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The Role of Arts & Culture in Lifting Communities Out of Poverty, A Review of Evidence

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The Role of Arts and Culture in Lifting Communities Out of Poverty: A Review of Evidence

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This evidence review was written by Dr Sophie Mamattah (Centre for Culture, Sport & Events at UWS), Tamsin Cox (DHA Communications), Professor David McGillivray & Professor Gayle McPherson (Centre for Culture, Sport & Events at UWS) as part of the UKRI Enhancing PlaceBased Partnerships for Public Engagement project.

ISBN: 978-1-903978-61-0 Published: September 2020 Š University of the West of Scotland

Photo: Willie Kay (illustration Katie Chappell).

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Contents 1.0 Introduction

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2.0 Poverty – a note on definitions

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3.0 Policy approaches to the utilisation of arts & culture for social good

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4.0 Art, culture & the alleviation of poverty; development and transition economies

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4.1 UK–based examples of interventions with more tangible economic effects

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5.0 Social Prescribing

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5.1

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Social Prescribing – Accruing Social Capital

6.0 Conclusion

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6.1

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Recommendations

7.0 References 19

Photo: Willie Kay

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The Role of Arts and Culture in Lifting Communities Out of Poverty: A Review of Evidence 1.0 Introduction The purpose of this evidence review is to present an overview of the available academic and grey literature that identifies and analyses evidence relevant for understanding the contribution of arts and culture to the alleviation of poverty (see particularly Sections 4.0, 4.1, 4.1.1-4.1.4). The review was conducted using search terms focussing on the themes of “art” and “arts,” “culture” and “poverty” alongside related terms and their proxies. Further, the reference lists associated with these sources were interrogated to identify other relevant material for inclusion in the review. Literature searches were initially undertaken using the terms “art,” “culture” and “poverty” / “poverty alleviation” alone. It was immediately clear that the literature that directly connects these terms has primarily developed within the context of (sustainable) development, often this work examines processes ongoing within developing and transitioning economies (i.e. Hagg, 2006; Sagina, 2005; Sim, 2017). Literature presenting analyses of data collected in the UK or, which reflects Europe-focused policy agendas and projects, generally does not utilise a contextualisation that associates the realms of art, culture and poverty alleviation overtly.1 While macro-economic analyses which echo those made for developing country contexts are evident (i.e. ACE: 2014), proxy indicators which – taken together – suggest that communities or individuals are likely to live in financially constrained circumstances, are preferred. Such indicators are focussed around measures of likely “social inclusion,” and “social exclusion” and include metrics such as “employment,” “education,” “wellbeing” and “personal development”.2 Notably, however, it is also clear that, equating “employment” with prosperity or – at least – the absence of poverty, is not unproblematic (i.e. Bakare: 2020; ACE; 2014; Inman 2020). In an attempt to uncover relevant literature with an explicit focus on “material poverty,” the term was added to the keyword combination searches. These initial searches demonstrate the fluidity of the term ‘poverty,’ evidencing the variety of ways in which it is defined and, utilised to frame discussions analysis or evaluation. For the purposes of this review it is useful to address these conceptual issues prior to reviewing any of the extant literature on arts, culture and poverty alleviation. So doing highlights the challenge of harnessing the impetus generated by arts and cultural interventions to address issues of ‘poverty’ effectively. It also points towards the ways in which careful attention to the parameters of the term at a project’s outset might accrue increased benefit over the lifetime of the intervention and beyond.

Rather, literature returned for searches including terms or combinations of terms “arts,” “culture” and “poverty” often focussed on the social behaviour, cultural tools and constraints informing the day-to-day actions of people and communities living in poverty (i.e. Small et al, 2010). 1

See Jermyn for a list of ‘claimed impacts of the arts’ compiled from a survey of literature on arts projects and their evaluation (Jermyn, 2001: 13-14). For a summary list of studies which examined the impacts of arts participation summarising methodologies used and impacts identified see Jermyn (2001:14-15). 2

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2.0 Poverty – a note on definitions The term ‘poverty’ has both a broad usage and connotations, and a particular history, modern usage and associated discourse in domestic and international policy. It often sits alongside other terms including ‘inequality’, ‘disadvantage’ and ‘deprivation’; however, these terms frequently refer to a wider set of negative conditions, factors and experiences. Overall, the term poverty is most specific and codified in relation to the material circumstances in which people live. The Joseph Rowntree Foundation (JRF) offers the following definition of poverty: ‘When a person’s resources (mainly their material resources) are not sufficient to meet their minimum needs (including social participation).’ (Goulden & D’Arcy, 2014: 3) Goulden and D’Arcy go on to add detail and context to this definition, pointing out that concepts like ‘minimum needs’, for example, are subject to all sorts of variables, including the role of the state and the market, the costs of goods and social norms. Thus, the definition itself is complex and subject to a variety of factors when applied in different contexts; however, at its heart is the relationship between the resources which people have available to help them meet their needs (which may, for many, be primarily their income) and the costs of meeting those needs. Goulden and D’Arcy argue that the causes and impacts of poverty are important to acknowledge and are strongly related – including factors such as low educational attainment, unemployment, exclusion – but that conflating these issues with poverty is unhelpful. Similarly, these authors identify that issues like social mobility, well-being or inequality are also related to poverty, but that conflating or using these terms interchangeably dilutes understanding of poverty as a key concept, and may limit the clarity of any policy response (2014).3 This elision or conflation of poverty with other terms and issues reflects several different things. Goulden and D’Arcy acknowledge that: ‘It would be easy to make the mistake of thinking that all good things go together, not simply as a conceptual or philosophical question, but in terms of thinking about policy interventions and making sure measures relate to anti-poverty policies.’ (Goulden & D’Arcy, 2014:7) They are reflecting on a well-meaning perspective in which gathering together not just poverty but other related issues occurs as a desire to acknowledge the full gambit of challenges, and attempt to solve them together. Stewart and Roberts (2019) identify a similar tension in navigating the use of the term poverty in approaches which also advocate for acknowledging multi-dimensional approaches to measurement. They highlight, for example, conceptions of poverty within development literature, where wider deprivations beyond material resources are more routinely included in the literature, and in approaches to measurement.4

Black et al (ND, 7-8) recognise both the challenge and the importance of separating out different realms of poverty, noting the Welsh government’s identification of 3 dimensions of poverty: income poverty, service poverty and participation poverty. The Welsh government’s action plan was based around this typology. 3

