Sing to Health - the public health argument

“Group singing might be taken - both literally and figuratively - as a potent form of ‘healthy public’, creating an ‘ideal’ community, which participants can subsequently mobilise as a positive resource for everyday life" (Camlin et al. 2020)

Many systems at play in our capitalist world promote increased isolation couched as “independence”, “consumer choice” or “convenience”. This individualism is reflected in our health care sector based on a one-to-one interaction between a clinician and patient. “Personalised care” is being championed as the gateway to better health by the NHS in the UK - treating patients as consumers and health as a matter of personal choice - and responsibility. Similarly, the wellness movement treats our health and wellbeing as a result of our personal discipline - our step counts, our keto diets or minutes spent on the headspace app. Under a capitalist framework, healthcare is treated as a commodity rather than a right, which fosters an individualistic approach to public health.

The 80% Gap - medical care only accounts for approximately 10% to 20% of health outcomes.

However, in his landmark Shattuck Lecture, Dr. Steven Schroeder (2007) revealed this startling statistic - that social determinants of health - where and how we are born, grow, live, learn and work have an 80% impact on health whereas medical care only accounts for 10-20%. This builds on the foundational work of McGinnis and Foege (1993), who argued that we must look past the "clinical" causes of death to the "actual" causes, such as the socio-economic pressures that drive chronic stress and poor nutrition. When we approach public health through a purely individualistic lens, we effectively ignore the 80% of factors that act as the true pathogens of modern society (Woolf, 2019).

The Biological Case for Group Intervention

If 80% of our health is social, then our 'prescriptions' must be social too. This is where Social Prescribing steps in. By connecting individuals to collective resources like group singing initiatives, the healthcare system finally begins to address the social isolation and environmental 'pathogens' that a traditional medicine simply cannot reach. This means viewing the community as a single biological unit.

A primary example of this is the research into group singing. Professor Daisy Fancourt (UCL/WHO) has demonstrated that collective singing provides a multi-modal intervention that medicine cannot replicate in isolation. Her studies (2016) found that just one hour of group singing produces measurable biological changes:

• Endocrine Regulation: A significant reduction in cortisol (stress) and an increase in oxytocin (social bonding).

• Immune Function: An increase in cytokines, the proteins responsible for signaling the immune system to fight inflammation.

• Preventative Resilience: Fancourt's longitudinal data shows that regular cultural engagement reduces the risk of developing depression in older age by 48%.

Group Singing as a "Healthy Public"

Dr. Dave Camlin builds on this by framing group singing as a Complex Adaptive System (Camlin et al. 2020). He argues that musicking is a form of "social ecology" that fosters reciprocity and democratic equality, values that stand in opposition to capitalist competition. In this view, a choir is not just a leisure activity, it is a "Healthy Public" where health is co-produced through social resonance and collective action. In his 2020 study, Group singing as a resource for the development of a healthy public, Camlin et al (2020) explored how collective singing creates an "ideal" community, confirming a "social bonding effect" that remains stable regardless of environmental factors and allowing participants to "rehearse and perform" healthy relationships.

Healthy communities create healthy individuals

Individualism in healthcare is biologically and economically inefficient. It attempts to solve systemic problems with private, clinical solutions. By shifting our focus toward collective resources such as the community-driven models supported by the NHS and the biological interventions identified by Fancourt and Camlin we move toward a model of "Mutual Recovery" (Crawford et al. 2015).

To improve the health of the individual, we must first improve the health of the collective. Public health is not a private commodity - it is a shared social asset, which should be funded accordingly.

References

Camlin, D. A., Daffern, H., & Zeserson, K. (2020). "Group singing as a resource for the development of a healthy public: a study of adult group singing." Humanities and Social Sciences Communications, 7(1), 1–15. https://doi.org/10.1057/s41599-020-00549-0

Crawford, P., Brown, B., Baker, B., Tischler, V. & Abrams, B. (2015) Health Humanities. Palgrave: London.

Fancourt, D., et al. (2016). Singing modulates mood, stress, cortisol, cytokine and neuropeptide activity. ecancermedicalscience.

McGinnis, J. M., & Foege, W. H. (1993). Actual causes of death in the United States. JAMA, 270(18), 2207–2212. https://doi.org/10.1001/jama.1993.03510180077038

Schroeder, S. A. (2007). We can do better — improving the health of the American people. New England Journal of Medicine, 357(12), 1221–1228. https://doi.org/10.1056/NEJMsa073350

WHO (2019). What is the evidence on the role of the arts in improving health and well-being?

