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As a freelance writer, I’m one of the growing number of women who spend their day hunched in a near-constant state of anxiety over a desk. My life centers around deadlines, often breathlessly tight ones, and the constant hustle to keep myself afloat is taxing. It started to wear on me.
Wired and with an increasingly painful tension in my neck and shoulders, I recently found myself unable to sleep, a problem that triggered a snowball effect of other health issues: decreased attention span and difficulty concentrating, a weakened immune system, increased irritability.
Unsurprisingly, my doctor promptly diagnosed me with chronic stress. But I was surprised by my prescription: Spend more time outside.
The Park Ranger Will See You Now
Park prescription programs—the official name for the Rx I was given to help treat my debilitating stress—may sound like the latest woo-woo wellness trend, but they’re actually gaining steam among mainstream medical providers.
Here’s how it works: In lieu of a more traditional method of treating stress and anxiety, like meditation or therapy, a doctor might give you a referral to a local green space. “In the ideal clinical setting, doctors talk with patients about how far to walk, help them find a space to walk”—sometimes using a specific local trails program—“and set small goals, like going outside three times per week for a half hour per session,” says Kristin Anderson, M.D., a family physician in Missoula, Montana, and a member of the state’s Trails Rx program. That prescription goes right into your electronic medical record so your doctor can track your progress; just as you’d book a follow-up appointment after being prescribed a new medication, your doctor would check in on how things are going, how you’re feeling, and whether your prescription needed any adjustment. “It’s really similar to how you prescribe medicine,” Anderson says. At follow-up appointments, doctors might measure things like BMI, blood pressure, or mental health outcomes in order to quantify results.
It’s important to note that nature prescriptions don’t mean medications are becoming irrelevant. “Medications and other therapies have very important roles in disease management,” Anderson says. Many conditions from depression to diabetes can't be cured with self-care alone—if you need meds, you should take them. Prescribing time in nature is often about working in tandem with traditional drugs, Anderson says. “Nature prescriptions highlight the cross between the importance of medical management and behavior change. When that synergy occurs, patients are more likely to see lasting benefits and meaningful results.”
The science behind a park prescription is legit. Hundreds of studies link time outside to better health outcomes: lower blood pressure and heart rate, better immune system function, lower stress. Two hours spent outside a week is all you need to reap the benefits, according to a 2019 study from Scientific Reports. Doctors are so convinced of the healing power of Mother Nature that park prescriptions are gaining traction as recognized medical treatments for a range of conditions: heart disease, hypertension, high cholesterol, diabetes, chronic stress, depression, anxiety, insomnia, and even PTSD.
While a growing body of research (and number of #forestbathing posts on Instagram) suggests simply going for a walk in the park can do your brain and body good, many nature Rx programs are more structured. “There’s a vast array of different types of programming across the country, but they all have one thing in common: a referral from the health care side, and a partner on the public-lands-system side that can connect with the patient and provide the actual prescription,” says Diane Mailey, director of the Institute at the Golden Gate. One program in California, Stay Healthy in Nature Everyday (SHINE), buses groups of patients, doctors, and naturalists to local parks each month for a dose of nature and social connection. Other programs include guided walks with a park ranger, trailhead displays, or a tie-in to the national Walk With a Doc program, which enables people to ask questions and learn about health from a local physician.
There are currently 71 Park Rx programs in 32 states with another 11 expected to launch in 2019, according to 2018 census data.
Women in the Wild
After I was given my own nature Rx (my doctor and I decided I would start taking some calls from the trail a mile from my house—one small way to fit 30 minutes of walking outside three times per week into my crazy schedule), I learned nature prescriptions are particularly beneficial for women’s health.
According to REI’s National Study on Women in the Outdoors, time in nature serves as an escape from the pressures unique to women in everyday life (i.e., conforming to expectations about weight, appearance, demeanor, etc., and putting in longer hours on the job, childcare, and housework), which in turn boosts self-esteem and happiness, lowers stress levels, and positively affects both mental and physical health.
Studies also show that women need a longer exposure time to nature to see a measurable stress reduction—which is why women shouldn’t feel that taking the time for self-care outside is indulgent or extra. It’s a critical component of overall health, says Nooshin Razani, M.D., who runs the Center for Nature and Health at UCSF Benioff Children’s Hospital in California.
Razani has been involved with Park Rx since the beginning and published two studies that quantify how nature prescriptions can relieve stress and improve health outcomes. She came to this work through her own experience as a mother, which proved to be more stressful and isolating than she'd anticipated. “It was easier to be outside where the kids had people to play with and things to do; I felt less stressed, and it was an opportunity for me to make friends,” she says. “Time outdoors saved me. The neighborhood park is like the old village center that used to exist, where you can connect with other people to know you’re not alone and to normalize what you’re going through. It’s so important for mental well-being, particularly for mothers and women.”
Before handing out a prescription, most doctors will spend some time talking with patients about barriers to getting outdoors—lack of child care, affordable transportation, or access to parks—and how to overcome them. It's easier than you might think. Reaping the benefits of nature does not require going on a three-mile hike, an activity not everyone is into. “Many people have never been on a trail in their lives," says Merry Davis, senior program officer at the Blue Cross Blue Shield Foundation of North Carolina. "Moreover, not every culture feels safe going outside and being in nature by themselves.” The good news? The great outdoors can be as close to home as your backyard, a trail in your neighborhood, or even an urban green space where you can take your lunch.
The Power of the Park Prescription
The most surprising signal that park prescriptions are a new frontier in mainstream medicine? Major insurance companies are getting behind them. Blue Cross Blue Shield of North Carolina is rewarding doctors for writing nature prescriptions with points through its Blue Quality Physician Program, which financially incentivizes physicians for improving the quality and lowering the cost of health care. “With more research coming to light about the importance of nonmedical drivers of health—like time in nature, housing, healthy food, social context, physical environment—it shows things that create health for the most part don’t happen within the clinic walls,” says Davis. “That’s why health plans are getting involved in nature prescription programs.”
Nature prescriptions aren’t covered as widely as drugs are—at least not yet. But leaders in the nature prescription movement think that a fundamental shift to focus more on preventive health care isn’t far off. “I think that it helps us toward really supporting people in healthy living, as opposed to working on illness after it happens,” says Razani. “This movement helps people take control of their own health and well-being, and really understand that mental health is integrated into physical health.”
On that note, it’s time to step away from my computer for the next half hour in favor of a stroll outside. I have a prescription to fill.
Cassidy Randall is a writer in Missoula, Montana, covering public lands, conservation, and women in the outdoors. Follow her @cassidyjrandall.
