Connection with coast and inland waterways has multiple health benefits – here’s how we measure them

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One blue health study shows that virtual reality experiences that involve being by the sea can reduce experience of dental pain more than inland walking experiences. Elizaveta Galitckaia/Shutterstock
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Imagine you’ve had a hard day. You’ve only managed to get a fraction of your urgent tasks done. Your partner, boss, friend or mother (delete as appropriate) has been giving you a hard time. Just thinking about this is raising your blood pressure (my apologies).

Now, imagine “paradise”. Suddenly, thoughts of a calm, deep blue sea lapping gently onto a white sandy beach fringed with palm trees start to come to mind.

Others may turn inland and imagine a mountain lake reflecting the pine trees and jagged peaks with a sparkling waterfall cascading down. Just thinking about such scenes can quickly stabilise negative emotions and reduce stress-related biomarkers such as lower heart rate (you’re welcome).

Water is present in nearly all of these daydreams. Oceans are lapping, rivers are bubbling, waterfalls are cascading, lakes are sparkling.

These “blue spaces” feature highly in the places we visit for recreation, holidays and retirement, so why do they play such an important role in helping us to de-stress? Are our intuitions that blue spaces are good for us backed up by evidence?

As part of what has become known over the last 15 years as the “blue health” programme of work, colleagues and I around the world have been trying to answer these and related questions.

In one of our earliest studies, we focused on the coast. Using census data from 40 million adults in England, we found that people living closer to the sea tended to report better overall health once other factors, such as age and local area income, employment, education and crime levels were accounted for.

A second study tracked more than 15,000 people for a decade, some of whom moved closer to the coast and some further away during that period. Supporting the census data, people reported being healthier and having less mental distress in years when they lived within 5km of the sea. Importantly, this wasn’t just a “happy retiree effect” – we found the same results with the working age population.

Other researchers found similar effects for inland waters, such as lakes, rivers and canals.

Why might living near the coast or inland waters benefit our health and wellbeing? One simple mechanism is more exercise. Our research showed that people who live near water are more likely to meet recommended levels of physical activity and this seems to be a major reason why they also report better health.

woman bare legs and feed in shallow sea water walking along sandy beach, white waves in background
A direct connection with coastal spaces and other water can improve your physical health and mental wellbeing. Oleg Elkov/Shutterstock

Looking at, listening to, and immersing ourselves in both inland and coastal waters could directly benefit mental health. Lots of data relies on large-scale public surveys which suggests that visiting inland and coastal waters can reduce negative emotions and boost positive ones.

Laboratory and field experiments show that exposure to blue spaces is associated with lower stress markers, such as heart rate and sweating response.

A study conducted in a dental surgery showed that patients “walking” along a virtual beach during treatment reported lower pain both directly after the procedures and a week later when asked to recall pain levels, than those undergoing normal procedures or walking around a pleasant town setting. Lower recalled pain is important because it’s a major factor in deciding whether to go back to the dentists in future.

In-depth interview studies have been conducted to provide meaning to the numbers, with people often referring to the importance of the dynamic changes which water settings magnify such as sunrises and sunsets.


Swimming, sailing, even just building a sandcastle – the ocean benefits our physical and mental wellbeing. Curious about how a strong coastal connection helps drive marine conservation, scientists are diving in to investigate the power of blue health.

This article is part of a series, Vitamin Sea, exploring how the ocean can be enhanced by our interaction with it.


Blue spaces are considered important places to spend quality time with friends and families, which has a range of benefits for mental and physical health.

Although much of the work started in the UK, similar findings have now been demonstrated across Europe, North America, Australia and Asia. One study from a remote island in Indonesia showed that local people who went sea swimming or snorkelling regularly during COVID coped better with the crisis.

Although it’s tempting to explain these benefits in terms of a hardwired connection with blue spaces reflecting an evolutionary heritage, it’s impossible to test those assumptions in a scientific way.

Inland and coastal waters also pose a myriad of threats to our health and wellbeing from floods to microbial pollution, and they can be breeding grounds for disease-carrying insects and larger predators, so a “pro-water” evolutionary account seems problematic. We have tried to better understand the balance of risks and benefits and view our evidence in terms of current benefits to individuals and societies rather than ones that may or may not have helped our ancestors.

Building resilience

Blue spaces can help us cope with adversity by building resilience. Well-designed urban blue spaces such as fountains can help reduce urban heat island effects, a growing threat under climate change especially for older people. Blue spaces can also be a great social leveller, reducing inequalities in health and wellbeing between rich and poor.

Improving access to local urban blue spaces in poorer districts can increase community cohesion and resident wellbeing. At a more personal level, sharing blue space memories can stimulate positive shared experiences with friends and families in potentially stressful care contexts, such as with people with dementia.

As blue spaces are under increasing threat from pollution, overdevelopment or climate change, enhancing the quality of blue spaces for our health and wellbeing is just part of a much wider challenge to protect these vitally important places.

Hopefully when asked to think about paradise, future generations can still daydream about clean pristine beaches and clear mountain lakes, knowing these exist in reality and are not just forgotten remnants of a once beautiful earth.

The Conversation

Mathew White's work was funded by the following programmes: BlueHealth (EU Horizon 2020 Grant Number: 666773), Seas Oceans and Public Health in Europe (EU Horizon 2020 Grant Number: 774567), Blue Communities (UK Global Challenges Research Fund Grant Number: NE/ P021107/1) and Building individual and community RESilience thrOugh NATurE based therapy (RESONATE – EU Horizon 2020 Grant Number: 101081420 ).