A Solution to the Health Crisis: Prescribed Time in Neighborhood Parks

ASLA 2018 Professional General Design Awards. Re-Envisioning Pulaski Park, Northampton, Massachusetts. Stimson / Ngoc Doan

The average American now spends 90 percent of their life indoors. Some 40 percent of adults no longer engage in any leisure physical activity at all. Some 90 percent of healthcare costs go to treating the 132 million Americans who suffer from treatable chronic diseases such as diabetes, depression, anxiety, and high blood pressure. There are now 78 million obese adults and 12 million obese kids. Furthermore, the trends seem to only be heading in the wrong direction.

How can we turn this around? For John Henderson, executive director of Park Rx America, a key solution is getting people outdoors and active again.

At the American Planning Association (APA) conference in San Francisco, Henderson explained that exposure to nature reduces the damaging impacts of chronic stress and improves mood and cognition. And exercising in nature amplifies the many health benefits of physical activity.

Given Americans experience 90 percent of their exposure to nature in their neighborhood, it’s important to provide “meaningful” opportunities for healthy nature engagement through high-quality local parks.

But with Americans spending so little time outside, even in their own neighborhoods, who’s going to get people to actually go outside to exercise?

The answer may be doctors and nurses, who have some of the highest levels of trustworthiness and credibility among any professions.

There are now more than 100 “Park Rx” programs in which doctors and nurses prescribe activities in neighborhood parks as treatment for a range of medical conditions. Washington, D.C.-based Dr. Robert Zarr has been credited with spearheading this growing nature-based healthcare movement.

Instead of detailing doses of pharmaceuticals in a conventional prescription, doctors in Park Rx programs prescribe doses of the “nature pill” — time spent in green spaces — including directions about how often and how long to do various activities there. Instead of sending a prescription to a pharmacy near the patient’s house, they send the patient to a park near their home.

Doctors and patients can use Park Rx America’s “Find a Park” web tool to identify parks near them. The tool enables users to filter parks that have been deemed safe and accessible by available amenities. According to Henderson, the number one question doctors ask about local parks is: “Are they safe?”

Park Rx America map of spaces in Washington, D.C. / Park Rx America

Once patients are assigned a park, they can use a smartphone app to keep track of their progress in following a nature activity prescription. They can send their medical provider a text message and geo-tagged marker from the park, proving they’ve completed tasks. This data also helps inform the provider about the efficacy of different prescriptions.

Park Rx shows that a nascent healthcare infrastructure for doctors and patients is forming. But what about the other side of the equation — providing widespread access to high-quality neighborhood parks with lots of amenities?

Also on the panel at APA was a team from Montgomery County, Maryland, a suburban county outside Washington, D.C. that is being strategic about using its limited funds to create local parks, plazas, and trails with the biggest bang for the buck, health-wise.

The county has a population of one million and includes small cities like Wheaton, Silver Spring, and Germantown. Montgomery County already leads on national health indicator rankings but government leaders realized the county has much more to do to make green space accessible to everyone.

Christina Sassaki, a planner in charge of the county’s “energized public spaces (EPS)” program, explained how they recently forged an EPS master plan, which is the result of an exercise to map gaps in green space along with public surveys measuring demand for various amenities, such as playgrounds, trails, dog parks, and outdoor exercise equipment.

Energized Public Spaces master plan / Montgomery County

The team found that “parks and public spaces are not equal” across the county. Some neighborhoods enjoy larger parks, say 2-3 acres, while others in denser urban areas have smaller ones at an acre or less. But they found park size wasn’t the only determinant of park quality — it’s also about what amenities are available. “We decided to measure neighborhood access to different types of experiences instead of acres,” Sassaki said.

Through a systematic GIS analysis, Montgomery County analyzed all green public spaces in terms of their ability to provide contemplative experiences where residents can re-connect with nature; active recreational experiences with sports and exercise facilities; and social gathering experiences where residents can feel welcome and comfortable. GIS Manager Christopher McGovern then plotted all the amenities that enable these experiences on a grid covering the entire county.

The EPS plan identified the top 12 “deficit clusters,” mostly in the mixed-use centers, the downtowns where there are high concentrations of populations and multi-family apartment buildings. In these denser deficit areas, “there was particularly a shortage of contemplative and active experiences,” Sassaki said.

