There has been recent public health interest in the positive effects of coastal proximity on health and well-being. With significant experience of 'green' social prescribing, where people with mental health problems such as depression, anxiety and problems with substance use are directed to nature-based activities, we are beginning to look at the potential of 'blue' social prescribing, such as the use of wild swimming to promote social connection, positive mental health and well-being. This links well to Plymouth’s role as the UK’s first National Marine Park.Questions nevertheless arise as to whether proximity to the coast can mitigate the effects of lower-than-average wages, seasonal jobs, low skills, poor education attainment and social immobility. In research undertaken for the 2021 Chief Medical Officer’s annual report, Dr Alex Gibson and Professor Sheena Asthana found a higher burden of disease and health risk factors in coastal areas, including heart disease, diabetes, cancer, mental health and chronic obstructive pulmonary disease. While this difference is partly explained by age and deprivation, there remains a 'coastal excess' even after adjusting for these factors (and others including ethnicity). There is also some evidence of a health service deficit in terms of recorded service standards, cancer indicators and emergency admissions. The cause of this is unclear. Standardised mortality ratios for a range of conditions, including preventable mortality, are significantly higher in coastal areas compared with non-coastal ones, while life expectancy, healthy life expectancy and disability-free life expectancy are all, on average, significantly lower in coastal areas for both males and females. These findings challenge the lack of attention that has been given to the disproportionately high burden of ill-health in coastal communities and require further explanation for effective solutions to be identified.