# Short communication: Five ways UK European Capitals and cities of culture have connected cultural activities with nature and their impacts on health and wellbeing, wider determinants of health and inequality

## TL;DR

This paper summarizes five types of initiatives in UK cities that connect cultural activities with nature and their effects on health, environment, and inequality.

## Contribution

It identifies five distinct initiative types and highlights their potential to improve health and wellbeing while addressing inequality risks.

## Key findings

- Initiatives may improve mental health, community relations, and environmental quality in the short term.
- There is a risk of widening inequality if marginalized groups are not included in these initiatives.
- Co-creation with local communities and equitable access to opportunities can mitigate inequality risks.

## Abstract

To rapidly synthesise evidence for local practice on what initiatives UK European Capitals and Cities of Culture (UKEUCoCs) have implemented connecting cultural activities with green, blue, or outdoor space (culture-nature initiatives) and their impacts on planetary health outcomes: personal health and wellbeing, wider determinants of health particularly the environment, and existing inequality.

Rapid evidence review.

A rapid review of published articles and evaluation reports. Published articles were identified through database searches (Proquest, OVID, Scopus, Web of Science, MEDLINE) in January–February 2024. Data was extracted directly into a table and findings synthesised narratively by theme.

Published evidence about UKEUCoC culture-nature initiatives was limited but five initiative types were identified: 1) growing-focused activities; 2) activities exploring human-nature relationships; 3) targeted nature-based wellbeing activities; 4) activities connecting cultural engagement with environmental activism; and 5) use of outdoor spaces for artworks, performances and festivals. UKEUCoC culture-nature initiatives may contribute to short-term improvements in mental health and wellbeing (confidence, self-esteem, subjective wellbeing), community health (community relations, civic pride), cultural participation, and local environmental quality and use, but risk widening existing inequalities. Co-creating initiatives at hyper-local levels with marginalised groups and trusted Community Champions, active involvement, and creating equitable access to livelihood opportunities may mitigate inequality risks.

Evidence is limited but suggests UKEUCoC culture-nature initiatives could positively support planetary health outcomes in the short-term. Equity in these outcomes appears to rely however, on action to ensure the involvement of and sustainable livelihood creation for marginalised groups. It is unclear how outcomes are generated across the initiative types identified, including through interactions between them, where they are implemented. The five initiative types identified in this work could be targeted for further investigation in research and practice on culture-nature initiatives for health more generally, using a complex systems approach to evaluation.