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GMH Newsletter Practicum Feature – September 2021

Featured topic: Blue Space, Mental Health + Urban Design

By Andrea Petzel

Nearly 40% of the world’s population lives within 100 km of a coast, resulting in a population density twice the global average [1]. Defined as a transitional area between land and water, human settlements have thrived along biologically rich coastal areas (blue space), and today twenty-three of the world’s largest cities are situated on a coast [2,3]. A growing body of research indicates that access, even visibility access, to blue spaces promotes positive mental health benefits, even more than similar access to green space [4].

Recent research from Europe’s 2016-2020 BlueHealth project demonstrates intriguing policy implications for how cities are designed to improve equity and access, while balancing environmental protection for fragile coastal systems.

Mental Health Benefits of Blue Space

The definition of blue space includes lakes, oceans, and rivers. Access to blue space has shown to have positive directly and indirect influences mental health by allowing for [4]

  • Increased physical activity, which is associated with improved mental health.
  • Planned or unplanned social interaction, which is linked to improved mood.
  • Calming or therapeutic experiences that can decrease stress.

A New Zealand study found that increased access to views of blue space was significantly associated with lower psychological distress when controlling for covariates such as age, socioeconomic status, gender, as well as neighborhood-level variables. The study also found that the calming influence and associated improvements in mental health benefits similarly apply to green space views [4,5].

A recent study of older adults in Ireland examined the association between depression, coastal proximity (living close to the sea), and views. Using data from the Irish Longitudinal Study on Aging, researchers found a beneficial association between living close to the sea and depression risk. Considering factors such as income, social connectedness, gender, employment status, and anti-depressant and alcohol use, research findings indicated that people with access to sea views had less depression than those without view of the sea. When modeling both coastal proximity and sea view, researchers found that living close to the sea was no longer significant, suggesting that the positive mental health benefits of visibility access to sea views is independent of how close a person lives to the sea [6].

Europe’s BlueHealth Project

In 2016 researchers across Europe launched the BlueHealth Project to better understand how urban blue spaces can affect people’s mental health and physical wellbeing. Most of Europe’s population live in urban areas in close proximity to inland and coastal waterways. From 2016-2020 the BlueHealth project conducted over 20 studies in 18 countries, with the aim of better understanding the positive health benefits of blue space, and how cities and towns, and the policy implications of future development along European coastlines [7].

One BlueHealth study found that coastal proximity could improve better mental health in England’s poorest urban communities. Approximately one in six adults in England suffer from mental health disorders such as anxiety and depression, and these are far more likely in low-income communities. Using data from the Health Survey for England, researchers found that coastal living is linked with better mental health for those in the lowest earning households. Because everywhere in England is within 70 miles of the sea, improving accessibility to the coast could help reduce health inequities in some cities and towns [8].

Our research suggests, for the first time, that people in poorer households living close to the coast experience fewer symptoms of mental health disorders. When it comes to mental health, this ‘protective’ zone could play a useful role in helping to level the playing field between those on high and low income.”

-Dr. Jo Garrett, BlueHealth Project

Blue Space + Urban Design

Given the opportunities to developing urban blue spaces to support both mental and physical health, BlueHealth researchers created a Decision Support Tool (DST), which is applicable to almost any blue space, from coastlines, lakes and rivers, to ornamental features such as fountains. Designed for planners, policy makers, urban designers, and community stakeholders, the DST allows users to assess, plan, design, and manage urban blue spaces with a focus on health and wellbeing. The DST can be used to support three specific design goals [9]:

  1. Prevent health risks associated with blue spaces (drowning, vector-borne diseases, etc.).
  2. Promote human mental and physical health benefits.
  3. Improve and protect shoreline ecosystems and habitats.

The DST can be used in cities and towns of any size, and its applicability does not require a minimum population threshold. In addition to site design features, the DST can assess impacted population groups and site characteristics that can be addressed through ongoing management and maintenance [9].

Blue Space Policy Implications

The growing body of European research has potential policy implications for both the natural and built environments around the world. Given the fragile nature of coastal ecosystems that can be susceptible to impacts from overuse, and research indicating that simply having views of water has positive mental health benefits, cities and towns could pursue policies to creatively design living spaces to maximize water views. Rather than reserve views for those who can afford it, to further promote equity, cities could develop affordable housing with views of the water, or mandate that a percentage of affordable housing have access to water views [4,10].
Communities could also prioritize development that promotes more equitable access to the physical and recreational opportunities afforded by water bodies. With research indicating that mental health benefits are particularly beneficial to low-income communities, cities could require access to shorelines and coastlines to ensure everyone has options for the positive mental benefits of the world’s blue spaces.


1. Environment, U. N. Coastal zone management. UNEP – UN Environment Programme (2017).
2. Rural development through entrepreneurship.
3. Wheeler, B. W., White, M., Stahl-Timmins, W. & Depledge, M. H. Does living by the coast improve health and wellbeing? Health & Place 18, 1198–1201 (2012).
4. Nutsford, D., Pearson, A. L., Kingham, S. & Reitsma, F. Residential exposure to visible blue space (but not green space) associated with lower psychological distress in a capital city. Health & Place 39, 70–78 (2016).
5. Michigan State University. “Ocean views linked to better mental health.” ScienceDaily. ScienceDaily, 28 April 2016.
6. Dempsey, S., Devine, M. T., Gillespie, T., Lyons, S. & Nolan, A. Coastal blue space and depression in older adults. Health & Place 54, 110–117 (2018).
7. About BlueHealth. BlueHealth
8. Hall, Kerri. Coastal living linked with better mental health. BlueHealth
9. Decision-Support Tool (DST). BlueHealth
10. The Washington Post. Study: Living near water has mental health benefits.

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