Why doctors are prescribing 2 hours outside per week to boost brain and heart health

Canadian doctors have written more than 4,000 prescriptions to spend time outdoors in an attempt to turn the widely acknowledged health benefits of nature into another tool in the modern-day medical toolkit.

The program, called ParkRX, was developed in 2020 by a Vancouver physician in partnership with British Columbia’s BC Parks Foundation. Participating physicians hand their patients instructions to go outside, usually for two hours a week, as a means to improve specific conditions. These include everything from asthma to cardiovascular disease to ADHD and depression and anxiety.

ParkRX (PaRX for short) received a big boost and the backing of the Canadian government when, last month, Parks Canada, the agency that manages the country’s national parks, joined in the effort. The agency allowed physicians to “prescribe” a Parks Canada Discovery Pass. The prescribed pass allows people to enter any of Canada’s 38 National Parks for free; admission would otherwise cost $72 per person or $62 for a senior.

All for their health, participants can take in the mountain views of Banff National Park in Alberta, hike twisting trails through lush forests at the Pacific Rim National Park Reserve in British Columbia, or walk the footbridges that stretch across the waters of Prince Edward Island National Park. Doctor’s orders.

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Science in Action — The underlining idea of the PaRX program is not controversial: The health benefits of being outdoors have been widely recorded and studied.

“When a doctor writes something down research has shown patients are more likely to follow it.”

Yet, the average person in the U.S. spends 93 percent of their life indoors, according to the Environmental Protection Agency. The statistics available about Canada are more complex. A Neilson survey found that Canadians, on average, spend more than an hour outside on weekdays and on weekends, but researchers say that number is skewed by a few Canadians who are always outdoors (snowboarders, lumberjacks, and the Royal Canadian Mounted Police, presumably). 40 percent say they get no outdoor leisure.

PaRX is betting that a written note from a doctor will be the motivator needed to get people to the trailhead. Those who may block out other health advice may adhere to a note from their doctor, Prama Rahman, a coordinator for the BC Parks Foundation's Healthy By Nature Program tells Inverse. “When a doctor writes something down research has shown patients are more likely to follow it,” she says.

Nurses and doctors are the most and second-most trusted professionals in Canada, according to a poll, trusted by 92 and 89 percent of the populace, respectively.

Why It’s a Hack — PaRX has produced a library of handouts for patients outlining the scientifically tested benefits of green space for a range of medical concerns, including cancer care, cardiovascular health, mental health, advanced age, pregnancy, respiration, immunity, ADHD, allergies and asthma, and weight maintenance. There are even handouts on how nature has been shown to improve work performance‍ and school success.

Canada is not the only country to experiment with a “Park RX” program. There is a small movement in the U.S. encouraging doctors to give patients written, prescription-like instructions to spend more time outside. It picked up some traction due to concern about the shut-in phase of the Covid-19 pandemic.

Some physicians have also questioned the lack of research on the effectiveness of writing a nonmedical prescription and have clamored for a “unified research agenda” to test its outcomes.

Canada’s program may provide a large pool from which to study. The program has expanded from British Columbia to Ontario, Saskatchewan, and Manitoba, with plans to extend across the Great White North. Some additional nature attractions, like the Japanese gardens at the University of British Columbia, have accepted the “prescriptions” as passes, waiving admission.

How This Affects Longevity — As cited in PaRX’s literature, robust research shows that time outdoors can help ease a range of chronic conditions. Meta-analyses show wide-ranging health benefits of nature and many studies have examined these mechanisms in action.

Some examples:

• Middle-aged males in Japan who engaged in four hours of “forest therapy,” show-paced time in nature, dropped their blood pressure by an average of about 10 points.
• People who sat in a forest for 15 minutes reduced their cortisol levels and heart rate variability, signs of stress, while a control group that sat in an urban environment recurved no benefit.
• Participants who went on a 90-minute walk through a natural environment said they had lower levels of rumination and showed reduced neural activity in an area of the brain linked to risk for mental illness compared with those who walked through an urban environment.
• After a day trip to a forest, subjects in one study had elevated rates of NK cells for seven days. NK cells are immune cells that fight cancer and bacterial infection.
• Children with ADHA did better on school tests after walk in the park, better than children with ADHD who worked around a street.

Name a chronic condition and there has probably been at least some research demonstrating that getting outside for a few hours could improve it.

Hack Score — Seven out of ten breaths of fresh Rockies air 🏔 🏔 🏔 🏔 🏔 🏔