Creative health in the urban Global South: barriers and facilitators in the cases of Cochabamba and Salvador

Abstract

Aims:

The Global South has some of the world’s largest cities, where rapid, ad hoc development of urban centres and ‘megacities’ has fuelled major socio-economic, environmental, and public health concerns. These urban environments can generate feelings of loneliness, with multiple barriers for access and participation in socio-cultural infrastructures. An inclusive future agenda for global creative health must, therefore, consider how urbanisation impacts social public health, what creative health approaches can do to alleviate this, and what the barriers are to access. This article explores barriers and facilitators to accessing socio-cultural urban infrastructures in two case-study cities: Salvador in Brazil and Cochabamba in Bolivia.

Methods:

Data were collected as part of a survey examining access to, and engagement in, arts and cultural activities undertaken between 25 January and 1 May 2023. This article focuses on two questions: What helps you to access artistic and cultural events in your city? and What barriers do you face in accessing artistic and cultural events in your city? 239 open responses from adults, in Portuguese and Spanish, were analysed using descriptive thematic analysis.

Results:

Findings highlight how emergent issues around existing economic inequality, safety, and accessibility can limit residents’ capacity to engage in creative health activities. While preliminary in scope, this raises wider public health implications for how creative health approaches may be leveraged within urban, Global South contexts.

Conclusions:

Findings highlight how greater dialogue is needed between the urban development, public health, and creative health sectors. Given the emerging evidence of the role of creative engagement to alleviate loneliness, integrating creative health approaches within urban public health may further strengthen connections with the most vulnerable communities, and help to build healthier cities. The article ends by outlining an approach that incorporates both local and city-wide creative encounters, highlighting how future interventions could be appropriately designed that gradually scale these types of interventions from tailored local offerings to larger, city-wide activities.

Plain language summary

What are the aims of your study?

• This study focused on two cities in South America, Salvador and Cochabamba, to explore how city spaces might impact how creative health activities are delivered and received by residents. We focus in particular on the barriers and enablers that residents report in accessing creative and cultural activities.

What are the key findings/results?

• Residents of the two case-study cities reported that lack of money, lack of accessible transport, and not feeling safe in travelling to participate in cultural activities were the main reasons they did not access them, and that more needs to be done to make these activities more accessible.

What is important about your study?

• Research has shown how engaging in creative activities can promote social connection and alleviate loneliness, which are important factors for supporting social public health. This study was the first to look at how this might be applied in two South American cities and highlights the barriers and enablers that residents report in accessing creative infrastructure.

How could your study inform public health practice?

Our findings indicate that when creative programmes are designed for, or delivered in, cities in South America, the impact of the urban environment must be considered. This can support public health through ensuring that socio-cultural infrastructure is accessible to as many residents as possible.