Prescribing Nature: A Physician’s Perspective on Wellness and the Outdoors
Chances are that some time in
recent months you’ve dusted off that old bike in the garage, put on your walking shoes a little more
regularly, or enjoyed other outdoor activities that are normally outside of your daily routine. This
seems to be a pretty universal phenomenon that, as we are faced with the uncertainty and stress of our
current situation, we turn to outdoor experiences for comfort and relief. To those in the landscape
architecture and site furnishings industries however, this doesn’t come as a surprise—creating positive,
uplifting experiences outdoors is what we do. We know being outside makes us feel better, but does it
make us actually be better? Can access to outdoor spaces drive larger positive public health outcomes?
Caption: Dr. Sara Warber,
Clinical Professor Emeritus of Family Medicine at University of Michigan, discusses how our health is
deeply intertwined with outdoor spaces and the environment.
Dr. Sara Warber, Clinical Professor Emeritus of Family
Medicine at University of Michigan, says the answer is yes, our health is deeply intertwined with outdoor
spaces and the environment. “While it’s something that we intuitively understand as humans, studies prove
the health benefits of spending time outside. The emotional benefits of being outdoors are the best studied
and most well-known—when outdoors, people's reported mental wellbeing is generally improved, positive
emotions are enhanced, perceived stress is down, and feelings of depression are down,” says Dr. Warber. “But
what I find even more fascinating is how the environment can actually change our physiology.”
Caption: Forest bathing is a
practice in which one makes a concerted effort to be immersed in the outdoor environment.
Dr. Warber points to studies involving “forest bathing,” a practice in which one
makes a concerted effort to be immersed in the outdoor environment, as evidence of this phenomenon. "The
research that has been done on forest bathing particularly in Japan and Korea has shown us that when in
nature, our immune system changes, our endocrine system changes, and our heart rate variability changes into
a more nurturant state rather than an anxiety-stress state.” This physiological lens is just one aspect of
what Dr. Warber calls the “bio-psycho-social-spiritual model,” a way of holistically conceptualizing the
impact of outdoor experiences throughout the different facets of human health.
“Bio-psycho-social-spiritual model” is a way of holistically conceptualizing the impact of outdoor
experiences throughout the different facets of human health.
"When we think about how COVID-19 has affected us all, we have this deep need to
reflect and understand our surroundings. Nature provides a context for us to get into the reflective mindset
that we need as individuals to put our lives in order,” continues Dr. Warber. “Some of our research has
focused on spiritual wellbeing, and while not everyone is comfortable with this concept, I think a focus on
the transcendent experiences some people feel in nature is important.” Dr. Warber highlights these
“mountaintop experiences,” as she also calls them, as an aspect unique to the outdoors that can help nurture
a healthy relationship with oneself and provide meaning to one’s place in the world.
“Mountaintop experiences,” as Dr. Warber calls them, is an aspect unique to the outdoors that can help
nurture a healthy relationship with oneself and provide meaning to one’s place in the world.
Expanding the discussion from the individual level to the larger level of public
health, Dr. Warber describes how COVID-19’s differing impact on different communities is important evidence
of the role that designers, urban planners, and landscape architects play in supporting the health of their
Nature provides a context for us to get into the reflective mindset that we need as individuals to put
our lives in order.
“From a public health standpoint, we are always thinking about the social
determinants of health,” says Dr. Warber. “As a primary care physician, I know that everything we do in a
doctor’s office, while important, is minuscule compared to the impacts of the social dimensions such as
housing, transportation, economic opportunity, food security, and access to the outdoors. COVID-19
demonstrates this stark reality as different communities in our country experience differing levels of
severity and mortality. So if designers, architects, and urban planners ever wonder if their work can make a
difference in regard to the health of their communities, I say look at the social determinants of public
health and how in many ways, design can touch on them all."