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74 OUTSIDE MAGAZINE 05.19 you do often “How 76 climb and the obesity epidemic rages on—by rates anxiety and depression As centers. treatmenthospitals,outpatient clinics,and thority figure to go play—outside and often. au- an frommandate a and map a had they Fernandoand clinic,Ariel when the But left sumed less than three minutes out of twenty. con- It attention.paying been hadn’t you actual stethoscope. torrisesto test Ariel’s lungs, brandishing an Fivefilled.later, secondsbeen doc- has the prescriptionwhenever the Buchholz notify to link a includes and prescription,nature new a outlines parks, the of locations the shows which message, text a with pings health—Fernando’smental phone and cal physibetterexperience totend outdoors time spend who play—children outdoor of benefits the Ariel’scoacheson father he After family’s home. the near parks city good-sized some finds and quickly gates navi- gray. He with flecked hair brown health nonprofit Park RxAmerica. center,public- the Zarr,Robertof founder the at pediatrician another createdbywas which Rx, Park called tool mapping a up doctor’spulls stethoscope,modern he the desktopcomputer,outdoors.a time On ing teeth,their getting vaccinated—and spend- brushing right,eating is child a means ness exam.wellnessToroutinewell Buchholz,- a performing is Center,Buchholz Health menudo. Not often. father,his as Fernando,bear answers. teddy blue a clutches Ariel all. after old, question—he’stwoderstandyearsthe only in the room next door. Maybe he doesn’t un- vaccine he just heard administered to a child doesn’t answer. Maybe his mind is on the flu Ariel, named boy a patient, practices. His Washington,for one D.C.,whereBuch It’s a Thursday afternoon in October, a warm primary-care physician Ryan Buchholz asks. all get There’s a movement brewing in America’s if talknature the Youhavemissed could Buchholz is warm and earnest, with short In exam room three of the Upper Cardozo OUTSIDE MAGAZINE outside?” 05.19 No a a No holz holz - from generalfrom encouragement outsidegetto offering incentives for nature prescriptions. begun has insurerhealth major one least at and ones,pharmacological do they as just prescriptionsincorporatenature to begun ters, electronic medical-record systems have and health are opening at major medical cen- offices.Researchnaturetheir for institutes sadder, or sicker, they are looking far outside to help their patients avoid growing heavier, means,procedures but anyby and pills ing with traditional tools. They aren’t abandon patience losing are providerscare health obese— nowarefive children in nearlyone tion’s last count, one in three U.S. adults and the Centers for Disease Control and Preven- hs pecitos ae ay forms, many take prescriptions Those US TO SPENDMORE TIME OUTDOORS —KATE SIBER A GROWING NUMBER OF INSURERS ARE ENCOURAGING We Got You Covered because it’s the rightthingto do.” it believe,do theyto be may it as hard as members.healthierAnd betterhave to yet,”does it says.that shownit’she reallybeen “But hasn’t It them? formoney nies aren’t necessarily doing all this just to improve their bottom line. “Does it save severalofcompaauthorcare,- managed Universitythe textbooksand on Mason cards, clothing, andfitness devices. rewardsearn giftlikecan usersparks, Timucuan participating 22 ofany visiting while app Go365 company’s the into logging by outside: time spend who people the Timucuan Parks Foundation in Jacksonville, Florida, on a program that rewards trainstaff.parkKentucky-basedand partnered insurer the 2018,with Humana In cityofFrancisco,the San in programsfunding and introducethat to parkspeople farming gardeningand urban supports that van mobile a launching court, ness fit- a playgroundsnewand building alone,California Northern projectsspacein Since 2015, the company has spent more than $7 million on 25 local park and open- parks and improve park access on the West Coast, particularly in low-income areas. to get usto spendmore time outdoors. effortsinvestingin begun havecompanies health of recently,more handful But a checkup. annual gettingan by bag goodie a earn ordiscounts advantagegym of taketo HRfrom prodstogotten used has plan employeemedical an on Anyone bettermakechoices.to us Insurancegetprovidersincentivestoof offer kinds all According to Peter Kongstvedt, a senior health-policy faculty member at George upgradeto helping been California,has Northern in Permanente,Kaiserbased Nature Rx Outsde Outsde - “Because ofmy weight.” me,”at mad get might Buchholz.tellsJason you that scared daughter.