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Daisy Fancourt, "Art Cure: The Science of How the Arts Save Lives" (Cornerstone Press, 2026)
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A
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B
Welcome to the New Books Network. On this episode, I'm talking to Daisy Fancourt about Art Cure. So welcome to the podcast.
- [02:02]
C
Thank you so much for having me.
- [02:03]
B
This is a great book and it really kind of, I suppose, transforms how we think about the arts and culture in contemporary society. It's also, I think, and this really comes through in the writing of it, it's a book that you've been clearly really kind of passionate about as well. And I'm Intrigued really to know what got you writing about, I guess, kind of arts, health and science all at once together.
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C
I think like many people, I loved arts and science growing up and couldn't really pick between them. But I ended up with this amazing job which was working in the NHS designing arts programs within hospitals. And it was fantastic because it gave me kind of hands on experience in putting together programs. But I also got to see firsthand every day the impact that the arts had in clinical settings. From children with burns who didn't need morphine when they were distracted by theatre, through to patients with dementia who couldn't remember their loved ones but could see sing along to songs from their childhoods. So for me, that was what made me think this is what I wanted to pursue and do my degrees in, in order to be a scientist, really looking at trying to understand these effects.
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B
And the book kind of goes through a whole different range, I guess, of effects. Before we kind of get into that though, and this will probably sound like a kind of strange question, but I wonder what are we actually going to talk about? Like what do we mean by kind of art? What do we mean by, by culture? I guess for some people they might have a, maybe I was gonna say a traditional view, but you know, it's like going to a theater, it's looking at a painting. For others, it's about the kind of, you know, the doing, the crafting, the making. But how do you sort of understand the. The subject of the book?
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C
So for me, arts engagement is a really diverse practice. So I define it in the book along the sort of common lines that arts engagement is about creative practices that are primarily carried out for their beauty ideas or emotional expression. But they can include everything from engaging in or attending performing arts, visual arts, literary arts, and also things like circus arts, culinary arts, horticultural arts that sometimes don't fall under that umbrella in our minds initially, but share all those same ingredients of multi sensory stimulation, creativity, imagination.
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B
I guess the book starts with one particular art form, music, but it as you say, kind of ranges quite widely. And one of the things I was struck by was the way the book immediately is talking about, I guess, kind of like biology, you know, the stuff, sort of how our kind of brains and nervous systems works. And part of what the book is doing early on is saying that music and actually other art forms as well can make us happy. And this has a sort of, you know, biomedical basis. And I'm intrigued actually to, to kind of hear a bit about how that is. I guess again, you know, lots of people might think about, oh, you know, if I've read a novel and it's made me happy or sad or whatever, that's maybe an emotional response. But you're really keen early on to say, actually there's a kind of biological element to.
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C
Yes, exactly. I mean, this is my area. My background scientifically is in psychoneuroimmunology. So it's about understanding the interaction between psychological and biological processes. So you could say I'm coming in with a particular angle on this that I really like, which is thinking about these more clinical and objective markles. But I also think these are the things that can be really interesting for people because many people will instinctively say, like, yeah, I feel happier if I do arts. Or I know that songs relax me. But I think it's really exciting to delve underneath the surface of this and say, well, why? What's happening in our brains, in our bodies, to have those effects. So that's something I really wanted to foreground across the book is understanding and explaining those mechanisms that I think are so fascinating.
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B
I mean, what. What are some of those mechanisms? I guess one of the things that the book is really good at is translating what is, you know, quite a lot of, I guess, quite in depth, even dense kind of biomedical research into stuff that people would intuitively be able to kind of understand. And I wonder, yeah, if you've got a couple of these kind of hardwired examples.
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C
Well, let's take the example of people saying that they feel, like, happier and more relaxed when they engage in certain art forms when we feel happy in the arts. That's actually because arts engagement activates reward and pleasure networks in the brain that are involved in processes like dopamine release. And dopamine is a neurotransmitter that's involved in feelings of happiness. So we particularly get this when there are moments of tension and resolution in arts experiences. Like we're waiting for that chorus to come back in a song, and then it does. And both the anticipation and the resolution lead to dopamine release. But at the same time, we can also be experiencing reductions in our stress response systems in our body. So reductions in the messages that get sent along our nerves, affecting things like our heart rate and blood pressure, and also reductions in stress hormones like cortisol. And in fact, research that colleagues and I have carried out have even shown reductions in levels of inflammation within the immune system, which is related to symptoms of low mood, for example. So we can see these correlates biologically of the things that instinctively we might feel when we engage in the arts.
