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Natural Medicine: More Doctors Prescribing Time Outdoors

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As more studies affirm the health benefits of nature, doctors are writing it into their prescriptions. Michael H / Getty Images

Birdwatch for long-tailed ducks. Search for shells. Sketch some snowdrops.

These are some of the prescriptions you might receive if you go to a doctor in the Shetland Islands of Scotland and say that you are suffering from stress, heart disease, diabetes, mental health problems or other chronic conditions.


Starting Oct. 5, the UK's National Health Service (NHS) in Shetland has authorized doctors there to prescribe time outdoors, The Guardian reported. Doctors will pass out pamphlets written by the Royal Society for the Protection of Birds (RSPB) advising patients on walks to take and wildlife to watch out for.

The Shetland doctors are only the latest in a growing number of healthcare providers incorporating nature into their treatment plans as evidence mounts for the health benefits of time spent in wild spaces. In his 2005 book Last Child in the Woods, Richard Louv cited 60 studies finding that time outside helped mental and physical health, and that too much time spent away from nature caused harm. Now, the website of his Children & Nature Network lists more 700, Louv told The New York Times.

One doctor who was inspired by Louv's book was Dr. Robert Zarr, a Washington, DC pediatrician who started a nonprofit called Parks Rx America to make it easier for doctors to prescribe time in nature. The site has mapped and rated parks in the DC area and allows doctors to find parks near patients' homes.

Dr. Zarr told The New York Times he usually writes one or two park prescriptions per day, usually for children dealing with weight issues or teenagers dealing with mental health problems. Zarr said he lets his patients take the lead in planning activities.

"Is there anything they want to do that's enjoyable outside, that they're willing to commit to?" he said he might ask. "[Y]ou just told me you play soccer. How often do you go? Would you be willing to commit to going once a week or twice a week?"

Across the country in San Francisco, Dr. Daphne Miller wrote for The National Parks Conservation Association that she had seen success with prescriptions like:

Drug: Exercise in Glen Canyon Park (See attached Google map.) Dose: 45 minutes of walking or running Directions: Monday, Wednesday, Friday, and Saturday at 7:00 AM Refill: Unlimited

What I've noticed in my practice mirrors what has been observed in the studies: Inactive patients who initiate a new exercise regimen outdoors are more likely to stick with it than those who join a gym or work out in the confines of their basement. It seems that a number of things contribute to this "stickiness": the constantly varying scenery, the camaraderie of the trail, the fact that monthly dues and expensive Spandex outfits aren't required. And consistent with the research findings, my patients report a host of other benefits from their nature routine: less fatigue throughout the day, a sense of calm, better sleep, a drop in weight, and even lower blood pressure. Of course, not every patient takes the nature Rx and "runs" with it. But for many, a physician's advice, backed by a paper document, is just the push needed to venture onto the trails.

The phenomenon is not limited to the U.S. and UK. In fact, the benefits of spending time in forests was extensively researched in Japan in the 1980s, Joanne O'Connor wrote for The Guardian.. The researchers found that just two hours in the woods could reduce blood pressure and stress hormones and boost concentration and memory. Further, chemicals released by trees called phytoncides actually boosted the immune system. The practice of forest bathing, or shinrin-yoku, then grew into a national health program in Japan. It has since spread around the world, with sessions offered in parks from London to New York.

Akasawa forest in Japan was the first designated area for forest bathing.Saigen Jiro

Dr. Qing Li, who wrote Forest Bathing: How Trees Can Help You Find Health and Happiness, gave Time readers a primer in the practice. Try this out next time you find yourself stressed out and near some green space.

First, find a spot. Make sure you have left your phone and camera behind. You are going to be walking aimlessly and slowly. You don't need any devices. Let your body be your guide. Listen to where it wants to take you. Follow your nose. And take your time. It doesn't matter if you don't get anywhere. You are not going anywhere. You are savoring the sounds, smells and sights of nature and letting the forest in.

The key to unlocking the power of the forest is in the five senses. Let nature enter through your ears, eyes, nose, mouth, hands and feet. Listen to the birds singing and the breeze rustling in the leaves of the trees. Look at the different greens of the trees and the sunlight filtering through the branches. Smell the fragrance of the forest and breathe in the natural aromatherapy of phytoncides. Taste the freshness of the air as you take deep breaths. Place your hands on the trunk of a tree. Dip your fingers or toes in a stream. Lie on the ground. Drink in the flavor of the forest and release your sense of joy and calm. This is your sixth sense, a state of mind. Now you have connected with nature. You have crossed the bridge to happiness.