“I’minfant her him,besideholdingsits mother his as table grayexam the on is Jasoncheckup. his skip wantedhe Jason,tothat explainsnamed old Buchholz’sof patients,Another 11-year-an mood in exam room three is a bit more tense. would use italot.” says,were,thereZarr “I Woodsif the —but book Richard2008 his Louvin nature-deficit disorder—the term coined by for health.”code of diagnostic There’sno determinant social a as also recreate,but to place a as just not nature about think to movement’sthe pioneers, “We startingare liveinglylives our indoors, says Zarr, of one increas- we where world a frequency.In and duration,activity, location, for tions instruc- specific to week a twice least at at me when I take the ball awayhim,”ballfrom takethe I when me at bully.mad getsemerges:a reason “He the gently,pries, Buchholz home. and his near park the in soccer play toloves he though even much, as out getting been hasn’t he He’sgoodbeen sugar,the about says,he but back. latelyit he’sweight.gainingBut been fewer sugary drinks, Jason had begun to lose drink and more outside go to Buchholz with plan a years.making Aftereight past the overweightfor been has Jason prised. Buchholz looks tired but not terriblytirednot looks but Buchholz sur theCardozo, Upper at day the in Later

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PREVIOUS PAGES: SABINE VILLIARD/TRUNK ARCHIVE Jason says. “I say it’s just a game. Then he quite new. Many credit the concept to a re- Outsde starts calling me stuff, like fat.” The boy gional Australian recreation department, tears up. “Every time when I start running, Parks Victoria, which began to link the out- Nature Rx he makes fun of my stomach,” he says. “I doors and human health through initiatives just want to be skinny.” He seems defeated. with medical providers in the early 2000s. “I hate being fat.” Soon after, the first mainstream, provider- Buchholz puts a hand on Jason’s shoulder. based outdoor programs in the U.S. started to tions of our bodies, which are regulated by “I think you are just fine,” he says. “I want tackle common diseases. In 2005, in Colum- our parasympathetic nervous system. These you to know that.” He frowns. “Let me see if bus, Ohio, cardiologist David Sabgir invited functions are suppressed when a threaten- we can find another park close to where you his heart-disease patients for the first of ing stimulus, whether a venomous snake or live.” Buchholz opens the Park Rx America what would become hundreds of group park an aggressive work e-mail, triggers our sym- tool and begins to hunt. walks. (His organization, Walk with a Doc, pathetic “fight, flight, or freeze” system. If “Have you ever been to Bancroft Elemen- now has some 450 chapters in 25 countries.) that response stays active long enough, our tary School?” he asks. Jason hasn’t. Buch- In 2006, Prescription Trails—the nation’s immune, digestive, reproductive, and psy- holz scans the park details to make sure first nature-prescription program—was chological health suffers. In an increasingly founded in Al- urbanized world, in other words, nature buquerque, New cues our brains to shift us from a deplet- Mexico, with the ing to a restoring state. “The environment IN A WORLD WHERE WE INCREASINGLY LIVE OUR aim of encour- of our original adaptation is all outdoors,” aging chronic- says Chao-ying Wu, a pediatrician in Bell- LIVES INDOORS, SAYS PEDIATRICIAN ROBERT disease