Nature Rx: Reemergence of Pediatric Nature-Based Therapeutic Programs From the Late 19th and Early 20th Centuries
Current nature prescription programs would do well to heed lessons from pediatric nature-based therapeutic programs from the past
The term “Nature Rx” or “nature prescription” may be new to the academic literature, but the concept isn’t. Prescriptions for the therapeutic use of nature were popular in some US cities in the late 19th and early 20th centuries. Such programs typically served children who were underweight and children with such orthopedic conditions like polio, rickets, and tuberculosis. These programs tended to operate from a wide range of objectives — from providing a safe place for children to play to treating seriously-ill infants and children. Such programs, however, all promoted time outdoors as beneficial to children’s health and well-being. These nature-based therapeutic programs were popular among working-class families, philanthropists, and physicians. Current nature prescription programs are similar in some ways to their historical antecedents, but there are ways in which they also differ. Current nature-based programs tend to focus on health-related ailments associated with a more sedentary and indoor-focused lifestyle, such as overweight and obesity, attention deficit hyperactivity disorder (ADHD), anxiety, and depression. Like programs in the past, they are usually found in urban environments, especially in socially disadvantaged areas.
This paper discusses the importance of learning lessons from the past in order to improve the chances of success for current nature prescription programs. For purposes of the discussion, Philadelphia is presented as an instructive historical case study. The Sanitarium Association of Philadelphia (SAP) and the Children’s Seashore House (CSH) were both popular nature-based health programs operating out of Philadelphia in the late 1800’s. Both programs temporarily removed children from the city center, often during the summer. Urban families did not need to be convinced of the value of placing children in a more nature-rich environment. Both institutions (SAP and CSH) provided food, clothing, child care, and a safe place for children to play away from the pollution and congestion of the city. Despite their popularity, these and other nature-based therapeutic programs gradually faded from medical practice during the 20th century. By the mid-20th century, physicians had largely abandoned nature-based therapeutic programs and replaced them with more clinical practices. Health care moved away from environmental ideologies and practices and became, instead, an increasingly “laboratory-oriented, technologically dependent, and hospital-based” profession.
There has recently been a reemergence of pediatric nature-based programs in cities across the US, with physicians showing more support for initiatives providing urban children with access to nature. Such support is based, in part, on scientific studies documenting improved health outcomes associated with time spent in natural environments. Despite renewed interest and scientific evidence of the benefits, these urban nature-based health initiatives face multiple challenges. Even with the scientific literature providing strong evidence of human health benefits of nature, some physicians want more quantifiable measures to prove the intervention’s success. Additional challenges relate to the lack of funding and the dependence on local parks. Nature prescription programs today often depend on the unfunded efforts of individual care providers, parks managers, and other public employees; and because there is no money for transportation, programs have to rely on patients’ access to nearby urban parks and green spaces.
Lessons from the past call attention to the importance of providing needed resources – such as accessible parks – and building on existing social networks. Lessons from the past also tell us that nature and its health related benefits aren’t easily quantified with scientific measures. We would, thus, do well “to pursue the role of nature not only in physiological processes but also in general well-being and in our common social history.”
Citation
Crnic, M., Kondo, M.C., (2019). Nature Rx: Reemergence of Pediatric Nature-Based Therapeutic Programs From the Late 19th and Early 20th Centuries. American Journal of Public Health
