Happy Earth DAY!

Outdoors for All: Access to Nature is a Human Right

Richard Louv, with photos by Tytia Habing April 2021

A FEW YEARS AGO, pediatrician and clinical scientist Nooshin Razani treated a four-year-old girl whose family had recently fled Yemen and settled in the San Francisco Bay Area. The family had received news the night before that members of the father’s family had been killed in a bombing back home. The child was suffering from anxiety. “I was thinking, ‘I have nothing to give to this little girl. What can I give her?’” Razani says. The typical medical response would be to offer the girl some counseling and, if necessary, medication. Razani decided the patient needed an additional, broader prescription. She asked the girl and her parents if they would like to go to the park with her. “The expression on that child’s face, the yearning for a piece of childhood, was deeply moving,” the doctor recalls.

Razani is the founder of the Center for Nature and Health, which conducts research on the connection between time in nature and health and is the nation’s first nature-based clinic associated with a major health provider, UCSF Benioff Children’s Hospital in Oakland, California. The clinic collaborates with the East Bay Regional Park District to offer a program called Stay Healthy in Nature Everyday. Participating physicians share local park maps with their patients and offer family nature outings–70 of them so far. Often, the physicians will join the outings. Burned-out doctors need these experiences too, Razani says.

“We did a randomized study of the impact on the participating families,” she says. “Every single park visit substantially reduced parent stress.” In June 2018, the center began billing insurance companies for patient visits that include nature connection as part of the treatment. This was a breakthrough for the increasing number of US health care professionals who now prescribe nature or integrate it into their practices in other ways, including pediatrician Robert Zarr in Washington, D.C., who organized ParkRx America to encourage health providers around the country to do the same. Neither Razani nor Zarr considers time in nature a panacea, but both regularly witness its preventive and therapeutic effects, particularly on children and adults undergoing traumatic stress.

The increased popularity of incorporating the healing power of nature into health care, public health programs, architecture, and education has been inspired by a relatively new body of scientific evidence that associates improved wellness and lower mortality rates with access to green and biodiverse spaces. In the span of a decade, the number of studies indicating that time spent in natural surroundings–whether groomed urban parks or unruly wilderness landscapes–can improve people’s well-being has increased from dozens to hundreds. In 2017, a study published in the prestigious medical journal The Lancet Planetary Health suggested that people who live in green neighborhoods live longer than those with little nature nearby. The study tracked 1.3 million Canadian adults living in the country’s 30 biggest cities and considered socioeconomic and education differences as control factors. Dan Crouse, a health geographer and the lead author of the study, told the Canadian Broadcasting Corporation, “There was a lot bigger effect than I think any of us had been expecting.”

Expanding research has also shown that exposure to nature can reduce children’s symptoms of attention deficit hyperactivity disorder and help prevent or reduce obesity, myopia, and vitamin D deficiency. And the research suggests that time spent in nature may improve social bonding and reduce violence, stimulate learning and creativity, help raise standardized test scores, and serve as a buffer to toxic stress, depression, and anxiety. Most of these findings are correlative, not causal. But longitudinal studies are beginning to support them.

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