Does Cultural Service Provision Contribute to Improving Public Health Levels? Empirical Evidence from 283 Chinese Cities

Lili Yang¹Li Wang²Zhen Zhang^2*

• ¹School of Art and Design, Shandong Women’s College, Jinan, China
• ²Macau University of Science and Technology, Taipa, Macao, SAR China

Revealing how public cultural service provision relates to urban public health is important for improving population well-being. Using panel data for 283 prefecture-level cities in China (2019–2023), we estimate generalized spatial two-stage least squares (GS2SLS) models with inverse-distance spatial weights to examine how changes in public cultural service supply (PSC) are associated with public health (PH). To mitigate spatial endogeneity, we use higher-order spatial lags of PSC and exogenous controls as instruments and conduct standard weak-IV and over-identification checks. Results show pronounced spatial dependence in PH: the spatial lag coefficient is 𝜌= 1.12 (SE = 0.32; 95% CI: 0.49–1.75; 𝑝< 0.01 ). The PSC–PH association is economically meaningful: across specifications, the elasticity of ln⁡ 𝑃𝑆𝐶ranges 0.36– 0.76; for example, in the fixed-effects model 𝛽ln⁡ 𝑃𝑆𝐶= 0.758(SE = 0.125; 95% CI: 0.513–1.003), implying that a 1% increase in PSC is associated with ≈0.5% higher PH. Findings are robust to alternative spatial matrices and instrument sets. These results indicate that strengthening cultural infrastructure and service quality correlates with 2 improved public-health performance and underscores the value of integrating cultural and health policies in Chinese cities.