The Scottish Government

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Susan Galloway with Nicola Birkin and Christine Hamilton, Centre for Cultural Policy Research, University of Glasgow
Dr Mark Petticrew, University of Glasgow and Professor David Bell, University of Stirling
ISBN 0 7559 2908 X (Web only publication)
This document is also available in pdf format (128k)

The Tourism, Culture and Sport Group commissioned CCPR to carry out a literature review on the impact of culture and sports participation on individual quality of life ( QOL) and well-being, with a view to assisting in the evaluation of cultural and sport interventions. This review of the social research and economics literature has multiple objectives. It looks at how the concepts are defined, both generally and within the context of culture and sport, and explores the difficulties faced in measuring QOL and well-being. It then describes the methods and results of a range of studies investigating the contribution of culture and sport to QOL and well-being at both individual and community level.

Main Findings

• A standard cross-disciplinary definition of either QOL or well-being does not exist. Instead definitions vary according to research interests and objectives.
• Broadly speaking QOL is viewed as a multi-dimensional, shifting concept in which both objective and subjective domains combine to sum QOL as a whole. In the social research literature, well-being is variously defined as synonymous with QOL, or as a component or an outcome of QOL, while economists define well-being as satisfaction with life as a whole.
• How QOL is measured relates to how the term is defined and what is being measured; for example, QOL at population or at individual level.
• Most individual level studies have defined QOL as subjectively perceived well-being, ie self-reported life satisfaction; and have found that cultural participation has either a very small effect, or no effect on this.
• Cultural indicators of QOL have tended to focus on the social capital and community building domain or to view levels of cultural activity as an indicator of good QOL in itself.
• Studies demonstrate an association between exercise and the domain of psychological well-being and between sports participation and the personal growth, social integration/community well-being domains.
• The review highlights the scarcity of empirical research in this area. The largely experimental work that exists has not yet produced evidence of a causal link and experts consider the actual process to be more complex than this.
• There are significant problems in generalising from QOL research and this may be a concern for policy makers.
• Future research needs to be conceptually clear, consider the variable quality of culture and sports programmes as a factor affecting outcomes, and develop more rigorous methods for collecting self-report data from participants.

The Literature Review

DEFINITIONS

Standard definitions of QOL and well-being do not exist. Both terms are widely used, but with little consistency. There is a widespread tendency not to define QOL or well-being at all, or alternatively, to conflate QOL with well-being or with other concepts, such as life satisfaction.

Experts from different disciplines approach these concepts from the perspective of their own research interests and objectives, and so the subject of research also varies widely. Thus different definitions have been developed, for example, to assess QOL at individual level - eg psychology or disability research - and at a population level - eg social indicators research.

There is a great deal of consensus about the importance of certain core definitional issues. Broadly speaking we can view QOL as a multi-dimensional concept whose core domains, both objective and subjective, combine to sum QOL as a whole. Commonly included domains include: health, material well-being, community well-being/social inclusion, emotional well-being, relationships with family and friends, personal development, self-determination and safety. The relative importance individuals place on each domain are influenced by their personal values, expectations/aspirations and degree of adaptation, as well as by cultural context. What is considered "the good life" therefore varies between individuals, and between different societies and cultures. It is also constantly shifting, reflecting social change and individual progress through the life cycle. 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 sports or cultural activity is most likely to have a positive impact on perceived QOL?

Well-being is also conceptualised, variously, as either uni- or multi-dimensional; and as either solely about the subjective perception of individuals, or as a combination of the subjective and objective conditions of life. There are also competing views about the relationship between QOL and wellbeing. Well-being is variously seen as interchangeable with QOL, as one component of the broader concept of QOL, or as an outcome of good QOL.

How QOL is measured clearly relates to how the term is defined, and therefore to what is being measured. We can make a broad distinction between methods used to measure the QOL at population and at individual level. In both approaches the dominant research methodology is positivist and quantitative. Common measurement issues include:

• On what basis should QOL domains and indicators be selected?
• How to weight QOL domains or indicators.
• Methodologies vary according to what is being measured: polarised as subjective perception of QOL or solely objective indicators of external conditions of life. Alternatively some argue for a core set of QOL dimensions which may be assessed either subjectively or objectively.

The Contribution of Culture

Over the past ten years research studies have attributed a wide range of social impacts to participation in culture. However none of this research has explicitly aimed to investigate the effect on QOL.

INDIVIDUAL LEVEL

Our search produced 8 culture-related QOL studies at individual level. Four were concerned with the QOL of older people, and 4 looked at music listening and making. Just one study found evidence of a substantial contribution while the rest found either no effect, or a very small effect on the QOL of subjects. In one study older people were found to place a high importance on both social and solo activities in which cultural activities figure. However culture and sport were just a few of a very wide range of reported activities which, in themselves, form part of just one domain out of 10 constituent domains of QOL as perceived by older people.

In the majority of cases 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.

Whether explicitly or implicitly, many of the studies define QOL as subjectively perceived well-being and operationalise this in terms of satisfaction either with life as a whole, or with a series of domains of life, pre-determined by the researchers. In contrast, two of the studies asked respondents to identify and rank QOL domains in order of importance.

