Do perceived walking distance to and use of urban blue spaces affect self-reported physical and mental health?

A cross-sectional analysis among 1041 urban residents was done to examine associations between self-reported walking distance to and use of freshwater urban blue space and health-related quality of life in two German cities: a city with poor urban blue space supply (Bielefeld; 0.8% blue space) and one with better urban blue space supply (Gelsenkirchen; 3.0% blue space). Health-related quality of life was assessed with the SF-12v2, which measures residents' self-reported mental and physical health. Results showed a significant association between use frequency and perceived walking distance to blue space. Blue space use was a better indicator of health outcomes than perceived walking distance. After controlling for green space, socio-economic and demographic variables, use frequency was associated with higher mental health in Gelsenkirchen. These cross-sectional findings suggest that blue space use increases the probability of being healthier in highly urbanised areas in cities with an appropriate amount of blue space.