Water features are frequently an important part of outdoor recreation sites, whether for activities such as fishing, boating and swimming, or as a scenic setting for hiking or birdwatching. Recreation and eco-tourism are sometimes treated separately, with the latter being a sub-class that decisionmakers may want to isolate as an economic activity. For the purposes of the Freshwater Health Index, this distinction is unnecessary.

Fishing has been one of the more common recreation activities quantitatively assessed, because it often requires travel (a proxy for its monetary "value") and many jurisdictions require and keep data on licenses. However, many recreational sites may be multi-purpose, so having a more comprehensive measure of recreation is often desirable. Gathering additional data on the features that make a site attractive for recreation also enable one to estimate changes in the future.

Assessments may begin by estimating the recreation potential within a basin, or even the opportunity, which also take account of site accessibility (Paracchini et al. 2014). Inputs typically include data on water quality, proximity to other sites, ecological integrity of the surrounding landscapes, roads and trails and population location. These maps provide a baseline that can be confirmed with actual data on visits or used to model how future changes could affect recreation. Their main limitation is that they measure the potential supply of the service only.

We recommend using some measure of demand, in the form of person-days of use, or an economic proxy such as the travel cost one incurs to recreate. National parks, for example, typically collect information on visitors, but this is less likely to be the case for less prominent recreational sites. The advent of ubiquitous digital cameras, geo-tagging and online photo sharing makes it possible to harness "revealed preference" data from recreators and not only map demand but also use regression analysis to assess explanatory variables, such as landscape features or proximity to major roads (Tenerelli et al. 2016). The social media site Flickr makes its database of geotagged photographs accessible and offers a promising source of data for low-cost assessments of outdoor recreation demand, though the photographs are skewed towards North America and Europe (Wood et al. 2013).

The alternative, more conventional (and costly) method to collect data on recreation demand is to conduct a survey at the site(s) of interest. This requires skilled surveyors to be posted at recreation sites to collect data from visitors (the distance they travelled, amount of time they are spending, activities they engaged in and features they enjoy about the site). Thus, while it is the most hands-on and time-consuming approach to an assessment, it provides the most reliable estimates of demand (which can be converted into an economic valuation) and helps identify less obvious forms of recreation, such as daily strolls in a riverside park, that are nonetheless valuable to stakeholders.