What if your doctor prescribes you a walk in the park?

More and more countires are thinking about developping a green prescriptions framework. Besides being an effective answer to health and social concerns, green prescribing can bring important co-benefits on the environment too.

Biodiversity loss and climate change may appear to develop independently from public health issues, however they are often deeply connected. There is a growing recognition of the link between environmental concerns and poor human health and social care. In connection to this, the term “planetary health”, which couples environmental and human health, is becoming increasingly popular. This is encouraging research and investments in integrative approaches to address these issues holistically. In this regard, nature-based activities for improving physical and mental health are emerging as innovative and effective answer. That is why green prescriptions are gaining increasing attention, sparking the debate on whether they should be embedded in national healthcare services.

What is a green prescription?

The term green prescription was developed by health professionals in New Zealand in the late 1990s, and mainly referred to a range of monitored physical activities and diets aimed at improving the health and wellbeing of patients. Today, green prescriptions include more innovative strategies designed to improve physical and mental health through exposure and interaction with nature. Indeed, contact with nature and its elements can effectively reduce stress, have a positive effect on depression, provide restoration, and even improve our immune system response . In urban contexts, accessible parks and green spaces can promote physical activity, relaxation, and social cohesion. Green prescriptions are usually issued by doctors, while the management of the activities is entrusted to Green Care associations and initiatives. Green prescribing usually require the interaction of three main elements: natural environments, a social context, and meaningful activities. For example, activities can involve walking in green spaces, regular participation in gardening sessions (horticultural therapy), or undertaking of biodiversity conservation activities. In general, activities associated with green prescriptions are monitorable activities that involve spending time in natural environments.

What are the benefits green prescriptions?

Green prescriptions have a lot of potential. First, they provide both a reactive and proactive solution to public health issues, treating and preventing diseases. Indeed, green prescribing can have a double contribution: improving the health of patients while promoting a healthy lifestyle and supporting the development and maintenance of health-promoting infrastructures. Second, they offer significant environmental, economic, and social co-benefits. For example, the need to improve and maintain green spaces connected to green prescriptions could potentially lead to important environmental benefits. In the case of biodiversity conservation volunteering – an activity associated with green prescriptions – these benefits can further increase, since enhancement and maintenance of green spaces can be incorporated into the green prescribing strategy itself. In addition, participating in Green Care activities can promote pro-ecological behaviours and environmental stewardship. Finally, green prescriptions can have potential financial co-benefits. Green Care practices are a cost-effective solution for patients, and for public health bodies too. For example, a study by Leeds Beckett University found out that for every £1 invested in green prescribing activities, there is an £8.50 social return.

What are the mai challenges connected to green prescriptions?

While green prescriptions have a great potential to enhance human end environmental health, there are still some pending issues. First, there is a need for more research to assess the benefits of green prescriptions and evaluate the correlation between different natural elements and the positive impacts brought by these practices. Indeed, the habitats in which interventions take place are very different form each other, from woodlands to costal habitats, which could affect the results. A second challenge is represented by the need to integrate two disciplinary languages, namely the one of ecology and the one of healthcare. The integration of these two sectors is crucial to take advantage of all the benefits and co-benefits green prescribing can provide. Finally, other constraints for the development of this practice are represented by the simplistic perception of green prescribing and the perceived loss of revenue.

An example from New Zealand

New Zealand has been using green prescriptions for decades, usually for encouraging patients to be physically active. Green prescriptions are implemented by doctors or nurses, and they are often connected with regional sports trusts. These local trusts have the task to facilitate access to activities and follow up on patients. Research in the country demonstrates that green prescribing is one of the most cost-effective strategies to promote physical activity and healthy behaviours in general. In addition, a study published in the British Medical Journal found that green prescriptions can improve a patient’s quality of life over 12 months, without evidence of adverse effects.

In conclusion, green prescriptions have a huge potential, but they need to be seen as part of wider holistic approach to health and social care. Green prescriptions are not meant to substitute conventional ones, but they underline the need for more green spaces and practices for health, social care, and education.

Photo: Tobias Keller / Unsplash


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