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On Wednesday, April 12, a buzzing group of health care professionals, city planners, parks department representatives, educators, and community members came together to discuss the growing evidence that time spent in nature can support both mental and physical health. “Nature-Based Social Prescribing and Programming: Route to Wellness” was a day-long event organized through a collaboration between the Renée Crown Wellness Institute and the Community Engagement, Design and Research Center (CEDaR). The occasion featured four innovative professionals who have engaged in research and programs centered around connecting communities to nature to address key health issues.  

Nature-based social prescribing refers to a non-medical community referral system in which people interact with the outdoors as a method to promote health and well-being. While significant, the concept is not necessarily new. Historically, health professionals and city planners worked closely together to design integrated outdoor spaces within urban centers as a response to unsanitary conditions and health concerns.  

“If you look at the goals of the City Beautiful Movement that spread across the United States during this period, they were about public health as much as beautifying cities,” Louise Chawla, a CEDaR fellow, stated in her opening remarks.  

As advances in medical technology rose in the mid-20th century, health clinicians, and their patients, largely moved indoors. To address the obesity crisis in recent decades, health professionals have started once again to work with city planners to encourage people to exercise outdoors with a focus on active transport by walking and biking. 

But according to Jill Litt, professor of environmental health in the ŷ���ڱ���Ƶ’s Environmental Studies Program and one of the four panelists, “Telling people to exercise more doesn’t work.” Litt, whose research focuses on the health benefits provided by community gardens explained that “rather, engaging someone in an activity or space that they love is a good place to encourage change.” In her work, she found that gardens provide a model system for changing behavior and improving health, including increasing physical activity and fiber intake and reducing levels of stress and anxiety. According to her research, the evidence base supporting nature-based programming (such as gardening) as a health intervention continues to strengthen.  

Unlike the more traditional medical prescriptions, the panelists discussed that nature-based prescribing can and should be informed by community knowledge and designed with community culture in mind. Another panelist, Nooshin Razani, an associate professor of epidemiology and biostatistics at University of California, San Francisco (UCSF) School of Medicine, recommended a socioecological model that integrates social norms and culture shifts when promoting nature for health. In partnership with San Francisco’s Parks Department, Razani’s work invites identified patients to join in monthly park outings with an emphasis on free, unstructured outdoor play to encourage “moments of ‘Ah’ and wonder.” These moments, shared between family and friends, expanded participants' definition of community to include time spent in nature. 

The power behind community, and community relationship to nature, became a central theme throughout the program. Ashby Sachs, a recent PhD graduate from the Environmental Studies Program and a current postdoctoral fellow in the Barcelona Institute for Global Health, focused her discussion on loneliness reduction in teen parents through nature and social connection. Wesley Tate, Medical Director for the National Trauma Foundation and board-certified psychiatrist, outlined the practice of mindfulness-based nature therapy work for people struggling with mental health. Both panelists promoted the idea of using community-based models, rather than medical-models to address health issues.   

"We're experiencing the biggest mental health crisis ever recorded, and we simply can’t rely on the medical experts to fix these things,” Tate explained. 

The session finished with an afternoon of small group planning and coordination to discuss potential partnerships for advancing the practice of nature-based social prescribing and evaluating it through research. Break-out groups were asked to discuss who, in fact, should be responsible for delivering nature programming for mental health. The consensus was that this responsibility shouldn’t be put solely on health experts, but rather should be shared in partnership with nature providers such as parks departments, educators, designers, and planning professions—in other words, everyone in attendance. The groups stressed the importance of collaborating once again and reconnecting their relationships to community and to nature. 

After all, as Tate aptly put it, “Nature is not new, we’re just re-discovering it.”