COMMUNITY LEVEL

Cultural indicators are currently being developed both (a) as part of broader frameworks of socio-economic indicators measuring the QOL/well-being/ sustainability of communities and (b) as community cultural indicators in their own right, attempting to monitor the QOL/health/well-being of communities through measures of the "vitality" of local cultural activity. This is often linked to cultural planning.

Our search produced 9 articles, the majority concerned with the development of cultural indicators at community level. Four of the studies focused on one QOL domain: community-building/social capital. One study looked at each of 10 domains of QOL and 2 developed indicators of cultural vitality, starting from the premise that cultural activity itself is a vital part of QOL.

All these studies have had to square up to the lack of a theory based on empirical 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. Another is to use cultural indicators as a research tool to test a model of cultural impact. A final option is to take as a given that culture plays a key role in QOL, based either on beliefs, or on the cultural research suggesting social impacts. This is the approach adopted by most of the cultural indicators projects.

The Contribution of Sport

There is a limited literature on sport and QOL or well-being and most of this relates to exercise. The review identified 9 articles. These lacked a common definition of QOL and well-being and most looked at just one dimension of QOL. The research findings indicate an association between exercise and aspects of mental/ psychological well-being such as the alleviation of depression and anxiety, and the promotion of self-esteem and positive affect. In the sports literature there is a wider case made for the link between participation in sport and other outcomes such as personal growth, social integration, social support, and community well-being. However overall there is neither the empirical evidence to support a causal link in either area nor to help us understand how sports participation may play a role in combination with other social factors, for example through the social support, friendship and collective identity gained through participation.

Conclusions: Lessons for Future Research

First, the review highlights the lack of empirical research in this area, and the need to fund well-designed, large-scale research to explore and test the impact of culture and sport on QOL and well-being. A large number of QOL researchers argue that both combination and multiple methodologies best suit the multi-dimensional nature of QOL. There is a need to explore more complex types of research design and learn from some of the large scale QOL studies conducted in policy areas such as health.

One of the desired outcomes of the review was the establishment of social and economic indicators to measure QOL and well-being in relation to culture and sport. This is not considered possible, principally because the evidence base supporting a causal link (rather than an association) between culture and sports participation and QOL does not yet exist. Without this it is difficult to develop meaningful theory-based indicators. In addition existing studies provide just a partial view of the possible impact of culture and sports participation on QOL as a whole.

The review raises a number of points for future research:

Researchers need to consider how to allow for the variable quality of culture or sports projects in QOL research. The way in which cultural or sports activities or events are organised, managed, delivered, all the variables that determine the nature or quality of the participants' experience, help to determine the outcomes.

A key concern of public policy is to demonstrate causality. The review raises some important issues with respect to this. The findings of several of the sports/exercise and community level cultural studies suggest that it is very difficult to pinpoint a single cause relationship between participation and impact on QOL. Experts consider the actual process to be more complex.

Another key issue for public policymakers is the need for research whose results can be extrapolated or generalised to the population as a whole. QOL as a concept does not allow for this. What contributes to the QOL of one person or community will be different to another. As the relative importance of cultural participation to the QOL of individuals and communities may vary widely, the scope for generalising from QOL research findings is limited.

These points might also suggest that the natural science research model, of which notions of "causality" and "generalisability" are part, may not be the most useful for this type of research subject. Several of the studies reviewed point towards other types of research models that may better fit this purpose.

Whatever the model, a key lesson from existing QOL research is the need for conceptual clarity. Researchers need to state explicitly what kind of definition of QOL they are using, and what exactly they intend to measure. Second, cultural and sports researchers need to consider how to define participation. Definitions of cultural activity or participation may be either too narrow or 'top down' to capture the full range of what people on the ground understand and engage with as culture, or they can be too broad for policy use and therefore compound the problems involved in identifying causality.

A key criticism of cultural social impact research is the strong use of narrative and anecdotal evidence. Given the importance of subjective perceptions in much QOL research, we can conclude that it is not self-reporting in itself, but how self-report data is collected that is the issue. Future culture and sports research needs to involve more rigorous, theory-based, measurement instruments.

About the Literature Review

The review was undertaken during Summer 2005. Nicola Birkin undertook the scoping, with advice from Dr Mark Petticrew of the MRC Social and Public Health Sciences Unit, University of Glasgow, and Christine Hamilton of CCPR reviewed the literature on sport and QOL. CCPR commissioned Professor David Bell, University of Stirling, to review the economics literature. The focus was on articles published post 1995. The scoping included searches of four electronic databases, a review of web sites of key organisations/research centres, contact with experts, posts to lists, manual journal searches, and bibliography reviews. Once agreed exclusion criteria had been applied, 244 social research articles were included for review.

CCPR were also asked to do a 'thinkpiece' on the contribution of culture and sport to quality of life and well-being, highlighting the issues that arise in attempting to measure these concepts. The full Literature Review and Think-piece are available at: www etc

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