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Attendance at cultural events, reading books or periodicals, and making music or singing in a choir as determinants for survival: Swedish interview survey of living conditions

BMJ 1996; 313 doi: (Published 21 December 1996) Cite this as: BMJ 1996;313:1577
  1. Lars Olov Bygren, head of departmenta,
  2. Boinkum Benson Konlaan, research assistanta,
  3. Sven-Erik Johansson, senior statisticianb
  1. a Department of Social Medicine, University of Umea, S-901 85 Umea, Sweden
  2. b Swedish Central Bureau of Statistics, 115 81 Stockholm, Sweden
  1. Correspendence and requests for reprints to: Professor Bygren.


    Objectives: To investigate the possible influence of attendance at cultural events, reading books or periodicals, making music or singing in a choir as determinants for survival.

    Design: A simple random sample was drawn of 15 198 individuals aged 16–74 years. Of these, 85% (12 982) were interviewed by trained non-medical interviewers between 1982 and 1983 about cultural activities. They were followed up with respect to survival until 31 December 1991.

    Setting: Swedish interview survey of living conditions comprising a random sample of the adult Swedish population.

    Subjects: 12 675 people interviewed between 1982 and 1983.

    Main outcome measures: Survival of subjects after controlling for eight confounding variables: age, sex, education level, income, long term disease, social network, smoking, and physical exercise.

    Results: 6301 men and 6374 women were followed up; 533 men and 314 women died during this period. The control variables influenced survival in the expected directions except for social network for men; a significant negative effective was found when the analysis was made separately for men and women. We found an influence on mortality when the eight control variables were controlled for in people who rarely attended events compared with those attending most often, the relative risk being 1.57 (95% confidence interval 1.18 to 2.09).

    Conclusion: Attendance at cultural events may have a positive influence on survival. Long term follow up of large samples with confounders that are well controlled for and with the cultural stimulation more highly specified should be used to try to falsify the hypothesis before experiments start.

    Key messages

    • When other determinants of survival were controlled for, this study found that people attending cultural events often had a better chance of survival than those attending rarely

    • Education unexpectedly had no significant influence on survival when other variables were controlled for

    • Long term follow up of large samples with con- founders that are well controlled for may provide empirical evidence to support experiments on the effects of cultural stimulation on people not attending events


    • Funding No external funding.

    • Conflict of interest None.

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