To your health.

Do you like the way you look? Are you satisfied with the food you eat? Ever been pestered by someone for a date? In the most comprehensive survey of dancers' health ever undertaken, Dance Magazine asked you these and a host of other questions. And you answered--by the mailbag full! Here's what you told us.

Thank You!

Several months ago many of you did the dance world a great favor by completing our mail survey about health concerns and other problems that dancers may have while training on the job. In return, we would like to share the results with you.

The following report provides vital information on a number of previously overlooked but important topics in dance. One of our primary goals at Dance Magazine in doing this research is to help reduce occupational stress for dancers, now and in future generations. Therefore, we are offering practical suggestions with the hope of generating programs aimed at prevention and early intervention. The results from our second survey, bound into the April 1996 issue, will be part of an upcoming article.

Who Are You?

As you can see in Table 1, most of the dancers who answered our survey are female students. Over half (52%) are eighteen years or older (average age, twenty-five), and 21% have a college degree. Forty-five percent of the college graduates majored in dance. Almost all (91%) of our dancers were excellent (53%) or good (38%) academic students. In response to the question "How important is/was it for you to dance professionally?" four out of five dancers (84%) said it was very (56%) or somewhat (35%) important. The average time spent dancing is fourteen years.

        Table 1
      Who Are You?

                   Female     Male

Student            80%       35%
Professional       12%       35%
Other(*)            8%       30%

(*) This group includes teachers, choreographers,
directors, administrators, journalists, professors,
and therapists.

We Are Family

Because our sample is so mixed, we separated the dancers into the following groups: young dance students, older dance students (twenty-five years or over), professional dancers, and former dancers who transferred to a dance-related career. Males and females are examined separately. The differences that are reported in this article are all statistically significant at .05, meaning that the probability of finding these results by chance is less than five out of one hundred. Therefore, we assume that our findings represent real differences between these groups. To put these results in context, we refer to national statistics in Health, United States, 1994, compiled by the U.S. Department of Health and Human Services. Other sources are identified when appropriate.

Why You Started to Dance

The top reason for going into dance for young female students is having been "enrolled by their parents," followed by "having fun." This was not the case for boys--none of whom began their dance training because of their parents. We learned, instead, that males choose to dance because of their "love for the art form" and in order "to become professionals." Both boys and girls who later developed professional careers vigorously pursued this goal from the beginning. In contrast, older dancers started class as a way to challenge themselves, overcome physical obstacles, and gain inner satisfaction.

About You and Your Body

Weight

Do you consider yourself overweight? The dancers whose weight fell within the normal or above range for their height said "yes"; 37% were females (-1% below ideal weight) and 11% were males (+14% above ideal weight). Dancers are concerned about their body weight because they must be thinner than average in order to survive in their profession. Surveys of professional ballet dancers in the United States, China, and Russia indicate that female dancers range from 10% to 15% below their ideal weight for height. Modern dancers tend to be 6% below ideal, whereas males in both dance techniques are at their ideal weight. Of the dancers who report being overweight in our survey, only the men are accurate. However, our female dancers who say they're overweight would be heavy compared to professional dancers.

Body Image

How satisfied are you with your body? A British study in the Journal of Psychosomatic Research (Wardle & Marsland, 1990) addressed adolescents' concerns about their bodies. Body satisfaction differed between the sexes: 47% of the girls were "satisfied" versus 72% of the boys. In our survey 23% of female dancers and 33% of male dancers expressed satisfaction with their bodies. Body image is established during adolescence, when physical development often deviates from the long, lean look favored in dance. As we can see, very few dancers compare themselves favorably to this physical ideal.

Eating Problems

How often do you engage in fad diets? One out of three dancers (34%) resorts to fad diets at different times. This behavior is higher in female dancers, who also report more eating problems. According to The Diagnostic and Statistical Manual of Mental Disorders, published in 1994 by the American Psychiatric Association (APA), the prevalence rate for anorexia nervosa in the general population ranges from 0.5% to 1%, whereas bulimia nervosa is 1% to 3%. Seventeen percent of the women and 6% of the men in our survey report eating problems. However, only 4% of our female dancers actually meet all of the diagnostic criteria for these specific eating disorders. The group most at risk are older dance students, who have a significantly higher incidence of bulimia nervosa than the other groups (6% versus 1%). They are also heavier than all current dancers, which paradoxically places them at their ideal weight for height in the general population. Lastly, 31% of our females have a history of amenorrhea (no menses for at least three months). This problem, which is one diagnostic criterion for anorexia nervosa, is associated with stress fractures and osteoporosis in later life.

