Practice
It is difficult to know where to begin this story, as
acknowledgement of the health benefits of the arts
dates back to antiquity. (1) In the early modern era (1736-
7), William Hogarth brought the arts into the healthcare
environment by painting biblical scenes on the walls
of St Bartholomew’s Hospital. In late modernity (1859),
Florence Nightingale observed that the ‘variety of form
and brilliancy of colour in the objects presented to
patients are actual means of recovery’. In 1942, artist
Adrian Hill coined the term ‘art therapy’ to denote the
harnessing of health impacts. The late 1950s saw the
birth of Paintings in Hospitals, which continues to loan
artworks to health and care organisations. The early
1970s saw visual art graduates in Manchester rejecting
the market in favour of site-specific works in healthcare
settings, (2) and the second half of the decade saw
dance artist, Gina Levete offering dance workshops to
disabled children and then adults across London and
the rest of the UK through Shape Arts.
In late 2024, the Mayor of London published a
report I had written, based on research undertaken
in collaboration with London Arts and Health called
Understanding Creative Health in London: The Scale,
Character and Maturity of the Sector. The report
captured the evolution of creative health approaches
since Hogarth’s time in metropolitan health, care,
culture, heritage and community settings. Two timelines
– beautifully visualised by artist Rae Goddard – include,
for example, the inception of the Carl Campbell Dance
Company in 1978, Academy of Indian Dance (now
Akademi) in 1979, Adzido Pan African Dance Ensemble
in 1984, Green Candle Dance Company in 1987 and
Sadlers Wells’ Company of Elders in 1989, collectively
extending the benefits of dance to health and wellbeing.
People Dancing’s website is replete with examples
of present-day dance practice directly and indirectly
enhancing health and wellbeing throughout life.
Research
In parallel with the growth of practice, the evidence
base for the health and wellbeing benefits of dance has
been expanding to encompass a range of methods.
In the United States in 1968, an early workshop of
dance therapists, movement researchers and clinicians
considered the mental health benefits of dance. (3) In
the 1970s and ’80s, US researchers advocated dance as
a resource vital to the physical and mental wellbeing of
older adults (4) as part of a holistic approach. (5)
In the UK, Trinity Laban Conservatoire of Music and
Dance was an early entrant into the field of dance,
health and wellbeing research. A review of research
articles published over the first two decades of the new
millennium found dance making contributions to health
and wellbeing across seven domains: embodiment,
identity, belonging, self-worth, aesthetics, affective
responses and creativity. (6)
A significant portion of the evidence base for dance,
health and wellbeing is centred on the role of dance and
movement in promoting physical activity and fitness. (7)
Adjacent research highlights the contribution of dance
to social connectedness, mental health, wellbeing
and quality of life, (8), including in people with chronic
conditions. (9) A considerable body of work has been
dedicated to the integration of movement and cognition.
(10) In children, a link has been discerned between
dance, literacy and reading comprehension. (11) In
people with dementia, multiple positive effects have
been observed via engagement with dance. (12)
A contested area in the literature relates to dance
and falls prevention. An early randomised controlled
trial (the gold standard of empirical health research)
suggesting that ballroom dancing among care home residents improved balance and reduced the number
of falls in the study population. (13) However, a 2024
review of 41 previous studies found little evidence that
dance could help to reduce falls. (14) More encouraging
results have been seen in relation to fear of falling,
coordination, mobility, stamina and social relations.
(15,16)
In 2023, the Sport and Recreation Alliance calculated
the social value of movement and dance activities,
attributing the highest value (£2 billion p.a.) to an uplift
in mental health and wellbeing for participants and
volunteers. (17) Further social value was observed in
reducing the risk of type 2 diabetes (£157 million) and
in diminishing the risk of developing dementia (£149
million), with significant value also seen in relation to
cardiovascular disease/stroke (£45 million) and hip
fractures (£39 million) as well as in reduced demand
for psychotherapy services (£28 million) and GP visits
(£19 million).
