Blue Space, Health and Wellbeing

Hydrophilia Unbounded

Ronan Foley, Robin Kearns, Thomas Kistemann, Ben Wheeler, Ronan Foley, Robin Kearns, Thomas Kistemann, Ben Wheeler

• Publisher: Routledge
• Year: 2019
• eBook ISBN: 9780429631603
• Edition: 1
• Topic: Physical Sciences
• Subtopic: Geography
• Index: Geography

Health geography makes critical contributions to contemporary and emerging interdisciplinary agendas of nature-based health and health-enabling places. Couched in theory and critical empirical work on nature and health, this book addresses questions on the relationships between water, health and wellbeing. Water and blue space is a key focus in current health geography research and a new hydrophilic turn has emerged with a particular focus on the aspects of water which are affective, life-enhancing and health-enabling. Research considers the benefits and risks associated with blue space, from access to safe and clean water in the Global South, to health promoting spaces found around urban waters, to the deeper implications of climate change for water-based livelihoods and indigenous cultures. This book reflects recent theoretical debates within health geography, drawing from research in the public health, anthropology and psychology sectors. Broad thematic sections focus on interdisciplinary, experiential and equity-based elements of blue space, with individual chapters that consider indigenous and global health, water's healing properties, leisure and blue yogic culture, coastal landscapes, surfing, swimming and sailing, along with more contested hydrophobic dimensions.

The interdisciplinary lens means this book will be extremely valuable to human geographers and cultural geographers. It will also appeal to practitioners and researchers interested in environmental health, leisure and tourism, health inequalities and public health more broadly.

1 Introduction

Ronan Foley, Robin Kearns, Thomas Kistemann and Ben Wheeler

Part A: hydrophilic beginnings

The time is right for a new text on relationships between water, health and wellbeing. Across many different subjects, there is an enhanced orientation towards the water, and a new hydrophilic turn has emerged with a particular focus on aspects of water that are affective, life-enhancing and health-enabling. Within the wider discipline, recent cultural geographies have reflected increasing public interest in writing around all things blue, including oceans and the sea, water-based sports and leisure geographies (Anderson and Peters, 2014); but also wider water-focused environments as sites of economic, imaginative and theoretical concern, especially in relation to climate change (Brown and Humberstone, 2015; Ryan, 2012). These authors speak to a range of perspectives oriented towards, by, from, on and in the water, that attest to its importance as a relational space and how it emerges as a polyvocal subject for ongoing discussions around nature and culture, the human and more-than-human (Abram, 1996; Gesler, 1992).

While more implicit than explicit, these wider cultural geographies have drawn attention to health in various guises, with a more explicit focus evident in recent texts on environmental health, technology and planning (Bartram, 2017). What makes the present book different is its focus on the relationships between water, health and wellbeing with an innate assumption of a hydrophilic leaning as a starting point. This perspective is developed by a range of researchers who fall loosely, though not fully, within the ambit of health geographies. Recent research within the subfield has been developed through therapeutic landscape studies. These studies have built on the foundations laid down by Wilbert Gesler (1992) and have served as an important driver in bringing wider attention to the subject. Such research has intersected with other research strands focused on both historical and contemporary green and blue spaces, and how they produce health and wellbeing (Foley and Kistemann, 2015; Gladwell et al., 2013). At the same time, and across a wider range of disciplines, there has been a parallel development in research on nature-based health and health-enabling places (Duff, 2012; Mitchell, 2013). Such research draws from a range of cognate disciplines including planning, landscape architecture, psychology, anthropology and public health (Groenewegen et al., 2012; Hartig et al., 2014).

