The research on the impact of urban blue spaces on residents' mental health has attracted great attention from scholars internationally, and quantitative studies of the effects dominate the current academia. This study, on the basis of reviewing the theories of urban blue spaces and residents' mental health, conducted a meta-analysis of 47 key studies by systematically selecting and examining the literature from Web of Science, CNKI, and other databases. This paper analyzed the measuring indicators and research models among the literature and standardized the effect size of the research findings. The meta-analysis results include that: 1) the measurements of the characteristics of urban blue spaces are mainly conducted in space-based and individual-based dimensions; 2) residents' mental health is mainly measured from aspects of general mental health, positive psychology, and negative psychology; 3) the proximity of blue space has a significant positive effect in improving residents' general mental health and positive psychology; 4) the availability of blue space is significantly positively correlated with general mental health and positive psychology; 5) although there are studies confirming that factors such as blue space visibility, frequency of visit, and exposure types have an impact on mental health, the relevant studies are still limited; and 6) research on the effect of blue spaces on negative psychology is controversial, especially on mental disorders such as depression, and the findings among existing studies vary significantly. The results of this meta-analysis can provide guidelines for future research and the construction of healthy cities.
Online First Date: 09 September 2024Issue Date: 01 November 2024
Cite this article:
Wenya ZHAI,Hanbei CHENG,Feicui GOU, et al. A Meta-Analysis of the Impact of Urban Blue Spaces on Residents' Mental Health[J]. Landsc. Archit. Front.,
2024, 12(5): 20-36.
Self-reported mental health; anxiety and depression
Cross-section analysis
32
2019
Hong Kong, China
Older adults
Blue space quality (rating on safety, presence of wildlife, whether generally be free from litter, and have good facilities); types of exposures; visit frequency; walking distance to blue space; activity intensity; visit duration
Subjective well-being
Cross-section analysis
35
2019
England
Adults
Euclidean distance to blue space; freshwater presence
Self-reported mental health
Cross-section analysis
53
2019
New Zealand
Children (students)
Euclidean distance to blue space; presence of inland blue space in the neighborhood
Subjective well-being; depression
Cross-section analysis
54
2019
Chinese mainland
Older adults
Ratio of the number of blue space pixels per street view image; Normalized Difference Water Index (NDWI)
Geriatric depression
Cross-section analysis
55
2019
Singapore
Children (students)
Whether visit blue spaces
Momentary happiness
Cross-section analysis
56
2019
UK
Adults
Taking part in twice a week wetland nature-based health intervention for six weeks
Subjective well-being; stress; anxiety
Controlled experiment
11
2020
Spain
Adults
Walking distance to blue space from residence; visit frequency; visit duration
Perceived restorativeness
Cross-section analysis
15
2020
Chinese mainland
Adults
Ratio of the number of blue space pixels per street view image; blue space within a 1, 500-m buffer from residence
Self-reported mental health
Cross-section analysis
57
2020
Chinese mainland
Older adults
Euclidean distance to blue space; NDWI
Self-reported mental health
Cross-section analysis
58
2020
Chinese mainland
Older adults
Euclidean distance to blue space; ratio of blue space, per capita water area, and patch separation index of blue space within a 1-km buffer
Self-reported mental health
Cross-section analysis
59
2020
Spain
Adults
Walking in blue space (on 4 days each week, 20 min per day, for 3 weeks)
Euclidean distance to blue space; percentage of blue space within 800-m and 1, 600-m buffers from residence
Antidepressant medication prevalence
Cross-section analysis
14
2021
Chinese mainland
Adults
Percentage of blue space within a 500-m buffer from residence and a 200-m buffer around travel route
Subjective well-being
Cross-section analysis
20
2021
The Netherlands
Adults
Proportion of blue space within 50-m and 100-m buffers from residence
Depression
Cross-section analysis
34
2021
USA
Younger adults (students)
Walking in blue spaces (compared with walking in the urban environment)
Restorative experience
Randomized crossover trial
38
2021
UK
Adults
Visit frequency
Subjective well-being; life satisfaction
Cross-section analysis
60
2021
Chinese mainland
All-aged
Euclidian distance to blue space; blue space area within 300-m, 500-m, and 1, 000-m buffers from residence
Depression; subjective well-being
Cross-section analysis
61
2021
18 countries/regions including the UK and the USA
Adults
Percentage of blue space within a 1, 000-m buffer from residence; visit frequency in the last 4 weeks; nature connectedness
Subjective well-being; mental distress; depression/anxiety medication use
Cross-section analysis
62
2021
Denmark
Adults (blood donors)
Percentage of blue space within 500 -m, 1, 000-m, and 3, 000-m buffers from residence
Subjective well-being
Longitudinal analysis
63
2021
Belgium
Adults
Whether live in coastal cities; visit frequency
Subjective well-being
Cross-section analysis
64
2021
Chinese mainland
Children
Environmental characteristics of blue space based on the adolescents' activity paths in the park
Restorative perception
Cross-section analysis
65
2022
18 countries/regions including the UK and USA
Adults
Childhood exposure to blue spaces (availability, parents/guardians' attitude to blue space visits, and visit frequency); visit frequency in adulthood
Subjective well-being
Cross-section analysis
66
2022
USA
Adults
Visit frequency; distance to blue space from residence; visit duration
Stress; subjective well-being; life satisfaction
Cross-section analysis
67
2022
England; Welsh
Adults
Whether can see blue space; whether visit blue space in the past 24 hours
Self-reported mental health
Cross-section analysis
68
2022
UK
Adults
Perceived proximity to blue space from residence; visit frequency; contact time
Subjective well-being
Cross-section analysis
69
2022
Belgium
Younger adults (students)
Rating for blue space pictures
Restorative perception
Cross-section analysis
Tab.2 List of selected literature for meta-analysis in the research
Fig.3 Statistics of the included literature for meta-analysis (3-1. published year; 3-2. research subjects; 3-3. geographical distribution).