This is certainly reflected in the literature uncovered in the process of researching this review. For example, many of the sources returned debated the usefulness of social inclusion as a guide for policy (Jermyn, 2001) or acknowledged its utility (i.e. Goodlad et al, 2002; Barraket, 2005; Jermyn, 2001) but debated definition. While the markers of social exclusion were delineated (i.e. Long et al, 2002), they were recognised as being ‘linked to poverty but not synonymous with it’ (Jermyn, 2001:2). In other studies, the appropriateness of positioning arts (GLAM) institutions as ‘agents of social inclusion’ (Belfiore, 2002:103) is problematized (i.e. Belfiore, 2002; also, McPherson, 2006; Barnes & McPherson, 2019; Sandell, 1998). The accumulation of social capital is linked to involvement in arts and cultural activity (i.e. McClymont et al, 2020; Gould 2001). In these analyses, this range of social markers is debated and discussed with reference to poverty and access but it is not clear that material poverty can be necessarily effectively addressed though these channels. The challenge of capturing and measuring the effects of arts and culture interventions is widely acknowledged (i.e. Matarasso, 1997; ACE, 2014; Kay, 2000). 4

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When we look at formal measurements of poverty, it is possible to recognise the way in which definitions - which are either too simplistic or too broad - can create space (or perhaps cover) for particular political and ideological framings of poverty. Measurements of poverty, both domestically and internationally, often involve setting a line beneath which a household - or individual - may be termed as ‘living in poverty.’ The difference between absolute and relative measurements, for example, is not just a technical one but indicates conceptual (and potential ideological) variance too. Francis-Devine (2020) notes that the use of both absolute and relative indicators, with commonly used measures being either the relative or the absolute low income, (which the government in the UK defines as living in households with income below 60% of the median in that year). The ‘official’ statistics on poverty in the UK come from the Department for Work and Pensions’ Households below average income (HBAI) statistics, which looks at both low income and material deprivation. Jefferson (2018) puts these different measures into some global context when he notes that ‘many developing countries’ use an absolute measure, and that the US is unusual as a high income country which also uses an absolute poverty line.5 In 2016 the UK government removed indicators for low income and material deprivation from the official child poverty measurement (although the government is still required to publish this data annually), replacing them with other indicators of household ‘worklessness’ and children’s educational attainment; the aim was to remove those measurements relating to material resources. Stewart and Roberts suggest that even where international practices may prefer multi-dimensional approaches (e.g. including educational attainment or other wellbeing indicators), they do so in addition to indicators on material resources (i.e. income and material deprivation). In their review of consultation responses, Stewart and Roberts found that the large majority of ‘experts’ (including local authorities, charities, front-line services and academic researchers) were not in favour of the removal of indicators of material resources. They conclude that: ‘Poverty measurement is highly political: what is measured and reported on is what enables governments to be held to account, and in turn drives policy [….].Responses to the 2012–2013 consultation reveal concern that to broaden measurement is to detract attention away from income poverty, and away from structural drivers of poverty towards individual failings, just when government benefit reforms are putting pressure on material resources in low income households with children.’ (Stewart & Roberts, 2019) In 2018, an independent commission – the Social Metrics Commission, involving several key independent organisations including the Legatum Institute, Joseph Rowntree Foundation and others – launched a report in which a new framework for measuring poverty in the UK was proposed (Social Metrics Commission, 2018). The issue of whether measures such as households with income below 60% of the median are the right gauges of material resources continues to be debated. The Joseph Rowntree Foundation, for example, produces its own metrics on poverty including work around a minimum income standard that is based on research which asks the public what they consider households need in order to reach a minimum socially acceptable standard of living. Despite debates on definitions and measurements, poverty is a key policy concept. Eradicating poverty is the first of the United Nations’ 17 sustainable development goals, listed separately from a range of other areas like well-being and education. The Poverty Alliance in Scotland identifies ‘adequate incomes’ as the first of its four goals. In the context of exploring how arts and cultural interventions engage with poverty, what we can observe from this brief overview is: •

The contested nature of the concept, and associated challenges with definitions and measurements

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That this contestation is often political and ideological

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That, if we take the narrower definition of poverty – even within a wider multi-dimensional landscape so that other deprivations (which are more properly understood as the effects of poverty) are also recognised – the core challenge is substantial, and speaks to the ways in which we organise our societies and economies.

Stewart and Roberts (2019) briefly discuss absolute versus relative poverty indicators, and summarise the debate about the two approaches as ‘overplayed’ and ‘sterile’. 5

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Examining some of the definitional uncertainty with regard to poverty is valuable as it highlights the difficulty encountered in arriving at a definition and, accounting for the effect of political context on both the definition per se and, the levers that stakeholders may choose to use in attempting to tackle poverty. The focus of this review is the contribution that arts and cultural activity can make in the context of people and communities experiencing poverty. It is clear from the preceding discussion that the substantial and political nature of material poverty make it a difficult space in which to operate and make claims in relation to arts and cultural activity. In this respect it is important to consider: •

How poverty is referred to and understood within arts and cultural interventions (e.g. as an indicator of need or proxy for low cultural engagement, rather than as the central problem to be addressed; or as interchangeably with wider multi-dimensional issues, such as educational attainment or wellbeing, which may more readily be addressed); and

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Where arts and cultural activities and policies directly address issues of poverty – with a narrow definition of material resources – and what approaches are used; and to

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Recognise that both the substantial and political nature of material poverty may in any case make it a difficult space within which to act.

The results of the keyword searches conducted for inclusion in this review reveal that many of the academic and grey sources of relevance do not adhere to a focussed definition of poverty – as material need – rather, a broad range of causal and impact factors and indicators are deployed within the analytical space. For example, Bashir & Dayson, (2014), South et al (2008), Cawston (201), and Polley et al, (2017) write about social prescribing, the benefits of which are analysed from both social and economic – in terms of return on investment – standpoints (particularly Bashir & Dayson, 2014:21-35, Polley et al, 2017). Arguably, this reflects the fact that it is difficult for arts and cultural activity to be leveraged in ways that bring substantive, measurable change to the experience of material poverty. This is acknowledged in some of the evidence reported; for example, the Culture, Welsh Language & Communications Committee (CWLC) report the progress of their efforts to tackle poverty and social exclusion (CWLC, 2019:25-26). Indeed, the work of the Welsh Government and scholars/practitioners focussing on social prescribing can be seen as moving towards concrete ways of addressing material poverty by leveraging arts and culture while appropriately acknowledging the limitations placed on such activity by overarching political and financial constraints. The Welsh government’s approach is striking for its explicit acknowledgement of material poverty as a central challenge (rather than the more common focus on poverty as the absence of opportunity – or unwillingness – to engage with culture central to English and Scottish policy).6 With the foregoing in mind, it is nevertheless valuable to examine the literature in and relating to this space as it allows us to recognise the impact of political context, identify the ways in which arts and culture can be of influence and, perhaps just as importantly, be clear about what arts and culture cannot do.