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B
I mean, you mentioned things like what's going on in the brain. I was intrigued slightly later on in the book. And actually, to be fair, this is something the book is really kind of strict about, not over claiming. You do try and draw some boundaries around maybe where studies have had these kind of oversized claims or have maybe not looked at other factors that might be driving some of the impacts. And I was interested, I guess, in what the arts kind of can't do in the brain and maybe some of the limits of their impact on things like whether it's low mood and emotions or impacts on brain chemistry too.
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C
I think it's really good to be clear about where the evidence is strong or where there is exciting new directions versus when things might be more about hype or sensationalism or myth. Because I don't think we do need to overclaim because there is so much evidence that is really strong. There are some things though that I think have become kind of common knowledge, even though they're not technically accurate. So things like the idea that music might improve intelligence in children, might increase their iq. And this, this is one of those hugely problematic claims that Circulated in the 1990s, the concept of the Mozart effect, for example, that Mozart would make you cleverer. But then actually when there were more rigorous study designs, it turned out that wasn't the case. But then there is really interesting evidence that's looked at the role of music in early years in supporting the architectural development of the brain to support language. And actually that's interesting in its own right. You don't have to over claim and say that it's going to make you get a better math at GCSE or whatever. But there are also some other things that I think can be slightly damaging. I talk in the book about studies that have suggested that playing music at petri dishes can affect cancer cells. And I think things like this can give false hope. So we've got to be really clear about when things are not scientific. Petri dish cells don't have ears, so they can't even hear the music. So I think there are some sort of important ethical boundaries as well about not overclaiming.
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B
I mean, one, I guess, kind of area we're on sort of safer ground is things like the impacts of the charts on physical health. And I was really struck actually by when you're getting into kind of physical health, the way that you're quite kind of clear that there is a sort of added extra ingredient about things like dance. I Mean, not to get too personal, but I went for a run this morning. I moderately regretted it because I'm getting old and my knees are quite sore. But you know, it released a series of kind of positive chemicals, like it's kind of good for me in a variety of different ways. But as you talk about with things like dance, if I'd gone to a dance class, I might have got even more benefit as compared to kind of regular exercise. So what's going on with, I suppose, that extra secret ingredient the arts have?
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C
Some of the trials that I found really interesting that I go into in the book have directly pitted dance classes against aerobic exercise. And I quite like these because of course, dance is a form of exercise. So it's not wholly surprising when dance is linked to physical related outcomes. But what I've liked in these studies is they've shown that dance can sometimes have larger effect sizes than exercise, particularly for outcomes that have got this combination of physical and psychological. So there have been studies that have demonstrated that dance can not only support physical outcomes, but also have mental health benefits that might go beyond what we can get just from exercise alone. Because dance is bringing in that emotional expression, that creativity. There are also interesting studies that have suggested the edge sometimes for dance in terms of motivating people and helping them to stay engaged. There have been number of trials that have shown that you get better adherence to regular dance classes compared to regular exercise classes. But you know, that said, it doesn't mean that you should never go for a run just because it's not got arts involved. I love running as well, but sometimes there are ways of bringing in music when you're doing that as well, that can just add that extra motivation or that extra mood lift.
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B
That might be a good moment actually to talk about the way that you've structured the chapters and you've got these, I guess, kind of recommendations, you know, the sort of sense of a possible kind of good, you know, almost like daily dose for people. And it strikes me you're talking about there that the book isn't about saying you should kind of stop what you're doing and do the arts. But actually, you know, there is kind of even more we could be doing with the arts. And I guess one sort of example of that comes when you're thinking about arts in sort of hospital settings. And one of the things that I was struck by in that chapter, as well as the kind of discussion of you meeting Brian Eno and being, if I've read this right, slightly disappointed that he wasn't a kind of flamboyant 70s superstar rock star is the importance of the way the arts can kind of help stressful situations, particularly things like stressful situations in hospitals. So what's going on when we're kind of engaged with the arts to help deal with stress?
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C
Well, the arts are a really powerful manipulator of our arousal levels. And so music, for example, if it's got slow, calm beats, one of the things that it encourages in the way we process it in our brains is something called entrainment. So the fact that we then synchronize our breathing, our heart rate, our movements to the beats in the music. And this can be really effective if we choose music that's got slow beats because it encourages us physiologically to slow down ourselves. So there have been some brilliant trials now, a very large number in hospitals that have looked at how you can use this principle to relax people in the stressful situations of waiting for things. So waiting for surgery is one of the areas. There have been so many studies now showing reductions in heart rate and blood pressure and anxiety levels. And this is really key because if people are more anxious prior to surgery, it increases their risk of all kinds of complications during and afterwards. And actually the studies have now shown that when you listen to music prior to surgery, you also tend to need lower levels of sedatives, of anti anxiety medications, even pain medications like opioids. And in fact, some of the direct head to head trials that have compared listening to music with taking anti anxiety medications to try and combat anxiety prior to surgery have shown that music is more effective. So I think this is really exciting because it's cheaper, it doesn't have side effects, and it's also a nice sort of humanizing experience rather than popping another pill whilst you're waiting. So I think it's a really nice example of where we're probably being less ethical by not offering music routinely prior to all surgeries compared to if we actually offered it.