and other ingham, Washington. “It just makes sense.” ZARR, “WE ARE STARTING TO THINK ABOUT patients to hike The second—and more common—reason and walk outside. that clinicians prescribe nature is that with NATURE NOT JUST AS A PLACE TO RECREATE, BUT Since then the parasympathetic system happily acti- ALSO AS A SOCIAL DETERMINANT OF HEALTH.” “the movement vated, the outdoors becomes a great place has exploded,” to do beneficial things that we might not says Betty Sun, there’s a soccer field and plugs in a new pre- the health-program manager at the Institute scription. “I can go once a day,” Jason offers. at the Golden Gate National Parks Conser- His mom swipes her phone to see Jason’s vancy, a San Francisco nonprofit that has ex- updated prescription, with maps, images of panded its mission to include public health, green fields, and descriptions of a number of in part by coordinating knowledge sharing park options. She puts the phone down and across nature- prescribing programs. Ac- The Rise of the Jason picks it up. He sniffs lightly, rubs his cording to Sun’s most recent survey, in July Nature Rx Movement eye, and begins scrolling. 2018, the U.S. now has 71 provider-based Buchholz turns away from his computer. nature-prescription programs in 32 states, 485+ “In my experience, kids who try and make with the potential to reach hundreds of Approximate number of published other kids feel bad usually have a problem, thousands of patients. The programs tend studies linking time in nature to better and they don’t want anyone to know about to fall into two camps: Some, like Park Rx health. it,” he says. “So they try to make everyone America and Tennessee’s Park Prescrip- else feel bad.” He’s trying to provide some tions, are widely available and center on ONE comfort, but Jason isn’t listening. He’s read- doctor counseling supported by digital tools Number of nature-prescription ing his prescription. to help patients find nature and remind them programs in the U.S. in 2006. “Oh, this is Bancroft?” Jason asks. to go out in it. Others, like California’s Santa “Mm-hmm.” Clara County ParkRx, are available to high- 71 Jason whistles. “Bancroft is nice.” risk patients at select clinics and follow up Nature-prescription programs in the on doctors’ orders with phone reminders, U.S. in 2018 (in 32 states). DOCTORS HAVE been encouraging their transportation support, and group outings. patients to go outside for millennia. Hip- For health care providers, there are two NINETEEN pocrates called walking “man’s best medi- reasons to prescribe nature. The first has to Programs expected to launch in the cine.” Han dynasty physicians encouraged do with what it may do for us. Exposure to U.S. in 2019. outdoor “frolicking exercises” to ward off nonthreatening natural stimuli, scientists aging. And until the mid-1940s, tuberculo- have discovered, lowers blood pressure, $1 MILLION sis patients were sent to mountain retreats to reduces stress-hormone levels, promotes Support pledged by REI in October take in the “magic airs.” physical healing, bolsters immune-system 2018 to fund the Nature for What’s happening now is different. It’s function, raises self-esteem, improves Health research initiative at the widespread, systematic, and, at least in as- mood, curtails the need for painkillers, and University of Washington. piration, evidence based. Though boutique reduces inflammation. One leading theory wilderness treatments for trauma and some is that these stimuli—the scent of plants, 1,200 behavioral disorders have existed for years, the sight of trees swaying in the breeze, Approximate number of nature the idea that your primary-care physician, the sounds of birds, streams, and rustling prescriptions written by physicians in psychiatric nurse practitioner, or cardiolo- leaves—combine to activate the uncon- the past year in the 17 states actively gist might prescribe a park before a pill is sciously controlled “rest and digest” func- using the Park Rx America app.