Photo: Willie Kay (illustration Katie Chappell).

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Notably, the Welsh government has made child poverty a central policy issue where the English government has deemphasised this issue (see above, this section).

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3.0 Policy approaches to the utilisation of arts & culture for social good

It is useful to look at some of the ways in which the policy debates outlined above are reflected in the literature. The influence of changing approaches to the economy and society are clearly reflected in the attitude to arts and culture as units of potential economic activity. Belfiore’s review of the policy approach to arts and culture as a potential contributor to the alleviation of societal “ills” notes the differential framing of the issues at hand evident over time. Analysis reveals that, ‘[t]he Art Council’s Royal Charter (1967) contains an explicit pronouncement of the Council’s obligation to increase the accessibility of the arts to the public throughout Britain and across the social classes’ (Belfiore, 2002: 92). The tenor of approach to this task has changed over time. In the 1980s, for example, ‘the arts sector decided to emphasise the economic aspects of its activities and their alleged contribution to the wealth of the nation’ (Belfiore, 2002:95). At the same time, Sandell describes the change of approach heralded by the incoming UK Conservative government of 1979; one informed by a profoundly different interpretation of poverty in which inequality was no longer viewed as endangering social cohesion but ‘as an ‘engine of enterprise,’ providing incentives for those at the bottom as well as those at the top’ (Sandell, 1998:402). This understanding of the potential benefits of involvement in the arts and culture for people meeting the definitional threshold for material poverty justified spending in the area in terms of a conventionally understood economic matrix of profit and loss. Progress towards an instrumental interpretation of cultural policy in which public spending on the arts is seen as an ‘“investment” accruing positive social change and the mitigation of social exclusion in disadvantaged regions (Belfiore, 2002:92-3) came later, reflecting European trends towards this policy area (Belfiore, 2002:92; also see Kay, 2000; 415-416; Long et al, 2002). As Belfiore also notes, more recently the British government – through DCMS7 and SEU’s8 Policy Action Team – has begun to embrace the idea that the arts can be leveraged to address issues of social inclusion (Belfiore; 2002:93). As Ruiz reports, the devolved Scottish government ‘committed to developing a National Cultural Strategy, recognising that arts and culture play a central role in enhancing the quality of people’s lives and contributing to civic pride in Scotland’ (Ruiz, 2004:7. Also see Foley et al, 2007:23; Scottish Government, 2019). Policymakers’ novel insight into the potential usefulness of the arts and culture in this realm does not mean that realisation of the stated policy aim in community contexts is unproblematic. In his detailed analysis of arts programme evaluations, Matarasso records the doubts that some policy stakeholders express regarding the efficacy of arts-led approaches to community challenges. Reservations did not concern the ‘impact of the activities themselves, but […] whether such localised change could have any effect on the scale of problems like poverty, unemployment or crime’ (Matarasso, 1997:9.2). Similarly, Long et al note that, whatever the outcomes recorded by an arts programme, these programmes are not a substitute for paid work which remains essential for participation in contemporary consumer society and for charting a path away from dependent status (Long et al, 2002:38). 7 8

The Department of Media, Culture & Sport The Social Exclusion Unit

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Ruiz’s comprehensive review of literature examining ‘the social and economic impacts of culture, the arts and sport’ (2004:7) assessed evidence in order to provide a robust basis for policy decision making in Scotland. The review acknowledged the Scottish Government’s recognition of the potential value of arts and culture for processes of social inclusion, regeneration and promoting ‘a sense of place and pride in the community’ (Ruiz, 2004:7-8). However, it is also recognised that the benefits of such interventions are difficult to identify (Ruiz, 2004:7-13) and, the evidence to demonstrate the ‘impact of participation in arts or cultural activity on the creation of jobs or finding employment’ in particular, is scarce (Ruiz, 2004:81). More recently, it is interesting to note the observation made by Grauer et al (2001:46-5) that ‘the shift from traditional manual and industrial work to jobs based on information, communication and the provision of services has placed a renewed value on the kinds of skills which are learned through arts and cultural education – creativity, flexibility, empathy, adaptability, communication and social skills’ (also see: Cultural Learning Alliance, 2019). This shift might provide a potential pathway away from material poverty based in arts, culture and craft – this could be advantageous as evidence suggests ‘that 87% of job roles in the creative economy are at no or low risk of automation’ compared to 4 in 10 jobs in other sectors (Cultural Learning Alliance, 2019). Arguably, however, it is challenging to realise this potential within the rubric of arts projects and interventions as currently conceived. It is worth acknowledging the findings of studies analysing the economic impact of flagship arts projects such as Turner Contemporary in Margate and Hepworth Museum in Wakefield. While the regional level return on investment is straightforwardly recognised,9 it is important to acknowledge that the employment opportunities generated in such circumstances are typically ‘mostly part-time, insecure or low wage, and therefore, are far from being a solution for contemporary problems of structural unemployment’ (Belfiore, 2002:95. Also: Long et al, 2002:38&85; Jermyn, 2001: Matarasso, 1997:7.2; Foley et al, 2007:51; Bakare, 2020). Campbell et al highlight the emphasis on economic indicators as a measure of success noting that, the ‘economic case for leveraging cultural and creative industries can be overstated’ which can, in turn, obscure other benefits (Campbell et al, 2015:41-2) although economic impacts are perhaps more straightforwardly measured that their psychosocial counterparts (Campbell et al, 2015:50). This pinch point also emerges in the CWLC report on Welsh government efforts to tackle poverty and social exclusion by leveraging culture. Although poverty reduction is one of the overarching aims of the programme’s flagship vehicle – the Fusion Programme – and the work undertaken within Fusion is evaluated according to indicators that foreground employability skills,10 the report narrative elides both economic and psychosocial causes/effects of poverty. Butler and Leathem (2014) state the case for using social return on investment (SROI)11 measures to discover and understand the change achieved – as opposed to outcome attained – through a project or intervention. SROI measures enable capture of value that may elude conventional financial accounting. SROI involves stakeholders in the process, providing space for them to articulate ‘how value is created for them.’ Relating the methodological steps necessary to attain SROI values, Butler and Leathem note that ‘following SROI convention, and apply[ing] appropriate financial proxies to place values on [outcomes enables] the monetisation of outcomes.’ This is a distinctive element of SROI, leading to the ‘expression of a return value resulting from the investment in a given activity’ (Butler & Leathem, 2014: 4-6).

Locating the Turner Contemporary in Margate created 49 FTE jobs and supported a further 81 FTE roles. In its first year of operation, Hepworth Wakefield attracted 500,000 visitors contributing approximately £10,000,000 to the local economy (ACE, 2014:19-20). 9

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See section 4.1.3 for listing, also see: CWLC, (2019:35).

