Coastal residents more likely to have worse midlife health

People who live by the coast in midlife are more likely to have worse health, finds a new study in England and Wales led by UCL researchers.

The research, published in BMJ Public Health, found that migration trends have left more disadvantaged people living in coastal communities and that those who moved away from coastal areas before the age of 42 tended to have better health than those who moved to or stayed in coastal areas.

Poorer health in coastal communities is not simply due to coastal living itself. Instead, it reflects a combination of higher deprivation and selective migration, where people with worse health are more likely to remain in or move to coastal areas.

This suggests coastal regions may need targeted policies and resources to address growing health inequalities.”

Professor Stephen Jivraj, Corresponding Author, UCL Epidemiology & Health Care

For the study, researchers used data from 13,691 people from the 1958 National Child Development Study (NCDS) and 14,683 people from the 1970 British Cohort Study (BCS). Participants were followed from birth, through adolescence and into midlife.

The researchers examined whether participants who lived in coastal areas were more likely to have two or more diagnosed chronic conditions by the ages of 55 (NCDS) and 46 (BCS).

These conditions included asthma, diabetes, backache, cancer, hearing problems, high blood pressure, eye disease, heart problems and depression.

Those who were born in England and Wales in 1958 and who either lived in or moved to a coastal area in midlife were at least 20% more likely to have multiple long-term conditions than those who moved out of the area between the ages of 16 and 42.

However, the team found that these migratory patterns were strongly associated with neighborhood deprivation.

People that grew up in the most deprived coastal neighborhoods were three times more likely to remain on the coast and still be living there in midlife compared with those who grew up in the least deprived coastal neighborhoods.

Those moving to the coast from other parts of England and Wales typically moved from less deprived neighborhoods in childhood to more deprived neighborhoods in midlife.

Professor Jivraj said: “Some evidence suggests that living closer to the coast has protective health effects – such as less pollution and the chance to reduce stress by exploring beautiful, scenic walks.

“However, the decline of traditional industries, such as tourism and fishing coupled with limited employment opportunities for residents, has led to a concentration of health inequalities in many coastal communities across England and Wales.

“This is also compounded by the physical barrier of the sea, which can limit transport to education and employment – something that is not experienced by those who live inland.”

As a result of their findings, the researchers are now calling for a targeted focus on deprived coastal communities with cross-cutting public health and economic development interventions to improve the health and healthcare in these places.

The study was funded by the Economic and Social Research Council and is in collaboration with the University of Essex Centre for Coastal Communities.

Study limitations

The paper identifies coastal communities using the Office for National Statistics definition of Built Up Areas. However, there is potential for misclassification of places that are coastal or not. There is also little to differentiate the types of coastal areas (such as industrial city ports, holiday villages or fishing ports).

The research also doesn’t consider the length of time spent living in a coastal area and the NCDS and BCS samples are hard to directly compare, as data at the same later age points is currently not available.