78 OUTSIDE MAGAZINE 05.19 otherwise enjoy doing—like exercising. nicians and offering funding for pilot proj- Outsde Behind closed doors, some providers will ects. In 2011, when Zarr was president of his also admit that prescribing time in nature local chapter of the American Academy of Nature Rx makes them feel better personally. “It’s hard Pediatrics, he began to test the use of nature for us, through the fatigue and burnout, to prescriptions at Upper Cardozo, as well as at be focusing all the time on the problem list,” George Washington University’s Children’s says Zarr. “I sometimes need a break from the National Medical Center. In the summer of tor’s recommendation can matter a good negativity.” Talking about getting outdoors, 2013, he and his colleagues launched a web- deal. Meta-analyses of multiple studies sug- he says, is “a positive thing to do in the room.” based prescription tool, DC Park Rx, con- gest that, for example, you’re almost four nected to a database of green spaces around times more likely to attempt to lose weight FOR ZARR, a typical park prescription starts D.C. They took it national as Park Rx Amer- if your doctor suggests it. with two questions: What do you like to do ica in 2017. Providers in 17 states now use it. “Providers can motivate people to change outside? And where do you like to do it? Erin Wentzell, a doctor of physical therapy their behavior,” says Megan McVay, a psy- at George Washing- chologist who studies weight-loss deci- ton University who sion-making at the University of Florida. EXPOSURE TO NATURAL STIMULI LOWERS works with children The trouble comes when the new behavior BLOOD PRESSURE, REDUCES STRESS- with disabilities, re- is difficult to sustain. “People’s motivation members when Zarr comes and goes. A prescription could get HORMONE LEVELS, PROMOTES PHYSICAL first pitched her de- people to the park, but it may not keep them HEALING, BOLSTERS IMMUNE-SYSTEM partment the idea. going back,” McVay says. She believes that “I thought, This is regular programs in parks, like ranger out- FUNCTION, RAISES SELF-ESTEEM, IMPROVES amazing—this is ex- ings or meditation classes, could help people MOOD, AND REDUCES INFLAMMATION. actly what we need. who arrive based on a nature prescription For kids, being out- build a habit out of a suggestion. side is so motivat- Last May, when Zarr presented his pre- “With that,” he says, “half my prescription ing,” she says. Some of her patients—for scription software to Georgetown Univer- is done already. It gives me a baseline place example, children with developmental dis- sity’s family-medicine department, one of and activity that they feel good about. Then abilities who have difficulty walking—may the final questions from the largely receptive it’s my job to push it up a notch in terms of give up quickly if they’re inside a clinic or audience was about any evidence from ran- frequency and dose.” at home. “But if there’s a really big hill and domized control trials. Zarr acknowledged Zarr has the bookish air of a Manhat- we’re going to collect leaves at the top of it,” that no large trials existed yet. “I promise tan intellectual (glasses, receding hairline) she says, “they’ll keep going.” that I am trying to get that evidence,” he told combined with the physique of a triathlete. Now the million-dollar question is: Do the physicians, “but let’s not wait for that.” Despite a busy clinical and travel schedule, these programs work? While it’s too soon to A few months later, the National Institutes he walks, cycles, or hikes outdoors three or say whether health outcomes, like depres- of Health would decline to fund a trial that four times a week. “I try to get out for my sion or obesity, will shift noticeably in pa- Zarr and his collaborators had proposed. own mental health,” he says. tients who are told to get outdoors, we have Such studies are expensive, says Charm When I visit, articles about hypertension reason to be optimistic. For starters, a doc- Lindblad, executive director of the program share space on his desk with how-to guides on Shinrin-yoku, the Japanese art of forest bathing. But nature medicine is a relatively new preoccupation for Zarr. Around 2010, “something shifted,” he says. That’s when he The National Park Service Is Your New HMO heard Richard Louv give the keynote speech AMERICA’S GRANDEST PUBLIC LANDS HAVE A BIG ROLE at the American Academy of Pediatrics’ TO PLAY IN OUR HEALTH —K.S. national convention, connecting the rise in childhood obesity and ADHD to kids spend- If time outside is good medicine, then the national parks, which see some 330 ing more time inside. “Whenever I go to a million visitors each year, might just be the country’s most important health care talk or read a book,” Zarr says, “I ask myself, provider. In 2011, the agency launched a program called Healthy Parks Healthy Is that what I see in my own clinic? And I real- People, which sought to promote the idea that the parks are a national wellness ized that there was a lot of truth to what he and fitness resource. Now it’s looking to double down on some of the program’s was saying.” So many of Zarr’s pediatric pa- most promising practices, including investments in community gardens and tients and their family members were suffer- healthy food programs, plus encouragement of nature prescriptions. As part of ing from anxiety, obesity, and ADHD. “They the initiative, the Park Service is having individual parks host physicians, medi- were on their devices constantly,” he recalls. cal students, and researchers so that staff can collaborate with them to develop “Their routines were horrible. I thought health-focused projects and events. maybe a nature prescription would solve a The effort comes on the heels of National Park Rx Day, an annual event launched lot of these seemingly unrelated problems.” in 2016 to promote the idea that getting outside is good for us. Last year’s edition The timing was right. Inspired by news saw events in 69 parks in 34 states and included hikes with doctors, al fresco yoga coming out of Australia, leaders from the classes, and workshops on plant-based nutrition. Golden Gate National Parks Conservancy, the “We’re seeing park prescriptions catching on,” says Diana Allen, chief of the National Park Service, and the U.S. Fish and Healthy Parks Healthy People program. “But there are a lot more opportunities to Wildlife Service had just begun training cli- engage with doctors and other people from the health sector.”

