Removing Barriers to Nature Access and Improving Health Through Nature

Full Solution
Doctors in Canada can now prescribe national park passes to patients
The Washington Post

Chronic diseases are the largest cause of mortality in Canada, costing $190 billion every year in treatment and lost productivity. Mental illness costs Canadians over $50 billion per year. Increasing access to nature is a powerful strategy for improving health and reducing healthcare costs.

 

PaRx is Canada’s national nature prescription program, led by health-care professionals who want to improve patient and planetary health by encouraging time spent in nature. The PaRx program makes it possible for health professionals to prescribe the health benefits of nature to any patient who would benefit from it. Collaboration between the BC Parks Foundation and Parks Canada on the PaRx program has expanded awareness of the health benefits of spending time in nature and increased the accessibility of Parks Canada administered places.

 

As the impacts of climate change on human health increase, increasing connections to nature will improve people’s health and resilience and increase public support for nature-based solutions.

Last update: 11 Jul 2023
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Context
Challenges addressed
Changes in socio-cultural context
Health

Social: The PaRx program addresses a nature deficit that negatively impacts people's health and well being. The PaRx program is improving health outcomes that increase support for nature protection, by allowing healthcare professionals to prescribe nature.  

Economic: The collaboration between the BC Parks Foundation and Parks Canada expanded the reach of the PaRx program. It targets patients who live close to Parks Canada places removing a financial barrier for patients who may not otherwise be able to experiece these places.

Environmental: The PaRx program is based on the demonstrated health benefits that come from spending time in nature. By prescribing nature as a tool to improve health outcomes for patients, the PaRx program is building connections between patients and nature. These connections strengthen long term public support for the protection of nature. 

Scale of implementation
National
Ecosystems
Cold desert
Temperate deciduous forest
Temperate evergreen forest
Estuary
Rocky reef / Rocky shore
Coastal forest
Beach
Pool, lake, pond
River, stream
Wetland (swamp, marsh, peatland)
Temperate grassland, savanna, shrubland
Tundra or montane grassland
Connective infrastructure, networks and corridors
Green spaces (parks, gardens, urban forests)
Urban wetlands
Theme
Access and benefit sharing
Biodiversity mainstreaming
Ecosystem services
Health and human wellbeing
Outreach & communications
Culture
Healthy Parks Healthy People
Nature pour tous
Nature For All
Location
Canada
North America
Process
Summary of the process

By establishing clear connections between Canada’s national nature destinations and regulated health professions across the country, the concept of parks and protected areas as an integral part of our healthcare system is emphasized and developed. Decision-makers, health-care professionals and the general public are becoming increasingly aware that healthy people depend on healthy ecosystems. At the same time, population health improves as a result of more people gaining access to natural spaces. Expanding access to natural spaces in turn increases support for conservation objectives.

 

PaRx Program: Nature prescription program increases patient health and awareness of role of parks and protected areas in health and wellness.

 

Collaboration with PCA: Increased access to Parks Canada nature destinations and awareness of role of natural and protected areas in health.

 

Outreach and Engagement: Amplification of message regarding link between nature and health led to uptake in program participation leading to more access and health benefits. 

 

Increased support for conservation by experiencing nature: More people spending time in natural and protected areas leads to more support for conservation efforts.

Building Blocks
PaRx Program: connecting nature to physical and mental health

The PaRx program is Canada’s national nature prescription program. Developed by the BC Parks Foundation, PaRx creates a framework to guide health-care practitioners in prescribing nature to improve patient health and wellbeing. The PaRx program features practical, clinician-focused resources like quick tips and patient handouts, in order to make prescribing time in nature easy and effective. PaRx prescriptions for nature recommend spending at least 2 hours a week in nature, at least 20 minutes at a time, in order to achieve the health and wellbeing benefits of connecting with nature.

 

The PaRx program design is based on studies suggesting that written prescriptions are better received than oral advice in motivating patients to make a change. Moreover, surveys indicate that health-care providers are consistently ranked among the most trusted professionals, increasing the likelihood that patients will adhere to recommendations to connect with nature for their health and well-being.

Enabling factors
  • Formal connections with and strong support from the health care community to issue prescriptions and track outcomes for the program.
  • Extensive research that supports the connections between time spent in nature and improved health outcomes.
Lesson learned
  • Important that the program be health-care-provider driven to ensure its relevance to prescribers and best support patients whose health can most benefit from time spent in nature.
  • The collection of data over time in the implementation of the program is key to determine if it is meeting objectives.
PaRx Program: Collaboration with Parks Canada

PaRx and Parks Canada worked together to identify shared objectives around increasing access to nature and the connection between health, well-being and spending time in nature. This collaboration was formalized in a three-year partnering agreement, establishing that Adult Discovery Passes (valued at $72.25 a year) would be provided free of charge to PaRx to be prescribed by health-care professionals during the course of regular visits. The Parks Canada Adult Discovery Pass provides admission for one adult to over 80 Parks Canada administered places across Canada that typically charge a daily entrance fee for an entire year, including national parks, national historic sites, and national marine conservation areas. When prescribing Adult Discovery Passes to patients, health care providers are asked to prioritize those who live close to national parks, national historic sites, or national marine conservation areas, and who could benefit from it the most, such as those for whom cost of accessing nature may be a barrier.