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B
Yeah, I mean, that links actually to quite a lot of the examples in the book that are really sort of useful. Almost kind of, you know, tweaks and nudges to what not just medicine, but you know, what maybe people are doing in their everyday lives already. Something you said earlier about that kind of, you know, you've got to be cautious around areas that don't have the same level of really robust findings as you've given with the anti stress examples comes towards the end of the book where you're kind of grappling with whether the Arts kind of increase longevity. And I guess this was one of those points in the book where I was reading it thinking this is maybe where the risks of overclaiming are greatest. I mean, there's probably all kinds of things that people say will help you live longer. Or I can think of lots of negative examples of someone's grandparent did all these bad things but still lived to their 90s, those sorts of anti epidemiology examples. And I wonder what's going on like in terms of can the arts increase people's length of life? Or is this one where we really do need to be a bit cautious because the science isn't quite there yet.
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C
There's a reason that I leave this to the final kind of evidence based chapter in the book, because this is, as you say, one of these areas that it is sort of tantalizing, but it's not yet come from causal evidence. What we now have is actually over a dozen different epidemiological studies that have shown that people who engage more regularly in the arts have longer life expectancies. But one of the things I talk about in this chapter is that the statistical complexities about this, because all of these studies have taken account of what they think are the confounding factors in this. And I think it's really encouraging that these findings have been found across multiple different cohort studies for different kinds of mortality. So different causes of mortality when people take account of lots of different confounders using different statistical methods. But the truth is it's not a randomised trial because you can't do that. You can't randomize people to arts or not and see who dies first. So I think that there are challenges. And that's why in the chapter I talk about longevity. I then say, well, you know, if this is the case, how could it be happening? And I talk about the evidence that we do have coming through on how the arts affect various different organ systems. And I think one of the really exciting areas that's emerging now is the relationship between arts engagement and biological aging. And actually this seems to be coming through more and more strongly now from multiple different studies showing that when people engage in the arts, they actually have lower younger brain age, that the patterns of biological aging in their brain indicate that their brains are aging slower than people who don't engage in the arts, even when we've considered other demographic and socioeconomic factors. And we're also now seeing this across other organ systems, across epigenetic aging, which is a measure of the patterns of gene expression in our DNA that give a sense of our biological age in a different way. And also physiological aging indices that suggest that look at different clinical biomarker data to try and ascertain if we're older or younger biologically than our chronological age. So I don't think it's far fetched that these epidemiological analyses of arts and longevity are coming through. I think that there is some really interesting biological mechanistic evidence that's also giving plausibility to this. But as I say in the book, like this is a really challenging thing. And as you say, there can always be exceptions individually. This is about population level evidence. So it doesn't mean you will live longer, but it means that on average we see that people who engage live for longer. But I think it's one of the most intriguing areas because we see it for other health behaviours with the same kind of methodological challenges. But it's interesting we see it for the arts as well.
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B
I mean, that point about kind of population level impact is something that the book also kind of brings in at the end. And I guess readers might kind of work through the book with that kind of sense of what are my daily art doses, what is the kind of individual evidence. But you also say actually the arts can have social transformations. And I wonder if you can give a couple of examples of these. Some are really obvious in terms of helping public health campaigns be better designed, better targeted, more interesting, more engaging. But also you talk a bit about how the arts can have a role in maybe even something as broad as kind of social change too.
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C
Yeah, there are some really wonderful projects that have been done on this. And I give examples of things like radio plays, TV dramas. One of the ones I go into is called East Los High, which is a program that was developed in Los Angeles to try and help address some of the health inequalities affecting Latinx adolescents through using storytelling through television shows to educate young people about issues like domestic violence, like safe sexual practices, like other kinds of factors like family planning. These are really interesting because they use narrative often to help people explore different ideas, challenge their way of thinking. And there have been some wonderful evaluations of some of these large scale programs in various countries that I talk about in the book, which I think highlight how the arts, you know, the arts don't solve poverty, for example, but the arts can be a really interesting way of helping to change behaviours that are related to social determinants of health. But I mean, equally as I keep coming back to across the book, I also try and highlight some of the times when this might not work in the way we've hoped. I talk about one program called El Sistema in Venezuela, which was hailed as this kind of miracle program for saving youth in Venezuela and actually was fraught with all kinds of issues that I discuss and wasn't the miracle it claimed to be. But I think it's good to sort of flag when there's really good examples and when there are examples that haven't worked as well because it helps us to learn well, what could we then do with programmes to really try and optimise the benefits that they can have?
