Green Prescriptions

By Jake Robinson

Nature

Given the fundamental premise that we are all part of ‘nature’—each of us made up of atoms just like the rest of the biotic community; we all inhale the exhalations of plants, and our bodies are mini jungles teeming with other living entities—it may sound strange when someone suggests we should ‘prescribe nature’ to heal our ills. But many of us have forgotten that we’re part of a diverse community of subjects and the rest of the natural world has shaped our bodies and minds over millions of years. We need to spend time in the biotic community nurturing it and allowing it to nurture us in return. As Indigenous Professor Robin Wall-Kimmerer said, “as we work to heal the earth, the earth heals us”; connections and reciprocity are vital.

But many of us now live in brick, metal, and glass cubes, often stacked on top of one another, hundreds of feet high in the polluted ravines of the concrete jungle. Our physical, emotional, and experiential ties with our co-evolved friends (plants, animals, and microbes) have been severed. We’ve created new socio-ecological systems and desolate urban cocoons where nature’s collection of holobionts is shut out. So, now more than ever, ‘nature’ seems like a separate entity instead of a community that we are part of.

Nested nature

Many of us—and I speak through the white western lens—distance ourselves from fostering reciprocal connections with the land (or are prevented from doing so), consumed by the notion of convenience at all costs, whilst our ecosystems pay a heavy price, but not just our external ecosystems. As immunologist Dr Tari Haahtela said, “we’re protected by two nested layers of biodiversity”. He refers to the microbes in the plants, air, water, and soil, but also the microbes in and on our bodies, our “walking ecosystems”. Indeed, the current global megatrend of biodiversity loss coincides with the rapid increase in chronic autoimmune diseases and mental health issues. Social isolation is also rising and is a significant risk factor for mortality; some liken it to smoking heavily every day. These biological, psychological, and social maladies are now linked to our growing disconnection with natural environments and their biodiverse residents (including our microbial “old friends”).

Green prescriptions

My second PhD paper was called Green Prescriptions and Their Co-Benefits: Integrative Strategies for Public and Environmental Health. In this paper, Dr Martin Breed and I explored the concept of ‘green prescribing’. Doctors can now prescribe activities that involve spending time engaging with natural environments to benefit health and wellbeing. It’s a way to bring people closer to the rest of nature. A green prescription might involve gardening activities known as ‘therapeutic horticulture’. Alternatively, it could involve volunteering for a local biodiversity conservation group, or it could be in a much simpler form: “walking in an enchanted forest and immersing oneself in the sights, smells, and sounds of nature”—also known as forest bathing or shinrin-yoku (森林浴).

There’s potential for green prescriptions to contribute to both reactive (health care) and proactive (health-promoting) public health solutions whilst enhancing the natural environment. We discussed how green prescriptions could potentially benefit the environment, social cohesion, and the economy (i.e., ‘co-benefits’). We also discussed the challenges of the green prescribing concept and made recommendations for future research.

Green prescribing should not be seen as a low-cost alternative to conventional treatments. To be effective it still demands investment and resources. If it is to be successful in the long run, governments must make firm commitments to scaling up while addressing systemic issues such as social inequality. All this will take time, and if this holistic approach is not adopted then people in crisis with more immediate priorities will be less likely to engage with the rest of nature. Green prescribing also needs to be seen as one part of a holistic health-promotion strategy based on planetary health principles. In order to care for ourselves, we also need to care for our environment.

I spent many hours working with Sheffield’s awesome Greener Practice group on this concept. They are a group of GPs who recognise that the health of humans and our planet are deeply interconnected. As friend and GP, Gillian Orrow says, “we need to create the conditions for health to flourish”. This requires a community-centred approach whilst allowing biodiversity—including our invisible friends—to reach the core of our society and remain there as integral members of our communities.

Our children must have the opportunity to mingle with other life forms and develop a sense of reciprocity with the land from an early age. Otherwise, we will continue to see ourselves as separate from nature, and our health and ecosystems will continue to suffer.

Protect our habitats, walk through them, climb trees, caress the soil and the leaves. As Margaret Atwood said, “at the end of the day, we should smell like dirt”.

Find out more about green prescriptions in future blog posts and in my forthcoming book Invisible Friends.

Read the full paper here: https://www.mdpi.com/2078-1547/9/2/40/htm

Authors: Jake M. Robinson and Martin F. Breed