Enabling factors
  • Parks Canada’s willingness to present and protect natural and cultural spaces for overall ecosystem health benefits and benefits to human health.
  • Knowledge and capacity within the BC Parks Foundation to design and run a national health-care-provider-driven program.
  • Parks Canada’s management of a well-established and trusted network of nationally managed cultural and natural spaces across Canada.
Lesson learned
  • Initial administrative challenges in issuing Parks Canada passes to prescribers are being overcome and streamlined through new practices and Customer Management Systems (CRM) to improve ease of access for prescribers and patients.
  • Requirement for flexibility in issuing passes based on demand from prescribers. Originally 100 Adult Discovery Passes were offered as part of the program. When interest in the program ballooned after the launch of the collaboration, Parks Canada substantially increased its support in the form of additional Adult Discovery Passes,  to approximately 1500 passes in the first year of the collaboration.  
PaRx Program: Outreach and engagement with the public and with health-care professionals

The BC Parks Foundation and PaRx program conducted outreach and media events to raise awareness of the program and the link between health and nature. The launch of the collaboration with Parks Canada generated substantial media coverage, including from international outlets, thus raising awareness of the connections between nature and well-being, and the PaRx program. Parks Canada has also developed informational materials to help health-care providers connect patients with Parks Canada administered places, in so doing creating connections with the health-care community, increasing interest in health and wellness activities across Parks Canada destinations, strengthening engagement between health care sector and protected and conserved areas, and raising awareness of protected heritage areas in Canada.

Enabling factors
  • Both the BC Parks Foundation and Parks Canada have a track record of educating the public about the health benefits of time spent in nature and the importance of protecting nature to maximise these heath benefits for current and future generations.
  • Health care professional spokespeople as trusted messengers
Lesson learned
  • Regular communication between PaRx and endorsing health organizations ensures consistent and widespread promotion of the program to help build public and health-care professional trust in and awareness of the program.
  • Uptake of the program increased with targeted media campaigns and launches across provinces in Canada. Continued targeted marketing, new resources, and improved usability of the platforms is important for maintaining and growing interest in the program.
PaRx Program: Support for conservation objectives through experiencing nature

Research shows that people who are more connected to nature do more to protect it and engage in more pro-environmental behaviours in general. Through time spent in nature, people develop a sense of attachment to natural and cultural areas and increase their support and interest in the conservation of these protected and conserved areas.

 

Enabling factors
  • Research demonstrating the links between human health, nature connectedness and pro-environmental behaviours; time spent in nature, and protecting nature are solutions to improve health outcomes for both people and ecosystems.
  • Existing resources highlighting the connection between health and well being and time spent in nature
Lesson learned
  • Demonstrating the connection between nature prescriptions and a longer-term shift to prioritize nature protection is a complex research question that will take time and more resources. Longer term data sets and new research endeavours are required to confirm the link of nature use through the program to improve support of nature protection over time.
Impacts

The PaRx program collaboration with Parks Canada has helped to increase awareness of the importance of connecting people to nature for personal and planetary health, both in Canada and internationally:

  • In the month after the launch, there were over 90 media pieces in Canada and internationally. Including social media, the potential reach was 207,685,800 people exposed to information and evidence on the link between health and nature.
  • As of September 2022, over 9,500 licensed health professionals registered to prescribe nature through the program, including almost 5,000 doctors, or over 5% of all practising physicians in Canada.

PaRx continues to expand its reach and profile, improving patient and community well-being:

  • Over 3,000 prescriptions for nature have been issued through PaRx.  In June 2022, PaRx’s first prescriber survey revealed almost 80 per cent of respondents were prescribing nature to their patients monthly, primarily for mental health reasons such as anxiety, depression and stress.
  • PaRx was recognized by the World Health Organization in its COP26 Special Report on Climate Change and Health for inspiring protection and restoration of nature as the foundation of our health.

 Research indicates that intact, biodiverse natural spaces provide economic value through ecosystem services, that positively impact health.

Beneficiaries
  • Licensed healthcare professionals in Canada.
  • Canadians can be prescribed nature, who live where the PaRx program is active.
  • The collaboration between PaRx and Parks Canada targets Canadians who live in proximity to Parks Canada places.  
Sustainable Development Goals
SDG 3 – Good health and well-being
SDG 17 – Partnerships for the goals
Story

Marjorie Schurman, one of the first patients prescribed nature through the PaRx program, described the benefits to her mental health in a special feature by CNN. Schurman visited a doctor for depression and was prescribed time in nature. Within six weeks she saw noticeable improvements in her well-being.

 

To view the video story please visit: https://www.cnn.com/2022/04/30/health/canada-doctors-prescribe-nature-wellness/index.html

Connect with contributors
Other contributors
Melissa Lem
BC Parks Foundation et PaRx
Sarah Kraemer
Parks Canada
Erin MacNeil
Parks Canada