Arts engagement as part of broader health behaviour patterns in 22 countries

The definition of health behaviours and the activities they encompass continues to evolve. While behaviours such as alcohol use, smoking and physical activity are widely recognised in public health research, newer forms of behaviour, including social media use, have increasingly entered health discourse. Arts engagement has more recently emerged in public health discourse as a potential health-relevant behaviour with implications for health and wellbeing, yet little is known about how it co-occurs with other health behaviours across populations and contexts. This study examined how arts engagement as a health behaviour clusters with other health behaviours, including physical activity, smoking, alcohol consumption, and social media use, and across countries. We analysed data from the Global Flourishing Study, comprising 123,847 adults from 22 countries and territories, using latent profile analysis. Four health behaviour profiles were identified: Low risk, At risk, Mixed, and Disengaged, with arts engagement tending to co-occur with other health-promoting behaviours. These clusters were also observed (broadly) in the country-specific sample. Some country differences in the distribution of health behaviours within clusters were found and the proportion of the clusters also varied across country. Exploring predictors of the identified clusters revealed clear social inequalities in health behaviour patterns, with the strength of the gradients differing by country income level. These findings suggest that arts engagement is a behaviour distinct from other health behaviours, yet one that frequently co-occurs alongside other low-risk behaviours. Moreover, the observed social disparities in health behaviour clusters within and across countries highlight the importance of adopting a social-ecological perspective in health research and intervention.