The “healthy dose” of nature: A cautionary tale

Bell, Sarah; Leyshon, Catherine; Foley, Ronan; Kearns, Robin

doi:10.1111/gec3.12415

Cited by 44 publications

(21 citation statements)

References 79 publications

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“…However, simply viewing nature as a "pill" with a "dose-response curve" is not the endgame of clinical ecology as the "family practice" arm of planetary health. Indeed, this may run counter to its very goals [132,133]. Clinical ecology can only be realized with input from ecologists, geographers, and related experts.…”

Section: Practical Implicationsmentioning

confidence: 99%

Clinical Ecology—Transforming 21st-Century Medicine with Planetary Health in Mind

Nelson¹,

Prescott

Logan³

et al. 2019

Challenges

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Four decades ago, several health movements were sprouting in isolation. In 1980, the environmental group Friends of the Earth expanded the World Health Organization definition of health, reminding citizenry that, “health is a state of complete physical, mental, social and ecological well-being and not merely the absence of disease—personal health involves planetary health”. At the same time, a small group of medical clinicians were voicing the concept of “clinical ecology”—that is, a perspective that sees illness, especially chronic illness, as a response to the total lived experience and the surroundings in which “exposures” accumulate. In parallel, other groups advanced the concept of holistic medicine. In 1977, the progressive physician-scientist Jonas Salk stated that “we are entering into a new Epoch in which holistic medicine will be the dominant model”. However, only recently have the primary messages of these mostly isolated movements merged into a unified interdisciplinary discourse. The grand, interconnected challenges of our time—an epidemic of non-communicable diseases, global socioeconomic inequalities, biodiversity losses, climate change, disconnect from the natural environment—demands that all of medicine be viewed from an ecological perspective. Aided by advances in ‘omics’ technology, it is increasingly clear that each person maintains complex, biologically-relevant microbial ecosystems, and those ecosystems are, in turn, a product of the lived experiences within larger social, political, and economic ecosystems. Recognizing that 21st-century medicine is, in fact, clinical ecology can help clear an additional path as we attempt to exit the Anthropocene.

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Section: Practical Implicationsmentioning

confidence: 99%

Clinical Ecology—Transforming 21st-Century Medicine with Planetary Health in Mind

Nelson¹,

Prescott

Logan³

et al. 2019

Challenges

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show abstract

“…Rigorous evaluations are needed to identify appropriate interventions, and to understand the mechanisms and the contexts in which they are effective. There have been recent calls to take a more critical view of the 'dose of nature' approach, and to include a focus on social practices to cater for the complexities of how individuals experience and interpret nature [78]. This exemplifies the importance of diversity and holism in our approaches to public and planetary health.…”

Section: Challenges and Remaining Fundamental Questionsmentioning

confidence: 99%

Green Prescriptions and Their Co-Benefits: Integrative Strategies for Public and Environmental Health

2019

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There is a growing recognition of the links between the increasing prevalence of noncommunicable diseases, environmental concerns including biodiversity loss and ecosystem degradation, and socioecological issues such as ecological (in)justice. This has encouraged a number of recent calls for the development of integrative approaches aimed at addressing these issues—also known as nature-based solutions. An example of an emerging nature-based solution is a ‘green prescription’, broadly defined as a nature-based health intervention. Green prescriptions are typically designed for patients with a defined need and they have the potential to supplement orthodox medical treatments, particularly those aimed at addressing noncommunicable diseases. It is also thought that green prescriptions could bring about significant environmental, economic, and social co-benefits. However, researchers have recently expressed concerns over taking the ‘dose of nature’ approach, in that it may be too reductionistic for the complex social settings in which it is provided. Here we frame a holistic philosophical perspective and discuss green prescribing logic, types, mechanisms and fundamental remaining questions and challenges. We place a significant emphasis on the potential co-benefits of green prescriptions, and the importance of taking a planetary health approach. More research is needed to determine how this potential can be realised, and to further understand the complexities of the nature–human health relationship. However, with additional research and support, there is huge potential for green prescriptions to contribute to both reactive (health care) and proactive (health promoting) public health solutions whilst enhancing the natural environment.

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“…Nature Rx is an example of a non-pharmacological or social prescription intended to increase physical activity and increase time outside [16]. However, evidence documenting the specific health conditions that would benefit from the appropriate “dose” of nature and how different populations may respond to Nature Rx is lacking [17,18,19,20].…”

Section: Introductionmentioning

confidence: 99%

Walking Green: Developing an Evidence Base for Nature Prescriptions

Koselka

Weidner

Minasov

et al. 2019

IJERPH

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Although the health benefits of exercise and exposure to nature are well established, most evidence of their interaction comes from acute observations of single sessions of activity. However, documenting improved health outcomes requires ongoing interventions, measurement of multiple outcomes, and longitudinal analyses. We conducted a pilot study to guide the development of a protocol for future longitudinal studies that would assess multiple physiological and psychological outcomes. Herein, we report psychological outcomes measured from thirty-eight participants before and after three conditions: a 50 min walk on a forest path, a 50 min walk along a busy road, and a period of activities of daily living. Changes in positive and negative affect, anxiety, perceived stress, and working memory are reported. We benchmark these results to existing studies that used similar protocols and also identify elements of the protocol that might impair recruitment or retention of subjects in longer-term studies. Linear mixed-models regression revealed that walking improved psychological state when compared to activities of daily living, regardless of walk environment (p < 0.05). Comparison of mean differences showed that forest walks yielded the largest and most consistent improvements in psychological state. Thus, despite a protocol that required a 3.5 h time commitment per laboratory visit, the beneficial effects of walking and exposure to a forested environment were observed.

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The “healthy dose” of nature: A cautionary tale

Cited by 44 publications

References 79 publications

Clinical Ecology—Transforming 21st-Century Medicine with Planetary Health in Mind

Clinical Ecology—Transforming 21st-Century Medicine with Planetary Health in Mind

Green Prescriptions and Their Co-Benefits: Integrative Strategies for Public and Environmental Health

Walking Green: Developing an Evidence Base for Nature Prescriptions

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