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.

One thought on “A Solution to the Health Crisis: Prescribed Time in Neighborhood Parks

  1. Kris 05/01/2019 / 9:58 am

    Small clarification: I believe you are referring to “type 2 diabetes” 🙂

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