What if there were a pill-free way to reduce your stress and anxiety, relieve headaches and lessen insomnia? With Nature Rx, the road to better health outcomes for Cincinnati residents just might be a literal walk in the park.
(Photo by Lisa Dugan)
A groundbreaking, nature-as-wellness initiative, Nature Rx is a partnership between the Osher Center for Integrative Health at the University of Cincinnati Medical Center and the Cincinnati Parks Foundation that reframes time outdoors as a prescriptive health intervention.
“The Osher Center is primarily about transforming a system of mostly disease and sick care, which we have in this country, to one that also includes and prioritizes well care and prevention and self-care,” said Sian Cotton, psychologist and director of the Osher Center. “We do that by combining the wonderful benefits of modern medicine with tried and true integrative therapies and lifestyle medicine approaches, like food is medicine, nature is medicine, exercise and movement is medicine.”
The health benefits of communing with nature have earned the spotlight over the last decade or so. Research has shown that being in nature for just 20 minutes per day can reduce anxiety, lower blood pressure, strengthen the immune system, improve mood, sharpen cognitive function, balance the nervous system, decrease stress and more. Studies have also found that just viewing nature through a computer screen can be beneficial.
One such study in the United Kingdom (Monitor of Engagement with the Natural Environment) found that people who had been in nature for at least two recreational hours reported significantly greater health and well-being. Now, 120 minutes can sound like a massive time commitment. But the benefits exist even when the nature visits are spread out over the course of the week.
That’s where programs like Nature Rx come in. This initiative is part of the central hub that is Park Rx America, which helps health care providers and individuals locate nearby parks from any U.S. ZIP code.
“It’s going to be an individualized thing, just as a normal prescription would be,” said Barbara Walker, an integrative health and performance psychologist and the director of the Nature Rx program. “Each patient would be looked at individually to figure out what best meets their needs – where they feel comfortable, how they feel comfortable.”
(Photo by Lisa Dugan)
The seeds for the Nature Rx partnership were planted back in 2019. Former Cincinnati Parks Foundation board Chair Cathy Crain mentioned Parks Rx America to Cotton, who was intrigued by the idea. Crain then introduced Cotton to Jennifer Spieser, president and chief executive officer of the Cincinnati Parks Foundation. The two ended up meeting for three hours.
“They have the space and we have the science and health and medicine side that says, ‘This is really important,’ ” Cotton said. “To combine the science of nature as medicine with their gorgeous platform, it was just a no-brainer for all of us.”
The Cincinnati Parks Foundation is the philanthropic arm of the Cincinnati Parks system. The foundation, which turns 30 this year, raises money in support of the parks, including efforts towards restoration and enhancements, conservation, accessibility and programming.
Community partnerships are also woven into the foundation’s fabric, and Nature Rx is not the foundation’s first foray into nature-as-medicine. In 2019, the Foundation teamed up with Cincinnati Children’s and Jennifer Angeli, a pediatric physical therapist at Children’s, to get the be.well program up and running.
“[Two of] our values in the Cincinnati Parks Foundation are inclusion and accessibility,” said Spieser. “Parks are for everyone. But when you look at a 200-year-old urban park system, it’s never going to be ADA compliant and fully accessible. There was [a] conversation [to] give programming dollars to Cincinnati Children’s and bring inclusive and accessible programs into Cincinnati Parks.”
The be.well program gives children with disabilities the opportunity to be active outdoors, make new friends and improve their health. The partnership allowed for six to eight accessible programs to be held in Cincinnati parks, from yoga to biking to running to tai chi and more. In 2022, be.well created an adaptive hiking program, which ended up winning a Governor’s Award.
“There’s magic in there,” Spieser said. “You see not only the kids experiencing parks and having activities outside in this fresh air, but it’s really special to see the parents and guardians, like, take a minute and breathe and be with other parents in something fun that their kids can do that normally [is] not easy for them.”
Nature Rx capitalizes on the parks’ many resources and couples them with the life-improving assistance doctors and medicine provide for patients. At its very best, modern medicine promises to be a cure. This program acts as a restorative and a preventative, and, unlike medicine from a pharmacy, is free. But how can medical professionals know if a patient is filling their prescription? And if going into a Cincinnati Park is free, why is a prescription even necessary in the first place?
“A bit of the objective behind that is, if you have a prescription, it’s a bit of an accountability tool,” Walker said. “A lot of people listen to their physicians. If their physician is the one who’s writing that prescription and really holding them accountable and writing it down, like a goal, and then [the patient] can report that back to somebody, the likelihood of the behavior increases.”
Before diving into anything, Spieser and the Osher team decided to hold an event to gauge potential public interest.
“We thought, ‘Let’s first start with a test and see what kind of reaction you get from the general public having an opportunity to do a big event at Ault Park,’ ” Spieser said. “It was managed by Osher. We helped coordinate. There were almost 300 people that attended to do mindfulness walking, tai chi and yoga, and that was really well received.”
The program took off from there. Osher worked on getting an official designation in Epic, their electronic health services system, for parks for wellness, which came through in the fall of 2024. The Parks Foundation’s women’s committee took up the cause, as did many volunteers who run various Cincinnati Park Advisory Councils (which are similar to a neighborhood community council, only specifically for neighborhood parks.) Free publicity opportunities arose, like free programming during BLINK. Thanks to donors and fundraising, the Nature Rx program starts its first official pilot year on May 1, to the tune of under $50,000.
“What we’re doing now is gathering baseline data, meaning, how many people are being prescribed?” said Cotton. “What are the demographics of those people? Are they male, female; [what’s their] race? Where do they live? We are also looking at chronic conditions, so that we can at least start to get a baseline of X amount of people. And I anticipate maybe by the summer, we’ll have this data: X amount of people have been prescribed. We can start to get a snapshot of who’s being prescribed. We’re in Phase 1 research outcomes now.”
The Cincinnati Parks network has 130 parks and green spaces. By partnering with the Parks Foundation, Nature Rx can dramatically increase the opportunities available in nature for potential patients. The Parks already have robust programming of their own – like yoga in Burnet Woods in partnership with World Peace Yoga, or the free roller skating programs down at Sawyer Point.
The foundation is creating a field guide for visitors, whether they have a prescription or not, highlighting programming offered at 11 selected parks. The actual wellness programming through Nature Rx will happen in about five parks.
This is not an ownership thing,” Cotton said. “This is about, ‘We think we’ve got a great model.’ We feel very, very committed to serving our most under-resourced community members in particular, which is why we have focused on partnering with the Cincinnati Parks specifically.”
We’ve always thought of parks as places where we all can relax and enjoy ourselves. With programs such as Nature Rx, they also could be the cure for what ails us. Or the prevention of what might.
med.uc.edu/institutes/integrative/home
cincinnatiparksfoundation.org/programs
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