The purpose of this study is to understand the impact of health status and cultural participation upon psychological well-being, with special attention to the interaction between patterns of cultural access and other factors known to affect psychological well-being. Data for this report were collected from a sample of 1,500 Italian citizens. A multi-step random sampling method was adopted to draw a large representative sample from the Italian population. Subjects underwent a standard questionnaire for psychological well-being [the Italian short form of the Psychological General Well Being Index (PGWBI)], and a questionnaire related to the frequency of participation to 15 different kinds of cultural activities during the previous year. The results show that, among the various potential factors considered, cultural access unexpectedly rankes as the second most important determinant of psychological well-being, immediately after the absence or presence of diseases, and outperforming factors such as job, age, income, civil status, education, place of living and other important factors. According to a semantic map generated by a powerful data mining algorithm, it turns out that different factors (among which cultural access and health status in particular) may be viewed as concurrent elements of a complex multi-causal scheme that seems to play a primary role in determining psychological distress or well-being. In particular, distress seems to be tightly connected with: living in the Southern part of Italy, average income level, living in semi-urban and urban areas, age group 46-60, presence of more than two concomitant diseases and a low level of cultural access. Well being, on the other hand, is tightly connected with: male gender, high