80 OUTSIDE MAGAZINE 05.19 82 OUTSIDE MAGAZINE 05.19

JOERG BUSCHMANN/GALLERY STOCK and her colleagues lead a nature outing for outing nature a leadcolleagues her and search program. One day each month, Razani re - nature hospital-based firstcountry’s the UCSF Center for Nature and Health, the launched SHINE in 2014 and in 2016 founded towhoflock Woods Muir Yosemite,and she wealthierthe as BayAreamuch as residents that her low-income patients needed nature activist’sConvincedmedicine.approachto Francisco during the AIDS crisis, she takes an outdoors.”go San physicianin a Trained as wasit unethical to simply tell patientsour to poor, or unwell to make ithappen. busy,too be may most benefit could who critics of park prescriptions argue that those poverty.”threadis hard, and is out Getting diverseclients,” common says,the she “but outside.“Wetime tospend serveextremely struggled often clinic her to,in patientsing despitewantthat ture,noticed - had Razani Hospital. An early adopter of prescribing na- Francisco’sSan at fornia Children’sBenioff Cali- Universityof the at Razani Nooshin pediatrician by Everyday),run Nature in by a program called SHINE (Staying Healthy place,” shesaid. this loveawe.exuberanceovercame “I her natural her enough, Soon emotion. with overcomewas she her,and beforeground the illuminated light of shaft redwoods.A coast 150-foot-tall by surrounded fornia, Oakland,Cali- outside forest just a were in TINA IGBINAKENZUATINA “But,” sheadds, “I know Ihave to prove it.” exposure to natural stimuli improves health. totakeoff,” says.that confidentKash is She used to be about 30 years ago, when it started Nature.by “We wherearephysicalexercise Bush’sLauraprogramlady Texan first mer with the Texas A&M Science Center and for collaboration in year last established was Houston Methodist Hospital in Texas, which PRAY TOBETHESAMEWAYIAMNOW.” HERE, IAMVERYOK.WHENLEAVE,JUST IMMIGRANT FROMNIGERIA.“BUTWHENIAM ABOUT,” SAYSTINAIGBINAKENZUA,AN “I HAVESOMANYTHINGSITOTHINK rector of the Center for Health and Nature at ment is still in its infancy, says Bita Kash, di- long timeago.” money, a had wethem havewouldwedone behind New Mexico’s Prescription Trails. “If Forreason,this says,Razani that “wefelt woods the tobrought was Igbinakenzua In terms of clinical evidence, the move-the evidence,clinical of terms In was speechless. Wespeechless.was - stepped up onto a chair near the front door.front the near chair ontoa steppedup two 16-foot photographs ofredwoods. stairwell,glass-roofedatrium illuminating a from in streamed Sunlight logo. EBRPD the with emblazoned Nalgenebottles fill to waterfountainchild-high a at up lined kids ParkDistrict, which supports SHINE, while brochure published by the East Bay Regional the in gatheredparents and kids crowdof had completed chemotherapy. whoreceived patientreferral cancer a a for fall,she’dlast visited just network. I When aroundchildren50 parentsand UCSFthe in hn h cekp fnse, Razani finished, checkups the When November, a of Saturday first the On the more intriguing new areasnewofwellourmoreresearch roleintriguing awe in playsthe the is of benefits,one health with outside spent time linking studies many the Among BLOW OUR MINDS —K.S. NATURE’S HEALINGPOWER MAY BEINITS ABILITY TO Open UpandSay Awe our publiclandsaspublic-health resources.” treating and outdoors people getto dollarscare health using be should we that ofsort what activitiesand it are best,” says.he we“Then makecan argument the rafting—just day-to-day awe can bereally important.” pact,” says Anderson. “It suggests that we don’t necessarily have to go whitewater faction andlonger-term well-being. tree—reportedunderevenbookreading a levelshighestof satis the short-term- reported having awe-inducing experiences in nature—say, watching the sunset or While other emotions also correlated with daily life satisfaction, the students who thing exceptional that transcends understanding, proved to have a unique power. presencesome- ofthe in