Defined ‘ a social accounting framework […] [providing] a set of tools for undertaking an analysis of social value that is created (or destroyed) for key stakeholders in particular activities’ (Butler & Leathem, 2014:10). 11

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4.0 Art, culture & the alleviation of poverty; development and transition economies The literature examining the role and effect of arts and culture in developing and transition economies provides the most clearly identifiable examples of a causal link between this activity and a positive change in material circumstances. South African governmental researchers observed that ‘research since the early 1990s clearly indicates that arts and culture are integral to sustainable development in many developing countries [and that] [t]his trend is in line with the use of arts and culture in urban regeneration’ (Hagg: 2006, 4). Sagina (2005) provides numerous examples of small, medium and larger scale enterprise endeavours seeking to exploit local creative industries and their outputs for economic advantage, arguing that, if fostered and exploited effectively, ‘creativity can provide new opportunities for job creation, income generation and poverty alleviation in developing countries’ (Sagina, 2005: 25). Exploring the example of the African music industry, the author notes the inherent contradiction currently at the heart of that continent’s music industry; namely that global popularity and success do not translate into jobs in Africa as the majority of African music that reaches an international audience is produced in Europe (Sagina, 2005: 17). Despite this paradox, the author highlights that the continent-wide embeddedness of creativity creates a ‘ubiquitous asset’ (Sagina, 2005: 25; also see Grauer et al, 2001) functioning as an attainable alternative to agriculture as a locus for income generation where appropriate access to international markets can be negotiated (Hagg, 2006: 19; also see Sagina, 2005: 1 & 34).12 The economic arguments for the expansion13 and exploitation of arts and culture in development contexts outlined above are also reflected in Sim’s (2017) discussion of the role of art and culture in community development in Indonesia. This study examines the case of the Creative Communities programme ‘designed to empower people to participate in the community planning process of the large-scale National Program for Community Empowerment (PNPM)’ (Sim, 2017:171) which comprised the Indonesian Government’s foremost poverty reduction plan (Sim, 2017:171). Sim’s analysis broadens the frameworks set out above, acknowledging that arts and culture can produce a range of benefits. On one hand, there are the ‘well-recognised economic benefits of culture tourism and creative industries; at the other end [of the spectrum], the benefits of arts and culture in fostering participation and social inclusion in community participation are equally valuable but less tangible’ (Sim, 2017:171). In this study, Sim notes the use of forms such as puppet theatre, folk song and dance, poetry as pathways for the effective communication of thoughts and values (Sim, 2017:176) and finds that the case study project ‘has clearly demonstrated the ability of community arts to motivate community participation in village development planning’ (Sim, 2017: 179).14 Dirksen’s research on the applications of cultural wealth for surviving material poverty analyses a Haitian case study (Dirksen, 2013). The author seeks to address the question of whether culture ‘can be exploited to enhance daily life and improve material existence’ (Dirksen, 2013:43). The research reveals the activities of grassroots groups using music ‘as an explicit and fundamental tool for addressing complex and distinctly non-musical social issues’ deriving from material poverty and associated infrastructural flaws (Dirksen, 2013:43). One such example comprises the rap collective Wucamp who rallied their community to tackle the issue of mountains of uncollected garbage that despoiled their Port-au-Prince locality causing significant concern along with psychological and physical stress (Dirksen, 2013, 49-52). In fact, the teenaged rappers made significant investments of time and effort for no financial return for themselves, their families or wider communities. Instead, gains were achieved in terms aligned with ‘education and infrastructure […] [and] boosting the community’s dignity and self-sufficiency […] [encouraging] agency among people who could readily become victims’ (Dirksen, 2013:52 & 54). Activities are analysed using cultural action as a frame of

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Also see Gould (2001:72) re: the importance of accounting for cultural context in design of a cultural/arts project intervention.

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Echoing Sagina’s observation of the centrality of the practise of cultural/arts forms for day-to-day identity.

See Foley et al (2007), Flinn & McPherson, (2007) for discussion of research based in the Scottish context and examining the intersection of culture, community, participation and Community Planning Partnerships in North Glasgow. 14

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reference, where the term is understood as ‘the process of putting culture in the service of the community, especially in the advancement of certain community defined goals’ (Dirksen, 2013:52). While Dirksen is clear that such undertakings will neither reorder society nor eliminate deep-rooted structural inequality, they do nevertheless ‘enable positive discourse and provide clear direction, as well as musical enjoyment’ (Dirksen, 2013: 54). In his brief summary of the ways in which he and his theatre troupe utilise drama for poverty reduction, Daogo Guingané emphasises the awareness raising potential of drama interventions. Useful drama – socalled because it raises people’s awareness of issues relevant to them – is a popular intervention across the African continent, creating ‘a bridge between art and developmental issues’ which, Daogo Guingané argues has the effect of ‘encouraging people to change their behaviour, and helping to deal with moral and material poverty at its root’ (Daogo Guingané, 2010:10&12). While neither Dirksen nor Daogo Guingané, propose that the cultural interventions they describe can ‘solve’ material poverty they do suggest that ‘if poverty is an absence of means, then culture can sometimes open the doors of possibility’ (Dirksen, 2013: 54). The approaches they reference are impactful but low cost (Dirksen, 2013: 54) and the outcomes described – i.e. increased agency, awareness – foreground some of less tangible, more psychosocial potential effects of interventions might accrue for people living in materially poor circumstances.