The plan focuses on improving the range of experiences found via amenities in smaller parks and creating new parks and plazas in underserved areas. The county has also been piloting revamps of public spaces — all of this with the goal of packing in more amenities groups like Park Rx America can then offer to nature-savvy doctors and patients.

Your Chance to Comment: The Latest Georgetown C&O Canal Designs

C&O Canal in Georgetown / James Corner Field Operations

Last November, landscape architecture firm James Corner Field Operations presented ambitious designs for the 1-mile segment of the 182-mile-long C&O Canal that passes through Georgetown. The goal then seemed to be to throw a bunch of bold ideas out there to see what sticks. Six months later, at a public comment meeting in Georgetown sponsored by the National Park Service (NPS) and Georgetown Heritage, a non-profit group financing the planning and design process, Field Operations offered a pared-back plan more respectful of historic preservation concerns. Sarah Astheimer, ASLA, a principal at Field Operations, said the latest design concepts are “smarter, more incisive, and more responsive to the site.”

NPS said they can either take no action other than immediate repairs or maintenance to this highly-popular national park, or they can design and build the “alternative design” approach, which for the purposes of public evaluation is separated into two options.

NPS, Georgetown Heritage, and Field Operations clearly listened to community concerns that the original proposals would be too radical a shift in the laid-back feel of the canal. Responding to over 350 comments from the public, power point slides in the presentation now highlighted the “historic significance” and “informal charm” of the linear park beloved to many D.C. residents and tourists.

An important discussion in this review focused on whether to expand the width of the narrow towpaths that limit access along parts of the canal. But instead of long, cantilevering pathways that were offered last November, Field Operations now proposes widening the paths slightly and only at key “pinch points,” a more strategic solution. Astheimer imagined new linear platforms as contemporary equivalents of the wooden decks that once lined the canal.

Cantilevered pathways onto the Canal / James Corner Field Operations

At mile-marker zero, the beginning of the 182-mile-long trail, Field Operations proposes intelligent fixes to improve pedestrian and bicycle connectivity and make the marker more of a destination. One option includes fun “habitable nets,” where people can lounge over the water, a feature now seen in other urban waterfront parks.

Current view at Mile Marker Zero / James Corner Field Operations
Mile Marker Zero area conceptual design / James Corner Field Operations

The proposal for the area they call Rock Creek Confluence, where the canal meets the creek, is also sensible, opening up views to the creek and the sequence of locks through a viewing platform set in pollinator-friendly meadows. A new pedestrian bridge will make both sides of the canal more accessible.

Rock Creek Confluence / James Corner Field Operations
Rock Creek Confluence design concept / James Corner Field Operations

The Mule Yard design options feature more trees and expanded visitor infrastructure. Heading west towards Wisconsin Avenue, a busy corridor lined with coffee shops, restaurants, and stores, they propose a few alternatives to improve accessibility. Where the canal flows under Wisconsin Avenue, there are a few configurations with stairs and an elevator; and on the south side of the canal, a new boardwalk.

Market plazas area design option / James Corner Field Operations

Further west down the canal, at Potomac Street, one of the central commercial hubs of Georgetown, where crowds come hear a jazz trio at Dean & Deluca on the weekends, an overlook has been transformed either into a “sky deck” or terraced seating. The designers propose opening up views across the canal here by clearing old trees along the south side of the canal. Elevators and Americans with Disabilites Act (ADA)-accessible ramps would make the canal, which can only be reached via steep stairs, far easier to traverse. These proposals would likely increase activity here and help bring more people down to the canal and perhaps the Georgetown Waterfront Park a few blocks to the south.

Market areas design concept / James Corner Field Operations

Lastly, the aqueduct and stone yard segments, the points in the plan furthest out from downtown Georgetown, are proposed as new destinations. The Stone Yard area could be left alone, but Field Operations proposes adding a platform or outdoor seating nooks there.

At the old aqueduct, which is now an interesting, graffiti-covered ruin, Corner’s team proposes heavily redeveloping the space — either as zig-zagging overlook platform or as a structure covered in a trestle, with a kiosk. This is the remaining ambitious piece perhaps most reminiscent of the High Line in New York City, which Corner’s firm also designed.

