Anyone who birds a favorite park over and over knows intuitively why they keep going back: It just feels good. Being in nature—pausing in it, sitting with it, discovering its wonders—brings a sense of calm and renewal. Now science is backing up our intuition with data and revealing the benefits run much, much deeper. Of hundreds of published studies, none alone is definitive, but together they offer a growing sense of what’s lost as people spend more time than ever indoors.
In England, for example, research revealed that urban green spaces reduced residents’ sense of isolation and loneliness. Living a short walk from a park in Los Angeles seemed to offer the same mental-health boost as a two-point decrease in unemployment. In Spain, schoolchildren raised in greener neighborhoods had more neural connections in brain regions tied to working memory and attention.
“The field is starting to build momentum right now,” says University of Washington environmental psychologist Gregory Bratman, who led a recent review of findings across social and health sciences. “Evidence is there to support the conclusion that contact with nature benefits our mood, our psychological well-being, our mental health, and our cognitive functioning,” he says.
What’s harder to pinpoint is precisely why this relationship exists. One leading theory is that nature can restore our attention and counter the mental fatigue that today’s urban and sensory-filled environments cause. A second is that it can reduce stress; blood pressure, heart rate, and stress hormones all drop with time in nature, studies show. Both factors—cognitive function and stress response—have been linked to conditions such as depression.
More investigations are now delving into complex practical questions that doctors, therapists, educators, and public-health experts want to understand. What elements of an outdoor setting are most important and for how long? How do our individual traits, preferences, and backgrounds influence how we respond? Answer- ing these questions isn’t easy, since it can be tricky to design experiments that isolate nature’s diffuse effects. Bratman calls this a “next huge frontier” to explore.
Doctors will be key partners in this effort. Nooshin Razani, director of the Center for Nature and Health at UCSF Benioff Children’s Hospital in Oakland, works with low-income patients to “prescribe” regular park visits. In two small early trials, she’s found that these excursions increased children’s resilience and also reduced parental stress and loneliness. Whether the adults visited a park independently or in a group didn’t affect the results—a finding that could help inform other programs. “I really felt like we needed experimental data,” she says.
But Razani also believes in simply talking with patients and listening to their experiences. “I think we really need to take a moment to understand why depression and anxiety are increasing,” she says. With that knowledge will come more tools for addressing the public-health challenge. “I absolutely think being outside is part of the solution to that.”
Doctor's Note
No one needs an excuse to go birding, but in Shetland, Scotland, some residents have a good one anyway: a doctor’s advice. Since the fall of 2018, the U.K.’s Royal Society for the Protection of Birds (RSPB) has teamed with the islands’ 10 health centers to steer patients outdoors, especially as they see more people arriving with issues like diabetes, anxiety, and depression. “This is a new health challenge,” says National Health Service Shetland communications officer Carol Campbell. “Until just a generation ago, Shetland’s population lived a very active life as fishermen and crofters eating a simple diet based on potatoes, kale, and oily fish.”
While Shetland has plenty of nature to offer—rock outcroppings, beaches, and seabirds—RSPB creates a seasonal calendar of activities, including lichen study, backyard-bird feeding, and eating outdoors, that ensures homebound residents can participate. “We’re not suggesting that this replaces medicine,” says RSPB’s Helen Moncrieff, who is now discussing expanding the program more widely in Scotland. “It’s another tool.”
For years, nature’s therapeutic services have been overlooked or hard to quantify, but that’s changing: Around the world, national parks alone improve visitors’ mental health to the tune of benefits worth an estimated $6 trillion, one study found. Beyond Scotland, many health professionals and their partners at public land and conservation organizations are now looking to tap this value. In the United States, there are now 87 park prescription-style programs in 32 states—more than triple the number from five years ago, according to a recent census by the Institute at the Golden Gate.
Robert Zarr, a Washington, D.C., physician and founder of the nonprofit Park Rx America, is working to get other doctors and healthcare professionals on board. More than 600 have signed up to the group’s platform to make it easy for doctors to locate green spaces near patients and track how patients “fill” prescriptions, which specify an activity and a frequency. He envisions a similar tool embedded in electronic health-record systems one day, and this past fall, the National Institutes of Health funded a five-year research trial to test physical and mental health outcomes at the community health center where he works.
Over time, such programs may be a boon both for people and nature, especially with recent surveys indicating that 25 percent of U.S. residents spend two or fewer hours a week outdoors. Says Moncrieff: “You can’t have conservation without people involved.”
School's Out
Once a week in Eliza Minnucci’s kindergarten class in Vermont, students would gear up for the weather and march up a hill. Then they’d spend the whole day outdoors: quiet time, play time, and lesson time, in addition to everyday rituals such as snack, lunch, and bathroom breaks. The public-school teacher saw these “forest days” building developmental skills, such as fine motor control. But also, she simply wanted her students to like school. “It was really about joy,” she says.
Studies of similar programs bear out her experience, though data are still limited: Nature curriculums can confer academic, social, and emotional benefits, such as improved concentration during learning and fewer behavioral issues. Children also develop stronger relationships with the outdoors—what Minnucci observed in her class as a sense of place and belonging.
Minnucci had the backing of her principal and grant funding for an assistant’s help during her experiment in 2013. Since then, she’s been supporting others, teaching in a nature-based, early-childhood-education certificate program and maintaining a professional community. At least 31 schools in Vermont and New Hampshire now have forest-day programs, she says, with some extending the practice to higher grades.
Outdoor learning is quickly gaining ground across the United States, especially with even younger kids: A 2017 survey identified more than 250 nature-based preschools, a 10-fold increase since 2012. That tally includes European-modeled “forest kindergartens,” where kids spend most or all days outside, and nature sanctuaries that launch their own preschools—in Wisconsin, Schlitz Audubon’s program, now with more than 140 students a year, was an early pioneer in 2003. This September, Washington State created the first specialized licensing for this new wave of outdoor schooling, a step that allows for full-day programs and wider access.
With education becoming more scripted, Minnucci says her forest-day experience offered her a creative boost as a teacher, while challenging star students in new ways. Other kids got to shine. One child, she recalls, felt he wasn’t “good” at school, but loved the outdoor classroom because he knew the names of caterpillars and trees: “We got to acknowledge him as an expert."
This story originally appeared in the winter 2019 issue as “The Nature Antidote.” To become a subscriber, make a donation today.