Background Interventional research has shown that cultural activities, such as singing and dancing, can bring about improved health outcomes, including improvements in indicators of biological dysregulation. However, large-scale quantitative analyses on cultural engagement and biomarkers are lacking to date. As a result, the potential mechanisms through which cultural activities may become biologically embedded, or lead to changes in health, are unclear. This research therefore examines associations between cultural engagement patterns (including active and passive engagement in arts, sports and heritage activities) and indicators of biological dysregulation in a large, representative dataset.

Methods Data from the Understanding Society dataset were used to conduct cross-sectional linear regression analyses between a data-driven latent class model of cultural engagement (previously published) and indicators of anthropometric, cardiovascular, metabolic, immune, and neuroendocrine function. Analyses were adjusted for age, gender, ethnicity, childcare responsibility, urbanicity, leisure time satisfaction, capacity-related factors, socioeconomic position, social and economic capital indicators, and sensitivity analyses further adjusted for physical activity and medication use.

Results Overall, participants who were more culturally active were found to have better indicators of biological health, including lower blood pressure, waist circumference, and fibrinogen blood concentration than participants who were culturally disengaged. Additionally, a range of specific associations between cultural engagement patterns and the different biological outcomes were observed. Although the associations were explained in part by socioeconomic, demographic and access related factors, cultural engagement patterns were found to be independently correlated with the biomarker outcomes. For some outcomes, clinically meaningful differences were observed between the cultural engagement groups.

Conclusion The data suggest that patterns of cultural engagement are associated with indicators of biological health, although the sociodemographic characteristics of people who engage with culture is an important consideration when interpreting this research. Although the analyses were cross-sectional, the findings are relevant to the UK’s social prescribing movement and other international arts-on-prescription type initiatives and policies.