Effects of freshwater blue spaces may be beneficial for mental health: A first, ecological study in the North American Great Lakes region.

Research linking green space and mental health abounds. It also appears that oceanic blue spaces may be salutogenic, benefitting mental health through their expansive viewscapes, and possibly auditory and olfactory stimuli. Yet, it is unknown whether the same is true for freshwater bodies. In this ecological study, we explored associations between hospitalizations for anxiety/mood disorder in Michigan (>30,000) and proximity to the North American Great Lakes. As a sensitivity analysis, we examined associations for 15 different inland lake sizes. Results showed small, protective effects for distance to Great Lake (β = 0.06, p<0.001) and percentage of inland lakes (β = -0.04, p = 0.004). Unexpectedly, shorter distance to nearest inland lake was associated with higher anxiety/mood disorder hospitalizations. The protective effects of percentage area covered by inland lakes was observed for all lake sizes. These initial findings provide a foundation for future individual-level research with finer measurement of health outcomes and blue space exposure.