Nature Champions and Park Prescriptions


by Avril Swan, MD

In late September of 2010, I had the opportunity to gather with a group of like-minded health care providers who believe, as I do, that time spent in nature is important for the physical and mental well-being of children. The occasion was a workshop sponsored by the National Environmental Education Foundation called “Train the Trainer”. We spent 3 days learning, collaborating, and brainstorming about how to link healthcare and our public lands through the use of “Park Prescriptions.” Park Prescriptions is the newly coined term that refers to an actual prescription given by a doctor to a patient that instructs them in an individualized plan for spending time in parks or other natural settings. Medical literature is starting to become available that provides data to support what we all suspect: time in nature is important to human health.  Time in nature has been linked with increased physical activity, decreased stress and depression, better concentration, and even improvements in breathing function. (McCurdy L, et al.Curr Probl Pediatr Adolesc Health Care 2010;5:102-117)  At the end of the three-day conference, participants came away with knowledge about the current medical literature on the subject and tools to teach other physicians how to write park prescriptions. Most importantly  we developed new relationships with community organizations such as  US Fish and Wildlife and the National Park Service.

As a result of this training, I met another physician, Nooshin Razani, MD,MPH a Pediatrician with the Pediatric Environmental Health Specialty Unit at UCSF, and Howard Levitt, director of communication and education at the National Park Service in San Francisco. We were all enthusiastic to get to word out about park prescriptions, and decided to collaborate to get the ball rolling. After many meetings we have started to put together a pilot project to write park prescriptions to get kids from all parts of the city out to Crissy Field. The program will involve our training physicians at UCSF and hopefully in the Community Clinics throughout San Francisco. These physicians will then incorporate park prescriptions into their practice, handing them out to youth as they see appropriate. The children  will be given incentives (small prizes) for every 3 visits they make to Crissy Field.

The project has been helped along by students at Expressions College of Art and Design in Emeryville who have created a public service announcement, prescriptions pads, and a “passport” that the kids will get stamped by a staff member at Crissy Field to record their visits.

Ultimately, of course, anyone can go spend time in nature with or without a prescription, but, we hope by formalizing the process that it will help emphasize that physicians recognize and want to improve on the health problems that result from our personal and societal disconnection to our land.

Why Park Prescriptions? Take a look at some of these statistics:

7.5  hours/day: Average daily media time spent by children ages 8-18 (Rideout VJ et al. Kaiser Family Foundation Report. 2010)

40: Percentage of adults who do not engage in any leisure time physical activity (Center for Health Statistics. Health, United States, 2007 with Chartbook on Trends in the Health of Americans. 2007)

33%: Estimated population born in the year 2000 to eventually develop diabetes over the course of their lifetime (Narayan KM et al. JAMA 2003:290:1884-90)

9.5%:  Percent of children ages 4-17 estimated diagnosed with ADHD (Pastor PN, et al. Vital Health Stat 2008;10:237)

To reverse the statistics above, we need to think outside the traditional Western medicine chest. We also know that people who spend time in nature for their own benefit are more likely to become advocates for the preservation and support of the lands that they use. It is a symbiotic relationship.

Park prescriptions almost always make sense and only have positive side effects. No pharmaceuticals can claim the same.


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