Culture, Wellbeing, and Health. Towards a Cultural Welfare?

The relationship between culture and health has been the subject of increasing interest in recent years, in particular thanks to the results of scientific research and some interesting experiences.

Numerous epidemiological, observational, and longitudinal scientific studies, conducted principally in the English-speaking world and Northern Europe, have made clear that active cultural participation, and the intelligent use of free time more in general, are allies in prolonging life expectancy, active aging, post-operative recovery, and the slower aggravation of degenerative diseases such as Alzheimer's and Parkinson's.

Neurosciences have identified the neural structures involved in the sensation of wellbeing and reward, demonstrating how they are stimulated by aesthetic pleasure, de facto opening research to the influence of cultural experience on connective activity, but also on its structure and brain biochemistry. Positive psychology goes in this direction: science now pays attention to the potential to support individual and social development, and the role of emotions and processes for the cognitive elaboration of stress is clear in that regard. This is an area of investigation for PNEI (psycho-neuro-endocrino-immunology) that offers a systemic interpretation of the organism, demonstrating that excessive incretions of the stress hormone (cortisol) produces effects on the immune system with significant, longitudinal, and transgenerational biological impacts. More recently, epigenetics has begun to speak of how lifestyles can modify the behavior of our genes.

These are new and stimulating perspectives that shift the focus from a biomedical treatment approach, that has characterized the struggle against pathologies, to a bio-pyscho-social approach, whose assumption is that every sick and health condition is the consequence of the interaction among multiple factors able to influence the onset and evolution of pathologies, going beyond single vital functions and organs.

These perspectives supplement studies on medical humanities (that enrich biology with the view of humanistic disciplines) with an approach to care that starts from the prevention and the promotion of health (in which the individual plays an active role). This is the "healthgenic" approach (the definition given by the medical sociologist Aaron Antonovsky): generate health by creating social contexts that are favorable to people's wellbeing.

In the definition given by the World Health Organization (WHO), health is already not understood as the contrast between two opposite poles – the presence or absence of pathologies – but as quality of life and wellbeing, and as such requires a multifactorial interdisciplinary approach. The fundamental nucleus of life skills defined by the WHO includes ten basic cognitive, emotional, and relational skills (different among cultures, but with a basic core) that allow people to develop versatile and positive behavior through which to seize opportunities and face the challenges of daily life; these challenges are the basis of the promotion of the health and wellbeing of children, adolescents, and adults.

The cultural experience, eudemonia (construction of meaning), can become an integral part of prevention and treatment strategies in all phases of life, starting from conception, touching the importance of nurturing care, i.e. the creation of fertile situations for cognitive and social growth, starting in the first 1000 days of life, that are essential for the development of neuron synapses, all the way until the fourth age.

In this sense, there are considerable investments of energy in the search for active practices, especially from the bottom-up on the part of third sector organizations, health and social workers, educational departments of museums (active in audience engagement, but also ancillary and subordinate to the curator function), and other cultural subjects (in musical language, theaters, dance, and even circus disciplines). There are countless pilot cultural projects in the health sphere: from art in hospitals to music therapy, passing through reading starting from the perinatal period. But as Prof. Pier Luigi Sacco, a culture economist, says, although these projects are producing promising results, they are still mainly "pulviscular," confined to the status of a curiosity, like marginal episodes in the processes of treatment, rarely incorporated into intersectoral approaches.

For Italy, high-level training in care professionals does not yet look to humanities with dedicated professorships. The relationship between culture and health is present only sporadically and as an exception, as in the field of cultural and educational training.

Today cultural institutions are at a turning point due to the role and importance they aim to take on within contemporary society. The mantra of the last decade has been audience development and engagement, in an era of transformation: interculturality and acceleration of technological innovation above all. Cultural institutions are thus passing through a profound reflection on their impact vision, that regards the entire organization. The awareness of this value does not weaken the functions of historical-artistic research, preservation or enhancement of cultural heritage, but strengthens them, making it possible to design strategies that incorporate their anticipated effects from the start and not as a spillover effect.

The path is in any event clear: cultural participation has repercussions on quality of life, a prerequisite for sustainable social and economic development. These results also change the way of looking at the issues of new forms of inequality, the unanticipated fruits of the era we have called the "economy of knowledge and social justice."

Catterina Seia is co-founder and vice president of the Fondazione Medicina a Misura di Donna