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Mechanisms of impact of blue spaces on human health: a systematic literature review and meta-analysis
Georgiou, M.; Morison, G.; Smith, N.; Tieges, Z.; Chastin, S. (2021). Mechanisms of impact of blue spaces on human health: a systematic literature review and meta-analysis. International Journal of Environmental Research and Public Health 18(5): 2486. https://hdl.handle.net/10.3390/ijerph18052486
In: International Journal of Environmental Research and Public Health. MDPI AG: Basel. ISSN 1660-4601, more
Peer reviewed article  

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Author keywords
    physical activity; stress; social isolation; pollution; heat island; urban nature; park; lake; health; environment

Authors  Top 
  • Georgiou, M.
  • Morison, G.
  • Smith, N.
  • Tieges, Z.
  • Chastin, S., more

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.

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