Nature Prescriptions Improve Physical and Mental Health

Research confirms the nourishing effect of enjoying the beauty of the natural world

Spending time in nature has been proven to lower blood pressure and improve anxiety and depression. simona pilolla 2/Shutterstock

How good does it feel to walk barefoot on the beach, sit in the grass on a sunny day, or stroll through a forest and enjoy the grandeur of the trees?

Although most of us can feel the therapeutic benefits of being in nature, we may not think of them as prescriptions for some of our most common ills. Could doctors prescribe a walk in the park for an ailment the way they prescribe medication for an infection or heart condition?

The idea isn’t so far-fetched, according to a recent analysis of 28 studies that show that spending time in nature, especially around trees, benefits our physical and mental health. And although it seems like a logical conclusion, it hasn’t been widely explored scientifically until recently.

The study, a systematic review and meta-analysis published in The Lancet Planetary Health in April 2023, “aimed to synthesize evidence on the effectiveness of nature prescriptions and determine the factors important for their success,” according to the authors.

The analysis concluded that those in nature prescription programs had a greater increase in daily step counts, had lower blood pressure, and improved their depression and anxiety.

“This study is built upon a long-term program of research that we are doing, where we show contact with nature—and trees especially—is really good for strengthening mental and physical health across our lives,” Professor Xiaoqi Feng, of the University of New South Wales in Sydney and one of the study’s lead authors, said.

In Australia, there is a growing public interest in nature prescriptions. A recent survey led by Ms. Feng found that more than 80 percent of Australian adults are receptive to the idea.

Previous research by Ms. Feng has shown that living near green spaces can improve health. In a study of almost 47,000 adults in New South Wales (NSW), those living in the 30 percent of areas with the most trees reported better health and well-being. This research has informed Sydney’s $377 million strategy to attain a 40 percent green cover by 2050.

“But even if you have a high-quality green space like a park nearby, it doesn’t mean that everyone will visit and benefit from it,” Ms. Feng said. “How can we encourage and enable people to (re)connect with nature? That’s where the idea of a nature prescription comes in.”

Countries around the world are realizing the benefits of nature prescription programs. Eva Pruchova/Shutterstock

The Rise of Nature Prescriptions Worldwide

The study results support a growing trend. Nature prescriptions are emerging as a supplement to standard medical care in places beyond Australia.

For example, the United Kingdom recently invested £5.77 million ($7.41 million) in a pilot program for green social prescribing.

The program links people to nature-based interventions and activities such as local walking, community gardening, and food-growing projects.

The two-year initiative will explore how to implement green social prescribing into communities to improve mental health outcomes, reduce health inequalities, reduce the demand on the health and social care system, and develop the best ways to make green social activities more resilient and accessible, according to the National Health Service.

The United Kingdom has already been implementing other social prescribing programs to help people make use of nourishing activities such as dance and crafting.

Canada also has a national nature prescription program. Park prescriptions, or PaRx, is Canada’s first federal, evidence-based nature prescription program, according to its website. PaRx was a health initiative started by the BC Parks Foundation in 2020 and has now been officially introduced in every province across Canada. The initiative is driven by health professionals who want to improve their patient’s health by connecting them to nature. Doctors can prescribe time in nature and give patients passes to National Parks to improve their health.

Park prescriptions started as a grassroots movement in the United States more than a decade ago and have been growing ever since.

The United States offers numerous park prescription programs all over the country, which are searchable through a directory on parkrx.org.

There was even a 2020 National ParkRx census conducted by the Institute at the Golden Gate.

The census information is used to determine how ParkRx programs are being adopted, different ParkRx program activities (ranging from self-guided meditation to park ranger-led walks), types of health benefits, and how the data are collected.

The census represents a sample population of 37 ParkRx programs, but the Institute hypothesizes that more than 100 ParkRx programs exist nationwide.

Shinrin-yoku is the Japanese practice of immersing oneself in nature to improve health. Alyna Andrushko/Shutterstock

In Japan, the art of shinrin-yoku, or forest bathing, has been recommended by health practitioners since 1982 and involves connecting with nature through the senses. In fact, the word “shinrin-yoku” was coined by the Japanese Ministry of Agriculture, Forestry, and Fisheries. A range of guided tours offers shirin-yoku throughout Japan to teach people the benefits of forest bathing.

Although there are not yet large-scale nature prescription programs in Australia, there likely will be soon. According to Ms. Feng, there are some questions that still need answering.

“So, how long should the nature prescription be for? What should be in the prescription? How should we deliver it, and by whom? These questions don’t have firm answers yet,” Ms. Feng said.

“If we want nature prescriptions to become a national scheme, we really need to provide the evidence.”

And then there is the question of accessibility. Nature prescriptions should be available to everyone, regardless of their circumstances.

Previous research conducted by Ms. Feng and her colleague Thomas Astell-Burt has shown that low-income communities are the least likely to have access to green spaces. Yet these communities have a higher risk of chronic health issues such as Type 2 diabetes, obesity, and cardiovascular disease.

“We don’t want nature prescriptions to be a luxury item for the rich who already have access to beaches and a lot of high-quality green space,” Ms. Feng said. “We want these benefits for everyone.”