Travelling is part of your life, no doubt about it. Everyone loves to travel, there is no doubt about that. But is it exactly the same to travel as a sailor and to travel as, for example, your neighbours (tourist package, cruiser, etc.)?
Well, let’s solve this dilemma right away in the introduction – it’s not.
The fact is that people love to travel, and travel can actually have a significant positive effect on physical and mental health, as shown by a recent study published in the Journal of Travel & Health. The study surveyed more than 1,000 adults who had recently returned from a trip and found that most reported improvements in overall well-being, including increased energy and reduced stress levels. In other words, they benefited from the trip.
Travelling also enables people to get to places where they can access different opportunities (e.g. employment, education, leisure), go shopping, access services (e.g. health care), meet other people or just see new things. This ability to travel is particularly important for older people as it gives them the freedom to do things independently, contribute to society and feel connected to others. Yes, yes, don’t put your elderly in a home if you don’t have to, at least give them the opportunity to travel from home to the shops.
In theory, travelling outside one’s local area offers additional benefits by allowing people to go to more places, have access to more opportunities, meet more people and see more things. However, it is also a fact that some people are limited in their ability to travel outside their local area. This can be due to long travel times and high costs, lack of good transport, or personal factors (as fuel prices soar, we will all soon have this problem). For example, studies in several countries have found that some people travel less often to visit family and/or friends because they do not have a car or a driving licence. The (lack of) availability of public transport is also associated with fewer visits to family and friends. In a study in Switzerland, social networks (not Facebook, but actual personal contacts) were significantly smaller for people who did not have a public transport ticket and for those who did not have a car.
Restrictions on the ability to travel can lead to reduced social participation, with possible negative health consequences. In fact, various travel restrictions and the associated unmet travel needs may be more important in determining people’s quality of life than the actual number of trips they take. And here we come to the first problem with you seafarers: regardless of the fact that you also travel (a lot), you actually reduce your social participation through your travel (working on a ship) and the amount of your travel alone does not meet your needs that you may have (I am sure you have them).
In another study, researchers argued that travelling outside your local area (for example, your small town) allows you to meet other people and access a wide range of services and opportunities. So, they were not talking about tourism, but simply leaving one’s home for a shorter or longer period of time. For example, you can go to the doctor or to a shopping centre outside the city, and that is a trip. They also assumed that such a trip could be limited by a lack of good transport or by personal factors. In the study, they wanted to see whether these limitations were associated with poor self-reported health and to what extent this association was mediated by reduced social activities. The relationship between these limitations and indicators of social participation (frequent visits to family and friends or membership in clubs or societies) and self-reported health. In other words, for romantics who dream of getting away from the hustle and bustle of the city – which means living in a cottage in the countryside with poor access to the city. Or, to put it in the context of your sailing, because you are also separated from the bustle of the city and poorly connected to it.
It was no coincidence that this travel study was carried out in the North of England. This region has consistently had worse health outcomes than the rest of England. For example, between 1965 and 2015, the North had an increase in mortality among people aged <25 and 45+, and an increase in excess mortality among people aged 25-44 since 1990. And it was travel restrictions that were identified as a factor contributing to economic deprivation and lower subjective wellbeing in the North, but until this study, which inspired our text, there was very little evidence of negative health effects. Large urban areas (e.g. Manchester) have good road and rail links to the rest of the North and beyond, but many of their suburban and rural areas are poorly served by frequent and regular public transport. Does this remind you of anything? If so, read the rest of the text carefully.
The study used what is known as self-assessment of health. Self-reported health is a subjective indicator of health, usually collected in surveys by asking people about their general health. In other words, how you feel about your health. Your self-rated health is influenced by contextual, demographic and cultural factors, but believe it or not, self-rated health is usually a good predictor of mortality. As such, it has become a widely used indicator in academic studies in various fields (not only medical, but also social and economic), as well as in official health research. I have been working as a doctor for more than 30 years and I can name at least a dozen patients who signalled their early death in this way. My old professors used to say: “Always trust the patient. If he says he is not feeling well, then something is wrong and you have to find out what it is.
