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Why doctors are increasingly prescribing nature

As rates of chronic disease among children have skyrocketed over the past few decades, pediatricians have increasingly looked for solutions beyond the clinic. Sometimes that means actually prescribing time outside. Special correspondent Cat Wise reports from Oakland on the medical evidence that indicates escaping modern urban life, even temporarily, can yield health dividends.

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  • Judy Woodruff:

    As rates of chronic diseases among children have skyrocketed in the past few decades, pediatricians have increasingly looked for solutions beyond the traditional. Sometimes, that means prescribing time outdoors.

    Special correspondent Cat Wise has our story from Oakland, California.

    It's part of our regular series on the Leading Edge of science and health.

  • Cat Wise:

    Tina Igbinakenzua wishes Saturday mornings didn't look like this, with her 6-year-old Alex cooped up inside playing video games, playing, 7-year-old Lisa glued to the television.

  • Tina Igbinakenzua:

    OK, guys. Breakfast is set.

  • Cat Wise:

    And Tina herself frantic with chores. But even when she manages to drag the whole crew out into downtown Oakland for some fresh air, it's not what you would call rest and relaxation.

  • Tina Igbinakenzua:

    Alex, watch where you're going. Watch where you're going. Stop moving the tablet.

  • Cat Wise:

    The stress can be too much.

  • Tina Igbinakenzua:

    Every day, being a mother, you have to wake up, take them to school, go to work, get back home, get dinner for them, get them really read for school the next day. It's really challenging, for real.

  • Nooshin Razani:

    What are the barriers to getting outside and being in nature?

    Alex, can you turn it off for a second?

  • Cat Wise:

    That's why primary care doctor Nooshin Razani has written this entire family an unconventional prescription for the great outdoors.

  • Nooshin Razani:

    And we made a goal. And I think our goal was to walk around Lake Merritt three times a week. How did it go?

  • Cat Wise:

    At this clinic run by UCSF Benioff Children's Hospital in Oakland, Razani and her colleagues check on time spent outside nearly as much as they check their patients' pulse, weight and blood pressure.

  • Nooshin Razani:

    Do you think we could bump that up to getting outside every day?

  • Woman:

    Maybe, yes.

  • Nooshin Razani:

    Yes.

  • Cat Wise:

    Their goal is to write outdoor prescriptions as often as they prescribe pills — and to keep the dosage high.

    Depression, anxiety, and obesity rates in America have spiked in recent years, with the Centers for Disease Control and Prevention now estimating that nearly one in five children is obese.

  • Nooshin Razani:

    We see so many things that we don't have tools for. And family stress right now is something that it's — all those chronic illnesses happening in pediatrics.

    I mean, I didn't go into pediatrics to deal with like high blood pressure and issues that I deal with all the time now, or anxiety or depression. And so I think that nature and this idea of park prescriptions is empowering to me.

    Come in a circle.

  • Cat Wise:

    On this day, Dr. Razani was taking about a dozen of the low-income families she sees, all with serious inner-city barriers to getting outside, directly to one of the East Bay regional parks, which is actually partnering with the program.

  • Nooshin Razani:

    You have a beautiful world.

  • Cat Wise:

    The families meet on the first Saturday of the month for what's known as the SHINE program. They pile into a big yellow school bus and head out along the windy roads outside Oakland to Lake Chabot Regional Park.

  • Woman:

    Hello, everyone. Are you guys excited for a campfire tonight?

  • Children:

    Yes!

  • Cat Wise:

    Far from the sounds of downtown Oakland, they're encouraged to run wild without worry.

  • Woman:

    When all else fails, just run around.

  • Cat Wise:

    To think about things both bigger than themselves and smaller.

  • Woman:

    Look at all these little pathways. From the wood beetles, you think?

  • Cat Wise:

    It seems pretty common-sense that getting outdoors would be good for people. But does nature actually help to heal? There's growing scientific evidence it does.

    Studies have shown that exposure to nature can lower rates of everything from anxiety and depression to more surprising things like preterm labor, asthma and nearsightedness.