Research has consistently shown that dance
helps to improve clinical signs and provides holistic
benefits to people with Parkinson’s Disease. (18, 19)
At King’s College London, the Scaling-up Health
Arts Programmes: Implementation and Effectiveness
Research (SHAPER) project explored Dance for
Parkinson’s, run by English National Ballet since 2010,
finding that dance can lead to improvements in pain
and symptoms in people with Parkinson’s. Alongside
this, People Dancing’s project, Live Well & Dance
with Parkinson’s, was centred on participatory dance
practice across six areas in England, celebrating the joy
of people dancing together, community development
and lived experience leadership. (20) SHAPER also
examined Rosetta Life’s Stroke Odysseys, a dance-
based programme for adults recovering from acquired
brain injury, an approach known to be particularly
relevant to people recovering from a stroke. (21)
Policy
As practice and research advanced, various discussion
forums arose, with attention initially focused on the
arts in healthcare settings. For Understanding Creative
Health in London, we were able to provide an overview
of nationally significant convergences. Pertinent among
these was a collaboration between the Department of
Health and Arts Council England, which, in 2007, gave
rise to A Prospectus for Arts and Health, paving the way
for future collaboration.
While negative publicity curtailed this promising
joint initiative, one parliamentarian was not prepared
to allow momentum to be lost. Former Member of
Parliament and Minister for the Arts Lord Howarth of
Newport continued to advocate for recognition of the
health and wellbeing benefits of the arts. At a meeting
with members of the National Alliance for Arts, Health
and Wellbeing, Lord Howarth offered to set up an
All-Party Parliamentary Group (APPG) on Arts Health
and Wellbeing, which he did in 2014. The following year, the group initiated an inquiry into the health and
wellbeing benefits of the arts, to which I was recruited
as Researcher from a base at King’s College London.
The inquiry convened a series of specialist meetings
and 16 roundtables in Parliament, on themes as wide-
ranging as young people’s mental health, dementia,
palliative care, dying and bereavement. My task was to
bring oral testimony from the APPG meetings together
with the most compelling evidence and examples of
practice.
Seven years before the parliamentary inquiry began,
in 2008, the World Health Organisation had published
the results of a Commission on the Social Determinants
of Health, chaired by Professor Sir Michael Marmot. (22)
This had identified profound health inequalities between
and within countries, due to the uneven distribution of
power and resources. In 2010, Marmot had built on this
to publish Fair Society, Healthy Lives, commissioned
by the Secretary of State for Health, which applied this
thinking to the UK and made recommendations for
targeted work to improve the conditions in which we
are born, grow, live, work and age – collectively known
as the social determinants of health. (23) The arts were
conspicuous by their absence from both reports.
Addressing this omission during the APPG inquiry,
we persuaded parliamentarians to acknowledge
the potential contribution of the arts to tackling
health inequalities. Accordingly, I adopted a social
determinants framework and arranged my findings
across the life course to produce a substantial report,
which was published in 2017. (24)
The title of the inquiry report – decided via an open
competition – was Creative Health, which has been
widely taken up as the current name of the arts and
health movement. From a policy perspective, one of
the major successes of the Creative Health report has
been that discussion of the arts in relation to the social
determinants of health is now commonplace.
Dance featured throughout Creative Health, in
relation to early childhood development, educational
attainment, Parkinson’s, recovery from surgery,
rehabilitation from brain injury and improved physical
and mental health and wellbeing in people of all ages.
Building on evidence that dance and movement
activities delayed cognitive deterioration while reducing
challenging behaviours, improving mood and enhancing
quality of life, the report highlighted examples of
practice that realised the value of dance to people
with dementia. The inquiry report also evidenced
multiple indirect benefits of dance, including self-
expression, communication, creative capacity and
social and emotional capabilities.
A case study within Creative Health was devoted
to the Alchemy Project, a research collaboration
between Dance United and the early intervention
in psychosis team at South London and Maudsley
Hospital, with input from King’s College London. The
18- to 35-year-olds taking part demonstrated clinically significant improvements in wellbeing, communication,
concentration and focus, level of trust in others, team
working and quality of life.
Progress is being made against each of the ten
recommendations made in Creative Health, notably
the inception of the National Centre for Creative Health
(NCCH) and Arts Council England’s support of arts
and cultural organisations with health and wellbeing
outcomes. Collaboration between these organisations
led to creative health associates being hosted within
each of the seven NHS regions in England between
2023 and 2025. A similar scheme, operated by the
Greater London Authority in partnership with local
government, saw a creative health lead being appointed
by South East London Integrated Care Board.
In 2023, the All-Party Parliamentary Group published
the results of a review of the benefits of creative health,
which outlined a vision of the arts as ‘integral to health,
social care and wider systems, with creativity recognised
by the general public, healthcare professionals and
policymakers as a resource to support health and
wellbeing’. (25) The following year, the group was
renamed the All-Party Parliamentary Group on Creative
Health.
