample of attendees of Michigan's 26 anchor arts organisations and the executives of all 26 organisations, the findings of which were compared. The survey instrument comprised 10 questions relating both to global community QOL, and the three dimensions of QOL selected for the study. This was used as evidence of subjective perception of the impact of arts and culture on QOL in Michigan. Not surprisingly, both groups were found to have "a similar, positive perception about the impact of arts and cultural activities on their communities". Some 96.9% of attendees and 100% of executives agreed with the statement that "Overall arts and cultural organisations contribute to the QOL in the community." 320 The study appears to be largely designed for advocacy purposes rather than an attempt to empirically measure cultural impact on QOL.

Summary of studies focused on communities and cultural indicators

The development of cultural indicators of QOL requires a theory based on empirical evidence. All attempts to do so have had to square up to the lack of such evidence, and they have done so in a variety of ways.

  • One option is to try to develop, through intensive qualitative fieldwork over a period of years, the type of empirical evidence required to establish a theory of cultural impact. This is the "grounded theory" approach taken by the Urban Institute and the Social Impact of the Arts Project. 321
  • Another is to use cultural indicators as a research tool, as attempted by Cultural Initiatives Silicon Valley. 322 In this a model of cultural impact is proposed and a set of cultural indicators is used to test this out.
  • And lastly, one can take as a given that culture plays a key role in QOL, based either on beliefs, or on the body of existing research that suggests social impacts. For pragmatic reasons, and because the time-scales and budgets of most cultural research are limited, this is the approach adopted by most cultural indicators projects, including the Knight Foundation and Essex and Shropshire County Councils. 323

The definitions of cultural participation adopted by these indicator studies are either "top down" or "bottom up". Some studies stress the importance of taking a broad, inclusive definition of culture, using qualitative research to explore how specific communities understand and engage with culture and the significance they attach to it. The methodological problems for researching QOL that a broad definition presents have been noted above. So, for pragmatic reasons, other indicator studies have defined culture in a narrower way, to correspond with local authority cultural provision, or attendance and participation at a selected range of arts events.

Cultural indicator studies also vary in how they define the concept of QOL:

  • In 4 of the studies the focus is on one dimension of QOL - described variously as social capital/community building/community development. Notably, there is a wide variation in how these studies operationalise and measure this - there is no common method.
  • In contrast, one study attempts to measure the influence of culture on each of 10 domains of QOL at community level; 324
  • and two studies - Knight Foundation and Jacksonville Chamber of Commerce Inc start from the premise that culture is a vital part of QOL and that high levels of cultural participation and activity are an indicator, in themselves, of QOL. The way that they measure this has been discussed above. 325 The two UK local authority studies are also based on the premise that the positive impact of culture in society is a given.