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Brazilians living in The Netherlands organized a demonstration in solidarity with rainforest protectors and against the president of Brazil, Jair Bolsonaro on Sept. 1 in The Hague, Netherlands. Romy Arroyo Fernandez / NurPhoto / Getty Images

By Tara Smith

Fires in the Brazilian Amazon have jumped 84 percent during President Jair Bolsonaro's first year in office and in July 2019 alone, an area of rainforest the size of Manhattan was lost every day. The Amazon fires may seem beyond human control, but they're not beyond human culpability.

Bolsonaro ran for president promising to "integrate the Amazon into the Brazilian economy". Once elected, he slashed the Brazilian environmental protection agency budget by 95 percent and relaxed safeguards for mining projects on indigenous lands. Farmers cited their support for Bolsonaro's approach as they set fires to clear rainforest for cattle grazing.

Bolsonaro's vandalism will be most painful for the indigenous people who call the Amazon home. But destruction of the world's largest rainforest may accelerate climate change and so cause further suffering worldwide. For that reason, Brazil's former environment minister, Marina Silva, called the Amazon fires a crime against humanity.

From a legal perspective, this might be a helpful way of prosecuting environmental destruction. Crimes against humanity are international crimes, like genocide and war crimes, which are considered to harm both the immediate victims and humanity as a whole. As such, all of humankind has an interest in their punishment and deterrence.

Historical Precedent

Crimes against humanity were first classified as an international crime during the Nuremberg trials that followed World War II. Two German Generals, Alfred Jodl and Lothar Rendulic, were charged with war crimes for implementing scorched earth policies in Finland and Norway. No one was charged with crimes against humanity for causing the unprecedented environmental damage that scarred the post-war landscapes though.

Our understanding of the Earth's ecology has matured since then, yet so has our capacity to pollute and destroy. It's now clear that the consequences of environmental destruction don't stop at national borders. All humanity is placed in jeopardy when burning rainforests flood the atmosphere with CO₂ and exacerbate climate change.

Holding someone like Bolsonaro to account for this by charging him with crimes against humanity would be a world first. If successful, it could set a precedent which might stimulate more aggressive legal action against environmental crimes. But do the Amazon fires fit the criteria?

Prosecuting crimes against humanity requires proof of widespread and systematic attacks against a civilian population. If a specific part of the global population is persecuted, this is an affront to the global conscience. In the same way, domestic crimes are an affront to the population of the state in which they occur.

When prosecuting prominent Nazis in Nuremberg, the US chief prosecutor, Robert Jackson, argued that crimes against humanity are committed by individuals, not abstract entities. Only by holding individuals accountable for their actions can widespread atrocities be deterred in future.

The International Criminal Court's Chief Prosecutor, Fatou Bensouda, has promised to apply the approach first developed in Nuremberg to prosecute individuals for international crimes that result in significant environmental damage. Her recommendations don't create new environmental crimes, such as "ecocide", which would punish severe environmental damage as a crime in itself. They do signal, however, a growing appreciation of the role that environmental damage plays in causing harm and suffering to people.

The International Criminal Court was asked in 2014 to open an investigation into allegations of land-grabbing by the Cambodian government. In Cambodia, large corporations and investment firms were being given prime agricultural land by the government, displacing up to 770,000 Cambodians from 4m hectares of land. Prosecuting these actions as crimes against humanity would be a positive first step towards holding individuals like Bolsonaro accountable.

But given the global consequences of the Amazon fires, could environmental destruction of this nature be legally considered a crime against all humanity? Defining it as such would be unprecedented. The same charge could apply to many politicians and business people. It's been argued that oil and gas executives who've funded disinformation about climate change for decades should be chief among them.

Charging individuals for environmental crimes against humanity could be an effective deterrent. But whether the law will develop in time to prosecute people like Bolsonaro is, as yet, uncertain. Until the International Criminal Court prosecutes individuals for crimes against humanity based on their environmental damage, holding individuals criminally accountable for climate change remains unlikely.

This story originally appeared in The Conversation. It is republished here as part of EcoWatch's partnership with Covering Climate Now, a global collaboration of more than 250 news outlets to strengthen coverage of the climate story.

Author, social activist and filmmaker Naomi Klein speaking on the one year anniversary of Hurricane Maria on Sept. 20, 2018. Erik McGregor / Pacific Press / LightRocket / Getty Images

By Natalie Hanman

Why are you publishing this book now?

