Let Nature Be Thy Medicine: A Socioecological Exploration of Green Prescribing in the UK

Abstract

Prescribing nature-based health interventions (green prescribing)—such as therapeutic horticulture or conservation activities—is an emerging transdisciplinary strategy focussed on reducing noncommunicable diseases. However, little is known about the practice of, and socioecological constraints/opportunities associated with, green prescribing in the UK. Furthermore, the distribution of green prescribing has yet to be comprehensively mapped. In this study, we conducted a socioecological exploration of green prescribing. We deployed online questionnaires to collect data from general practitioners (GPs) and nature-based organisations (NBOs) around the UK and conducted spatial analyses. Our results indicate that GPs and NBOs perceive and express some common and distinct constraints to green prescribing. This highlights the need to promote cross-disciplinary communication pathways. Greenspace presence and abundance within close proximity (100 and 250 m) to GP surgeries (but not greenness—as a proxy for vegetation cover) and NBO presence within 5 km were associated with higher levels of green prescribing provision. Lower levels of deprivation were associated with higher frequency of NBOs. This suggests that the availability of greenspaces and NBOs could be important for green prescribing provision, but there could be greater opportunities in less deprived areas. Important foci for future research should be to establish transdisciplinary collaborative pathways, efficient infrastructure management and a common vocabulary in green prescribing—with the overall aim of reducing inequalities and enhancing planetary health.

Nature-Based Interventions and Mind–Body Interventions: Saving Public Health Costs Whilst Increasing Life Satisfaction and Happiness

“…The Department for Health and Social Care [ 9 ] observed that “prevention and early intervention programmes represent very good value for money” in that poor health and well-being can be improved while at the same time taking cost and pressure away from primary and secondary health and public service systems. There are high levels of satisfaction with social and green prescribing [ 63 , 66 ], but it also important that these programmes do not become a reason for cutting public services. We conclude that nature-based and mind–body interventions can play an important role in helping to achieve these aspirations, particularly in a post-Covid-19 world, where economic and social stresses on individuals and health systems will be higher.…”

“…The NASP notes that SP is part of an aim to prescribe bespoke personalized medical and social interventions, but also note that health improvements may be “long slow journeys” for many patients. The term green prescribing has been used to refer to the nature-based options available to SP operations [ 65 , 66 ].…”

Exposure to Airborne Bacteria Depends upon Vertical Stratification and Vegetation Complexity

“…Buffer sizes of 10 m, 25 m, 50 m, and 100 m were considered appropriate for the study scale. Similar distances have been used in previous green space and epidemiology studies ( 31, 70–72 ). A 100 m maximum buffer radius was chosen; at greater distances, effects would no longer be local to the sampling points (i.e., they would overlap with other sampling points).…”

Vertical Stratification in Urban Green Space Aerobiomes

“…Do people who lie down or work close to the ground (e.g., gardeners bending over to dig) have different exposure levels to those who remain upright, and what are the downstream implications for health? Developing a refined understanding of this aerobiome-human interface could also have implications for the design and monitoring of nature-based health interventions, for example via green/nature prescribing (Robinson and Breed 2019;Shanahan et al 2019;Robinson et al 2020). Furthermore, protocols for sampling the aerobiome to date have often included a reasonable yet arbitrary sampling height of 2 m (Airaudi and Marchisio et al 1996;Cordeiro 2010;Mhuireach et al 2016;Domingue 2017).…”

“…Developing a refined understanding of this aerobiome–human interface could also have implications for the design and monitoring of nature-based health interventions, for example via green/nature prescribing ( Robinson and Breed 2019 ; Shanahan et al. 2019 ; Robinson et al. 2020 ).…”