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4.1 UK–based examples of interventions with more tangible economic effects The above (section 4.0) shows that even in transition contexts, there are very few concrete examples in which arts and cultural interventions are directly leveraged to relieve material poverty. Rather, these are realms in which people may be able to take steps along a path which ultimately leads to greater material security. There are very few examples of UK based projects which tackle material poverty directly discussed in the literature and sources uncovered for this review. Testimony from Bevan Foundation Think Tank for the CWLC provides clues as to why this may be the case: ‘There is limited research that suggests that improving participation is the arts can be part of the solution to poverty, although on its own it has little effect. Involving people who live in poverty in the production of cultural events can lead to increased confidence and the development of new skills. This can provide an important step in encouraging those who are currently not in work to seek employment opportunities and it can also give confidence to those who are already employed to seek progression opportunities, boosting their incomes’ (CWLC, 2019:26). There are – in truth – far fewer opportunities for the materially poor to become involved in the production of culture15 which might provide a more direct route out of poverty. Recently, there is noticeably increased focus on demography and experiences among those employed in cultural and creative industries sector (i.e. Creative Diversity All- Party Parliamentary Group, the Inquiry into Diversity in the Performing Arts (Labour Party, 2017)). Industry bodies representing employees have also examined trends in this arena (for example in the area of music work by Payne & Taylor, 2017; and Help Musicians, 2014). Scholarly investigation has also begun linking analyses of production and consumption (Oakley & O’Brien, 2015 & 2016; Brook, O’Brien & Taylor, 2020). Interventions delivered as part of cultural regeneration work have not been foremost in the sources returned in searches conducted for this review. Campbell et al’s work critically reviewing the role of arts and culture in the regeneration of urban communities and places shows that the evidence of a positive correlation is weak (Campbell et al, 2015: 41-56). These authors provide ample examples of work that calls into question the ‘continued assertions that culture is playing a regenerative role, regardless of evidence, or in opposition to evidence, in the current decade’ (Campbell et al, 2015:45). While the purported economic impact of interventions can often be overstated (p. 41-42), the success of built regeneration and cultural programmes has led to a blurring of outcomes and an absence of clarity regarding the mechanisms through which they have been achieved (p.41-42). Part of this difficulty relates ‘not so much to the nature of the evidence gathered as what this evidence shows us, or what it is evidence for’ (p.43, emphasis in original) nevertheless, the challenge of demonstrating causality – particularly regarding the social impacts of regeneration work – remains (p. 43-44). For example, it has been recognised that there was no cost benefit analysis conducted for the Yorkshire Sculpture Park and ‘no consideration [of] whether this intervention was better than others, nor how much of the activity it stimulated would have occurred anyway, or had been displaced from other locations’ (Campbell et al, 2015:43).16

Giving evidence to the same committee, Morag McDermont (Professor of Socio-Legal Studies, University of Bristol) emphasised the need to locate cultural infrastructure in less well-off communities (CWLC, 2019:28). 16 Also see Section 3.0 re: Hepworth, Wakefield and the macro economic impacts of the museum. 15

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Matarasso (2017) advocates for co-creation as a mode of production (c.f. participation), noting that ‘an artist intending to co-create […] has to find ways to disperse the power associated with their skill, knowledge, experience and position.’ A transition from hierarchy to network based working denotes a democratisation of production is the crucial step to realising the potential of culture in this space (coproduction) (Matarasso, 2017). UK based examples of projects and interventions which seek to address elements of material poverty and local community agency include Home Baked17 in Liverpool and Slung Low18 located in Leeds. The Welsh government’s Fusion Programme comprises a foremost example of a formal, executive-led intervention prioritising a recognition of material poverty in the manner we have described. Homebaked is ‘a community land trust and co-operative bakery situated on the boundary between the neighbourhoods of Everton and Anfield, just opposite the Liverpool Football Club’ that began life as 2up2down; was part of Liverpool Biennial. The undertaking employed an artist to facilitate local community reflection on what people wanted to do for themselves in the wake of a failed housing market regeneration initiative and, longer term, to take some decisions with regard to creating economic opportunity. As a business co-owned and staffed/run by locally resident community members, the bakery has hard economic outputs which benefit the local community in addition to the civic and social value it brings to the community. Homebaked pays the living wage, reinvesting profits into local economy. There work is, they say, ‘based on the simple belief that we all deserve to live well. For us, that means good jobs, secure homes, great food and welcoming spaces to meet, share stories, learn and celebrate’.

 Slung Low has been operating since 2000, it is ‘an award-winning theatre company specialising in making epic productions in non-theatre spaces, often with large community performance companies at their heart’. Slung Low run a working men’s club, a college and a woodland. They have been closely involved in supporting vulnerable community members during the COVID19 lockdown. Paying hourly work at the living wage, much of their work is shown on a ‘pay what you decide’ basis; their space and equipment can also be hired thus. The Slung Low approach foregrounds a very specific and committed set of values with regard to income inequality and a specific set of mechanisms through which this might be addressed. Economic transparency and equality is central to Slung Low’s ethos (they operate a horizontal wage structure). Their work seeks to address issues of access for the economically excluded along with activity aimed at the amelioration of urgent problems arising directly from material poverty (i.e. lack of food). Building on the recommendation of Baroness Andrews’ 2014 report – Culture & Poverty, Response by the Welsh Government: harnessing the power of the arts culture and heritage to promote social justice in Wales – Fusion is a M(useums), A(rchives) and L(ibraries) D(ivision) led initiative to ‘provide cultural activity that can help tackle poverty’ (Welsh Government, 2019:4). Within the framework of a national programme, Fusion prioritises partnerships at the local level as the most efficacious way to delivery ‘genuine collaboration and better outcomes’ (Welsh Government, 2019:4). In the period 2015-17, over 5,000 people participated in Fusion’s activities alongside 150 partner organisations comprising local authorities, theatres, heritage organisations, schools, museums, libraries and archives. Over 100 people were assisted in gaining qualifications (i.e. through the Cultural Ambition programme 19), 300 volunteering opportunities were created and 1,500 school aged children were supported to achieve better educational outcomes (Welsh Government, 2019:4). Data gathered from across the Fusion projects clearly evidences outcomes that positively affect participants’ employment prospects as well as those that speak to a wellbeing agenda: Table of Fusion Indicators (Welsh Government, 2019:5)

Fusion Indicator

17-18

18-19

F1 Supporting early years & family learning

4979

13087

F2 gaining a qualification

423

720

F3 Regular volunteering as a route to work

332

761

F4 Completing a work experience placement

110

160

F5 Improved digital skills

50

997

F6 Improved attitude to formal learning

2689

3046

F7 Better able to manage mental wellbeing and physical health

2941

5400

http://homebaked.org.uk/ https://www.slunglow.org/ 19 This programme supported 33 young people to achieve NVQ level 2 Cultural Heritage qualification having previously been not in education, employment or training (Welsh Government, 2019:6). 17

