Association of engagement in cultural activities with cause-specific mortality determined through an eight-year follow up: The HUNT Study, Norway

Participation in cultural activities may protect against cause-specific mortality; however, there is limited knowledge regarding this association. The present study examines the association between participation in a range of receptive and creative cultural activities and risk of cardiovascular disease- and cancer-related mortality. We also examined whether participation in such activities and influence by gender have on this association. We followed 35,902 participants of the Nord-Trøndelag Health Study (HUNT3) of Cardiovascular-Disease and Cancer Mortality from 2006–08 to 2016. Cox proportional-hazards regression was used to estimate the risk of specific mortality based on baseline cultural participation. During the eight-year follow-up, there were 563 cardiovascular-disease- and 752 cancer-related deaths among the sample (292,416 person years). Risk of cardiovascular-disease mortality was higher among non-participants in associations/club meetings (22%) and outdoor activities (23%), respectively, as well as non-attendees of art exhibitions (28%). People who engaged in music, singing, and theatre had a 27% reduced risk of cancer-related mortality when compared to non-participants. Among women, participating in associations/club meetings reduced the risk of cardiovascular-disease mortality by 36%. Men who participated in music, singing, and theatre had a 33% reduced risk of cancer mortality. Overall, a reduced risk of cardiovascular-disease mortality was associated with engaging in creative activities on weekly basis to less than twice per week. For both genders, participating in creative activities less than once a week reduced cardiovascular-disease mortality risk by 40% and 33%, respectively. For the overall sample, participating > 2 times per week in combined receptive and creative activities reduced cancer-related mortality by 29%. Participating frequently in both receptive and creative activities cultural activities was associated with lower risks of CVD and cancer-related mortality. Our data suggest that, to counteract the public health burden of cardiovascular disease- and cancer mortality, policies and initiatives to increase citizens’ participation in cultural activities should be considered.