The aim of this book is to exploit these linked interests and develop a corpus that combines human geographical and wider multidisciplinary explorations of water in a way that maintains and deepens a specific concern for health and wellbeing. Such an approach has potential theoretical and methodological value. Theoretically, it helps deepen the place of health geographers vis-à-vis contemporary theorising of health and wellbeing (Andrews et al., 2014; Crooks et al., 2018; Hall and Wilton, 2017; Kearns, 1993). Methodologically, it reflects exciting existing quantitative and qualitative approaches to inquiry, and develops these in innovative ways (Bell et al., 2015). In part, the collection draws on recent therapeutic landscapes research, but equally uses wider multidisciplinary literature to explore how other fields of scholarship measure and value the health benefits of ‘nature’, in both numeric and narrative forms (Keniger et al., 2013; Menatti and Casado da Rocha, 2016). In addition, recent developments that show the value of cultural and creative approaches to, and representations of, water will broaden the appeal of the book (Brown and Humberstone, 2015).

As a text grounded in health geography, it augments recent special issues and editorials in key journals, such as Social Science & Medicine and Health & Place, that advance the idea of healthy blue space (Foley and Kistemann, 2015). Additionally, however, it assembles chapters on healthy environments and practices more generally reflecting the wider concerns of nature-based health and the established importance of green space research within the arena of public health (van den Bosch and Bird, 2017). While these are important complementary reference points with green space, the main aim of our book is to explicitly consider blue space and water-based health. The book’s intent is to emphasise and promote the value of blue space thinking to a variety of health and wellbeing subjects and interventions. While other water-based research has focused on pathogenic dimensions of the subject and these will not be ignored, our collection has a more salutogenic focus with a strong emphasis on place-based promotion of health, echoing what Lea (2018) calls a ‘hedonic turn’. A further connection is that recent research in the area of therapeutic landscapes (Bell et al., 2018) emphasises the importance of a fuller understanding of what makes watery places health-enabling. This, the authors claim, can be achieved through a deeper focus on experiential, emotional and embodied geographies that also recognise the wider structural settings within which those geographies are framed and produced.

Relational waters

Waters have, over a considerable time span, been identifiable both as sites of healing and as material healing substances. Those long histories of water’s differential role as a healing ‘product’ can be found across cultures, from Roman Baths and spas, to contemporary indigenous spaces from Peru to Polynesia (Foley, 2010; Gesler, 1992). That ‘product’ can be found and used in many forms, from crystal purity to muddy lumps, and is strongly associated with the fact that water itself is fluid (every pun intended) in its relational associations with other elements: chemical, social, natural, cultural. All of these relational associations can, and often do, have a health and wellbeing component. There are significant curative scientific and discursive literatures, including many from within medical history and geography, on the multiple and different utilisation of water across cultures globally, especially in baths, spas, springs and wells (Foley, 2010; Gesler, 2003; Williams, 1999). These sites have been used within diverse manifestations of health and illness – for treatment and recovery (wounds, aches, pains), for health maintenance (spa cures, different chronic conditions), for mental health and wellbeing (stress reduction, contemplation, cognitive restoration) – and within a range of spiritual and religious rituals and practices (wells, springs) (Williams, 1999, 2007). The lengthy literature on therapeutic landscapes referred to above attests to the many ways in which water has been enrolled as a provider of healing in societies both ancient and modern.

But equally, in less affluent surroundings in the Global South, essential access to water for the maintenance of human life is still difficult, emphasising the ongoing importance of clean and healthy water to infectious disease management and prevention, wherein sustainable and equitable access to water is essential to basic survival. While global agencies such as the World Health Organization (WHO) or the UN International Children’s Emergency Fund (UNICEF) are centrally involved on the medical and environmental health side, access to safe and clean water remains a relational process with strong contextual, social and political overtones. Environmentally shaped networks of water supply and management are linked to climate and weather assemblages that produce too much or too little water in specific places, often at the worst possible time. This variable scarcity or abundance is a reflection of the increasing unpredictability of global water patterns due to climate change. This unpredictability affects not just supply and availability, but also the condition and form of water itself as it shifts from fresh to saline, present to absent (lake shrinkage, desertification), and frozen to flowing and back again. In terms of wider environmental risk, this uncertainty makes water a potentially dangerous and uncontrollable substance, wherein flooding, drought and extreme events all threaten human life. In addition, there is a strong argument to suggest that water will be at the heart of contestations within wider social and political contexts as in the future, whereby water’s resource value might make it potentially as valuable a liquid as oil (Gandy, 2014).

