“It’s become commonplace for San Francisco physician Daphne Miller to write prescriptions that look like this:
Drug: Exercise in Glen Canyon Park
Dose: 45 minutes of walking or running
Directions: Monday, Wednesday, Friday and Saturday at 7am
She estimates she has now written hundreds of prescriptions for outdoor activity. “For some reason, it is much easier to keep up a movement or exercise regimen when it’s outdoors,” Miller says.
Perhaps it’s because of the varying scenery, the fact that monthly dues and expensive Spandex outfits aren’t required, or even because of what she calls “the camaraderie of the trail”.
Miller’s not alone. Faced with mounting obesity rates and a stubbornly sedentary population, physicians – especially pediatricians – are refining their exhortations that patients need to get more exercise.
Nationwide, they are dispensing thousands of prescriptions with specific instructions – not just going to a gym, but exercising in nature, at a park, along a trail. They’re literally telling their patients to take a hike.
“This is a lot more than getting people physically active. This is about getting them outdoors,” says Zarnaaz Bashir, director of health initiatives for the National Recreation and Park Association, a group that melds parks, recreation, the environment and now, health.
When terms like “park prescriptions” began popping up in 2008 or so, many experts viewed it as a niche idea.
“It was a quirky, fun play on words. I don’t think a lot of people thought there was going to be much substance,” says Kristin Wheeler, program director at the nonprofit parks advocacy group, Institute at the Golden Gate, in San Francisco. “Now, it’s been validated.”
The number of programs has risen steadily. Officials have identified at least 50 specific programs in the US, Wheeler says, but smaller ones may be under their radar, and new programs are popping up all the time…
An early proponent was Robert Zarr, a physician with Unity Health Care in Washington DC who quizzes patients about their interests, checks a searchable database for information on parks in or near their zip code, and then writes a script for specific activities. He told one obese teen to skip one of the two buses she takes to school and walk through a park instead. She ended up losing weight and feeling happier.
“We’ve really got this down,” he told attendees at a conference last year in Philadelphia. “I see this as no different from prescribing medicine for asthma or an ear infection.”
Across the continent in San Francisco, Miller says she has learned that formalizing her recommendation to get out in nature by writing it as a prescription is highly effective. “Well over 80% of patients try it, and many stick to it,” she says.
Mounting evidence shows benefits of being out and active in green spaces: less tension and stress, lower blood pressure, improved immune system responses, and milder ADHD symptoms in children. Japanese researchers have found that adherents to Shinrin-yoku – “forest bathing” – have lower levels of the stress hormone cortisol than study subjects who walk the same distance in a lab…
Proponents say the nature prescriptions shift the focus of medicine from illness to wellness, leading to the potential for widespread changes in medical care.
Diana Allen, chief of the US National Park Service’s “Healthy Parks, Healthy People” initiative, is seeing mergers of medical schools and parks programs. “That’s wild,” she said. “I think there are going to be some new fields of practice.”
She acknowledges possible opposition from traditional practitioners and drug companies – “this goes against the money machine.” And patients who simply want to pop pills for whatever ails them also may balk…“
-- Sandy Bauers, “Doctors' new prescription: 'Don't just exercise, do it outside'”, The Guardian (theguardian.com), February 10, 2015
* * * * *
Some of us are better than others in motivating ourselves to do healthy things that are likely to benefit us – like, for instance, setting aside enough time for hikes.
Most of us certainly won’t need a doctor’s prescription (see above), but in our indoor-oriented culture, we don’t receive a lot of reminders to get outside.
Also, people are sometimes warned that visiting the natural world entails a variety of risks, especially the wilder places, given all the supposed (exaggerated) dangers.
Having doctors and other healthcare providers encourage patients to partake of the health benefits of outdoor exercise does sound like a step in the right direction.
Hiking isn’t an activity most of us can do several times a week, of course, but the benefits are such that it surely makes sense to schedule it as often as we can.
Plus it isn’t something that’s merely “good for us” -- but rather one of the most thoroughly enjoyable ways many of us know of to spend a Saturday or Sunday.
-- Charlie Cook