Regional progress
In addition to making recommendations to central
government, the Creative Health Review identified the
importance of devolved government in developing
local strategies. As such, the review advised ‘that
Metro Mayors consider how their devolved powers
can support creative health in their region and work in
partnership with ICS (Integrated Care System) leaders
to deliver coherent strategies and develop sustainable
creative health infrastructure at scale using local assets’.
This has led to the formation of the Metro Mayors’
Creative Health Network to share knowledge and
drive progress.
A founder member of the network, the Greater
Manchester Combined Authority, had previously
commissioned me to work closely with the local ICS
to develop a dedicated Creative Health Strategy,
which was published at the end of 2022. (25) This
strategy highlighted the benefits of dance to early
childhood development and detailed dance workshops
for NHS staff coordinated by Lime Arts. Adopting a
life course approach, the strategy advocated dance
during working-age and older adulthood, drawing on
the expertise of such local organisations as Company
Chameleon and Global Grooves.
Throughout 2023, another founder member of the
Metro Mayors’ Creative Health Network, the Greater
London Authority, convened a discursive policy-design
process that involved the sector and people with lived
experience, celebrated the capital’s diversity, and
considered ways in which creative health might be
embedded in the community beyond health and care
systems. Having evaluated the policy-design process,
in 2024 I partnered with London Arts and Health to
conduct a thorough scoping of the creative health sector
in the capital. This comprised an overview of settings
alongside a snapshot of practice, workforce, funding
and commissioning, resulting in the aforementioned
report Understanding Creative Health in London.
For the early months of 2025, another network
member, the West Midlands Combined Authority, invited me to undertake an analysis of creative health activity,
research and data in the region. The internal report
I drafted noted Coventry’s advocacy, during its year
as UK City of Culture in 2021, of the promotion of
physical activity through dance as one of five step
changes. My report also recorded the presence of a
dancer in residence at University Hospitals Coventry
and Warwickshire NHS Trust, workshops being offered
by Birmingham Royal Ballet to people of all ages, an
elders’ contemporary dance company at Warwick Arts
Centre and a Somatics and Pain Network at Coventry
University, working with dance to support people living
with chronic pain. Dance featured prominently among
regional organisations funded by Arts Council England
identified as pursuing creative health approaches.
West Yorkshire Combined Authority is in the process
of procuring a consortium to develop and deliver a
regional creative health strategy, with other network
members likely to follow suit.
Into the future
In the coming years NCCH creative health associates,
embedded in every ICS in England, will be pivotal to
ensuring that the arts are more fully integrated into the
NHS.
In the community, we are going to see more
creative health regions, cities and boroughs being
established and more dedicated work happening in
our neighbourhoods that draws out the health and
wellbeing benefits of creativity, culture and heritage.
(this is a good one) My hope is that the integration
of creative health approaches becomes less subject
to a postcode lottery and that every library, community
centre, school and college up and down the country
offers creative health activities. At the same time,
the creative health workforce and leadership will come
to be more representative of the communities they
serve.
For me, the biggest untapped potential of creative
health is recognition of its role in increasing equity.
Following on from the hypothesis advanced in Creative
Health, more research is needed into the relationship
between the arts and the social determinants of
health. Findings from this research will then need to be
implemented in practice, with resources being invested
according to the Marmot principle of proportionate
universalism, on a sliding scale according to need. Only
when the benefits of creativity, culture and heritage
are equitably distributed – and socioeconomic gaps in
health and wellbeing narrowed – will the full potential of
creative health be realised.
After this article was written, we very sadly lost
Alan Howarth, Lord Howarth of Newport, a great
parliamentary and personal champion of creative
health. Alan’s memoir – Begun, Continued – will be
published on 10 October 2025. His legacy in the sector
will live on.
References
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- Now Lime Arts, operating under the auspices of Manchester
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Info
Dr Rebecca Gordon-Nesbitt has worked in Parliament
and with the Greater London Authority, Greater
Manchester Combined Authority, London Arts & Health
and many universities, trusts and foundations. She
drafted the parliamentary report that gave the Creative
Health movement its current name, and she has done
much to advance the argument that creative-health
approaches can increase equity.
www.rebeccagordon-nesbitt.org