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B
That, I guess, kind of question and of how do we put these programs together and what's the kind of best way really does bring us to two great closing questions for the book. One is like, why aren't we doing more arts? And then the other is how do we fix things? And I think probably we'll do the first one first. Given the real kind of weight of evidence about how good arts practice, arts engagement, arts consumption in all its forms is, what is kind of stopping people? Why don't we both in the uk, but in other societies live in, I guess, a kind of more art rich environment for people and society?
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C
This is such a key question, I think, because I list in the penultimate chapter, like all the benefits we've talked about across the book and it's this massive list and I say, if art were a drug, we would all be taking it every day. So it's funny that actually arts engagement levels are really quite as low as they are. We just did a study in the US looking at exactly what the patterns of arts engagement are day to day. And if you ask a US adult on the street, did you do any arts yesterday? Only one in 20 people will say, yes, 5%. And this is so much lower than other health behaviors like eating vegetables or doing physical activity. And I think part of the issue is around awareness. I think there's been really amazing work on things like diet, exercise, sleep, for example, in the last decade or so that's helped people to understand what the benefits can be and therefore change their own behaviours. So I think that's part of the puzzle and that's kind of what I'm hoping this book will do, is help to bring that public awareness up. But I also think that there are these major structural factors that influence whether people even have the opportunity to engage in the arts. And I highlight some of them from lack of arts in many schools to defunding of the arts in so many societies, whenever we hit financial problems, to closure of arts venues, to the precarious job markets that we create for artists, making it so hard for them to sustain themselves. So I think there are lots of issues that we do have to challenge and I think really question what value are we placing on the arts in society? And are we giving it enough value?
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B
I mean, are we giving enough value, but also, like, what can we do about that? I guess part of, you know, that is like a kind of a sense of, well, we need to get people to recognize its value. And that might be, you know, arts in schools campaigns. But also the book, I think, has a kind of broader sense of how we fix things.
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C
Yes, I try to put forward a lot of different ideas. I mean, for readers of the book itself, I talk through a kind of checklist of questions about why you might not be engaging. And based on that, I explain what behavioural science shows you can do to help change your own behaviours, depending on whether you've got more psychological or physical barriers, for example. But I think as societies, there are some really good opportunities for us to think about the role that arts have in schools. Are we actually properly integrating them into curriculars so that all children have opportunities to engage? And can we find ways to ring fence arts funding so that it's not just routinely cut, but instead we value the benefits that arts funding brings to society? And I'm obviously not suggesting that arts should only be funded as a utilitarian way of supporting health outcomes, but it's more recognizing that regardless of why people engage in the arts, even if they are doing it just for the pure joy and pleasure of it, it can still be having health benefits. Therefore, funding arts and society inherently is influencing health and healthcare service utilisation as well.
- [24:15]
B
That, I guess, kind of set of recommendations gives the book a sense of, I guess having summarized all this material and said, here's what needs to change. And it sort of strikes me you could come back in sort of four or five years and write a did things change? You know, what do we still need to do to embrace the health and other benefits of the arts? But also, writing academic books is a long process. It's a lot of work. And you'd mentioned doing some work in the US as well. And that intersection of health, medicine, the arts means you're writing lots of academic papers as well. So are you thinking of future book projects or in terms of next steps, are you doing more kind of focused arts and health research or have you got very different research plans coming up.
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C
We're continuing very much on the academic research. I mean, the book for me has been a kind of passion project on the side over the last couple of years, but we've got a number of really large scale research programs underway. One of them is taking forward that epidemiology research that looks at these long term associations and particularly trying to dive into those biological mechanisms more so we've recently received a seven year grant from the Wellcome Trust that is allowing us to look globally in 52 countries at how ARTS engagement relates to population health outcomes and more about the epigenetic, proteomic and metabolomic mechanisms that underpin this. But we're also doing a lot on the applied side in terms of schemes like social prescribing, trying to track the rates of these in electronic patient health records and running clinical trials of these in various countries. And I also have a position both with the World Health Organization and also with UNESCO where we're trying to look at where the opportunities are to integrate ART within health policies as a way of helping to try and achieve health goals.