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5.0 Social Prescribing There are many areas of intersection with the themes and approaches that have been outlined above in the growing literature on social prescribing.20 Here the outcomes for patients are described in terms framed by wellbeing agendas (i.e. Bungay & Clift, 2010:281). It is notable too that the recently published Culture Strategy for Scotland utilises articulations of poverty reduction that are positioned within the wellbeing agenda (Scottish Government, 2019). For local authorities and health services, return on investment is identified in economic cost saving resulting from fewer medical appointments and referrals. Researchers and practitioners have identified the areas of overlap between individuals’ medical and social lives. Polley et al note that approximately 20 per cent of patients attend their ‘GP for what is primarily a social problem’ (Polley et al, 2017; also see South, 2008:214; Adbowale et al, 2014:14; Cawston, 2011; 350; Foley et al, 2007:17). Thus, while community health initiatives may endeavour to involve socially excluded communities in their work ‘general practice remains a key point of access, including for those presenting with social needs’ (South et al 2008: 310). Taking heed of patients’ day-to-day lives and concerns is a vital for the delivery of good quality medical care (Cawston, 2011:350; also Bungay & Clift, 2010:280).21 Among the challenges faced by patients, those of ‘low pay, alienating work conditions, low expectations, poor educational achievement, ready access to drugs and addiction including alcohol and tobacco, worklessness, poor nutrition and poor physical and mental health’ are among the most pressing (Cawston, 2011:350). The intersection between these challenges, material poverty - and its recognised effects - is clear. While the connections between community and voluntary sectors and the primary health care services in the UK are rarely well developed, social prescribing provides a platform for the utilisation of the voluntary sector within primary healthcare (South et al, 2008:310. Also see: Chatterjee et al, 2017:58; Thomson et al, 2015). Novel opportunities for innovations crosscutting these areas, further developing established programmes of arts on prescription – where practitioners refer service users to an arts activity or service as a source of support – have arisen on the basis of the Health & Social Care Act (Daykin et al, 2017:124). Though Bickerdike et al point out that there is still scope for improving the robustness of social prescribing evaluations (Bickerdike at al, 2017; also Rempel et al, 2017; Husk et al, 2020),22 Bashir and Dayson (2014:45) provide an overview of the characteristics of models of social prescription.23 These authors (2014:21) provide a list of wellbeing outcomes that emerged from the research they conducted in parallel with a 24-month social prescribing pilot undertaken in Rotherham between April 2012 and March 2014 (also see Thomson et al, 2015:22). The outcomes inventory was developed as part of an evaluation framework to provide baseline and follow up data with focus on gauging changes in wellbeing measures: •

Feeling positive: hope, learning to cope and feeling calm

•

Lifestyle: sleeping habits, smoking, diet and exercise

•

Looking after yourself: shopping, going out, transport and personal care

•

Managing symptoms: energy levels, pain, information and medication

•

Work, volunteering and other activities: new roles, volunteering and social groups

•

Money: debt advice, benefits and managing money

•

Where you live: heating, local facilities, stairs and fire safety

•

Family and friends: isolation, carer support

Also known as ‘social referral’ or ‘community referral,’ see Rempel et al, (2017). Also, Mossabir et al (2015:402) note that ‘in almost all the papers [included in the review] it was found that health professionals played an important role in referring patients to the interventions and in introducing the notion of utilising community groups with aspects of health management.’ 22 Husk et al (2020) identify enrolment, engagement and adherence as key loci for evaluation. They also argue that link workers are vital for assisting successful navigation of the social prescribing ‘pathway’. Also see Thomson et al, (2015:5). 23 Cawston (2011:350) also lists the types of activities from which interventions might be comprised. Also see Chaterjee et al (2017:98-100) and Thomson et al, (2015:1021). 20 21

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Data was analysed against a baseline to give insight into ‘distance travelled’ by participants and an overview of the sustained change they experienced. The findings showed that 83 percent of participants ‘experienced positive change on at least one outcome measure’ (Bashir & Dayson, 2014:23). Other studies support the positive findings described by Bashir and Dayson (2014). In their evidence reviews, Mossabir et al (2015) and Polley at al (2017) note that ‘improvement to participants’ psychological and social wellbeing’ (Mossabir et al, 2015:467)24 can also result in a lessening of demand on primary and secondary healthcare services (Polley et al, 2017:6; Mossabir et al, 2015:467; South, 2008:314). Analysis of the financial effect of the Rotherham Social Prescribing Pilot is revealing. The beneficial economic outcomes are projected as: •

estimated total cost reductions by the end of the pilot of £552,000; a return on investment of 50 pence for each pound (£1) invested

•

potential NHS cost reductions of £415,000 in the first year post-referral when the service is running at full capacity

•

if these benefits identified are fully sustained over a longer period

•

•

the costs of delivering the service for a year would be recouped after between 18-24 months

•

the five year cost reductions for commissioners for each full year of service delivery could be as high as £1.9 million: a return on investment of £3.38 for each pound (£1) invested

even if the benefits are sustained but drop off at a rate of 33 percent each year they could lead to total cost reduction of £807,000: a return on investment of £1.41 for each pound (£1) invested.25

Service users interviewed for the study by South et al (2008:314) ‘identified benefits including social inclusion, feeling ‘part of something,’ meeting new people through community groups and increased confidence.’ Those in Bashir and Dayson’s (2104:11) study reported benefits such as ‘improved mental and physical health, feeling less lonely and socially isolated, becoming more independent and accessing a wider range of welfare benefit entitlement.’ 25 Also see Thomson et al, (2015:9). 24

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5.1 Social Prescribing – Accruing Social Capital Arguably, social prescribing functions at the intersection between material poverty and some of its psycho-social effects – particularly when these manifest as pain and other ‘medical’ symptoms. Assisting people in the management of the issues for which they have consulted with their GP may then have a direct bearing on aspects of their experience of material poverty though it is unlikely to improve their financial situation per se.26 A growing body of research links involvement in arts and cultural activity and improved accumulation of social capital27 at individual and community levels (see, for example, Gould, 2001; Foley et al, 2007; Flinn & McPherson, 2007; Bungay & Clift, 2010:281-282). Though Campbell et al (2015:44) point out that there is little robust qualitative evaluation of these benefits. Some studies do evidence a link between cultural participation as a gateway for community involvement, skill acquisition and personal development and the accrual of social capital (Foley et al, 2007: 18; also see Gould, 2001:96-70). In this way, it has been increasingly recognised that where, before, culture and the arts have been seen as peripheral contributors to processes of renewal and regeneration, the opportunity for art and culture to fulfil a central role in such processes is advocated (i.e. Foley et al, 2007:3). CWLC propose that it is important to explore ways in which social capital might be more equitably shared/moved between communities; making grants conditional upon volunteers from more affluent areas involving themselves in projects in less well-off areas, potentially leading to two-way exchanges of skills and knowledge (CWLC, 2019:15). Create Scotland has developed a toolkit for equalities, diversity and inclusion with the addition of social and economic deprivation as a characteristic (Creative Scotland, 2019; also see Deverell, N.D.) thus, providing a framework to lessen some of the most exclusory effects of material poverty and access to arts and culture.

Photo: Willie Kay (illustration Katie Chappell).

26 27

Though Husk et al (2020:310) point out that social prescribing/referral may comprise financial advice where appropriate. Defined as ‘the wealth of the community measured not only in economic but in human terms’ (Gould, 2001:69).