In focusing on human health, the nature of water makes it an especially good fit with relational thinking. Cummins et al. (2007) summarised the differences for health geographers in shifting to a relational form of thinking that was mobile, multiple, layered, dynamic and characterised by differential understandings of bodies and places shaped by personal choice, social power relations and cultural meaning, as well as life stages. Water itself is multiple and ever shifting, even if its core chemical content is fixed; this contention equally applies to its production as a material healing element and as a connective surface on which many different inscriptions take place. If one were to look at an area of lake or offshore water across time (often recommended by health psychologists for stress reduction and attention-restoration), that water can start as a tabula rasa, a blank flat sheet, that over an hour, day, week or more produces multiple other surfaces, colours, flows, disruptions and odours – always relational to other near and far effects of swell, weather, human and more-than-human movements and flows.

Those surfaces and depths, peaks and troughs, reflect the different stages of human health and illness which at times seem incurable but may also be temporary, even reversible. The invertibility of water, especially in seas, rivers and lakes is one of its defining characteristics; landscape becomes waterscape, fixed surfaces are rendered fluid, tides rise and fall (Ryan, 2012). This same fluidity applies to its use for health and wellbeing purposes. The idea of water as a relational and performative force and space reflects wider theoretical writing which is also slowly seeping into health geographies, especially in relation to post-humanist, non-representational and assemblage thinking (Andrews et al., 2014; Duff, 2014; Hall and Wilton, 2017). Founded on the enacted relations between people and place, this contemporary writing acknowledges a debt to early humanist geographies by Tuan (1977), Relph (1976) and Seamon (1980), within which water – as performative and (inter/en) active space – becomes the setting for ‘affective becomings’. The natural extension of Wilson’s biophilia to our more focused hydrophilia seems to us a logical leap. As discussed in this book, hydrophilic theoretical concerns with embodiment, emotion and experience recognise that theoretical-empirical link, but equally recognise that those potentially transformative healthy interactions are always framed by environments, settings and contexts that are also already emergent, mobile and contingent.

Structures and themes

Thematically, the book is organised into three parts which will be more fully introduced below with a brief description of the content of individual chapters. The three parts consider, in turn, interdisciplinary perspectives, the experience of health in blue space and finally, the value of blue space to human health and flourishing. Each of these parts reflects recent theoretical debates across health geography, in turn, informed by wider literature drawn from human geography, cultural theory and health-related realms such as public health, anthropology and psychology. In drawing carefully selected but diverse cross-disciplinary scholarship on water into a health geography corpus, we make explicit the ‘spatial turns’ in those subjects. The shared concerns with health, place and space will, we hope, extend in turn an awareness of the potential of fruitful collaborations with health geographers in the future.

In bringing in a concern for interdisciplinary perspectives, one of the core tasks of the book is to provide a coherent orientation and framework for readers from different disciplines. From the start, we acknowledge that when it comes to the relationships between health and place, scholars working within other disciplines have had plenty to say on their own terms. We make no exclusive claim to that space but rather emphasise the potential for hydrophilia and wellbeing to act as an enhanced connecting concept. One has only to look at subjects like environmental psychology, health promotion/education, public health, landscape architecture, building design and medical humanities to come across similarly inspired work (Frumkin, 2003; van den Bosch and Bird, 2017). Indeed, several of the authors in this text might specifically identify with those subjects (Atkinson and Hunt, 2019). An associated theme developed in this first section of the book is the relationship between human and more-than-human worlds, by which we mean not just the environment but the wider living dimensions of that more-than-human world. Water itself is, of course, more-than-human, but it is affected in complex ways by its relations with humans – ditto the different flora and fauna which live in water. Those relationships are evident in a number of ways; for example, the different food chains of which humans are part or resource management and wider blue economy discussions that have implicit links to human health and flourishing, especially around healthy diets, sustainable fishing activity and the potential of new marine biomedicine (Winder and LeHeron, 2017). These economic and sustainability factors are important inclusions in our consideration, and the explicit commodification of water for health/healing has a long history which continues offshore as well as inland. Finally, in considering more-than-human health, the health of water itself is continually compromised by the actions of humans – especially in relation to chemical pollution, microbial contamination and environmental degradation, something picked up in chapters that consider more fully indigenous knowledge.

