Thank you very much, Rosa, and thank you for your kind introduction.

So, I'm going

to give a quick overview of the next session, in which Daisy, I'll ask you to come
up in a second. We'll give you the kind of meat and bones of what we're here to
discuss and learn about. I.e., she'll give you an overview of arts and health and
an overview of the report. But before she does so, I wanted to give you a quick
kind of background about why this stuff is even happening within WHO. So, I'm
assuming you know why you're here, but you probably have no idea why I'm here. In
fact, you probably have no idea who I am. So, I'm just going to say a little bit
about that first as a matter of introduction.

So, I'm part of a small but very dedicated team of individuals who work on a
project called Culture, a Cultural Context of Health and Well-being at the WHO
Regional Office for Europe. And it's a small team, it's a small program, but I
think it serves a vital part within WHO. It tries to articulate the case for why
culture matters in public health and in public health policymaking right down
through the life course. It doesn't matter how old you are, right down to the
continuum of care. It doesn't matter if you are self-medicating in bed because
you've got a cold or you're in surgery receiving a major operation. In all of those
parts of life, culture matters.

We do a whole bunch of things around the theoretical and conceptual part of culture
and health. We think through how culture matters in terms of eating, nutrition, and
nutritional health. We think through why culture matters in terms of antibiotic
resistance, why it matters, why you might want to take antibiotics or not. But we
also try to think through why culture matters on a practical level. And I think
that's exactly where this report is situated. We are a space within WHO that seeks
to systematically understand how cultural contexts affect health and well-being.
So, this report, in particular, is I think interesting in several ways.

Arts and health as a field has been around for, well, I mean, as the regional
director was saying, arts has been around ever since human kind of existence. But
arts and health as a research area has been around probably for 30 or 40 years. And
in that time, it's slowly grown and slowly gained momentum. There are some
countries in the Nordics but also the UK where arts and health, I think, has
received firmer and firmer footing. But there are still these questions that are
bound around the efficacy, the evidence base, whether or not arts can actually have
an impact and effect on health. So, this report was commissioned to try and examine
that question around the evidence base and hopefully put to rest some of those
questions.

So, I think the report achieves three main things. It provides a starting point, a
kind of map of evidence. There are almost a thousand references contained in the
report. Anybody who is interested in arts and health from a research perspective is
going to use this report as a starting point to further research the area. It will
serve as a place for practical examples. There are several case studies in the
report that I hope you will gravitate towards. I hope people in this room and
outside watching on the livestream will look at in order to get inspiration about
how arts and health actually works on the ground, how it works practically. But
most importantly, I think and I hope that this report will serve as the first word
to move the conversation on from the question about evidence and into the realm of
policymaking.

So, that's enough for me. I do want to take a moment to introduce Daisy. Daisy is,
I think, she's kind of a true interdisciplinary. She's a kind of unicorn within
this field. She has a deep background in music and the arts, but she also has a PhD
in psychology, which itself is an insanely interdisciplinary kind of topic. She's
an epidemiologist, and she has also worked several years on the ground in the NHS
managing arts and clinical intervention programs. Most importantly, though, she's
been a wonderful colleague to work with. So, Daisy, I'd like to welcome you onto
the stage to say a little bit about arts and health and the report. Thank you.
[Applause]

Thank you very much for that lovely introduction, Niels. It's a real pleasure to be
speaking to you today to launch this report. As Niels mentioned, the focus of this
report was to bring together the evidence base on scientific studies that have
looked at how the arts can affect our health. We defined arts for this report as
creative leisure time activities, including participating in performing arts
activities like singing and dancing, or visual arts, design and craft activities,
or otherwise engaging with literature activities, including reading fiction, and
being engaged in book clubs and libraries, engaging with online digital or
electronic arts, including things like photography or creating animations and
films, broader cultural engagements like going to museums, concerts, the theatre,
and exhibitions, and other types of creativity, such as gardening-based activities.

The position we took when we were writing this report was to consider all of these
activities as multimodal, in that these activities combine multiple different
factors, including aesthetics, imagination, evoking emotions, providing
opportunities for social interaction and cognitive stimulation, and also
opportunities for physical activity and engagement with health settings or themes
of health. And all of these different components can then be linked via
psychological, physiological, social, and behavioral mechanisms with both the
prevention and also the management and treatment of illness. So, we specifically
carried out this work as a scoping review, trying to understand the breadth of
studies that have been carried out and also get a sense of the depth, how much
these studies have looked at the particular aspects of different health outcomes.

