Rx: Get Out in Nature 

Healthy Parks Healthy Person Tennessee is an initiative of the Tennessee Department of Envrironment and Conservation’s State Parks, with support of the Tennessee Department of Health. This program works with healthcare providers across the state to promote the outdoors as a means of improving the health of Tennesseans.

A component of Healthy Parks Healthy Person Tennessee is the Parks Prescription program. It is a great avenue for nurses, physicians, and other health care professionals to assess physical activity of their patients, counsel on the importance of physical activity, and prescribe outdoor activity as part of the health or treatment plan. The park prescriptions come as a tear-off pad, just like regular prescriptions. As a bonus, patients can use the web-based phone app to log in outdoor experiences and earn rewards at state parks for participating in healthy outdoor activities. Points can be used for a healthy meal at a park restaurant, gift shop items, or a free 2 night stay at a TN State Park cabin!

Why nature and health?

According to the 2017 County Health Rankings and Roadmaps, 30 % of Tennessee adults report no leisure time physical activity, and 32% of Tennessee adults are obese. The Tennessee Department of Education Office of Coordinated School Health reports that in 2016, 38% of Tennessee public school children were overweight or obese. Obesity is a risk factor for many chronic conditions, including those among the leading causes of death in Tennessee, such as heart disease, stroke and diabetes.

Physical activity is critical to good health and most of us recommend it to our patients as a way to prevent obesity and its complications. One way to address physical activity is to think “outside the clinic” to Tennessee’s parks, greenways, green spaces and playgrounds for a dose of nature. While difficult to evaluate clinically or quantify through rigorous study (there’s no clear dose of nature, for example), there is a growing body of literature suggesting that exposure to nature is beneficial to overall health, with some studies demonstrating improved physical and mental outcomes. An excellent compilation of the literature can  be found in a 2014 review summarizing research, and proceedings from the Natural Environments Initiative meeting convened by the Center for Health and Global Environments at the Harvard School of Public Health.

In a popular 2006 book, Last Child in the Woods, journalist Richard Louv makes the case for children to be out in nature to improve creativity, critical thinking, focus, and sensitivity, as well as improvements in physical skills and strength.

The CDC lists specific evidence-based physical activity recommendations for adults (150 minutes of moderate-intensity aerobic activity per week) and children (60 minutes of moderate-intensity activity per day), so it makes sense for nurses and other medical professionals to suggest that people go outside for that activity, because there may be a lot of other benefits!

How did this develop?

Healthy Parks Healthy Person was started by Henry Horton State Park Manager, Ryan Jenkins, modeled after the nation-wide movement of the National Park Service to encourage people of all ages to enjoy time in nature, and burn some calories!  A big part of the success of Healthy Parks Healthy Person is due to the statewide Advisory Committee grassroots promotion of the initiative. A big thank you to all of our Advisory Committee members!

In Tennessee, many nurses, physicians, community health centers, and health department clinics are using the Parks Rx program. The Tennessee Medical Association (TMA) has passed a resolution encouraging physicians to use the program. The Tennessee Nurses’ Association (TNA) and Tennessee Hospital Association (THA) have written letters of support of the TMA resolution, and TNA will be writing its own resolution. The program is growing and improving with plans for expansion, having more healthcare providers involved and developing a robust app. This is just another we can build a culture of health!

How do I access materials?

Contact Ryan Jenkins for Park Prescription pads, brochures and posters for your office at:Ryan.jenkins@tn.gov

See Health Parks Healthy Person TN website and sign up for the reward program at: http://healthyparkstn.com/

View a you-tube video of Ryan talking about the program:

https://m.youtube.com/watch?v=5gDnMohkWDY

 

 

 

References and other Resources

Centers for Disease Control and Prevention Physical Activity Recommendations https://www.cdc.gov/physicalactivity/basics/index.htm

County Health Rankings and Roadmaps

http://www.countyhealthrankings.org/our-approach

 

National Parks Rx Program and Healthy Parks Healthy People US Strategic Action Plan

www.parkrx.org

https://www.nps.gov/public_health/hp/hphp/press/1012-955-WASO.pdf

 

2014 Paper from the Natural Environments Initiative meeting convened by the Center for Health and Global Environments at the Harvard School of Public Health:

http://www.chgeharvard.org/sites/default/files/resources/Paper-NaturalEnvironmentsInitiative_0.pdf