    But why nature is beneficial is not entirely clear. Some suspect that natural stimuli, the swaying trees, rushing water and singing birds, might reset our fight or flight response, which is too often switched into overdrive by the stresses of urban modern life.

    That rest, in turn, gives the body's psychological, digestive and immune systems the break they need to function normally.

  • Nooshin Razani:

    If you take an urban adult into a forest, within 15 minutes, you see improvements in cortisol, blood pressure, heart rate. But more convincing to me is the fact that people who live in green areas live longer.

  • Cat Wise:

    Through the SHINE program, Razani recently completed one of the first randomized trials on the benefits of park prescriptions for low-income families.

  • Nooshin Razani:

    Every park visit resulted in improved stress for parents. And every park visit resulted in improved resilience for a child. But it didn't matter if they came with us or they went on their own.

  • Cat Wise:

    The SHINE program is part of a network of more than 80 outdoor prescription programs in 34 states being tracked by the Park Prescription Census, most of which have sprouted in the last decade.

  • Narrator:

    From the people that brought you getting outside comes prescription-strength nature.

  • Cat Wise:

    The movement has even inspired spoof drug ads from the Colorado-based group Nature Rx.

  • Narrator:

    Nature can reduce cynicism, meaninglessness, anal retentiveness, and murderous rage.

  • Paula Morena:

    Are you feeling sad, depressed, anxious?

  • Woman:

    A little anxious, yes.

  • Cat Wise:

    The nature of the prescriptions vary by program, from general encouragement to old-fashioned paper scripts like the ones written at the Marin City Health & Wellness Center near San Francisco.

    Why is it important to write this all down on a piece of paper, a prescription pad, vs. just telling someone, why don't you get out into nature more?

  • Paula Morena:

    Yes, that's a really good question.

    So I feel like, if I'm writing this prescription, it's a form of an agreement between me and the patient. It's — but it's more for the patient themselves to take more accountability for their health.

  • Cat Wise:

    The idea is gaining traction in some unlikely quarters. San Francisco's VA Medical Center prescribes nature through its Warrior program for veterans who struggle with PTSD and anxiety.

  • Woman:

    If their roots are good and healthy, they're going to be holding on to that soil.

  • Cat Wise:

    Air Force vet Vercinia Vinzant saw the world as a threat before this program. After 22 years of service and some heavy trauma, she could barely leave her home.

  • Vercinia Vinzant:

    I don't know if people realize how important it is for people like me to be able to learn how to live in the world again, because trees are forgiving. The grass doesn't judge you.

    The grass doesn't care how squirrelly you seem to be that day. It doesn't care. When I first started this, I'm like, oh, come on, seriously? Going outside is going to help what, really? But, amazingly so, it does help.

  • Greg Moore:

    This pathway is used by about 1.5 million people a year.

  • Cat Wise:

    Greg Moore of the Golden Gate National Parks Conservancy helped create a national park prescription network to promote knowledge-sharing among all these groups.

    But the idea of using public lands as health care facilities isn't a new one, he says, just one in need of a comeback.

  • Greg Moore:

    I think that not many people are aware that, actually, the genesis of the park was a public health genesis. Central Park was developed because people in New York thought that there were unhealthy living conditions in New York.

    So, we're just returning to something we have known for a long time, and giving it a contemporary lens and motivation.

  • Woman:

    So in the time before time, they say that coyote was the creator of all great things.

  • Cat Wise:

    Several of the nation's largest insurers have begun supporting this work and reimbursing visits to health care providers as well.

    How would you address critics who might say that this is just a fad?

  • Nooshin Razani:

    I think, actually, what we're doing is common sense. The problem is that society has shifted so far away from common sense.

    I'm hoping that, rather than a fad, that kind of becomes an accepted standard of living and human right, not only for kids, actually, for everyone.

  • Cat Wise:

    A human right to fresh air and a taste of what's possible.

  • Woman:

    Delicious?

  • Cat Wise:

    For the "PBS NewsHour," I'm Cat Wise in Oakland, California.

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