Water, health and wellbeing (Blue Health)

Project aim

This aim of this project was to aid consideration of thinking of policy and practice linked to well-being and water. Funding was provided by Scotland’s Centre of Expertise for Waters (CREW) [1] and it ran from 2011-2012.

Research objectives

The research objectives were two-fold: (a) to systematically bring together and review the empirical evidence for the role of water settings or blue space (inland, coastal, rural and urban) on health and suggest how this information might be used for health promotion in Scotland and (b) to work with key stakeholders (Scottish Government [2], Scottish Environment Protection Agency (SEPA) [3], Scottish Water [4], Health Protection Scotland [5], NHS Scotland [6] and Scottish Flood Forum [7]) to focus the review on their priorities.

Methodology

Research methods used was a literature review based on systematic review principles to establish an evidence base for both the positive and negative relationships between water in the landscape, health and well-being (termed blue health [8]).

Key findings

• Across all three themes of our research we found little empirical evidence and many gaps in the literature on the links between blue space and health.
• The scientific evidence for salutogenic benefits of blue space is strongest for mental health, with evidence of water settings as a preferred landscape offering perceived psychological restoration [9], and some limited evidence that coastal settings may offer greater benefits for walking.
• However, there is a lack of objective measures and ‘real world’ research in everyday settings since much of the evidence has relied on self-reported indicators in student populations carried out in controlled laboratory conditions. The theory underpinning green health [10] would suggest blue space ought to offer similar benefits in terms of promoting social contact and active living, but we found no empirical evidence supporting this.
• Qualitative research has shown that flood disasters can have severe and long-term social and health impacts, but there is a lack of robust, quantitative and longitudinal evidence to support this. Much of the evidence base has focused on specific mental disorders (for example, post-traumatic stress disorder (PTSD)) with little research on the every day distress and anxiety experienced from living with floods and future flood risk.
• We found evidence of social and health inequalities, with greater psychological impact of flooding [11] being experienced by poorer communities, and amongst children, women and older people, but more research is needed to quantify this geographically and demographically. Whilst we found a number of educational initiatives directed towards places of flood risk (for example, the Scottish Flood Forum mental health first aid course [7]), we found no systematic analysis of the value of these initiatives to health.
• We found some evidence of the amenity benefits of Sustainable Urban Drainage Systems (SUDS) [12], particularly in support of the aesthetic and recreational value of SUDS, especially where they incorporate ponds. We found anecdotal evidence of the amenity value of SUDS in schools, particularly their benefits for outdoor learning and for promoting wellbeing in children, but no formal evaluation, nor any research exploring the risks associated with these features, how they can be best managed and the trade-offs with health and wellbeing. The environmental bias of senior teachers in schools is suspected to influence the adoption of SUDS in schools but further research is needed to explore this.
• The research complements that on the relationship between green space and human health using a range of methods and disciplinary approaches at different scales, GreenHealth [10], funded by Scottish Government [13].
• This capacity building CREW [1] project has led to development of a further project being funded by CREW 2013-2014.

Key contact

Sue Morris, David Miller [14], Jane Morrice [15]