Outdoor blue spaces, human health and well-being: A systematic review of quantitative studies

Int J Hyg Environ Health. 2017 Nov;220(8):1207-1221. doi: 10.1016/j.ijheh.2017.08.004. Epub 2017 Aug 18.


Background: A growing number of quantitative studies have investigated the potential benefits of outdoor blue spaces (lakes, rivers, sea, etc) and human health, but there is not yet a systematic review synthesizing this evidence.

Objectives: To systematically review the current quantitative evidence on human health and well-being benefits of outdoor blue spaces.

Methods: Following PRISMA guidelines for reporting systematic reviews and meta-analysis, observational and experimental quantitative studies focusing on both residential and non-residential outdoor blue space exposure were searched using specific keywords.

Results: In total 35 studies were included in the current systematic review, most of them being classified as of "good quality" (N=22). The balance of evidence suggested a positive association between greater exposure to outdoor blue spaces and both benefits to mental health and well-being (N=12 studies) and levels of physical activity (N=13 studies). The evidence of an association between outdoor blue space exposure and general health (N=6 studies), obesity (N=8 studies) and cardiovascular (N=4 studies) and related outcomes was less consistent.

Conclusions: Although encouraging, there remains relatively few studies and a large degree of heterogeneity in terms of study design, exposure metrics and outcome measures, making synthesis difficult. Further research is needed using longitudinal research and natural experiments, preferably across a broader range of countries, to better understand the causal associations between blue spaces, health and wellbeing.

Keywords: Blue spaces; Health; Outdoor; Well-being.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Exercise
  • Humans
  • Mental Health*
  • Water*


  • Water