Would a Natural Health Service help us build back better?

The Norweigan playwright Henrik Ibsen coined the wonderfully evocative friluftsliv in 1859, amalgamating the words for free, air and life. The Nordic countries have embraced this concept, best translated as ‘an outdoors lifestyle’. In Sweden, a country of 10 million people, nearly 2 million people are members of the 9,000 local and regional clubs devoted to outdoor activities, with around one third of the population engaging in activities at least once a week. In his famous Walden: Or, Life in the Woods, Henry David Thoreau wrote, “We need the tonic of wildness…We can never have enough of nature.” Similarly, Carl Jung wrote “we all need nourishment for our psyche. It is impossible to find such nourishment in urban tenements without a patch of green or a blossoming tree. We need a relationship with nature.”

Science has confirmed these feelings on multiple occasions. In 2009, a team of Dutch researchers found a lower incidence of 15 diseases, including depression, anxiety, heart disease, diabetes, asthma and migraines, in people who lived within about a half mile of green space. When Japanese researchers at Chiba University investigated the effects of Shinrin-yoku (‘forest bathing’), they found that “forest environments promote lower concentrations of cortisol, lower pulse rate, lower blood pressure, greater parasympathetic nerve activity, and lower sympathetic nerve activity than do city environments.” In 2011, the Scandinvian Journal of Public Health published a review of nature-assisted therapy, finding “that a small but reliable evidence base supports the effectiveness and appropriateness of NAT as a relevant resource for public health. Significant improvements were found for varied outcomes in diverse diagnoses, spanning from obesity to schizophrenia.”

Despite these continued findings, our daily lives trend in the opposite direction. The world is increasingly urbanised. People spend up to 90 percent of their time indoors, often in polluted environments. Even before the pandemic, total media time had reached an astonishing 12 hours 20 minutes per day, an increase of hour and a half in just two years. All while we spend more time and money on the pursuit of health and wellness than ever before, enthusiastically signing up for meditation apps and live-streamed spinning classes. 🤦🏼‍♂️

Natural Heath Service

For a state-funded behemoth employing 1.7 million people, Britain’s National Health Service (NHS) has some surprisingly radical parts. Green social prescribing is one such area, where health workers can refer patients to nature-based activities in order to help tackle mental ill health. The need is urgent, with the NHS reporting that as many as 40% of primary care appointments relate to mental health, and those with severe and prolonged mental health issues at risk of dying 15 to 20 years earlier than those without such issues.

As part of the recovery from the coronavirus pandemic, the NHS is part of a cross-governmental initiative focused on scaling up green social prescribing. The £4 million, two-year pilot project’s aims are to improve mental health outcomes, reduce health inequalities and demand on the NHS. The project builds on a number of previous initiatives within the NHS, including a Scottish program allowing doctors to prescribe walking in the fresh air; doctors in Manchester that prescribed plant care and gardening for patients suffering from anxiety, depression and loneliness; a social prescribing project in Rotherham that resulted in a 13% reduction in Emergency Room visits over a 12 month period. The Wildlife Trust, a nonprofit which runs nature conservation projects for people suffering from anxiety found that its specialised health or social needs projects, which connect people to nature have a social return of £6.88 for every £1 of investment.

The UK isn’t alone. New Zealand and Japan both have green social prescription initiatives. ParkRx is a Washington DC-based non-profit in a similar vein. The Montreal Museum of Fine Arts (MMFA) has offered patients free museum visits, and in Aalborg, Denmark, the Kulturvitaminer (Culture Vitamins) brings arts and culture to unemployed people suffering from stress or depression.

As always with health there are remedies, and then there is prevention and optimisation. There will be huge opportunities in reconnecting healthy people with nature. Getting outside has become a status symbol. Nilofer Merchant’s three minute TED talk claimed that “sitting is the new smoking” and encourages taking walking meetings outdoors. It has been viewed nearly 3.5 million times. Barack Obama and Steve Jobs were famed for embracing the habit. Some lucky tech workers don’t even need to go outside: Amazon’s biophilic-designed Seattle HQ, The Spheres, features over 40,000 plants from over 30 countries.

Our physical environments shape our mental health. How — and where — will you embrace the Future Normal in nature? Some thought-starters for you:

What if…?

🏃🏽‍♀️ You monitored your time outside as you monitor your screen time & step counts? Knowledge is power.

🖼 You looked to other alternative therapies? Art, sport and community have also been prescribed.

🌻 You could support these efforts? Take your team outside! Share your experiences! Sponsor nature-based activities!

🍀 You could adopt the principles of biophilic design in your daily life and work?

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Ridiculous? Or revolutionary?

The Future Normal asks what the world could look like as we move out of our current fracture.

We’d love your feedback, tips and advice. Will green prescriptions scale? Will we quickly be too busy and stressed to take the time to get outside? Will we even be able to experience nature in the next generation of mega-cities? How will this play out globally?

Let us know your thoughts in the comments below!

Thanks for reading,

Henry & Rohit.