But we didn't focus on any particular methodological approach. Rather, we wanted to

take a very broad approach to evidence, considering both randomized control trials
and other quantitative approaches like laboratory studies and analyses of cohort or
population-level data, but also looking at qualitative data, including
ethnographies, case studies, qualitative interview studies, and broader studies of
process evaluations in implementation. So, in total, we found over 200 systematic
reviews and meta-analyses that between them cover over 3,000 studies that have been
carried out on this topic. And we also found a further 700 individual studies that
we felt were key to include in this review. So, in total, we're looking at over
three and a half thousand studies that have been referenced in total throughout
this report.

So, this does, as Niels mentioned, make this the largest evidence review that's
being carried out on this field to date. We used a thematic coding approach in
order to identify the different themes that were coming out from all of these
studies. And we clustered these into two broad sections in the report: prevention
and promotion of illness and their management and treatment of health conditions.
And I'm going to give an overview of some of the findings from this.

And I'm going to start by speaking about management and treatment because that's
the evidence base that I think most people are most familiar with from the last few
years. So, the evidence suggests that the arts can support women across the
perinatal periods and particularly helping their mental health. This is something
that we see during pregnancy, during the birth itself, in terms of reductions of
pain and anxiety, and then in the postnatal period, both in terms of reducing
symptoms of postnatal depression and increasing the quality of life and the sense
of connection that women feel with their children and with their communities.

We also found evidence supporting the use of the arts in people living with
dementia, in particular, the use of music and singing-based interventions, but also
other creative activities, including visual arts and museum-based interventions, in
supporting people to feel more engaged with the present moment, to feel more
connected to other people and their memories, and also supporting care staff in
providing better care for the people they're looking after. We also found evidence
supporting the use of the arts in supporting mental health and well-being more
broadly, particularly in terms of reducing symptoms of anxiety and depression, but
also supporting people to manage their symptoms of schizophrenia and bipolar
disorder.

We also found evidence supporting the use of the arts in supporting people with
physical health conditions. So, in particular, we found evidence supporting the use
of music in reducing symptoms of pain and anxiety in people undergoing surgery or
other medical procedures, and also supporting people to better manage their
symptoms and feel more in control of their conditions when they're living with
chronic pain or other long-term conditions, like fibromyalgia or chronic fatigue
syndrome.

We also found evidence supporting the
recovering from strokes, particularly
interventions in supporting people to
themselves, but also supporting their
recovery.
use of the arts in supporting people who are
the use of singing and speech-based
regain their ability to speak and to express
social reintegration and their psychological

So, those are some of the key findings from the evidence base around management and
treatment. And then, I'm going to give an overview of some of the key findings
around the prevention and promotion of illness. And I'm going to start with
physical health outcomes. So, the evidence suggests that engaging in the arts can
support people to adopt healthier behaviors, including encouraging people to
exercise more regularly and eat a healthier diet, but also supporting people to
engage more regularly with health screening services, like breast cancer screening
or cardiovascular disease risk assessments. We also found evidence supporting the
use of the arts in supporting people to manage their long-term conditions, like
diabetes, asthma, and heart disease, particularly in terms of improving the quality
of life and supporting people to manage their symptoms better.

We also found evidence supporting the use of the arts in supporting people to
prevent and manage infectious diseases, including supporting people to adopt
behaviors that reduce their risk of exposure to infections, but also supporting
people to better manage their symptoms and feel more in control when they do become
infected. And then, I'm going to speak about mental health outcomes. So, the
evidence suggests that engaging in the arts can support people to build resilience
and protect against the development of mental health conditions, including reducing
symptoms of anxiety and depression and also supporting people to manage their
stress and adapt to changes in their lives.

We also found evidence supporting the use of the arts in supporting people to
recover from trauma and adversity, including supporting people to process their
experiences and make meaning out of them, but also supporting people to reconnect
with their communities and rebuild their sense of identity and self-esteem. We also
found evidence supporting the use of the arts in supporting people to develop
social relationships and reduce social isolation, particularly in terms of
supporting people to feel more connected to their communities and to other people
with similar interests and experiences.

So, those are some of the key findings from the report. And I want to stress that
this is just the beginning of the evidence base in this field. There's still a lot
more research that needs to be done to understand the mechanisms underlying these
effects, to understand who benefits most from engaging in the arts, and also to
understand how best to implement these interventions in practice.

But I think this report provides a really strong foundation on which to build
future research and practice in this field. And I'm really excited to see how this
field develops over the coming years. So, thank you very much for your attention.
And I look forward to hearing more about your experiences and perspectives on this
topic. Thank you. [Applause]