I still feel that the way that we talk about climate change is too compartmentalised, too siloed from the other crises we face. A really strong theme running through the book is the links between it and the crisis of rising white supremacy, the various forms of nationalism and the fact that so many people are being forced from their homelands, and the war that is waged on our attention spans. These are intersecting and interconnecting crises and so the solutions have to be as well.

The book collects essays from the last decade, have you changed your mind about anything?

When I look back, I don't think I placed enough emphasis on the challenge climate change poses to the left. It's more obvious the way the climate crisis challenges a rightwing dominant worldview, and the cult of serious centrism that never wants to do anything big, that's always looking to split the difference. But this is also a challenge to a left worldview that is essentially only interested in redistributing the spoils of extractivism [the process of extracting natural resources from the earth] and not reckoning with the limits of endless consumption.

What's stopping the left doing this?

In a North American context, it's the greatest taboo of all to actually admit that there are going to be limits. You see that in the way Fox News has gone after the Green New Deal – they are coming after your hamburgers! It cuts to the heart of the American dream – every generation gets more than the last, there is always a new frontier to expand to, the whole idea of settler colonial nations like ours. When somebody comes along and says, actually, there are limits, we've got some tough decisions, we need to figure out how to manage what's left, we've got to share equitably – it is a psychic attack. And so the response [on the left] has been to avoid, and say no, no, we're not coming to take away your stuff, there are going to be all kinds of benefits. And there aregoing to be benefits: we'll have more livable cities, we'll have less polluted air, we'll spend less time stuck in traffic, we can design happier, richer lives in so many ways. But we are going to have to contract on the endless, disposable consumption side.

Do you feel encouraged by talk of the Green New Deal?

I feel a tremendous excitement and a sense of relief, that we are finally talking about solutions on the scale of the crisis we face. That we're not talking about a little carbon tax or a cap and trade scheme as a silver bullet. We're talking about transforming our economy. This system is failing the majority of people anyway, which is why we're in this period of such profound political destabilisation – that is giving us the Trumps and the Brexits, and all of these strongman leaders – so why don't we figure out how to change everything from bottom to top, and do it in a way that addresses all of these other crises at the same time? There is every chance we will miss the mark, but every fraction of a degree warming that we are able to hold off is a victory and every policy that we are able to win that makes our societies more humane, the more we will weather the inevitable shocks and storms to come without slipping into barbarism. Because what really terrifies me is what we are seeing at our borders in Europe and North America and Australia – I don't think it's coincidental that the settler colonial states and the countries that are the engines of that colonialism are at the forefront of this. We are seeing the beginnings of the era of climate barbarism. We saw it in Christchurch, we saw it in El Paso, where you have this marrying of white supremacist violence with vicious anti-immigrant racism.

That is one of the most chilling sections of your book: I think that's a link a lot of people haven't made.

This pattern has been clear for a while. White supremacy emerged not just because people felt like thinking up ideas that were going to get a lot of people killed but because it was useful to protect barbaric but highly profitable actions. The age of scientific racism begins alongside the transatlantic slave trade, it is a rationale for that brutality. If we are going to respond to climate change by fortressing our borders, then of course the theories that would justify that, that create these hierarchies of humanity, will come surging back. There have been signs of that for years, but it is getting harder to deny because you have killers who are screaming it from the rooftops.

One criticism you hear about the environment movement is that it is dominated by white people. How do you address that?

When you have a movement that is overwhelmingly representative of the most privileged sector of society then the approach is going to be much more fearful of change, because people who have a lot to lose tend to be more fearful of change, whereas people who have a lot to gain will tend to fight harder for it. That's the big benefit of having an approach to climate change that links it to those so called bread and butter issues: how are we going to get better paid jobs, affordable housing, a way for people to take care of their families?

I have had many conversations with environmentalists over the years where they seem really to believe that by linking fighting climate change with fighting poverty, or fighting for racial justice, it's going to make the fight harder. We have to get out of this "my crisis is bigger than your crisis: first we save the planet and then we fight poverty and racism, and violence against women". That doesn't work. That alienates the people who would fight hardest for change.

This debate has shifted a huge amount in the U.S. because of the leadership of the climate justice movement and because it is congresswomen of colour who are championing the Green New Deal. Alexandria Ocasio-Cortez, Ilhan Omar, Ayanna Pressley and Rashida Tlaibcome from communities that have gotten such a raw deal under the years of neoliberalism and longer, and are determined to represent, truly represent, the interests of those communities. They're not afraid of deep change because their communities desperately need it.

In the book, you write: "The hard truth is that the answer to the question 'What can I, as an individual, do to stop climate change?' is: nothing." Do you still believe that?