havewefeeling researchersthe the as definedwhich how everyday experiences in nature related to various positive feelings. Again, awe, emotions over a two-week period, then researchers analyzed the data to measure the lower their stress. For the second study, college undergraduates recorded their ticipants reported experiencing, the better their self-reported well-being was and checked up on them a week later. The results showed that the more awe the then par entries, journal and surveys daily complete to them asking raftingtrips, militarynitiesand veteranssuffering from PTSD one-to-four-dayon whitewater- contexts for awe. In the first study, they followed youth from underserved commu- Francisco,San at nia coauthorshis and twodesigneddifferent at studieslooking dict lower stress andhigher levels of well-being andlife satisfaction. amazementwe experience outdoorsingularabilitytopreduring a activities has - journal the in summer last published Accordingfindings to The next step: “We need to figure out the dosage—how often people need to do vastlyawe,differenttheseacross showsthat im- “Thiscontexts, an have can Craig L. Anderson, a postdoctoral fellow in psychiatry at the University of Califor through an outdoor an through leafed parents ing Wait- nature. of benefits health the about sessions ing counsel- and ups check wellness brief vate for rooms pri- intoheaded lies fami- one, by One tal’sclinic. Oakland hospi- the of lobby - and soon her children, Alex, five, and Lisa,five,children,Alex, and her soon and trip),every SHINE of part is (lunch wiches sand- tempeh or turkey of picnic a begun just Wehad clinic. the family’swith third her was this like,and they as outings many welcomeareas attendtoPatientslaughing. stress,”much so is thereGod, said, my she single-handedly—“Oh, children two ing rais- and full-time workingbetween and hospital.5 She’sby up ria, she works as a nurse’s assistant at a local SHINE for stress. Animmigrant from Nige- beautiful.”so referredwasIgbinakenzua to It’sshade. the light,redwoodgrove. “The intothe yellowbus embarked schoola from later,me toldIgbinakenzuawe’dafter dis- circle her. Theouting hadbegun. to ran children as shouted she me!” hear can you excited.if looked hands your “Clap she and down, was hair curly dark Her “When you are here, you feel so relaxed,”sohere, feelareyouyou “When 05.19 OUTSIDE MAGAZINE the kind of kind the Emotion, Nature Rx A.M. everymorning, - being. Outsde Outsde - - 83 84 COMES WINTER the same way Iamnow.” veryleave,am I OK.I When pray just I to be ing portion of the trip. “But when I am here, think about,” she said as we began the walk havetoI things manyhave chological.so “I psy been has impactsimportant most the her,of for she’done But do.neverthought children, and try things like boating that she her to closer grow friends, new make her isted,” onefather told me. trips.ex“We place neverthis wouldknow guided no werethere if outside get to gle other families agreed that they would strug- way.”the knowdon’t they “Or the of Many park,”the to gosaid.ever toIgbinakenzua those withthegreatest need. reachtonecessary be may support further that suggestingoutings, nature group the to it make to failedfamilies stressed most says. “But so was theintervention.” modest,”wereeffects ments.“The Razani greaterimprovewith correlating- outings nature of numbers higher with response, dose- followeda Manyhealth. mental and activity physical their in improvements significant statistically but small encing experi- results, indistinguishable largely journal the year in reportedlast she similar.fact,as In were they surprise, her to benefits—and, given amapoflocal parks. weresimply others programming;the and transportation,included food,that outings 65percent were alsoinvited threeon nature park visits per week for three months. About outdoor-activityilythree prescriptionsfor anxiety,”receivedweretheyand told) fam - and stressless experiencenature,you (“In benefits healthpotential were on counseled randomized trial of 78 parents to find out. All a undertook2015,Razani In outside? goto ier? Is it more effective than just telling them patientshealthmakeoutdoors.