Blue Space: How Being Near Water Benefits Health

Abstract

Interacting with “blue space”—water sources in the form of lakes, rivers, ponds, oceans, and even swimming pools—may directly improve a person's physical and mental health. In fact, being in or near water environments may lead to relaxation, improved social interactions, better brain health, enhanced physical activity, and relief from stress, according to emerging research. To optimize health, experts suggest that clinicians consider a simple prescription for their patients—spending more time in or near the water.

In an interview, Wallace J. Nichols, PhD, marine scientist and author of the book Blue Mind ¹ stated: “Not long ago the idea that health practitioners would recommend a healthy diet, plenty of sleep, exercise and stress reduction as part of a healthy lifestyle seemed on the fringe or alternative, but now it is standard practice. The same is happening with recommendations that people engage in places with water sources and nature.”

In fact, living near coastal waters and freshwater sources has been linked to improved physical and mental health, according to researchers de Bell et al.² These authors explored the importance of nature and particularly blue space for people's well-being. Results of their survey showed that “social interaction and psychological benefits were the most important benefits obtained from visiting blue space.”² The authors stated, “This is consistent with evidence from the green space-health literature, which has identified social interaction and psychological benefits as key mechanisms through which green space benefits health.”²

How Blue Space Heals

Many people have experienced calm and peaceful feelings when approaching and spending time near natural sources of water, but how does interacting with water environments actually improve our health? Although research in this area is still emerging, Pearson et al. reported three main ways that blue space may benefit health, including “visual exposure to natural spaces as a calming backdrop and the subsequent mental health benefits”; engagement in physical activities in blue spaces and the potential physical health benefits; and through promotion of social connections “as blue spaces are venues for recreation (e.g., swimming, picnics, fishing), with concomitant benefits to both physical and mental health.”³

Volker and Kistemann stated that water sources are appealing to us because of specific properties that include sound, color, clarity, quality, movement, waves, landscape, long-range view, perspective, etc.⁴ They reported: “For perceptive reasons, landscapes with blue space are highly desired by humans. This includes wide stretches of water, waterscapes that provide an extensive view, natural scenes and urban scenes containing water, rushing water, waters with normalized flows, large water bodies, wild scenery containing water, river scenes, mountain waterscapes including rushing water and lakes, and canals.”⁴ Both restorative and recreational experiences are tied into blue space benefits, and research suggests that both natural and manmade or built water landscapes can offer positive health benefits, according to the authors, who recommend further research on the impact of blue space on health and urban and landscape planning.

Most are well aware of the impact of stress on our health and how poor lifestyle choices contribute to current health epidemics. To that end, in his book Blue Mind, Nichols discussed the rampant distractions in our predominantly urban lifestyles, which ultimately fatigue and exhaust the mind and the body and send us into overdrive. Nichols pointed to research that delineates between the directed mind (focused on tasks and multitasking) versus restful involuntary attention, which he stated occurs more in natural settings. In terms of how blue space time can help the mind relax, Nichols commented, “In a natural environment, and in particular, when we are on or by the water, there is a high degree of statistical predictability because it is so much the same from moment to moment. The background is fairly controlled and a little dreamy—in other words, highly normalized, which allows part of the brain to relax.”¹ Nichols added, “Envisage yourself being by the water: the sounds, the sights, the smells, all changing moment to moment yet essentially staying the same. It's regularity without monotony—the perfect recipe to trigger restful involuntary attention.”¹

In terms of specific research on how blue space interventions can help people heal or better manage illness, a systematic review by Britton et al. looked at the impact of “blue care interventions” (predesigned activities in a natural water setting targeting individuals to manage illness and restore health) on individuals with health issues. The review, which included 33 studies, explored how such interventions directly benefit mental health and psychosocial well-being in people with mental health issues, breast cancer, post-traumatic stress disorder (PTSD), addictions, and other conditions.⁵ Blue care interventions included activities such as canoeing, surfing, dragon boat racing, fly-fishing, swimming, and beach activities. Results showed short-term beneficial outcomes including improved social connection, a sense of belonging, increased interaction with others, and connection to water properties. The review authors reported, “The findings suggest how activities in blue space, rather than particular qualities of blue space, might contribute to rehabilitation and health promotion.”⁵

Prescribing Blue Space

Engaging in blue space can help people with conditions such as stress, anxiety, depression, pain, PTSD, cancer, and many others. In an interview, Nichols said, “People with high levels of anxiety, stress or distraction find that water time (in any form) is very helpful. I've found that the people who need it the most see the biggest benefits; however, anyone may experience positive results, even if small.”

