Fancourt, D; Steptoe, A; (2019) Cultural engagement and mental health: Does socio-economic status explain the association? Social Science & Medicine , 236 , Article 112425. 10.1016/j.socscimed.2019.112425. (In press).

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Abstract

There is a growing body of literature suggesting that the arts can support mental health. However, both arts participation and cultural engagement are unevenly patterned across the population, with a strong social gradient. This social gradient is also evident in mental health. So it remains unclear whether the relationship between arts engagement and mental health can in fact be explained by socio-economic status (SES). This study explores this question specifically in relation to cultural engagement (e.g. visiting museums/galleries/cinema/ theatre/concerts) using data from 8780 adults aged 50 + from the English Longitudinal Study of Ageing. We used a statistical triangulation approach, running three separate sets of analyses that each have different strengths and address different statistical limitations or biases. Using logistic regression, the relationship between cultural engagement and mental health was still present when including covariates relating to SES, and there was no evidence of moderation by SES either through the inclusion of interaction terms or stratification. Using propensity score matching, matching participants based on their SES, we also consistently found evidence of the relationship. Finally, using fixed-effects regression which takes account of all time-invariant factors (which include multiple aspects of SES) even if unobserved, we also found no attenuation of the relationship. Overall, this confirms previous reports that cultural engagement is linked with a lower odds of depression amongst adults aged 50 + by demonstrating a robust association in a nationally-representative sample of older adults. While SES does explain around half of the association between cultural engagement and depression, we found no evidence that it either acts as a moderator or the main explanatory factor, with independent associations maintained across all three approaches. However, the fact that higher SES is associated with more frequent engagement indicates that, in population terms, SES is still an important determinant of the salutogenic impact of culture.

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