Mental health
Measurement method
Literature
General mental health
The General Health Questionnaire (GHQ-12)
Refs.[10][15][18][33][35][36][50]
Mental Health Inventory (MHI-5, a sub-scale 36-Item Short Form Survey)
Refs. [45][57]~[60][66]
12-Item Short Form Health Survey (SF-12)
Refs. [51][62]
Spanish short version of the Profile of Mood States (POMS)
Refs. [33][59]
10 questions about current emotions using a 5-point Likert scale
Ref. [67]
Positive psychology
Self-reported well-being
The World Health Organization's Five Wellbeing Indexes (WHO-5)
Refs.[14][32][38][53][59][61][65][68]
The Short Warwick Edinburgh Mental Well-being Scale (SWEMWBS)/Warwick-Edinburgh Mental Well-being Scale (WEMWBS)
Refs. [44][56][63]
Four subjective well-being questions (life satisfaction) developed by the UK's Office of National Statistics
Refs. [13][59][60]
A single question assessing overall life satisfaction
Refs. [18][66]
Cantril Ladder
Ref. [40]
Perceived Restorativeness
Perceived Restorativeness Scale (PRS)
Refs. [11][64][69]
Restoration Outcome Scales (ROS)
Refs. [11][39]
Short-version revised restoration scale (SRRS)
Ref. [34]
Emotional restoration survey overview
Ref. [41]
Positive emotions
Positive and Negative Affect Schedule PANAS (positive)
Ref. [56]
Others
Reporting "happy moments" at any point in time by pressing one of the sensor buttons
Ref. [55]
Negative psychology
Negative emotions
Perceived Stress Scale (PSS)
Refs. [56][66]
Kessler Psychological Distress Scale (K10)
Ref. [46]
Positive and Negative Affect Schedule PANAS (negative)
Ref. [56]
Mental disorder
The anxious/depression dimension of the EuroQOL five dimensions questionnaire (EQ-5D)
Ref. [10]
Patient Health Questionnaire (PHQ-9)
Ref. [20]
ADHD/DSM-IV questionnaires
Ref. [42]
The Major Depression Inventory (MDI)
Ref. [43]
The Post Traumatic Stress Disorder Checklist Military Version (PCL-M)
Ref. [43]
McKnight Risk Factor Survey (MRFS)
Ref. [47]
The Center for Epidemiologic Studies Depression Scale (CES-D)
Ref. [48]
Short form of the Reynolds Adolescent Depression Scale (RADS-SF)
Ref. [53]
The shortened Geriatric Depression Scale (GDS-15)
Ref. [54]
Generalized Anxiety Disorder Scale (GAD-7)
Ref. [56]
Others
Self-reported visits to mental health specialists; history of anxiety or depression; history of medication; frequency of medication intake
Refs. [12][17][36][61]
Observation of different physiological effects on blood pressure or heart rates
Refs. [52][59]
The duration of hospital admission for patients of mental disorders
Ref. [21]
Tab.3 Overview of methods for measuring the level of mental health
SMD (95%CI)
Heterogeneity test
Statistical test
Literature
I2
Chi2
Df
z
p
General mental health
0.33[0.16, 0.50]
81%
10.44
2
3.82
0.0001
Refs. [10][18][35]
Positive psychology
Subjective happiness
0.15[–0.07, 0.36]
98%
141.34
3
1.35
0.18
Refs.[32][40][53][63]
Life satisfaction
0.19[0.13, 0.26]
0%
0.73
1
5.79
< 0.00001
Refs. [13][18]
Total
0.15[–0.01, 0.30]
97%
41.06
4
2.73
0.006
—
Negative psychology
Depression
–0.31[–0.75, 0.4]
91%
32.89
3
1.00
0.17
Refs.[10][17][48][60]
Anxiety
–0.44[–0.91, 0.03]
—
—
—
1.83
0.07
Ref. [17]
Total
–0.33[–0.72, 0.06]
89%
37.91
4
1.67
0.10
—
Tab.4 Effect size aggregation results of the proximity to urban blue spaces on residents' mental health (n = 11)
SMD (95%CI)
Heterogeneity test
Statistical test
Literature
I2
Chi2
Df
z
p
General mental health
0.16[0.08, 0.24]
100%
1, 106.70
5
4.04
< 0.0001
Refs.[10][18][35][45][49][62]
Positive psychology
Subjective happiness
1.02[0.26, 1.79]
72%
7.15
2
2.62
0.009
Refs. [53][60][61]
Life satisfaction
0.87[0.48, 1.26]
—
—
—
4.38
< 0.0001
Ref. [60]
Total
0.91[0.47, 1.35]
58%
7.21
3
4.06
< 0.0001
—
Negative psychology
Depression
–0.33[–0.72, 0.06]
99%
422.21
6
2.52
0.01
Refs.[10][12][20][21][36][60][61]
Tab.5 Effect size aggregation results of the availability of urban blue spaces on residents' mental health (n = 13)
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