“WHY I PRESCRIBE NATURE” — In D.C., Pioneering Pediatricians Offer New Hope and Health Through Park


By Robert Zarr MD on November 5th, 2013

What in the world is a doctor doing writing a prescription for Nature? With our nation’s current epidemic of obesity, asthma, ADHD, and now Nature Deficit Disorder, it’s time that we doctors prescribe time outside, in Nature, for all our patients

I have worked for the last 12 years as a primary care pediatrician at a community health center in Washington, DC, where I see firsthand how sick our children are and how they suffer from chronic disease.

Just the other day I saw Michael, a 15 year-old patient of mine. His 24-hour activity and food diary revealed 5 hours of screen time on a school night (split between X-box and TV), 2 slices of pepperoni pizza and watermelon-flavored powdered beverage for breakfast, hamburger (without lettuce or tomato) for lunch, and 4 slices of pepperoni pizza plus watermelon-flavored powdered beverage for dinner. Michael suffers from asthma, obesity, and Nature deficit. This is typical of many adolescents.

Robert Zarr and son in a D.C. park

As a pediatrician, I have a responsibility to give advice and prescribe therapies that provide the greatest benefit with the least risk.

For example, if Mary, an infant of 11 months has a serious bacterial infection, I prescribe an antibiotic with the least side effects and narrowest spectrum to decrease the chance of creating resistant super bacteria.

Prescribing a park is very much like prescribing an antibiotic. First I have to make the right diagnosis.

Then I have to consider all the possible treatment options, taking into account a number of factors: risk benefit, cost (insurance status), readiness of patient or family to accept and adopt treatment modality, complexity of treatment, social context of patient, and the environmental impact.

Before I prescribe a park, I need to know if what I am prescribing is safe, clean, accessible, and has lots of different activity options that best match the interests of the patient/family and their schedule. With the help of several partner organizations and many volunteers, we have mapped all the green space in D.C. We have rated all 350 parks for access, cleanliness, level of activity and safety, developed a searchable database by zip code, and linked the database to our Electronic Medical Records (EMR).

Since July 1, 2013, our “go live” date, we have dispensed over 400 Park Prescriptions (Park Rx).

Our patients, my colleagues, and I have embraced Park Rx with open arms because we are all ready for a positive approach to chronic disease that poses virtually no risk, but both prevents and treats our modern day plagues like obesity, asthma, and mental illness.

My colleague sent me an email a couple of weeks ago, and here is what she had to say, “Park Rx works!!!! I have a kid (whom) I saw last month and gave her the Parks Handout and she has been going there three times a week and has lost weight!!!”

I would be remiss, though, if I didn’t mention my ulterior motive. I am not embarrassed to say that I want to save the planet.

Because our health is intimately linked to the health of our environment, we can’t have one without the other. In order to protect and conserve the environment, we must first value it. In order to value it, we must know it, and in order to know it we must touch, smell, breathe, and experience Nature. By getting people outside in Nature, I find that much more happens than weight reduction, lower heart rate, and a sense of focus and well-being.

We start to understand and value trees, clean air, water, fauna and flora in a way we hadn’t before, and we feel committed. We are creating the next generation of environmental stewards, conservationists, and activists.

Park Rx, therefore, serves two purposes: (1) to help create a healthier, happier society, a