- it does But getting tobarriers potential any eliminate to seeks program the families, other and ecological scavenger hunt. an rangeron a with off headseven, would begin to color in the warmer valleys. In Jack aspens the whilesnow of dusting first their get mountains the September, In ming. Igbinakenzua says that SHINE has helped have rides don’there,they people “Most Her study also found that the poorest and Razani found that both groups saw health By wrangling transportation, food, guides, OUTSIDE MAGAZINE the two groups had groupstwo the One, PLOS quickly to westernWyoto quickly Nature Rx 05.19 Outsde Outsde - - - - - insurers have begun dipping their toes intotoes their dipping insurershavebegun healthintervention, low-cost potential a thusiasm oftheirchampions. whimsthe with funderstheir of en- the and giving.charitablePrograms flowor and ebb and group outings tends to come from grants brochures,prescriptionpads,surveys,park software,for Money institutions. medical individual or departments public-health mental nonprofits, local parks agencies, and environbetween- partnerships largelyby far,effortshave developedfunded been and Soones. new startto money find towhere and open programs existing keep to pay should who deciding is them among Chief hurdles.of number a faces still movement he pleaded. “That’s going to turn people off.” foresttermbathing,”habits. the use“Don’t improvesocial-mediatoparticipants their medical officer for WebMD, admonished the energeticWhyte, chief the John point, one Atprecision. for need the about grumbled doctorsresearchaction; moredelaywould ture.Conservationists worried callsthat for na- via medicine to came who those and medicine via nature to coming were who those between formed tension mild talks, the of course the Overbenefits. health of evidence generatehard and funding, tent consis- find movement, the within scale greaterachieve to how debated They ers. rangpark and - guides fromtestimonialsto listened Sabgir,and Davidcardiologist by walksled Razani,wenton and Zarr by tions bird,”presentathrough - sat attendees the outdoorsy- the bydescribed “blue groupas health benefits ofnature. the recreationdiscussconvened toleaders outdoor-managers,nurses,and land ists, scientists,hundreddoctors, conservation - range,severalsummer high-altitude their venturedfromdownelk the as Health,and year’s Lands,Public Last Public was theme tomorrow”).forinvest we how (“Shaping U.C.recreation,Festivalthe and servation con - conferenceon annual an of start the marksOctober of weather cooler the son, FACE TOFACE.MAYBEWENEEDTIMEOUTSIDE. DEVELOPED INA LAB. MAYBE WE NEED TO TALK THATWASN’TDISCARDED. MAYBEWENEEDFOOD HEALTH CARE SEEM TO BE THINGS WE’VE RECENTLY SOME OFTHEMOSTPROMISINGINNOVATIONSIN That may change. Intrigued by nature as as natureby change.Intrigued may That debates,the the during clear became As consistently days brisk severalAcross government andcommunity affairs. ment,”saysBerejka,MarcREI’s director of work.) “Weare totrying catalyze movethe - her $200,000forRazani granted Nooshin also Washington.has of (ToREI date,sity Univer the at initiative forresearch Health Nature a launch help to million $1 dustry, shortly after the festival REI pledged says. “It’s justamatter ofadaptingit.” alreadytechnologymove.exists,” “This he how long you’re out and how vigorously you monitor also app’swill developer,it hopes tracking.Wiley,locationGreg via ment the passivelyto app recordprescriptionfulfill- Parks,forexample,to refine plans itsphone State Tennessee problems. these of out patientsregisterRx must hikesthroughtheir ideally only after they’d visited a park. 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Since then, says Betty Sun, its support aroundConservancy’s workParks tional system, began funding the Golden Gate Na- largest not-for-profit integrated health care waters.the Permanente,Kaiser nation’s the In a show of faith from the outdoor in- outdoor the from faith of show a In insurers back other holding obstacle One li- CarolinaNorth 2018,the April in And innovatewaytheir soon wouldgrams pro - these behind managers and ers design- the that confidence voiced of its group trips. outside visits park tracking for tem sys - no has gram pro- SHINE The portal. online an Many at SHIFT at Many - -

