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Open AccessSystematic Review

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

1
School of Health and Life Sciences, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow G4 0BA, UK
2
School of Engineering and Built Environment, Glasgow Caledonian University, 70 Cowcaddens Road, Glasgow G4 0BA, UK
3
Geriatric Medicine, Usher Institute, University of Edinburgh, 51 Little France Crescent, Edinburgh EH16 4SA, UK
4
Department of Movement and Sports, Ghent University, Watersportlaan 2, 9000 Ghent, Belgium
*
Author to whom correspondence should be addressed.
Academic Editors: Paul Tchounwou and Simon Bell
Int. J. Environ. Res. Public Health 2021, 18(5), 2486; https://doi.org/10.3390/ijerph18052486
Received: 22 December 2020 / Revised: 16 February 2021 / Accepted: 27 February 2021 / Published: 3 March 2021
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. View Full-Text
Keywords: physical activity; stress; social isolation; pollution; heat island; urban nature; park; lake; health; environment physical activity; stress; social isolation; pollution; heat island; urban nature; park; lake; health; environment
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MDPI and ACS Style

Georgiou, M.; Morison, G.; Smith, N.; Tieges, Z.; Chastin, S. Mechanisms of Impact of Blue Spaces on Human Health: A Systematic Literature Review and Meta-Analysis. Int. J. Environ. Res. Public Health 2021, 18, 2486. https://doi.org/10.3390/ijerph18052486

AMA Style

Georgiou M, Morison G, Smith N, Tieges Z, Chastin S. Mechanisms of Impact of Blue Spaces on Human Health: A Systematic Literature Review and Meta-Analysis. International Journal of Environmental Research and Public Health. 2021; 18(5):2486. https://doi.org/10.3390/ijerph18052486

Chicago/Turabian Style

Georgiou, Michail; Morison, Gordon; Smith, Niamh; Tieges, Zoë; Chastin, Sebastien. 2021. "Mechanisms of Impact of Blue Spaces on Human Health: A Systematic Literature Review and Meta-Analysis" Int. J. Environ. Res. Public Health 18, no. 5: 2486. https://doi.org/10.3390/ijerph18052486

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