Sea swimming and snorkeling in tropical coastal blue spaces and mental well-being: Findings from Indonesian island communities during the COVID-19 pandemic

The COVID-19 pandemic has considerable mental health impacts. Immersive nature-based interventions, such as swimming or snorkeling, may help mitigate the global mental health crisis caused by the pandemic. To investigate this, we collected cross-sectional data from residents of coastal villages (n = 308) in Kepulauan Selayar, Indonesia. Analysis of Covariance (ANCOVA) was used with mental well-being as the outcome variable, operationalized as the Mental Component Summary (MCS) scores from the SF-12 (12-item Short Form Health Survey). After adjusting for covariates, the activity of sea swimming or snorkeling was found to be significantly associated with better mental well-being (η2 = 0.036;p < 0.01). Predictive margins analysis revealed that those who engaged in sea swimming or snorkeling for one to three days a week gained a 2.7 increase in their MCS scores, compared to those who did not. A non-linear dose-response relationship was detected: for those swimming or snorkeling more than three days per week, there was only an increase of 1.7 MCS score compared to the 0-day. Overall this study contributes to the expanding of evidence base, showing that interactions with blue spaces can be beneficial for mental health, especially in a potentially stressful time such as the current pandemic.

The Ocean Decade-Opportunities for Oceans and Human Health Programs to Contribute to Public Health

For more than 4.5 billion people, approximately 15% of their daily per capita intake of animal protein comes from marine products.5 Seafood provides a source of micronutrients and omega-3 fatty acids essential for good physical and mental health. Studies over the past 10 years have demonstrated that spending time in highquality "blue" spaces (through leisure activities or living in a coastal environment) directly supports and enhances health and well-being, combatting obesity and mental health problems, particularly in deprived populations.6 This highlights an enormous potential for these well-being promotion initiatives and healthcare interventions to address both preexisting and emerging health issues beyond the lifetime of the pandemic. There is now a tremendous opportunity and public momentum for health professionals to join with ocean researchers to help policymakers, the business community, and the wider public to address systemic global challenges in a new way (http://bit.ly/2ZDFMS3).7 We need international alliances, transdisciplinary collaborations, and global governance that support innovative, systemic ways of managing ocean resources. ACKNOWLEDGMENTS The research was supported in part by the European Union's Horizon 2020 research and innovation programme (grants 774567 [H2020 SOPHIE Project] and 666773 [H2020 BlueHealth Project]);the UK Natural Environment Research Council and the UK Research and Innovation's Global Challenges Research Fund for the Blue Communities Project;the Blue Climate Initiative Health and Wellbeing Subgroup (https://www.blueclimateinitiative.org);the University of Girona;the City Council of Roses;the Catalan Fishmonger's Association;the Roses Fishers' Association;the Town Council of Tossa de Mar;and the government of Catalonia (the sponsors of the Roses Oceans and Human Health Chair).