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Community May Be the Key to Wellness

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Well-being is a buzzword these days. The evidence based on how to look after our mental health continues to grow, with demonstrated links between a strong social network, enjoying leisure activities, participation in the arts, and regular exercise leading to improvements in well-being. 

Even the medical field is starting to address the links between leisure activities and overall improved health, through a relatively new phenomenon known as social prescribing. Dr Helen Kingston, a general practitioner in the English village of Frome, recognised that many of the people she saw in her practice were complaining of legitimate health concerns, which she felt would be responsive to non-medical treatment. Dr Kingston created a village-wide network of doctors, community organisations, and volunteers that could facilitate and ‘prescribed’ a wide range of community-based activities such as participating in the arts, visiting museums, joining a social group, or taking regular walks in nature. Since this initiative was started, Frome has seen a reduction of non-elective hospitalisations of a staggering 17%; to provide a comparison, a neighbouring village experienced a 28.5% increase over the same time frame. Last year Prime Minister Theresa May announced a new Loneliness Strategy with social prescribing at its core as a viable pathway to improve overall health while reducing the burden on the public health system. Other countries are also starting trials with similar models. 

While the uptake of such approaches by health professionals is most welcome, ensuring a strong evidence base becomes vitally important. There’s much that we don’t know, for example: are there differences between activities done alone and those done with others? Do some activities provide a bigger ‘well-being boost’ than others? How important are individual differences or preferences? 

Benefits of socialising

There are, of course, many benefits to taking time out by yourself, to take a break from constant stimulation. However, there are arguments for seeking out activities that are done with others, since having strong social networks is a predictor of both longevity and a higher level of state well-being – that is, a generally more positive outlook on life. And while introverts may complain more about attending social events, they also tend to enjoy them equally when compared to extroverts once they are dragged along. Individual differences may not have much of an effect on receiving benefits from social activities, but this is not a question that has a definitive answer. 

The case for incorporating music 

It has been proposed that human musicality is an evolutionary adaptation that helped hominids to develop cooperative behaviours through creating a shared and positive emotional state, resulting in a stronger sense of group cohesion and, over time, the development of pro-social behaviours – such as empathy, for example. If these theories are correct, then it may be that music-based activities may have a greater impact on well-being than other kinds of groups. Research has established that many aspects of music-centred activity do indeed have a positive impact on a range of well-being markers. Listening to music is the clear front runner, and may reflect the most widely-used method for self-regulating mood. Research with choirs and other music performance groups indicate that the collaborative aspect of music production increases pain tolerance, a proxy measure for elevated endorphin levels, a hormone with analgesic effects. Coordinated movement, often present in music-related activities, increases oxytocin levels, another hormone linked to human bonding. A particularly clever research design even found that when pre-school children played a game that incorporated singing, they demonstrated more prosocial ‘helping’ behaviour afterwards when compared to their peers who played the same game but without the music component. 

Still many questions

Exploring these theories, my own research, conducted with Nikki Rickard, found that choir members experienced a significant improvement in both their mood and their sense of social connection from pre- to post-session – but these changes were equally experienced by members of an exercise group and a current events discussion group. This was a surprise and indicates that well-being effects that have been attributed to choirs may also be equally experienced by other kinds of non-musical groups. 

In trying to understand our results, we turned to Self Determination Theory (SDT), which posits that a sense of agency (that is, having control over your life), competency (feeling capable in what you do), and relatedness (providing an appreciated contribution to a communal goal) are fundamental psychological necessities for humans. If this is the case, it may be that individual choice overrides any well-being ‘boost’ that would otherwise be ascribed to musical activities. In other words, it could be that the key driver for well-being experienced from social group participation is preference and choice rather than the type of activity. You can help us to pick apart some of these questions by taking a short online survey. This will allow us to compare different types of social groups and try to identify what underlying mechanisms promote changes – is it the principles of SDT, or perhaps there are different mechanisms at work for different activities?

Attempting to understand what propels changes in well-being will be an important contribution to understanding how to best prescribe social and other types of activities in a health setting. 

Susan Maury is a PhD candidate in psychology at Monash University. She is looking at the well-being benefits of social group participation. 

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