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

Author

Listed:
  • 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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    1. 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.
    2. Arne Arnberger & Renate Eder & Brigitte Allex & Martin Ebenberger & Hans-Peter Hutter & Peter Wallner & Nicole Bauer & Johann G. Zaller & Thomas Frank, 2018. "Health-Related Effects of Short Stays at Mountain Meadows, a River and an Urban Site—Results from a Field Experiment," IJERPH, MDPI, vol. 15(12), pages 1-19, November.
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    4. Zoë Tieges & Duncan McGregor & Michail Georgiou & Niamh Smith & Josie Saunders & Richard Millar & Gordon Morison & Sebastien Chastin, 2020. "The Impact of Regeneration and Climate Adaptations of Urban Green–Blue Assets on All-Cause Mortality: A 17-Year Longitudinal Study," IJERPH, MDPI, vol. 17(12), pages 1-12, June.
    5. Zhou, Peiling & Grady, Sue C. & Chen, Guo, 2017. "How the built environment affects change in older people's physical activity: A mixed- methods approach using longitudinal health survey data in urban China," Social Science & Medicine, Elsevier, vol. 192(C), pages 74-84.
    6. Alessandro Liberati & Douglas G Altman & Jennifer Tetzlaff & Cynthia Mulrow & Peter C Gøtzsche & John P A Ioannidis & Mike Clarke & P J Devereaux & Jos Kleijnen & David Moher, 2009. "The PRISMA Statement for Reporting Systematic Reviews and Meta-Analyses of Studies That Evaluate Health Care Interventions: Explanation and Elaboration," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-28, July.
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    2. 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.
    3. 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.
    4. Jing Guan & Sumarni Binti Ismail & Sarah Abdulkareem Salih & Wan Srihani Wan Mohamed & Norhuzailin Binti Hussain, 2025. "The Role of Blue Space in Enhancing Mental Health and Well-Being Among Older Adults: A Systematic Review," Sustainability, MDPI, vol. 17(8), pages 1-25, April.
    5. Ariane Gerami & Charlie Foster & Joey Murphy, 2022. "“Virtual Surf Booth”: Assessment of a Novel Tool and Data Collection Process to Measure the Impact of a 6-Week Surf Programme on Mental Wellbeing," IJERPH, MDPI, vol. 19(24), pages 1-18, December.
    6. 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.
    7. 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.
    8. 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.
    9. 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.
    10. 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.
    11. 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.
    12. 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).
    13. 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.
    14. 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.
    15. 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.

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