There is an increasing interest in the lived experiences of health within blue spaces incorporating aspects of embodiment and emotion (Foley, 2017). As noted by Duff (2012), we know in broad terms that certain places enable health; we just do not know enough about how that process of enablement works. In developing recent special issues of journals and wider green/blue space health scholarship (Pearce et al., 2016), a second core theme of the book is the question of how health is experienced in place and across time and life-courses. This theme will be developed by extending accounts and narratives from a range of different blue space cultures including canals, islands and coastal populations. The chapters consider the multiple contacts between human/non-humans with water as embodied experiences. Such experiences emerge as a set of sense-scapes (Bell et al., 2017) that are in turn visual (aesthetic and representational), haptic (touch, immersion, flow), sonic (trickle to roar, attention-restoration), gustatory (fresh/healthy to musty/contaminated) and olefactory (healthy and unhealthy smells). The very different and varied responses associated with the senses emphasise the multiple material/physical bodies involved; bodies with differential capacities; and bodies of all shapes, sizes, shades and conditions. As a reverse process, water relates to bodies in multiple ways that are relationally formed through the precise nature of the body-water engagement. In this book, a very direct interest in how this works for health, healing and wellbeing – as proxies for illness, treatment and positive management and maintenance – is central.

As broad advocates of a biopsychosocial model of health (though with newer relational and emplaced angles), we suggest that embodied emotional responses emerge within an affective/experiential continuum that ranges from very direct and physical contact to the more intangible impacts of water on identity-memory. Any relationally framed discussion of affective responses to water as a healing object must acknowledge its double-edged nature; just as there is hydrophilia, so there is hydrophobia. As well as its capacities to enable health, water can be and is a wounding and health-endangering object: one that is variable across time and place (Collins and Kearns, 2007). The experiential chapters in the book draw from the different relational actions and activities in which human-water engagements take place. Different bodies interact differently across life-courses, linked to family histories, mobilities associated with life events including work, risk events, exposure and access. These chapters provide valuable specific experiential accounts of health-related interactions by, on and in water around leisure and sport that link with other geographies and also to the work of environmental psychologists (White et al., 2010).

As a final key theme, we consider healthy blue spaces in the context of health and environmental inequalities and injustices. Evidence and activism on environmental justice and links with health inequalities have been developing for decades, and have great pertinence to hydrophilia. Blue environments and water more generally have the potential for universal benefit, but also have the potential for exclusion of specific groups or individuals, whether through economic, political, cultural or historic processes. There is a genuine interest in the book in exploring how robust and rigorous evidence bases can be developed through innovative and interesting methodological approaches that are more-than-quantitative. However, we also recognise the value of mixed numeric/narrative evidence; valuing blue space reflects the responsibility of critical health geographers to inform and be informed by public health politics/policy and consider spatial inequities in health outcomes across a range of different jurisdictions (Pearce et al., 2016; Philo, 2...

Table of contents

• Cover
• Half Title
• Series Page
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• List of figures
• List of tables
• List of boxes
• Notes on contributors
• Acknowledgements
• 1 Introduction
• Part I: Interdisciplinary perspectives on water and health
• Part II: Experiencing health in blue space
• Part III: Blue health inequality and environmental justice
• Index