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Prescribing Nature

A Physician’s Perspective on Wellness and the Outdoors

Es probable que en algún momento de los últimos meses hayas desempolvado esa vieja bicicleta que tienes guardada en el garaje, te hayas puesto las zapatillas para salir a caminar con más frecuencia o hayas participado en otras actividades al aire libre que normalmente no forman parte de tu rutina diaria. Parece tratarse de un fenómeno bastante universal que, ante la incertidumbre y el estrés de nuestra situación actual, buscamos consuelo y alivio en las experiencias al aire libre. To those in the landscape architecture and site furnishings industries however, this doesn't come as a surprise-creating positive, uplifting experiences outdoors is what we do. We know being outside makes us feel better, but does it make us actually be better? Can access to outdoor spaces drive larger positive public health outcomes?

Dr. Sara Warber, Clinical Professor Emeritus of Family Medicine at University of Michigan, discusses how our health is deeply intertwined with outdoor spaces and the environment.

Dr. Sara Warber, Clinical Professor Emeritus of Family Medicine at University of Michigan, says the answer is yes, our health is deeply intertwined with outdoor spaces and the environment. "While it's something that we intuitively understand as humans, studies prove the health benefits of spending time outside. The emotional benefits of being outdoors are the best studied and most well-known-when outdoors, people's reported mental wellbeing is generally improved, positive emotions are enhanced, perceived stress is down, and feelings of depression are down," says Dr. Warber.

“But what I find even more fascinating is how the environment can actually change our physiology.”

– Dr. Sara Warber, Clinical Professor Emeritus of Family Medicine, University of Michigan
Forest bathing is a practice in which one makes a concerted effort to be immersed in the outdoor environment.
“Bio-psycho-social-spiritual model” is a way of holistically conceptualizing the impact of outdoor experiences throughout the different facets of human health.

Dr. Warber points to studies involving "forest bathing," a practice in which one makes a concerted effort to be immersed in the outdoor environment, as evidence of this phenomenon. "The research that has been done on forest bathing particularly in Japan and Korea has shown us that when in nature, our immune system changes, our endocrine system changes, and our heart rate variability changes into a more nurturant state rather than an anxiety-stress state." This physiological lens is just one aspect of what Dr. Warber calls the "bio-psycho-social-spiritual model," a way of holistically conceptualizing the impact of outdoor experiences throughout the different facets of human health.

"When we think about how COVID-19 has affected us all, we have this deep need to reflect and understand our surroundings. Nature provides a context for us to get into the reflective mindset that we need as individuals to put our lives in order," continues Dr. Warber. "Some of our research has focused on spiritual wellbeing, and while not everyone is comfortable with this concept, I think a focus on the transcendent experiences some people feel in nature is important." Dr. Warber highlights these "mountaintop experiences," as she also calls them, as an aspect unique to the outdoors that can help nurture a healthy relationship with oneself and provide meaning to one's place in the world.

“Mountaintop experiences,” as Dr. Warber calls them, is an aspect unique to the outdoors that can help nurture a healthy relationship with oneself and provide meaning to one’s place in the world.
Nature provides a context for us to get into the reflective mindset that we need as individuals to put our lives in order.

Expanding the discussion from the individual level to the larger level of public health, Dr. Warber describes how COVID-19’s differing impact on different communities is important evidence of the role that designers, urban planners, and landscape architects play in supporting the health of their communities.

"From a public health standpoint, we are always thinking about the social determinants of health," says Dr. Warber. "As a primary care physician, I know that everything we do in a doctor's office, while important, is minuscule compared to the impacts of the social dimensions such as housing, transportation, economic opportunity, food security, and access to the outdoors. COVID-19 demonstrates this stark reality as different communities in our country experience differing levels of severity and mortality. So if designers, architects, and urban planners ever wonder if their work can make a difference in regard to the health of their communities, I say look at the social determinants of public health and how in many ways, design can touch on them all."