Is singing good for you? Can it contribute to your sense of well being? These are the questions being asked by Professor Stephen Clift, who presented his talk to the Music, Mind and Brain students at Goldsmiths College on the 1st November 2012. Clift has a 25-year history in public health and has been involved in many projects persuading people to actively avoid risk-taking behaviours. Within the last 10 years he has been involved in a number of research projects at the Sidney de Haan Centre in Kent, each of which is concerned with developing a better understanding of the psychological and physical benefits of singing. Originally inspired by an article written by Susan Digby about promoting singing in primary schools, Clift has become increasingly interested in gathering evidence for the real and measurable impact of singing on health and well being. His research has looked at community singing groups set up in the east Kent area for people with a range of health issues including Chronic Obstructive Pulmonary Disease (COPD), Parkinson’s disease, Dementia and other mental health problems.
Clift began his presentation by demonstrating how singing engages different systems within the body. He encouraged the audience to join him in a few simple vocal exercises, and used these examples to introduce the idea that singing is an activity that is powered by the lungs, and regular singing might have the ability to act as a kind of speech therapy for the voice. This can be especially important for older people with chronic health diseases such as Parkinson’s, a motor-coordination disease that can result in voice impairments, and COPD, a progressive lung disease in which lung capacity is significantly reduced. The basis of Clift’s research has to do with the fact that despite the chronic health problems experienced by people suffering from these diseases, they still manage to engage with music in a positive way.
When Clift began his research in 2000, there was very little published on singing and well being, but in 2010 he completed a systematic mapping of research in the area which included 40 empirical reports, indicating a growth of interest in the field (Clift, Nicol, Raisbeck, Whitemore & Morrison, 2010). The research at the Sydney De Haan Centre has continued to build on this knowledge base with qualitative evaluations for different populations, including a randomised control trial in the Silver Song Clubs study (Skingley, Clift, Coulton & Rodriguez, 2011). This project investigated measures of physical and mental health for older singing groups within the community, and in doing so, proposed that group-singing interventions for elderly people could be a cost-effective strategy for the NHS.
The Silver Song Clubs study (Skingley et al., 2011) investigated two groups of people: those who took part in a 12-week group singing program (the experimental condition), and those who carried on with life as normal, (the control condition). Participants completed the York SF-12 quality of life measure at the start of the project (baseline), at three months (at the end) and at six months (post). Results suggested a significantly greater improvement in mental health quality of life for individuals who participated in the group singing condition compared with those continuing with normal activities. The effect was greatest immediately following the intervention, but still apparent three months after discontinuation. There were limitations to the study, such as the short duration of the program, and the small geographical area in which the study took place, but the key findings indicate that singing groups for older people are likely to be cost effective as a health promotion strategy (Skingley et al., 2011).
Clift’s research has found the effects of singing to be beneficial regardless of age, gender, nationality or wellbeing status (Livesey, Morrison, Clift & Camic, 2012). A cross-cultural study spanning 1,000 choral singers in Australia, England and Germany has shed light on four areas that seem to hold a significant benefit; body control and posture, effects on breathing and lung function, energy and physical activity, and relaxation and stress relief (Clift, Hancox, Morrison, Hess, Kreutz & Stewart, 2009).
Although most of Clift’s research uses self-report questionnaires assessing participants’ mental well being, these measures are relatively accurate, as they give subjects the chance to reflect on themselves and evaluate the way they feel. However, for those more convinced by quantitative than qualitative data, Clift has also studied the effects of singing on individuals with COPD by measuring their lung capacity. His most recent piece of research has found a significant increase in both the volume exhaled in one second, Forced Expiratory Volume, and the maximum amount of air exhaled in one go, Forced Vital Capacity, within COPD patients that spent 10 months in a weekly singing group (in press). These are dramatic implications for beneficial effects on physical well being in a group of patients with a progressive and irreversible disease. The study ran across a period of 10 months spanning from early autumn to late spring, seasons in which COPD sufferers are most affected due to the icy cold wind and weather. However, participants’ feedback was filled with a heart-warming surprise, with some noting this to be the first winter in which they were not admitted to A&E with severe breathing problems. This is not only a relief for sufferers, but also has a huge impact on the NHS, as COPD is in fact the second most common cause of admissions to A&E in hospitals in the UK (British Lung Foundation, 2007). Decreasing the number of patients admitted to hospital will effectively save millions of pounds, with current costs spent on treatment of COPD, by the NHS, lying at £810 – £930 million per year (Department of Health, 2010).
In conclusion, Clift’s research has contributed significantly by investigating the potential value of music and the arts in healthcare and health promotion. He captivated the students at Goldsmiths with his interactive presentation, as he discussed the effects of group singing on physical and psychological health, and the implications that the results of his studies have in terms of healthcare interventions.
To read more about Clift’s work, go to the Sidney de Haan Research Centre for Arts and Health website, and to watch a short video on the East Kent ‘Singing for Health’ Network, click here.
Philipp Koch, Suzie Le Messurier and Steven Lyons
British Lung Foundation (2007) Invisible lives: Chronic Obstructive Lung Disease (COPD) finding the missing millions. London: BLF.
Clift, S., Nicols, J., Raisbeck, M., Whitmore, C., and Morrison, I. (2010). Group singing, wellbeing and health: A systematic review. The UNESCO Journal, 2, 1.
Clift, S., Hancox, G., Morrison, I.,Hess, B., Kreutz, G.,and Stewart, D. (2009). What do singers say about the effects of choral singing on physical health? Findings from a survey of choristers in Australia, England and Germany. In J. Louhivuoiri, Eerole, T., Saarikallio, S., Himberg, T. and Eerola, P-S. (Eds.) Proceedings of the 7th Triennial Conference of European Society for the Cognitive Sciences of Music (ESCOM 2009), Jyvaskkyla, Finland.
Clift, S., Hancox, G., Staricoff, R. and Whitmore, C. (2008). Singing and Health: A systematic mapping and review of non-clinical research. Canterbury: Canterbury Christ Church University.
Department of Health (2010). Consultation on a Strategy for Services for Chronic Obstructive Pulmonary Disease (COPD) in England. London: Department of Health.
Livesey, L., Morrison, I., Clift, S. and Camic, P. (2012). Benefits of choral singing for social and mental wellbeing: Qualitative findings from a cross-national survey of choir members. Journal of Public Mental Health, 11, 1, 10-27.
Skingley, A., Clift, S. M., Coulton, S. P., and Rodriguez, J. (2011). The effectiveness and cost-effectiveness of a participative community singing programme as a health promotion initiative for older people: Protocol for a randomised controlled trial. BMC Public Health, 11, 142.