Health-care providers offer prescriptions for nature,
New program prescribes green spaces, long walks as treatment for patients
A walk in the park. A stroll on the beach. A breath of fresh air. These could soon be some of the treatments the doctor orders to cure what ails you.
Starting today, Ontario health-care providers can offer prescriptions for nature.
The new Park Prescriptions program offers roughly 200 preregistered health-care providers prescriptions with unique codes and instructions on how to prescribe and log nature prescriptions for their patients. These prescriptions incorporate evidence-based recommendations for spending time in nature: two hours a week with a minimum of 20 minutes a day. They also have printable patient handouts on the health benefits of nature organized by medical issues.
A patient with depression, for example, may now be prescribed 20-minute daily nature outings by their family physician in addition to other therapies.
A strong body of research shows that those who spend as little as 20 to 30 minutes a day outdoors report better health outcomes, including regulation of blood pressure, diabetes, mental health and boosted immune response. Other benefits are improved concentration, sleep and sense of well-being.
“By formalizing nature prescriptions with a defined program, we can start to create a culture change within our profession and the public that recognizes nature time as essential for health,” says Melissa Lem, a family physician in B.C. and the director of Park Prescriptions. The Canadian non-governmental initiative is announcing the Ontario program Monday.
Park Prescriptions is modelled after Park Rx, a program first run out of California’s Golden Gate National Park. Andrew Day, CEO of BC Parks Foundation, started working on Park Prescriptions two years ago, and it launched in British Columbia in December.
“We’ve had an incredible amount of interest in PaRx (Park Prescriptions), with close to 500 prescribers signed up from nine provinces and territories since we launched less than three months ago,” says Lem. Most of the registered prescribers are family physicians, followed by oncologists, emergency doctors, psychiatrists and nurses.
“We also have psychologists, physiotherapists, pharmacists, occupational therapists, chiropractors and naturopaths signed up.”
The burden of chronic diseases such as diabetes, heart disease, and mental health disorders is increasing, as is public spending on prescribed drugs to manage these conditions, according to a 2020 Canadian Institute for Health Information report. A Statistics Canada report highlights that prescription medications accounted for $29 billion (14 per cent) of Canada’s annual health-care spending in 2013.
The bulk of it was for chronic conditions such as heart disease, high cholesterol, diabetes and depression.
As the population ages, the use of medication increases: 83 per cent of 65- to 79-year-olds have prescriptions, and many are on multiple prescriptions, making them more susceptible to adverse events. Often, a second medication is prescribed to mitigate the side effects of the first.
In parallel to the rise in medication prescriptions, our time in nature was already steadily decreasing before the pandemic. In a 2014 survey, time indoors or in vehicles accounted for 94 per cent of an average Canadian’s time, with similar findings in the U.S.
The U.S. Centers for Disease Control and Prevention reports “enhanced park use and physical activity sufficient to achieve just a five per cent reduction in the burden of diabetes, hypertension, and related conditions could save an estimated $24.7 billion (U.S.) annually in avoided health-care costs.”
“We are in active discussions with different organizations about ways to reduce barriers to nature access for patients, including free passes or transit discounts,” says Lem.
Nature prescriptions have strong roots in Japan, where the benefits of shinrin-yoku, or bathing in the forest atmosphere, have long been recognized, and the movement is spreading internationally.
In the U.K., the National Health System recently invested four million pounds (about $7 million Cdn) in a pilot project where “green prescriptions” are being used for patient treatment. The U.K. Wildlife Trusts suggest that the return on every pound invested in health or social needs projects to connect people to nature will be 6.88 pounds.
A survey of 1,600 urban Canadians last June showed that 70 per cent of respondents have increased appreciation for parks and green spaces, 82 per cent view parks as important to their mental health and 70 per cent to their physical health.
“We haven’t invested well in pockets of natural spaces in cities,” says Toronto health economist Jean Hai Ein Yong. “We need to strike a balance. Nature excursions to forests are not feasible for everyone. But we can spend our lunch break in a pocket of nature in a city like Toronto. Cities need to figure out how businesses support public spaces.”