Fewer pills, more parks: More doctors are prescribing nature to patients

Apr 26, 2022, 5:45 AM
(Palle Knudsen / Unsplash)...
(Palle Knudsen / Unsplash)
(Palle Knudsen / Unsplash)

Your mom was right: sometimes the best medicine is fresh air and green trees.

“Most people in the United States spend upwards of 90 percent of their time indoors,” said Robert Zarr, MD, MPH, founder of Park Rx America (PRA).

PRA is a non-profit that enrolls physicians into their nature prescriptions program. If you visit one of these doctors, they might write you a prescription to spend time in nature.

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“We know, from science and evidence, when something is written down, especially in the form of a prescription based on a brief conversation that happens during the visit, whether it be for well care, diabetes, hypertension, depression, anxiety, etc., we think the likelihood of filling that prescription goes up,” said Zarr.

PRA has been around since 2017 and over 1,300 doctors are registered. But more recently, Canada created a similar program called PaRx.

“We have a standard recommendation that patients spend at least two hours in nature each week and at least 20 minutes each time, based on the latest science,” said PaRx director and family physician, Dr. Melissa Lem.

Lem also said they were just able to add a major perk to the program.

“Healthcare professionals registered in our program can prescribe one free Parks Canada Discover Pass per month to their patients,” Lem continued. “We ask them to prioritize patients who live close to Parks Canada sites so they’ll use the pass more. And also those for whom the cost of the pass is a major barrier to access. It’s worth about 72 Canadian dollars and it gives you access to over 80 different Parks Canada administered sites across the country.”

Is it the exercise that’s improving the health of these patients?

“Absolutely,” said Lem. “Getting people more active is a part of improving health. But you don’t necessarily have to be active to reap the benefits. There is a study [of] young Japanese men who sat either on a sidewalk looking at a city or on a trail looking at a forest. If you were sitting in the forest you significantly dropped your cortisol, or stress hormone levels, more than if you sat on the city street. In fact, you didn’t drop those stress hormone levels at all if you sat on the city street.”

Zarr says visiting a national park or a beach is the best case scenario, but you don’t need to go far to absorb the benefits of nature.

“During the pandemic, I was working with patients who were so afraid to go outside that we had to work on sunlight, even,” said Zarr. “Is there a window near you? Can you open that window? What nature is really depends on where you are and what you have access to.”

The concept that nature is healing is not new. Zarr sites a study from the 1980s.

“One group of patients had a window in their hospital room looking out onto trees and natural landscape,” said Zarr. “And the other room didn’t have that. They just had walls. What they found was, the group that had a view of nature was discharged earlier from the hospital, had fewer requests for morphine or pain medications, fewer complaints over all.”

In Canada, more than 5,000 health care providers have subscribed to the program.

“I would say the majority of our prescriptions tend to be for patients with mental health concerns and also chronic diseases,” said Lem. “There’s almost no medical condition that nature isn’t good for. There is a huge body of research showing that from prenatal outcomes to improved diabetes, improved blood pressure, reduced anxiety and depression, ADHD, even cancer care outcomes.”

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The reason nature prescriptions is a news story is because it’s unusual. Lem hopes that changes.

“I really want to see nature time being recognized as mainstream within the healthcare profession,” said Lem. “Every physician recommends a healthy diet and healthy sleep and exercise as essential for a healthy lifestyle. But not everyone’s prescribing nature. I want to make it seem like common sense. I don’t want anyone to seem surprised when their doctor prescribes nature.”

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Fewer pills, more parks: More doctors are prescribing nature to patients