There is often a delay between knowledge about a health risk or benefit and action related to this knowledge.

For instance, regarding tobacco:

• Studies conducted in the 1950s showed a link between smoking and higher death rates.

• A 1954 survey of Massachusetts physicians found that more than 50% were daily smokers.

• It wasn't until over a decade later, in 1964, that the US Surgeon General held a press conference on smoking and health. In his conference, he discussed that smoking causes lung cancer.

• After the 1964 announcement, the public health service established the Office on Smoking and Health, expanding the knowledge and resources regarding smoking and health.

• The following year Congress passed the Federal Cigarette Labeling and Advertising Act, mandating that cigarettes carry a warning, but it wasn't implemented fully until 1971.

• It wasn't until the 1970s and 1980s that smoking rates decreased significantly among U.S. doctors.

• Since then, many factors have contributed to increased efforts against tobacco use in the U.S. American Cancer Society talks about a "quit day" and provides ways to prepare for this day.

Currently, NIH and FDA conduct extensive national tobacco research, including that on smoking cessation.

Regarding alcohol:

• Alcohol-related health risks were known in the 1930s but the Surgeon General didn't formally recommend limiting alcohol intake until the late 1980s.

• Fetal alcohol spectrum disorder was observed before 1900 but it wasn't until research was conducted in the 1960s and 1970s that a public awareness warning was delivered to the FDA in 1977.

• Now there is an entire government Institute, the National Institute on Alcohol Abuse and Alcoholism, dedicated to alcohol and health.

When will it be our turn?

According to an article published by the Yale School of the Environment, rigorous research related to nature and health began in the 1970s when Rachel and Stephen Kaplan devised the Attention Restoration Theory. The issue of health, greenspace, and now climate change is gaining momentum and over the past two decades numerous studies have shown links between nature exposure and improvements in mental health, physical health, and sense of well-being. These associations were particularly evident during the pandemic, when nature exposure was shown to be associated with less depression, anxiety, stress and more happiness and life satisfaction; in addition to increased physical activity and improved sleep. In fact, our very own Dr. Robert Zarr served as co-principal investigator on a randomized controlled trial in Washington DC during the pandemic, and found that issuing park prescriptions resulted in a significant increase in objectively-measured moderate to vigorous physical activity, park visits and time spent in parks.

Do we need to wait for a Surgeon General to publicly discuss health risks associated with lack of outdoor time? Do we need to wait for a specific medical organization to develop a statement or recommend healthcare providers devise programs to improve outdoor time for their patients? Do we need Congress to pass an Act that leads to increased time outside? Should we first develop an Office within the Department of Health and Human Services dedicated to Health and Nature? (For a brief moment during the last administration, HHS had an Office of Climate Change and Health Equity but that Office no longer exists).

The answer is a resounding NO. We healthcare providers, community workers, public health professionals, park staff, and activist citizens don't need to wait for the government to step in and develop a federal initiative, or Office, or Institute. This takes time. And time is of the essence. We just need to hear what the research is telling us and what the pandemic has taught us. Recognize how the outdoors has an effect on your own health. And start talking about spending more time outdoors with your own patients and clients. Instead of a "quit day," develop a "Get into Nature day." Prescribe nature. Follow up. And spread the word to other providers.

If you don't know how to start the conversation, feel free to contact us!

Zainab Nazir, M.S. Psychology

PhD Student, SNEWS Lab

Rice University, Department of Psychological Sciences

•  We have been incredibly busy these days. We just completed a study at El Centro de Corazon Clinics in Houston, Texas, where we evaluated reciprocal ecological and human health restoration. This was a community based project, enabled through a grant from the United States Forest Service, where we focused on reciprocal ecological and human health in a group of employees at a federally qualified health care center. It was comprised of many partners and intervention components, including nature prescription oversight and gamification conducted by PRA, tree planting and tending led by Dr. Tamberly Conway other arborists, monthly forest therapy experiences led by Paola Silva Rodriguez and other Certified Nature and Forest Therapy Guides, and surveys and program evaluation conducted by Dr. Rebecca Brossoit and Zainab Nazir at Rice University.

We evaluated outdoor behaviors (such as time outside), health and well-being (e.g., mental health), affective outcomes (e.g., affect towards trees and work), cognitive outcomes (e.g., job performance), and prosocial outcomes (e.g., pro-environmental behavior).

While we can't share all of our results yet, they are indeed exciting and promising, with some significant results. We can tell you that 82% of our participants who completed the end of study survey wanted the program to be continued and/or expanded. More to come soon...

• We are also excited to announce that we were chosen by Hack4Impact at Cornell University to develop a PRA app! Hack4Impact is an organization that connects student software developers with socially responsible nonprofit organizations to develop new tools for social change to help further their mission. 

Over the past several years, based on feedback from our registrants, we have researched how to develop an app, so our collaboration with this organization comes at a perfect time. We hope to bring your more detailed information with this endeavor over the next several months.

Stacy Beller Stryer will be speaking on September 16 at the 2-day Osher Symposium for Successful Aging. 

The Symposium for Successful Aging is an annual in-person event hosted by the Osher Lifelong Learning Institute at Boise State University focusing on health, wellness, and active living for older adults.

About Dr. Susan Abookire, BSEE, MD, MPH, FACP

Dr. Susan Abookire is a former systems aviation engineer, a Harvard Medical School Assistant Professor, and a seasoned healthcare executive with over two decades of leadership experience. She has served as Chief Medical Officer, and Chair of Quality and Patient Safety at a Harvard-affiliated hospital. With training in Internal Medicine, public health, and as a certified Forest Therapy guide, Dr. Abookire brings a an integrative perspective to provider wellbeing and healthcare transformation.

About Ronna Schneberger

Ronna Schneberger is a distinguished naturalist, certified executive coach, and professional hiking guide with over 30 years of experience in Canada's Mountain Parks. She is a forest therapy guide and ANFT trainer. Ronna serves as Chair of Nature and Forest Therapy of Canada. In 2021, she played a key role in the launch of Canadian Park Prescription Program, delivering forest therapy sessions to frontline health professionals during the pandemic.

With over 2,200 registered providers across the country, we know there are a lot of stories out there of prescribing nature for the first time and patient successes. Take a moment to Share Your Story and get a chance to be showcased on our Provider Spotlight page.

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