The main assumption of this study was that self-reported health is positively related to participation in society and negatively related to limitations in the frequency of travel, number of places visited and distance travelled. First, the proportion of people who reported poor and very poor health was identified and compared with the rest of the sample. We wanted to see if those in the group who saw family or friends less often than once a month, who did not belong to clubs and societies, and who reported the two highest levels of travel restrictions, had higher proportions of respondents reporting poor or very poor health.
As hypothesised, self-rated health was significantly and positively related to all three variables of social participation. The strongest association was with seeing friends frequently, followed by club membership and seeing family frequently. As expected, only one type of travel restriction (frequency of travel) was directly related to self-rated health, with a negative effect. Self-rated health was highest for the youngest age group (<25 years) and lowest for the oldest age group (>75 years), with an almost linear progression between these groups (everything is easy when you’re young). Respondents with a low income and those living alone also have a worse health status.
For those younger than 55, seeing family often was not significantly related to self-rated health (ah, those selfish young people), but in the model for those aged 55+, self-rated health was positively related to seeing family often. Travel restrictions were directly related to self-rated health, with a negative effect. This study provides evidence that travel restrictions outside the local area (>24 km from home) are associated with poorer self-rated health, both through reduced social participation and other unspecified reasons. Different aspects of travel had different associations with social participation and self-rated health. Travel distance restrictions had no significant association. Restrictions on the number of places visited outside the local area were associated with reduced social participation, both overall and for the two age groups considered. For respondents younger than 55, these limitations were associated with rarely seeing family. For those aged 55 and over, restrictions were associated with rarely seeing friends and not being a member of clubs and societies.
In general, the proportions reporting poor or very poor health were significantly higher among respondents who saw family or friends less than once a month, did not belong to a club or society and reported the two highest levels of limitations (in frequency of travel, number of places visited and distance travelled).
Did you get the picture? Put yourself in this context and you have the answer and the impact of travel on your health.
There are also other interpretations of the health benefits of travel (what we ourselves subjectively rate as ‘feeling really good’), such as, that travel allows individuals to get out of their daily routine and experience new environments and cultures. It can also lead to increased physical activity, as travellers (read: tourists) are more likely to walk or cycle rather than drive, or it can expose them to different types of food, leading to healthier diets. These are just some of the more obvious reasons for the health benefits of travel.
Hmm, even sailors used to be credited with this; they travelled from port to port, got to know new environments, ate food we didn’t know, and in the days before Ryanair and all the easily accessible ways of travelling today – the cheapest arrangements on cruisers can be obtained for a few hundred dollars – sailors were the only truly “worldly” part of the travelling population. But is that still the case today: two weeks in quarantine, the ship in port for only 12 hours? The turnover used to be 6 days (in 1970), in 1998 it was 16 hours, and now it is… The ports are outside the centre of the big cities and there is no time to go into town. And the food? Well, when you have an Indian cook on board, you get sick of curry and rice every day. More physical activity, cycling? Not really, you’re working on the boat, not lying in a deck chair by the pool.
However, studies among tourists have shown that travel can also have a positive effect on mental health. Most of the participants feel more relaxed and less stressed after the trip. This is probably because travel can provide a sense of excitement and adventure, as well as a break from the demands and responsibilities of everyday life. Well, this certainly doesn’t apply to you, even if you don’t have the happiest situation at home. I have yet to hear of anyone (and no study has shown this) that they felt rested and relaxed after disembarking. After all, for you, traveling is not a break from everyday demands, for you it is a demand and responsibility of everyday life.
Another benefit of tourism travel is that it allows individuals to make new social connections, which can be important for mental health. Meeting new people and making new friends can provide a sense of belonging and can also help reduce feelings of loneliness and isolation. Um, maybe this applies to you, but your social connections on the ship are actually forced, and you didn’t choose who you spent time with.
In conclusion, the study that led us to write this text suggests that travelling can be good for physical and mental health. It can help increase energy levels, reduce stress and improve general wellbeing. So, the next time you are planning a trip, remember that it is not only good for your soul, but also for your body.
Unfortunately, this is not my conclusion, but that of colleagues who carried out the study on civilians who had never tasted the sea. I’ve written this for you, so that you can show it to anyone who doesn’t understand how different your life is from theirs.
Your Maritime Doc.