A new study has shown that living near to the coast may be beneficial to mental health among England’s lowest-income communities.
The study, which was conducted as part of the BlueHealth initiative, found that living within 1 km of the sea was associated with better mental health among urban adults, compared with living more than 50 km away. However, stratification by income revealed that the effect was only observed among the lowest-earning households.
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The BlueHealth initiative
BlueHealth is a research initiative looking at the associations between environment, climate, and health. The project is specifically investigating the effects that water-based environments in urban areas have on health and wellbeing. The initiative, which was started in January 2016, involves researchers across Europe and will end in June 2020.
Exposure to natural environments can be beneficial
Poor mental health is one of the leading causes of disability globally. Research has shown that, in England, approximately one in six adults displays symptoms of a common mental disorder (CMD) such as depression or anxiety and around 7.3 million (17%) people take antidepressants.
However, a growing body of evidence suggests that exposure to natural environments is associated with general well-being and mental health benefits. Much of this work has looked at the associations between green space and mental health, where the measures used were exposures to green exercise, green space, and vegetation.
A smaller but growing amount of research also suggests that blue spaces such as coasts, rivers, and lakes are also associated with mental health benefits such as improved psychological restoration and reduced psychological distress.
Other studies have also provided evidence that socioeconomic status may have a moderating effect on this nature-health relationship. However, the majority of this work has again focused on measures of green space, and research into the links between blue space exposure and mental health remains limited.
One of the most detailed investigations to date
As reported in the journal Health and Place, Joanne Garrett and team have used cross-sectional data from the Health Survey for England (2008–2012) to assess the association between coastal proximity and self-reported mental health among almost 26,000 adults living in urban areas. The study is one of the most detailed investigations yet into the mental health effects of living close to the sea.
Mental health was measured using two surveys. The first was the General Health Questionnaire, a self-reported measure widely used to indicate the likelihood of an individual being at an increased risk for a CMD.
The second was the anxiety and depression dimension of the EQ-5D (EuroQol Research Foundation, 2018), a standardized measure of health-related quality of life.
Living near the coast may benefit the poorest communities
After adjusting for potential confounders, the team found that living near to the coast was associated with better self-reported mental health among lowest-earning incomes.
For urban adults, living within 1 km of the coast, significantly decreased the likelihood of being at risk of a CMD, compared with living more than 50 km away. Stratification by household income showed that the effect only applied to the lowest-earning households and also extended to those living within 5 km of the sea.
“This suggests that access to the natural environment may, at least partly, offset the adverse health and wellbeing outcomes associated with low incomes,” writes the team. The researchers think that the fresh air and open views may reduce stress and benefit overall health.
Coastal proximity was not found to be associated with the anxiety and depression dimension of the EQ5D measure.
The findings add to the growing evidence that, for urban adults, access to blue spaces might reduce health inequalities in England.
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."
Joanne Garrett, First Author
Making coastal paths accessible to all
The study comes as Natural England, a public body responsible for protecting England's natural environment, prepares to make all of England’s Coast Path accessible by 2020. Given that any area in England lies within 70 miles of the coastline, this improved access would mean more people could benefit from the health and wellbeing effects of living near the sea.
This kind of research is vital to convince governments to protect, create and encourage the use of coastal spaces. We want to the BlueHealth project to help policy makers understand how to maximise the wellbeing benefits of ‘blue’ spaces in towns and cities and ensure that access is fair and inclusive for everyone across Europe, while not damaging our fragile coastal environments.”
Mathew White, Environmental Psychologist, BlueHealth
Garrett, J. K., et al. (2019). Coastal proximity and mental health among urban adults in England: The moderating effect of household income. Health & Place. doi.org/10.1016/j.healthplace.2019.102200.