The promise of a healthier life by the sea may depend less on the coastline than on who can afford to leave.
A long-running study of people in England and Wales found that adults who remained in coastal communities or moved to the coast were more likely to develop multiple chronic health problems by middle age. Economic hardship and migration appear to be concentrating poor health in communities already facing limited opportunities.
Published in BMJ Public Health, the research tracked nearly 28,400 people from birth into midlife. It found no clear link between living near the coast during adolescence and developing multiple chronic conditions later. The difference emerged among adults, particularly those who stayed in coastal communities while healthier or more advantaged residents moved elsewhere.
Corresponding author Professor Stephen Jivraj (UCL Epidemiology & Health Care) said, “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.”
The team analyzed 13,691 participants in the 1958 National Child Development Study (NCDS) and 14,683 participants in the 1970 British Cohort Study (BCS). Both studies have followed people from birth, allowing researchers to examine how changes in residence, neighborhood conditions, and health unfolded across several decades.
Participants were considered to have multiple long-term conditions if they had been diagnosed with at least two chronic illnesses by age 55 (NCDS) or age 46 (BCS). The conditions included asthma, diabetes, back pain, cancer, hearing problems, high blood pressure, eye disease, heart problems, and depression.
Among participants born in 1958, those who stayed in a coastal community or moved to one by midlife were at least 20% more likely to have multiple chronic conditions than people who left the coast between ages 16 and 42.
How Migration Concentrates Health Disadvantage
That difference weakened after researchers accounted for neighborhood deprivation, suggesting that local economic and social conditions explained much of the health gap.
Migration also appeared to reshape the population of coastal communities. People raised in the most deprived coastal neighborhoods were three times more likely to remain on the coast into middle age than those from the least deprived coastal neighborhoods.
Meanwhile, people who relocated to the coast often moved from relatively less deprived childhood neighborhoods into more deprived communities as adults. Together, these patterns can leave struggling coastal areas with a growing share of residents who already face health and economic disadvantages.
Why Coastal Health Benefits Can Disappear
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.”
The findings help explain an apparent contradiction. Coastal environments may offer cleaner air, access to nature, and opportunities for physical activity, but those potential benefits can be overwhelmed by poverty, weak transportation networks, limited employment, and difficulty reaching health care.
Targeting Inequality in Coastal Communities
The researchers caution that coastal communities are not all alike. A former industrial port, a fishing town, and an affluent vacation destination may face very different conditions. The study’s geographic definition could not fully capture those differences, and it did not measure exactly how long each person lived near the coast. The two birth groups were also assessed at different ages, making direct comparisons more difficult.
The researchers are calling for coordinated investment in public health, health care, transportation, education, and employment in deprived coastal regions.
Reference: “Is living on the coast associated with midlife multimorbidity in England and Wales? A cross-birth cohort analysis of the relationship between long-term residence and selective migration” by Stephen Jivraj, Zongpu Yue, Avril Keating and Emily Murray, 30 July 2026, BMJ Public Health.
DOI: 10.1136/bmjph-2025-004020
The study was funded by the Economic and Social Research Council and is in collaboration with the University of Essex Centre for Coastal Communities.
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