Umeå University's logo

Background: The experiences of art and music are an essential part of human life and this study aimed to examine the longitudinal association between cultural participation and coronary heart disease.

Methods: This was a longitudinal study on a randomly selected representative adult cohort (n = 3296) of the Swedish population. The study period was over 36 years (1982-2017) with three separate eight-year interval measurements of cultural exposure (for example, visiting theatres and museums) starting in 1982/83. The outcome was coronary heart disease during the study period. Marginal structural Cox models with inverse probability weighting were used to account for time-varying weights of the exposure and potential confounders during the follow-up. The associations were also examined through a time-varying Cox proportional hazard regression model.

Results: Cultural participation shows a graded association, the higher the exposure the lower the risk of coronary heart disease; the hazard ratio was 0.66 (95% confidence interval, 0.50 to 0.86) for coronary heart disease in participants with the highest level of cultural exposure compared with the lowest level.

Conclusion: Although causality cannot be determined due to the remaining risk of residual confounding and bias, the use of marginal structural Cox models with inverse probability weighting strengthens the evidence for a potentially causal association with cardiovascular health, which warrants further studies. Johansson et al. examine the association between exposure to culture events and coronary heart disease (CHD) in an adult cohort of the Swedish population over a 36-year period. Cultural participation showed a graded association, with higher exposure associated with lower risk of CHD. Plain language summaryThis study examined whether people taking part in cultural activities, such as going to museums or theatres, were less likely to get coronary heart disease. The study included 3296 adults in Sweden over a period of 36 years. Information on cultural participation was collected by questionnaires on three occasions, eight-years apart. National healthcare data was used to identify cases of coronary heart disease. The main finding was that people who took part in more cultural activities were less likely to have coronary heart disease. This study suggests that taking part in cultural activities may be an important way to keep your heart healthy.