ANDRIC/GALLERY STOCK OUTSIDE MAGAZINE 85 if peopleenduphappierandhealthier.” versity of Washington. “We’ll know it worked director Josh Lawler, an carepractice,health saysNatureHealth for we needtimeoutside. face.Maybetoface talk to need weMaybe lab. a in developedwasn’t that food need we’vethings recentlydiscarded. Maybewe conservationists, with and us reconnectto journalists,also but insurers, parkagencies, tion, involving not just health care providers care seem to be the outcome of collective ac- health in innovationspromising most the of some that life modern paradoxof It’sa few.a just watersupply, name the tofrom removecontamination,foror deadlytoxins wastechannel away from cities, screen food change—to for efforts collective through arrivedhave number largeHistorically, a pharmacies.shelves of waysthe from come GREAT ADVANCES The initiative ultimately aims to inform to aims ultimatelyinitiative The Treating nature as medicine can’t overcan’t medicine as Treatingnature in public health don’t al- Nature Rx ecologist at the Uni - Outsde Outsde - ture—the sights, the sounds, the smells— the sounds, the sights,ture—the na- in ingredientsactive the that believed lar exercise—outdoors if possible. Anderson reguencouragedand that - counting calorie interventionprediabetesprogram a added blood-pressuremedication.Now Anderson ease, andpremature death. dis- diabetes,heartfor risk at him putting high, too werepressure blood sugar,and cholesterol, his tor,blood that him warned Navydoc- formerAnderson, Greg a sician, two years ago, Bulcroft’s primary-care phy checkup gardener.annual his during Then, mostly sat for leisure, though he was an avid University,ington work forand satBulcroft Western65-year-oldat Washsociologist - A sat. Bulcroft life, adult his of Formuch outside anddiscovering thatitsuits them. venturingthemselves finding are patients movementgrows,the as meantime, the In tion to those who lack the means of doing so. ture back into our lives and give more atten- normal, it could motivate us to welcome na- feeltonatural spacesdays in our of portion gentle insistence that we need to spend some the in But walkable.more cities our make or air chronicallyour won’tunwell.clean It us make to conspiring forces the come Reluctantly,alreadystartedhad Bulcroft experience. Bulcroft’s Rick was This - ( SCIENCE WRITERAARON REUBEN AT DUKE UNIVERSITY. CANDIDATE INCLINICAL PSYCHOLOGY billion-dollar drug.” a be would it pill, a in nature of power the put youpatients. if Andersonhis tells“But they went.” glad they’re and better feel they time the theygo. don’tIf they is happen can that thing worst “The scriptions.“There’s downside,”no says.he problem is that I’ve had to buy new clothes.” greatnow,”feel “I says.Bulcroftonly “The med. blood-pressure the off go probably could he him told Anderson that fact, in blood sugar were normal. He was so healthy, pounds. His blood pressure, cholesterol, and Bulcroft says. “I was justbeingoutside.” exercisinglikeanymore,”feel didn’t it park the “With clicked. morning—something the in cedar fresh smelling woods, the in trailstime—wanderingquiet this But gym. the at hours logginglargely past,by the in shape in getto tried had Bulcroftcounting. would doasmuchfor Bulcroft asthecalorie “We don’t see a lot of ads for parks on TV,” Last year, Anderson wrote 165 nature pre- 60 lost had later,Bulcroft months Six @AARONREUBEN) ISAPH.D. go, then 100 percent of percentof 100 go,then do

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