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6.0 Conclusions This review has examined some of the available literature relevant for understanding the ways in which arts and cultural activities and interventions might be of utility for less well-off communities and individuals. A definition of poverty that distinguishes between material poverty and the effects of material poverty has been advanced. It is clear that a spectrum of claims are made with regard to the ways in which arts and culture can be leveraged for the alleviation of poverty, but it is notable that few concrete examples of successful initiatives have been published. Where poverty is acknowledged, it is often framed as an indicator of need (i.e. denoting inequality of opportunity) or, as an indicator signposting other issues (i.e. wellbeing or educational attainment) that might be addressed through artistic or cultural interventions. It is rare for material poverty to be recognised and addressed as a central issue. Here, the example of the Welsh government’s approach discussed above is unusual. The economics of trickledown effect is more commonly cited as a potential benefit arising from a policy intervention or project. Approaches such as those seen in the work of the Fusion Programme, Homebaked and Slung Low – prioritising skills development, employment programmes, community-led decision making and asset creation to tackle economic inequality while also addressing some issues of immediate need (i.e. food parcels) – remain a rarity. It is difficult to demonstrate causality in the arts/culture and material poverty relationship. Even scholarship setting out to explore this causality provides few concrete examples of measurable success. Instead, evidence of the ways in which arts and cultural activities might assist communities to build skills and find opportunities is more common (see section 4.0). It is nevertheless of value to have a nuanced awareness of where and how interventions might be of utility. The indicators that we have delineated as effects of poverty are potentially more susceptible to intervention. Careful consideration of this interaction at the planning phase of a project will assist stakeholders in delivery of effective interventions. For example, involvement of community members in production and co-production appears likely to be a vital element of potential success. There are some small scale, community focussed examples of undertakings which prioritise this approach (see section 4.1). While they may not produce short-term effects on material poverty, the development of productive relationships, trust and reciprocity can provide stronger foundation upon which more ambitious initiatives can be built. The intersection between the relatively small literature deriving directly from studies of a narrow definition of material poverty/its effects and that on social prescribing is clear. The literature on social prescribing is framed within the wellbeing agenda and seeks to tackle some of the effects of poverty in a space that is slightly removed from the ideologically-charged politics of material poverty. The cross over with studies on health and social care and, the utilisation of medical benchmarks for analysis means that, arguably, social prescription work has begun the process of sharpening up some of the ‘wooliness’ found in the knowledge and evidence base around work with direct relevance for stakeholders working on ‘poverty’. The work that the Welsh Government has undertaken on the basis of Baroness Andrews’ work (Andrews, 2014, subsequently, CWLC, 2019; Black et al, N.D., The Welsh Government, 2019) provides the clearest evidence of a coherent, policy-led strategy to leverage art and culture in a manner in which outcomes demonstrably relate to some of the fundamental problems associated with material poverty. Though even here, indicators overlap with areas that we have identified as relating to the effects of poverty.

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6.1 Recommendations Those working in the field of cultural regeneration, cultural policy, in local government, the third sector or in cultural institutions might increase the leverage achieved through their arts and cultural intervention by taking early steps to consider the following: Whether an arts or cultural intervention is focussed on tackling material poverty or the effects of poverty and what is possible within the operational confines of the proposed intervention • is the intervention focussed on tackling material poverty directly or, is it intended to ameliorate the effects associated with poverty? • what is realistically achievable within the operational confines of the proposed intervention? Which indicators can be used to evidence efficacy from the outset of the arts or cultural intervention and produce transparency about what arts and cultural interventions can and cannot achieve • what indicators will be used to measure ‘success’? • can clear links between the intervention mechanism (arts or cultural) outputs and outcomes be established? • can a baseline be established so that ‘distance travelled’ can be charted? The appropriateness of longitudinal data collection methods to collecting evidence of success in arts or cultural interventions to tackle material poverty • can a baseline be established upon which to assess change over time? • can a systematic approach to gathering and analysing data be implemented at the outset? • what existing data collection methods are in place and which new ones are required to fill data gaps? The utility of small, focussed, community-based activity in comparison with larger scale, macro-level interventions • how can an emphasis on community building, confidence building through skills acquisition and mentoring be foregrounded when designing and implementing arts or cultural interventions? • how can participants be involved in the design phase of interventions, identifying the salient issues to be addressed and the approach to be taken? The need for long term strategic commitment to co-production and the involvement of community members in cultural production if it is to be successful • how can participants become involved in the cultural production /co-production? • is access to mechanisms of cultural production (section 4.1) feasible? • can access to mechanisms of cultural production (section 4.1) be enabled or enhanced?

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7.0 References Adbowale, V., Farmer, P., Rose-Quirie, A., Jenkins, P., Greatley, A. and Bailey, S. (2014). The Pursuit of Happiness: A new ambition for our mental health, CentreForum. Andrews, K. (2014) Culture & poverty: harnessing the power of the arts culture and heritage to promote social justice in Wales, the Welsh Government, Cardiff, available at: https://gov.wales/sites/default/ files/publications/2019-06/culture-and-poverty-harnessing-the-power-of-the-arts-culture-andheritage-to-promote-social-justice-in-wales.pdf [accessed 7th July, 2020] Arts Council England, (2014) The value of arts and culture to people and society; an evidence review, Arts Council England, Manchester Bakare, L (2020) Tate Britain’s £40k ‘head of coffee’ role sparks row over low curator pay, The Guardian, 29th January available at: https://tinyurl.com/smlgdax Barnes, P. & McPherson, G. (2019) Co-creating ,co-producing and connecting: Museum practice today, The Museum Journal, 62:2 Barraket, J. (2005) Putting people in the picture? The role of the arts in social inclusion, Social Policy Working Paper № 4, Melbourne Bashir, N., & Dayson, C. (2014) The social and economic impact of the Rotherham Social Prescribing Pilot: Main Evaluation Report, Sheffield: CRESR, Sheffield Hallam University Belfiore, E. (2002) Art as a means of alleviating social exclusions: does it really work? A critique of instrumental cultural policies and social impact studies in the UK, International Journal of Cultural Policy, 8:1 Bickerdike, L., Booth, A., Wilson, P.M., Farely, K. & Wright, K. (2017) Social prescribing: less rhetoric and more reality. A systematic review of the evidence, BMJ Open, 7 Black, C. Ingram, J. & Brown, J. (N.D.) Transforming futures: An anti-poverty resource pack to support arts, cultural and heritage organisations as they create pathways to cultural participation for children and young people in Wales, Museum Wales, available at: https://museum.wales/media/31207/TransformingFutures_Resource-Pack.pdf [accessed 2nd July, 2020] Brook, O., O’Brien, D. & Taylor, M. (2018) Panic! Social Class, Taste and Inequalities in the Creative Industries, http://createlondon.org/wp-content/uploads/2018/04/Panic-Social-Class-Taste-andInequalities-in-the-Creative-Industries1.pdf Bungay, H. & Clift, H. (2010) Arts on prescription. A review of practice in the UK, Perspectives in Public Health, 130, 277-281 Butler, W. & Leathem, K. (2014) A social return on investment evaluation of three ‘sport for social change network’ programmes in London, Active Communities Network, London, Manchester, available at: https://static1.squarespace.com/static/5733282860b5e9509bc9c4db/t/5964c1c978d171ed7 9c59732/1499775436857/Social+Return+on+Investment+SROI+-+Active+Communities+Network.pdf [accessed 2nd July, 2020] Campbell, P., Cox, T., Crone, S. & Wilks-Heeg, S. (2015) Evidence of Things That Appear Not’? A critical review of the role of arts and culture in the regeneration of urban places and urban communities, available at: http://www.petersoc.com/wp-content/uploads/2018/01/Campbell-et-al-2015-Evidenceof-Things-That-Appear-Not-AHRC-Cultural-Value.pdf [accessed 2nd July, 2020] CASE (2010) Understanding the drivers, impact and value of engagement in culture and sport, an overarching summary of the research, … Cawston, P. (2011) Social prescribing in very deprived areas, British Journal of General Practice, 61, 350 Chatterjee, H., Camic, P., Lockyer, B., & Thomson, L. (2017) Non-clinical community interventions: a systematised review of social prescribing schemes, Arts & Health, 10:2, 97-123

