Health: What are green prescriptions and which countries offer them?

For many people, a visit to the doctor often ends with a medication prescription. But what if your doctor prescribed a walk in the park instead of conventional medicine? Canada has become the latest nation where GPs are doing just that.

Doctors in four Canadian provinces - British Columbia, Saskatchewan, Manitoba and Ontario - are now prescribing time spent in nature and even providing patients with a pass giving a year’s access to the country’s national parks, marine conservation areas and historic sites.

The World Health Organization (WHO) describes nature as “our greatest source of health and wellbeing” and says enhancing biodiversity is critical to recovery from the COVID-19 pandemic.

Although the mental health benefits of getting out into the great outdoors have long been recognized, so-called green prescriptions are now being widely used to treat physical conditions like high blood pressure, diabetes and lung diseases.

Scientists say the health value of spending time in nature goes beyond the psychological. Research suggests contact with microbes in the environment can “train” our immune systems and reinforce the microbial communities on our skin, in our airways and guts.

Researchers say that venturing out into nature has been shown to improve sleep, reduce stress and boost happiness, as well as increase attention, memory and creativity, according to the New Scientist magazine.

Doctors in New Zealand were among the first to issue green prescriptions in the late nineties, and it’s become an established part of the government’s health offering. Residents can even self-refer to gain a range of free health benefits.

In 2020, the UK government committed £4 million ($5.2 million) to a two-year green-prescription pilot as part of its post-COVID-19 recovery plan. Spending time by water was the most highly-rated activity in nature for improving people’s mental health in a 2021 survey.

Clinicians in Japan have been recommending ‘shinrin yoku’, or ‘forest bathing’ since 1982, advising patients to get out and use the country’s 3,000 miles of woodland walks. To date, $4 million has been spent promoting shinrin yoku as a national health programme.

In the United States, the Park Rx America platform allows doctors to issue nature prescriptions at thousands of parks across the country. South Korea also encourages forest bathing to improve health and the Korean Forest Service says it provides a green welfare service.

You don’t have to go into wild places to feel the benefit of nature. Researchers in Finland say just 15 minutes walking in a city park is enough to improve energy and vitality. They recommend five hours a month in nature as the “minimum dose” needed to gain health benefits.

Researchers in Canada found that adding just 10 more trees to a city block improved perceived health and wellbeing as much as increasing people’s income by $10,000 or making them seven years younger.

COVID-19 has fuelled a parallel mental health pandemic with the WHO reporting that the two most common mental health conditions, depression and anxiety, now cost the world economy $1 trillion annually.

With the number of city dwellers forecast to grow from half of the global population to 70% by 2050, giving urban dwellers more access to nature is at the heart of the World Economic Forum’s Healthy Cities and Communities initiative.

To be effective, green prescriptions must be part of a systemic approach to incorporating nature-based interventions and nature-based thinking in urban infrastructure, says Professor Anna Jorgensen, Head of the Department of Landscape Architecture at Sheffield University.

“Green prescribing needs to be seen as one part of a holistic health-promotion strategy based on a planetary health perspective. In order to care for ourselves, we also need to care for our environments”, she adds.