Aqueduct design proposal / James Corner Field Operations

Astheimer seemed to understand what many community members conveyed in the first public review: that the C&O Canal is a “respite in a time when we are all overstimulated.” The new design concepts largely help preserve that vision while improving access and safety. Perhaps the community will find the final designs can be even more surgical, so as to further limit impacts on this historical landscape.

Review the designs and submit your comments by May 11.

Coming next this spring: NPS, Georgetown Heritage, and Field Operations will finalize the plan, and then present design concepts before the Old Georgetown Board and the National Capital Planning Commission (NCPC) in the coming year.

Singapore’s New Garden Airport

Jewel Changi Airport / PWP Landscape Architecture, Safdie Architects

International airports are in fierce competition for passengers and regularly one-up each other with new wow-factor amenities, shops, and restaurants. But Singapore decided to raise its game by going another direction: a plant-filled haven, a gateway consistent with its moniker — “the city in a garden.” The result is an inventive model other airports should copy, if not in form, then certainly in spirit.

The new Jewel Changi airport features a 6-acre indoor forest, walking trails, and the world’s tallest indoor waterfall. This restorative mecca filled with 2,500 trees and 100,000 shrubs not only revitalizes weary international travelers but is also open to the public.

Over the past six years, Safdie Architects has led a team that included PWP Landscape Architecture, Atelier 10, WET, Burohappold, and ICN International to create this bar-raising travel experience.

As anyone who experienced the stress of air travel can attest, the onslaught of digital signs, loud speakers announcing departures, shops blaring music, and carts flying by quickly leads to draining sensory overload. Now imagine if there was a natural place to take a break amid the cacophony. As many studies have shown, just 10 minutes of immersion in nature can reduce stress, restore cognitive ability, and improve mood.

Jewel Changi provides that nearby natural respite with a 5-story-tall forest encased in a 144,000-square-foot steel and glass donut structure. During rain storms, water pours through an oculus in the roof — creating the 130-foot-tall Rain Vortex, a mesmerizing waterfall sculpture that can accommodate up to 10,000 gallons per minute at peak flow. Stormwater is then recycled throughout the building.

Jewel Changi Airport Rain Vortex / PWP Landscape Architecture, Safdie Architects
Jewel Changi Airport Rain Vortex / PWP Landscape Architecture, Safdie Architects

According to Adam Greenspan, ASLA, a partner at PWP, there is a “forest valley” and a “canopy park.” Throughout, the firm used stone and wood to create winding paths that immerse visitors in nature.

Jewel Changi Airport / PWP Landscape Architecture, Safdie Architects

The valley is organized into terraces, like you would find in a shade-covered coffee or tree plantation, and features three types of trees: Terminalia, a native to Madagascar; Agathis Borneensis, which is native to Malaysia and Indonesia; and Agathis Robusta, which is native to Australia. Terraced planters are faced with Indonesian lava stone that epiphytic and and other plants can climb.

Jewel Changi Airport / PWP Landscape Architecture, Safdie Architects

Amid the canopy park, PWP planted a number of species of wide-spreading Ficus trees that will eventually create shade and a comfortable environment. Up on the fifth level, there’s a topiary walk and horticultural gardens, and an event space for up to 1,000 people.

Jewel Changi aiport upper canopy / PWP Landscape Architecture

Throughout the biosphere-like terminal, PWP selected some 200 species of mostly-highland plant species, calibrating them to the giant torus’ unique conditions where temperatures and humidity levels are slightly cooler than outside. “Air movement, humidity, and natural light have all been balanced.”

Jewel Changi Airport roof and oculus / Safdie Architects

In addition to hosting some 300 shops and restaurants and a transit hotel, the terminal connects to the city’s public bus system. Pedestrian bridges and an inter-terminal train link passengers and visitors to the airport’s many gates.

Jewel Changi Airport train tunnel / PWP Landscape Architecture, Safdie Architects

With Jewel Changi, Singapore has reinvented what an airport can be, just as they re-imagined what a hospital can be with Khoo Teck Puat Hospital, which is not only a medical facility but also a green hub open to the community. Now let’s hope Singapore’s biophilic design culture spreads around the world, like the planes that leave its terminals.