RX Here's What You Can Do

Chronic dieting is associated with depression and eating disorders in addition to amenorrhea and poor health. Consequently, we believe that dance students need to learn proper ways to control their weight through aerobic exercise (three to five sessions a week) and a daily balanced food plan (1400 to 1600 calories, including 25 to 40 grams of fat) before bad habits become entrenched. Dance programs can play an important role in this process by offering regular seminars on nutrition and eating problems. Teachers can also foster a more positive body image in dancers (few of whom become professionals) by allowing for different sizes and. shapes in class. Finally, dance schools and companies can refuse to give preferential treatment (such as a leading role) to dancers who are obviously emaciated. Dance students need healthy role models to emulate, as well as a clear message from those in authority that starvation is not an option--even in a world driven by extreme thinness.

Your General Health

Exercise

Do you exercise other than for dance purposes? Twenty-one percent of our dancers do not do additional exercise. The rest exercise an average of three days a week besides taking class. Our dancers' average weight is 6% below ideal weight for height. While more aerobic exercise may be needed by some to achieve a dancer's "ideal" low weight, these habits are extremely good compared to the general population, where 30% are completely sedentary.

Illness

How satisfied are you with your health? The majority of the dancers are "very" (41%) or "somewhat" (56%) satisfied with their health. Four percent answered "not at all" in contrast to 10% of the general population who report fair or poor health. The most common health problems in dancers are listed in Table 2. As you can see, asthma and depression are high in both sexes, followed by eating problems in women and sexually transmitted diseases in men. In terms of medical treatment, health insurance is a problem for professional dancers: 21% have no coverage compared to 6% of the rest of the sample.

          Table 2

Health Problems for Dancers

Illness            Female       Male

Cancer              2%           6%
Arthritis           0%           6%
Substance Abuse     4%           7%
Eating Problems    17%           6%
Asthma             14%          17%
STD(*)              2%          17%
Depression         21%          28%

(*)STD = Sexually Transmitted Disease

Mood Disorders

Because depression is reported as a primary health concern (see Table 2), we wondered if dancers were more vulnerable to mood problems than the average person. The lifetime risk for a major depressive disorder in community samples varies from 10% to 15% for women and from 5% to 12% for men (APA, 1994). In comparison, 9% of our women and 20% of our men report a clinical diagnosis of depression. In addition, professional dancers are significantly more depressed than the rest of our sample (19% versus 8%). Overall, one-third of our dancers (27%) have contemplated suicide and 2% have made a serious attempt. Ten percent have taken antidepressants. These results suggest that male dancers, and those who enter a professional career, are at greater risk for depression than the general population.

Substance Abuse

Do you use cigarettes, alcohol, or recreational drugs? Compared to the general population (eighteen years or older), the rate of cigarette smoking for dancers of the same age is 8% below average (17% versus 25%); they smoke, on average, one pack a week. Two-thirds (69%) of dancers also consume about three alcoholic drinks weekly. The national average for drinking alcohol is 67%. Lastly, illicit drug use for all ages is five times lower than average (7% versus 37%). The drug of choice is marijuana (71%); no dancers in this survey use heroin or cocaine. Among the different groups of dancers, professionals use significantly more recreational drugs than everyone else (15% versus 2%). This problem is higher in male dancers.

Sexual Behavior

Are you sexually active? Two-thirds (69%) of our dancers (eighteen and over) said "yes," making dancers 13% lower than the national average (82%). The majority (86%) practice safe sex (men, 100%; women, 84%). In terms of sexual orientation, female dancers are predominantly heterosexual (96%), with only a I small percentage homosexual (0.4%), bisexual (1%), or asexual (2.5%). Male dancers are equally divided among heterosexuals (47%) and homosexuals (47%); 6% are bisexual. When asked about AIDS, one-third (32%) of our sample personally knows someone with the HIV virus and 37% know someone who has died of an AIDS-related illness. One out of five dancers (23%) has been tested for HIV, and 7% are HIV-positive (men, 10%; women, 7%). This number represents 2% of our sample. According to an informal survey by Dance/USA (1992) of twenty-eight I dance companies, HIV affected 3.5% of the personnel compared with 0.6% of the general population. Importantly, 60% of our dancers who tested positive told their colleagues; only one out of three (33%) was offered emotional support.