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Jermyn, H. (2001) The arts and social exclusion: a review prepared for the Arts Council of England, available at: http://creativecity.smallboxcms.com/database/files/library/arts_social_exclusion_uk.pdf, [accessed, 5th June, 2020] Kay, A. (2000) Art and community development: the role of the arts have in regenerating communities, Community Development Journal, 35:4 Labour Party, (2017) Acting Up Report. Labour’s inquiry into access and diversity in the performing arts, London: Labour Party Lamont, M. & Small M. L. (2007) Cultural diversity and poverty eradication, Working Paper 2007-25, Background Paper prepared for the World Report on Cultural Diversity, UNESCO, http://nrs/harvard.edu/ urn-3:HUL.InstRepos:10494966 Lloyd, R. (2002) Neo-Bohemia: Art and neighbourhood redevelopment in Chicago, Journal of Urban Affairs, 24:5, 517-532 Long, J., Welch, M., Brambham, P., Butterfield, J., Hyleton, K. & Lloyd, E. (2002) Count Me In: the dimensions of social inclusion though culture and sport, a report for the Department of Culture, Media & Sport … Centre for Leisure and Sport Research Matarasso, F. (1997) Use of ornament? The social impact of participation in the arts, COMEDIA … Matarasso, F. (2017) A restless art: how participation won and why it matters, available at: https:// arestlessart.com/2017/03/09/co-creation/ [accessed 2nd July, 2020] McClymont, K., Jacobs, P. & Cavanagh, B. (2020) Social capital in Scotland: Measuring and understanding Scotland’s social connection, The Scottish Government – Office of the Chief Social Policy Advisor, Edinburgh. Available at: https://tinyurl.com/qpopow2 McPherson, G. (2006) Public memories and private tastes: the shifting definitions of museums and their visitors in the UK, Museum Management and Curatorship, 21 Mossabir, R., Morris, R., Kennedy, A., Blickem, C. & Rogers, A. (2015) A scoping review to understand the effectiveness of linking schemes from healthcare providers to community resources to improve the health and wellbeing of people with long-term conditions, Health & Social Care in the Community, 23 , 467–484 Newman, T., Curtis, K. & Stephens, J. (2001) Do community-based arts projects result in social gains? A review of literature, Community Development Journal, Vol. 38 No. 4, 310-322 Oakley, K. & O’Brien, D. (2015) Cultural Value and Inequality: A Critical Literature Review, AHRC: Swindon Oakley, K. & O’Brien, D. (2016) Learning to labour unequally: understanding the relationship between cultural production, cultural consumption and inequality, Social Identities, Vol. 22, No. 5, 471-486 Payne, J. & Taylor, S. (2017) Where are they now? Post graduate research report, November 2017, Executive Summary, London: Help Musicians Polley, M., Bertolli, M., Kimberlee, R., Pilkington, K., & Refsum,C. (2017) A review of the evidence assessing impact of social prescribing on healthcare demand and cost implications, University of Westminster Rempel, E.S., Wilson, E.N. Durrant, H., Barnet, J. (2017) Preparing the prescription: a review of the aim and measurement of social referral programmes, BMJ Open, 7, 1-9 Ruiz, J. (2004) A literature review of evidence base for culture, the arts and sport policy, Scottish Executive, Edinburgh Sagnia, B.K. (2005) Strengthening local creative industries and developing cultural capacity for poverty alleviation, International Network for Cultural Diversity, Sixth Annual Conference, 17-20 November, Dakar, Senegal Sandell, R. (1998) Museums as agents of social inclusion, Museum Management and Curatorship, 17:4 Shaw, P. (2003) What’s art got to do with it? Briefing paper on the role of the arts in neighbourhood renewal, Arts Council England, London Sim, K.E.A. (2017) The art of participation: the case of creative communities in Indonesia, Community Development Journal, 52:1

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Small, M.L., Harding, D.J. & Lamont, M. (2010) Reconsidering culture and poverty, Annals, AAPSS, 629 Social Metrics Commission (2018) ‘A new measure of poverty for the UKA summary of the report by the Social Metrics Commission.’ Available at: http://socialmetricscommission.org.uk/MEASURING-POVERTYSUMMARY-REPORT.pdf [Accessed 18th June, 2020] South, J., Higgins, T.J., Woodall, J. & White, S.M. (2008) Can social prescribing provide the missing link? Primary Health Care Research & Development, 9:? 310-18 Stewart, K. and Roberts, N. (2019) ‘Child Poverty Measurement in the UK: Assessing Support for the Downgrading of Income-Based Poverty Measures.’ Social Indicators Research 142, 523–542. https://doi. org/10.1007/s11205-018-1880-9 The Scottish Government, (2019) A culture strategy for Scotland, The Scottish Government, Edinburgh, available at: https://www.gov.scot/publications/culture-strategy-scotland/pages/7/ [accessed 2nd July, 2020] The Welsh Government, (2019) Fusion, creating opportunities through culture. Delivery in 2019-2020, Cardiff, available at: https://gov.wales/sites/default/files/publications/2019-11/fusion-programmereport-2019-to-2020.pdf [accessed 7th July, 2020] Thomson, L.J., Camic, P.M. & Chatterjee, H.J. (2015) Social prescribing, a review of community referral schemes, University College London: London Titon, J. T. (2013) Music and the US war on poverty: some reflections, Yearbook for Traditional Music, 45 74-82 Wilson, J. (1999) Acknowledging the expertise of patients and their organisations, BMJ, 319, 771-774

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Photo: Willie Kay

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