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Mechanisms of Impact of Blue Spaces on Human Health: A Systematic Literature Review and Meta-Analysis

Author

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  • Michail Georgiou

    (School of Health and Life Sciences, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow G4 0BA, UK)

  • Gordon Morison

    (School of Engineering and Built Environment, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow G4 0BA, UK)

  • Niamh Smith

    (School of Health and Life Sciences, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow G4 0BA, UK)

  • Zoë Tieges

    (School of Health and Life Sciences, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow G4 0BA, UK
    Geriatric Medicine, Usher Institute, University of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, UK)

  • Sebastien Chastin

    (School of Health and Life Sciences, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow G4 0BA, UK
    Department of Movement and Sports, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium)

Abstract

Blue spaces have been found to have significant salutogenic effects. However, little is known about the mechanisms and pathways that link blue spaces and health. The purpose of this systematic review and meta-analysis is to summarise the evidence and quantify the effect of blue spaces on four hypothesised mediating pathways: physical activity, restoration, social interaction and environmental factors. Following the PRISMA guidelines, a literature search was conducted using six databases (PubMed, Scopus, PsycInfo, Web of Science, Cochrane Library, EBSCOHOST/CINAHL). Fifty studies were included in our systematic review. The overall quality of the included articles, evaluated with the Qualsyst tool, was judged to be very good, as no mediating pathway had an average article quality lower than 70%. Random-effects meta-analyses were conducted for physical activity, restoration and social interaction. Living closer to blue space was associated with statistically significantly higher physical activity levels (Cohen’s d = 0.122, 95% CI: 0.065, 0.179). Shorter distance to blue space was not associated with restoration (Cohen’s d = 0.123, 95% CI: −0.037, 0.284) or social interaction (Cohen’s d = −0.214, 95% CI: −0.55, 0.122). Larger amounts of blue space within a geographical area were significantly associated with higher physical activity levels (Cohen’s d = 0.144, 95% CI: 0.024, 0.264) and higher levels of restoration (Cohen’s d = 0.339, 95% CI: 0.072, 0.606). Being in more contact with blue space was significantly associated with higher levels of restoration (Cohen’s d = 0.191, 95% CI: 0.084, 0.298). There is also evidence that blue spaces improve environmental factors, but more studies are necessary for meta-analyses to be conducted. Evidence is conflicting on the mediating effects of social interaction and further research is required on this hypothesised pathway. Blue spaces may offer part of a solution to public health concerns faced by growing global urban populations.

Suggested Citation

  • Michail Georgiou & Gordon Morison & Niamh Smith & Zoë Tieges & Sebastien Chastin, 2021. "Mechanisms of Impact of Blue Spaces on Human Health: A Systematic Literature Review and Meta-Analysis," IJERPH, MDPI, vol. 18(5), pages 1-41, March.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:5:p:2486-:d:509749
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    References listed on IDEAS

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    3. Steffen Andreas Schüle & Lisa Karla Hilz & Stefanie Dreger & Gabriele Bolte, 2019. "Social Inequalities in Environmental Resources of Green and Blue Spaces: A Review of Evidence in the WHO European Region," IJERPH, MDPI, vol. 16(7), pages 1-15, April.
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    2. Sofia Marini & Mario Mauro & Alessia Grigoletto & Stefania Toselli & Pasqualino Maietta Latessa, 2022. "The Effect of Physical Activity Interventions Carried Out in Outdoor Natural Blue and Green Spaces on Health Outcomes: A Systematic Review," IJERPH, MDPI, vol. 19(19), pages 1-15, September.
    3. Jonathan P. Reeves & Conor H. D. John & Kevin A. Wood & Phoebe R. Maund, 2021. "A Qualitative Analysis of UK Wetland Visitor Centres as a Health Resource," IJERPH, MDPI, vol. 18(16), pages 1-25, August.
    4. Yannick Klein & Petra Lindfors & Walter Osika & Linda L. Magnusson Hanson & Cecilia U. D. Stenfors, 2022. "Residential Greenspace Is Associated with Lower Levels of Depressive and Burnout Symptoms, and Higher Levels of Life Satisfaction: A Nationwide Population-Based Study in Sweden," IJERPH, MDPI, vol. 19(9), pages 1-19, May.
    5. Francisco Díaz-Martínez & Miguel F. Sánchez-Sauco & Laura T. Cabrera-Rivera & Carlos Ojeda Sánchez & Maria D. Hidalgo-Albadalejo & Luz Claudio & Juan A. Ortega-García, 2023. "Systematic Review: Neurodevelopmental Benefits of Active/Passive School Exposure to Green and/or Blue Spaces in Children and Adolescents," IJERPH, MDPI, vol. 20(5), pages 1-29, February.
    6. Argyro Anna Kanelli & Margarita Kokkinaki & Marios-Dimitrios Sinvare & Chrisovalantis Malesios & Panayiotis G. Dimitrakopoulos & Olga-Ioanna Kalantzi, 2023. "Keep Calm and Go Out: Urban Nature Exposure, Mental Health, and Perceived Value during the COVID-19 Lockdown," Sustainability, MDPI, vol. 15(11), pages 1-20, May.
    7. Xindi Zhang & Yixin Zhang & Jun Zhai & Yongfa Wu & Anyuan Mao, 2021. "Waterscapes for Promoting Mental Health in the General Population," IJERPH, MDPI, vol. 18(22), pages 1-15, November.
    8. Juntti, Meri & Ozsezer-Kurnuc, Sevda, 2023. "Factors influencing the realisation of the social impact of urban nature in inner-city environments: A systematic review of complex evidence," Ecological Economics, Elsevier, vol. 211(C).
    9. Syed Fawad Mashhadi & Aliya Hisam & Siham Sikander & Mommana Ali Rathore & Faisal Rifaq & Shahzad Ali Khan & Assad Hafeez, 2021. "Post Discharge mHealth and Teach-Back Communication Effectiveness on Hospital Readmissions: A Systematic Review," IJERPH, MDPI, vol. 18(19), pages 1-19, October.
    10. Song Song & Ruoxiang Tu & Yao Lu & Shi Yin & Hankun Lin & Yiqiang Xiao, 2022. "Restorative Effects from Green Exposure: A Systematic Review and Meta-Analysis of Randomized Control Trials," IJERPH, MDPI, vol. 19(21), pages 1-22, November.
    11. Niamh Smith & Ronan Foley & Michail Georgiou & Zoë Tieges & Sebastien Chastin, 2022. "Urban Blue Spaces as Therapeutic Landscapes: “A Slice of Nature in the City”," IJERPH, MDPI, vol. 19(22), pages 1-20, November.
    12. Ina Falfán & Luis Zambrano, 2023. "Lacustrine Urban Blue Spaces: Low Availability and Inequitable Distribution in the Most Populated Cities in Mexico," Land, MDPI, vol. 12(1), pages 1-18, January.
    13. Andreia Teixeira & Ronaldo Gabriel & José Martinho & Irene Oliveira & Mário Santos & Graça Pinto & Helena Moreira, 2023. "Distance to Natural Environments, Physical Activity, Sleep, and Body Composition in Women: An Exploratory Analysis," IJERPH, MDPI, vol. 20(4), pages 1-20, February.

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