Woolf, S. H. (2019). Necessary But Not Sufficient: Why Health Care Alone Cannot Improve Population Health. Annals of Family Medicine.

The evolutionary function of group singing - belonging as a way to survive

Why does singing with others feel so good?

From ancient ceremonies to modern community choirs, the drive to sing and make music together is a core human trait, which isn't just cultural tradition. It is a powerful evolutionary feature that helped our ancestors survive and thrive, remaining essential to our wellbeing today.

Science suggests that collective singing is one of humanity's most effective tools for social cohesion but why should this be so? The answer lies in our long dependence on other humans to fully mature, relying on a complex web of socially transmitted signals to learn language, culture and other necessary survival skills. This means that belonging to a social group is an integral part of human development and therefore survival. Jaak Panksepp's research in affective neuroscience demonstrates this by showing that the same brain systems process both physical and mental (social/emotional) pain, specifically the distress of social loss or separation, providing us with powerful evidence for the function of group singing to promote social bonding and correspondingly our survival.

From One-on-One to Group Bonding

In our primate relatives, social relationships are built and maintained through physical grooming. This intimate, one-on-one activity triggers the release of feel-good endorphins, the body's natural feel-good agents. However, as early human groups grew larger, spending hours grooming one another became impractical. We needed a new, more efficient way to bond dozens, or even hundreds of people simultaneously.

The answer theorised by evolutionary psychologists like Professor Robin Dunbar, was collective vocalisation. Singing provided a way to strengthen social ties across the entire group at once, which in turn supported the survival of the whole group.

The Physiology of Shared Harmony

The benefits of singing together are not purely psychological they manifest in verifiable physiological changes:

• Increased Endorphins: Research confirms that group singing elevates the body's endorphin levels (often measured via increased pain threshold, a scientific proxy for endorphin release). This is what creates that profound, shared sense of euphoria and connectedness experienced during and after singing together.

• Synchronisation of heart rate variability and breathing: When we sing in synchrony, heart rate variability between participants (the subtle variation in time between heart beats over time) synchronise and breathing patterns tend to converge. This physiological mirroring is deeply unifying leading to a palpable sense of trust and "oneness" with fellow singers.

So when you sing with your community you are engaging in an ancient, finely tuned system designed to overcome stress and maintain peaceful, cooperative group living.

The Takeaway

In our fast-paced world, the need for robust social support is as critical as ever. Group singing doesn't just offer an opportunity for artistic expression or a nice, fun activity - it delivers a dose of biologically mandated community connection, which is hard wired into our biological functioning to ensure survival. Put simply, we sing to belong and belonging means survival.

It rapidly fosters social closeness, calms us down and brings us pleasure, reinforcing the cooperative instincts that allowed humans to build complex societies. So, the next time you are looking for a measurable boost to your physical, mental and social health, remember that you are biologically built to thrive in harmony.

I wonder what the state of the world would be if our leaders got together and sang…

References

Dunbar, R. I. M. (2012). The ultimate function of music is to bond the group. Evolutionary Psychology, 10(5), 899-903.

Weinstein, D., Launay, J., Pearce, E., Dunbar, R., & Stewart, L. (2016). Singing and social bonding: Changes in connectivity and pain threshold as a function of group size. Evolution and Human Behavior, 37(2), 152–158.

Savage, P. E., Brown, S., Yamauchi, J., Hamaguchi, K., & Tarr, B. (2020). Music as a coevolved system for social bonding. Behavioral and Brain Sciences, 43, e136.

Dunbar, R. I. M., Kaskatis, K., Macdonald, I., & Barra, V. (2012). Performance of music elevates pain threshold and positive affect: Implications for the evolutionary function of music. Evolutionary Psychology, 10(5), 787–798.

Blog Post Title Four

It all begins with an idea. Maybe you want to launch a business. Maybe you want to turn a hobby into something more. Or maybe you have a creative project to share with the world. Whatever it is, the way you tell your story online can make all the difference.

Don’t worry about sounding professional. Sound like you. There are over 1.5 billion websites out there, but your story is what’s going to separate this one from the rest. If you read the words back and don’t hear your own voice in your head, that’s a good sign you still have more work to do.

Be clear, be confident and don’t overthink it. The beauty of your story is that it’s going to continue to evolve and your site can evolve with it. Your goal should be to make it feel right for right now. Later will take care of itself. It always does.