SynthesisInternational journal of environmental research and public health2021
Mechanisms of Impact of Blue Spaces on Human Health: A Systematic Literature Review and Meta-Analysis.
Synthesis in International journal of environmental research and public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
53 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- Greenspace Exposure and DNA Methylation Age Acceleration: A Systematic Review and Molecular Pathway Analysis.International journal of molecular sciences · 2026Pooled it
- Associations between the living environment and sleep through the mediation of the physical activity: a systematic review.BMC public health · 2025Pooled it
- Green spaces, blue spaces and human health: an updated umbrella review of epidemiological meta-analyses.Frontiers in public health · 2025Pooled it
- Restorative Effects from Green Exposure: A Systematic Review and Meta-Analysis of Randomized Control Trials.International journal of environmental research and public health · 2022Pooled it
- The Effect of Physical Activity Interventions Carried Out in Outdoor Natural Blue and Green Spaces on Health Outcomes: A Systematic Review.International journal of environmental research and public health · 2022Pooled it
- Post Discharge mHealth and Teach-Back Communication Effectiveness on Hospital Readmissions: A Systematic Review.International journal of environmental research and public health · 2021Pooled it
- Precision residential greenspace, urban environmental exposures, and incident dementia among older adults in Sweden: A 16-year cohort study.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Association between exposure to green and blue spaces and respiratory health in the elderly: a scoping review.BMC public health · 2026Article
- Climate resilient adaptation of coastal amenities for wellbeing.Cambridge prisms. Coastal futures · 2026Review
- A systematic review investigating the relationship between green and blue spaces and depression in older adults via DNA methylation.Environmental epigenetics · 2026Review
- The spatial and contextual exposome and subtypes of hypertensive disorders of pregnancy: a double machine learning-based analysis.Exposome · 2026Article
- Culturally and regionally relevant physical activity for public health promotion in a global context: nature of the evidence and definition development from a narrative review.BMJ public health · 2026Review
- More trees, more naturalness, and greater willingness to engage in physical activity: an image-based study.Frontiers in public health · 2026Article
- Environmental determinants of hiking, jogging, and cycling along the Beijing-Tianjin-Hebei grand canal: implications for health promotion.Frontiers in public health · 2026Article
- Youth perceptions of urban waterfront environments for stress relief: a social media text analysis study in Beijing.Frontiers in public health · 2026Article
- Swimming classes as campus blue space: a qualitative study of emotion regulation, social support and psychological resilience among university students.Frontiers in psychology · 2026Article
- "I know it will make me feel better": a grounded theory of sea gazing and well-being for women in midlife.International journal of qualitative studies on health and well-being · 2025Article
- Leveraging blue spaces for public health: Co-creating a whole-system action plan.Public health in practice (Oxford, England) · 2025Article
- Ocean for Health: A Transdisciplinary Framework to Accelerate Research on Ocean-Human Health Connections.Environmental science & technology · 2025Review
- A health impact assessment of progress towards urban nature targets in the 96 C40 cities.The Lancet. Planetary health · 2025Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Blue spaces have been found to have significant salutogenic effects. However, little is known about the mechanisms and pathways that link blue spaces and health. The purpose of this systematic review and meta-analysis is to summarise the evidence and quantify the effect of blue spaces on four hypothesised mediating pathways: physical activity, restoration, social interaction and environmental factors. Following the PRISMA guidelines, a literature search was conducted using six databases (PubMed, Scopus, PsycInfo, Web of Science, Cochrane Library, EBSCOHOST/CINAHL). Fifty studies were included in our systematic review. The overall quality of the included articles, evaluated with the Qualsyst tool, was judged to be very good, as no mediating pathway had an average article quality lower than 70%. Random-effects meta-analyses were conducted for physical activity, restoration and social interaction. Living closer to blue space was associated with statistically significantly higher physical activity levels (Cohen's d = 0.122, 95% CI: 0.065, 0.179). Shorter distance to blue space was not associated with restoration (Cohen's d = 0.123, 95% CI: -0.037, 0.284) or social interaction (Cohen's d = -0.214, 95% CI: -0.55, 0.122). Larger amounts of blue space within a geographical area were significantly associated with higher physical activity levels (Cohen's d = 0.144, 95% CI: 0.024, 0.264) and higher levels of restoration (Cohen's d = 0.339, 95% CI: 0.072, 0.606). Being in more contact with blue space was significantly associated with higher levels of restoration (Cohen's d = 0.191, 95% CI: 0.084, 0.298). There is also evidence that blue spaces improve environmental factors, but more studies are necessary for meta-analyses to be conducted. Evidence is conflicting on the mediating effects of social interaction and further research is required on this hypothesised pathway. Blue spaces may offer part of a solution to public health concerns faced by growing global urban populations.
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