In terms of the carbon, the individual decisions that we make are not going to add up to anything like the kind of scale of change that we need. And I do believe that the fact that for so many people it's so much more comfortable to talk about our own personal consumption, than to talk about systemic change, is a product of neoliberalism, that we have been trained to see ourselves as consumers first. To me that's the benefit of bringing up these historical analogies, like the New Deal or the Marshall Plan – it brings our minds back to a time when we were able to think of change on that scale. Because we've been trained to think very small. It is incredibly significant that Greta Thunberg has turned her life into a living emergency.

Yes, she set sail for the UN climate summit in New York on a zero carbon yacht ...

Exactly. But this isn't about what Greta is doing as an individual. It's about what Greta is broadcasting in the choices that she makes as an activist, and I absolutely respect that. I think it's magnificent. She is using the power that she has to broadcast that this is an emergency, and trying to inspire politicians to treat it as an emergency. I don't think anybody is exempt from scrutinising their own decisions and behaviours but I think it is possible to overemphasise the individual choices. I have made a choice – and this has been true since I wrote No Logo, and I started getting these "what should I buy, where should I shop, what are the ethical clothes?" questions. My answer continues to be that I am not a lifestyle adviser, I am not anyone's shopping guru, and I make these decisions in my own life but I'm under no illusion that these decisions are going to make the difference.

Some people are choosing to go on birth strikes. What do you think about that?

I'm happy these discussions are coming into the public domain as opposed to being furtive issues we're afraid to talk about. It's been very isolating for people. It certainly was for me. One of the reasons I waited as long as I did to try and get pregnant, and I would say this to my partner all the time – what, you want to have a Mad Max water warrior fighting with their friends for food and water? It wasn't until I was part of the climate justice movement and I could see a path forward that I could even imagine having a kid. But I would never tell anybody how to answer this most intimate of questions. As a feminist who knows the brutal history of forced sterilisation and the ways in which women's bodies become battle zones when policymakers decide that they are going to try and control population, I think that the idea that there are regulatory solutions when it comes to whether or not to have kids is catastrophically ahistorical. We need to be struggling with our climate grief together and our climate fears together, through whatever decision we decide to make, but the discussion we need to have is how do we build a world so that those kids can have thriving, zero-carbon lives?

Over the summer, you encouraged people to read Richard Powers's novel, The Overstory. Why?

It's been incredibly important to me and I'm happy that so many people have written to me since. What Powers is writing about trees: that trees live in communities and are in communication, and plan and react together, and we've been completely wrong in the way we conceptualise them. It's the same conversation we're having about whether we are going to solve this as individuals or whether we are going to save the collective organism. It's also rare, in good fiction, to valorise activism, to treat it with real respect, failures and all, to acknowledge the heroism of the people who put their bodies on the line. I thought Powers did that in a really extraordinary way.

What are you views on what Extinction Rebellion has achieved?

One thing they have done so well is break us out of this classic campaign model we have been in for a long time, where you tell someone something scary, you ask them to click on something to do something about it, you skip out the whole phase where we need to grieve together and feel together and process what it is that we just saw. Because what I hear a lot from people is, ok, maybe those people back in the 1930s or 40s could organise neighbourhood by neighbourhood or workplace by workplace but we can't. We believe we've been so downgraded as a species that we are incapable of that. The only thing that is going to change that belief is getting face to face, in community, having experiences, off our screens, with one another on the streets and in nature, and winning some things and feeling that power.

You talk about stamina in the book. How do you keep going? Do you feel hopeful?

I have complicated feelings about the hope question. Not a day goes by that I don't have a moment of sheer panic, raw terror, complete conviction that we are doomed, and then I do pull myself out of it. I'm renewed by this new generation that is so determined, so forceful. I'm inspired by the willingness to engage in electoral politics, because my generation, when we were in our 20s and 30s, there was so much suspicion around getting our hands dirty with electoral politics that we lost a lot of opportunities. What gives me the most hope right now is that we've finally got the vision for what we want instead, or at least the first rough draft of it. This is the first time this has happened in my lifetime. And also, I did decide to have kids. I have a seven year old who is so completely obsessed and in love with the natural world. When I think about him, after we've spent an entire summer talking about the role of salmon in feeding the forests where he was born in British Columbia, and how they are linked to the health of the trees and the soil and the bears and the orcas and this entire magnificent ecosystem, and I think about what it would be like to have to tell him that there are no more salmon, it kills me. So that motivates me. And slays me.

This story was originally published by The Guardian, and is republished here as part of the Covering Climate Now partnership to strengthen the media's focus on the climate crisis.

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