To prescribe blue space to patients, Nichols suggested that clinicians put a photograph or piece of artwork depicting water in waiting rooms and consulting areas, and he said, “These water images can be used as prompts to ask patients a personal question, ‘What is your water?’ In other words, what water settings does the patient remember, love, or prefer? Then listen to what the person says, and encourage him or her to once again spend more time near, in, on or under that water.” Nichols recommended that clinicians let patients describe their preferred water connection rather than guessing or assuming, and added, “Some people have a fear of water such as with swimming; however, they may love to walk by the water or sit on a bench and observe water. Some people used to surf, swim, fish or paddle, but haven't in a while. Bath time may be the best choice for some folks.” Recent research on float tank therapy found that float sessions were helpful for people with high levels of stress, burnout, PTSD, stress-related physical pain, depression, and others.¹

Nichols created a unique means of promoting water engagement, called “Bluescriptions” (www.wallacejnichols.org/), which are designed to encourage people to reconnect with their water and to initiate conversations about water wellness. The Bluescription looks like a formal prescription and includes a place for a person's name and date; check boxes for preferred or recommended water types such as lake, ocean, pool, or tub; check boxes for activities such as swim, dive, boat, or walk; and finally check boxes for health goals such as calmness, creativity, or connection. Nichols said, “Our goal is to distribute 1 million of these Bluescriptions this summer during the 6th Annual 100 Days of Blue Mind Challenge.”

In fact, there are a number of innovative efforts helping people engage in blue space, and clinicians may want to investigate or have their patients look into unique initiatives in their own communities that are promoting healthy connections with the water and water wellness activities. For example, Nature and Environment to Attain and Restore Health (NEAR Health) connects people with blue and green nature spaces, works on solutions to help communities value their natural environment, and promotes maintenance of healthy lifestyles. The Blue Gym Initiative in the United Kingdom was created to explore the link between blue space environments and improved health and well-being along with exploring how the public could help protect blue space environments. Blue Gym research affirmed that there “are numerous potential opportunities to improve health and well-being arising from interactions with marine, coastal and other aquatic environments.”⁶

Challenges when prescribing blue space center on issues of access and how we can increase access for the people who need it the most. de Bell et al. reported on the significant social inequalities in the use of blue space and that “the most socially disadvantaged groups were least likely to report visiting a blue space frequently.”² In contrast and interestingly, these authors reported that the most socially disadvantaged were also more likely to report social interaction as the primary benefit of engaging with blue space and pointed to the role that blue space could play in “supporting social engagement and improving wellbeing among those at greatest risk of poor health.”²

Finally, blue space is for the young and the old, and Nichols stated that he hoped the science around engaging in blue space will be taught to all health professionals and become a tool in their tool kit. He concluded, “I also hope that it is taught to all school children so that everyone understands the vast cognitive, emotional, psychological, social, physical and spiritual health benefits of water and oceans throughout our lives. It would be excellent if health practitioners were simply reminding and encouraging us of things most of us already innately know.”

Conclusion

Although there is more to be learned about how engaging in blue space directly improves our health, experts agree that the basics of how blue space benefits health are also the tenets of integrative care—reduce stress, get socially connected, and increase physical activity. When presenting lifestyle choices that may promote and improve health, clinicians' suggestions that people engage in blue space may be an essential part of a needed prescription for health. ▪

References

Nichols

. Blue Mind: The Surprising Science That Shows How Being Near, In, On, or Under Water Can Make You Happier, Healthier, More Connected and Better at What You Do. New York: Little, Brown and Company, 2014.

de Bell

, Graham

, Jarvis

, et al. The importance of nature in mediating social and psychological benefits associated with visits to freshwater blue space. Landscape Urban Plann, 2017; 167:118–127.

Pearson

, Bottomley

, Chambers

, et al. Measuring blue space visibility and ‘blue recreation’ in the everyday lives of children in a capital city. Int J Environ Res Public Health, 2017; 14:56–3.

4. Vö lker

, Kistemann

. The impact of blue space on human health and well-being—Salutogenetic health effects of inland surface waters: A review. Int J Hyg Environ Health, 2011; 214:449–460.

Britton

, Kindermann

, Domegan

, et al. Blue care: A systematic review of blue space interventions for health and wellbeing. Health Promo Int 2018. [Epub ahead of print]; DOI: 10.1093/heapro/day103.

White

, Pahl

, Wheeler

, et al. The ‘Blue Gym’: What can blue space do for you and what can you do for blue space?. J Mar Biol Assoc UK, 2016; 96:5–12.