RX Here's What You Can Do

Overall, dancers appear to be healthier as a group than the general population. They are thinner and more active, smoke less, and use alcohol in moderation. These benefits, however, must be weighed against the higher rates of depression, eating disorders, and HIV, for which additional services are needed. In addition, professional dancers appear to be at particular risk for problems related to mood and substance abuse, while having the least coverage in terms of health insurance. We believe that health insurance should be available to all dancers at a reasonable cost. A nonprofit organization soon to be developed, called the Dance Professionals Association, is planning to explore this possibility. For further information or to help out, contact Faith Petrides at [phone].

Sexual Harassment

Have you ever been sexually harassed as a dancer? This behavior is defined as any form of unwanted sexual attention, whether verbal or physical. Based on a national survey compiled by the New York State Coalition Against Sexual Assault, one in four schoolgirls and one in six schoolboys will be sexually harassed by the time he or she is eighteen years old. In our survey, 16% reported being sexually harassed, with male dancers being the most common targets in their late teens. The ratio of male to female harassers is seven to one.

As you can see in Table 3, three times more male than female dancers are the recipients of explicit sexual comments from their artistic directors and choreographers--authority figures who hold dancers' careers in the balance. Males are also more likely to be propositioned for sex by a variety of people in the dance world.

            Table 3
       Sexual Harrassment in the Dance World

                           Harassed                Harassed
Someone:(*)            Females  Who?          Male     Who?

Made explicit            6%    Teacher         22%     Director or
 sexual comments                                       Choreographer
 over a long period

Propositioned you        5%    Student         17%     Everyone
 to have sex

Forcibly hugged         5%     Student         11%     Student
 grabbed, or kissed you

Touched you in class    4%     Teacher          6%     Student
or rehearsals, not
related to dance
corrections

Group made sexual        3%    Student           0%      N/A
comments or asked
you to have sex as
you passed by

Asked repeatedly       2%     Student            0%      N/A
for a date with you
despite your lack
of interest

Forced you to have      1%     Other            0%        N/A
sex

(*) The choices were student, teacher, choreographer, or other
person in the dance world.

Further analyses were conducted on female dancers, due to their greater overall numbers in our sample. The results indicated that those who are asked repeatedly for a date by other students have a poorer body image compared to females who are not harassed. Furthermore, inappropriate touching by their dance teachers in class and rehearsals is related to a diagnosis of a clinical eating disorder. Female dancers who have been forcibly grabbed, hugged, and kissed by other students are less likely to practice safe sex. Thus, while females are less likely to be sexually harassed in dance than they are in regular school, the problems associated with these behaviors are severe.

RX Here's What You Can Do

Sexual harassment is viewed by the courts as a serious violation of the Equal Rights Act of 1964 and the Fourteenth Amendment to the Constitution of the United States. Currently, a school can be held liable for all types of problems in this area, including those generated from student to student. We encourage dance schools to find out more about setting up a sexual harassment and counseling policy by reading Robert J. Shoop and Debra L. Edwards's How to Stop Sexual Harassment in Our Schools: A Handbook and Curriculum Guide for Administrators and Teachers (Allyn and Bacon, 1994). Dance-companies should also have a specific policy in place to protect members, as well as any children who periodically perform in their productions.

Some Final Thoughts

While much of this article has focused on occupational stress in dance, it is important to remember that most dancers love their work. Our job, as auxiliary members of this special community, is to ensure dancers' continued health and well-being. We at Dance Magazine hope that the results from this survey will stimulate new ideas and lead to program development for students. professionals. and dance lovers of all ages and levels of training. After all is said and done, the dance world is a great place to be.

RELATED ARTICLE: How We Conducted the Survey

Our sixty-three-question survey asked current and former dancers about their concerns with body image, dieting, general health, and sexual harassment. The survey was designed with the help of our staff in concert with my own training in behavioral research. We mailed the survey to a random sample of 600 Dance Magazine subscribers; 58% were returned, resulting in 300 usable questionnaires (282 from women and 18 from men). Analyses were then performed by Mark Clements Research, Inc., and Dr. Richard Fox, a data analyst who specializes in dance.

Linda Hamilton, Ph.D., danced with New York City Rallet from 1969 to 1988. She is now a clinical psychologist whose practice focuses on performers.