Using Parks to Improve Children's Health
Using Parks to Improve Children's Health
Healthy Parks Healthy People Bay Area, which Razani has played a role in shaping, is the nation's most comprehensive park-prescription program. Launched in 2012, the effort involves numerous partners in all nine counties of the 7.1 million-resident metro area. It supports weekly, biweekly, and monthly activities targeting physical and mental health in a total of 35 parks.
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In addition, the City of San Francisco is, to date, the only city in the world to have fully adopted park prescriptions within its Department of Public Health, with weekly health-oriented programs at parks throughout the city. The program is still in pilot mode, says Curtis Chan, deputy health officer and medical director of the department's Maternal, Child, and Adolescent Health Section. Chan notes the program has had to combat some inertia in getting physicians to prescribe parks, but critical partnerships are being cemented citywide.
On the opposite coast, Washington, DC, is home to another well-known park-prescription program. There, Unity Health Care pediatrician and park-prescription advocate Robert Zarr has built a program from the ground up in which he has mapped and rated all the green spaces in the city for accessibility, cleanliness, safety, amenities, and services, producing a database that can be linked directly to patients' electronic medical records. Zarr's program has considerably less institutional support than the Bay Area program and therefore lacks the former's broad scope and participation. But it has still served as a model for other park-prescription programs across the country.
Currently 180 doctors at 26 Unity Health Care locations across the city have signed on, representing a potential reach of more than 100,000 patients. "If I'm successful in the next year and a half, I should have almost every pediatric practice [in the city] on board with prescribing nature," Zarr says.
Kids in Zarr's own clinic, which serves low-income and uninsured families (like all of Unity Health Care), have high rates of obesity, asthma, and mental health disorders including ADHD, depression, and anxiety. They also rarely visit parks, consistent with broader findings about socioeconomic factors and access to green spaces. "I have many, many patients who spend little to no time outside," he says.
While Zarr has yet to formally evaluate the health effects of his park referrals, he recently performed a study of 212 patients, currently under review at the Journal of Physical Activity and Health, that he says shows a statistically significant increase in time spent outdoors following a prescription.
Gilbert Liu, a pediatrician and associate professor at the University of Louisville, recently completed a 20-month pilot park-prescription program of his own and a concurrent study to determine if park referrals changed patients' behavior. Like Zarr, Liu developed a GIS-based map that could interface with patients' medical records and automatically provide a list of nearby parks and other resources such as dance studios and martial arts dojos. Unlike Zarr, however, Liu's unpublished findings showed that pediatricians' referrals to visit parks were ineffective. The system was well received by providers, he says, but it turns out that families didn't use community resources or change their behaviors any more than a random sample of families who didn't use the system.
"It's clear that you can't just tell somebody, 'Hey, you really need to go to a nearby park and exercise more,'" Liu says. "You need to figure out what exercise is attractive to patients, then identify barriers and overcome those."
Prescription Trails, based in Albuquerque, New Mexico, and likely the nation's longest-running park-prescription program, has since 2008 refined and expanded its own approach to encouraging physical activity. Detailed park descriptions and an electronic, customizable "prescription" serve as tools for physicians and other healthcare professionals to encourage patients to be active outdoors.
While the New Mexico program's grassroots approach has inspired similar efforts in other cities and states, executive director Charmaine Lindblad says she hasn't yet found funding to assess how many local physicians have embraced park prescriptions, let alone health outcomes for the patients of those who have. "It kind of just exploded, and we've never been able to really keep track of who's using it," she says.
Getting Doctors Onboard
Healthy Parks Healthy People Bay Area, which Razani has played a role in shaping, is the nation's most comprehensive park-prescription program. Launched in 2012, the effort involves numerous partners in all nine counties of the 7.1 million-resident metro area. It supports weekly, biweekly, and monthly activities targeting physical and mental health in a total of 35 parks.
(Enlarge Image)
In addition, the City of San Francisco is, to date, the only city in the world to have fully adopted park prescriptions within its Department of Public Health, with weekly health-oriented programs at parks throughout the city. The program is still in pilot mode, says Curtis Chan, deputy health officer and medical director of the department's Maternal, Child, and Adolescent Health Section. Chan notes the program has had to combat some inertia in getting physicians to prescribe parks, but critical partnerships are being cemented citywide.
On the opposite coast, Washington, DC, is home to another well-known park-prescription program. There, Unity Health Care pediatrician and park-prescription advocate Robert Zarr has built a program from the ground up in which he has mapped and rated all the green spaces in the city for accessibility, cleanliness, safety, amenities, and services, producing a database that can be linked directly to patients' electronic medical records. Zarr's program has considerably less institutional support than the Bay Area program and therefore lacks the former's broad scope and participation. But it has still served as a model for other park-prescription programs across the country.
Currently 180 doctors at 26 Unity Health Care locations across the city have signed on, representing a potential reach of more than 100,000 patients. "If I'm successful in the next year and a half, I should have almost every pediatric practice [in the city] on board with prescribing nature," Zarr says.
Kids in Zarr's own clinic, which serves low-income and uninsured families (like all of Unity Health Care), have high rates of obesity, asthma, and mental health disorders including ADHD, depression, and anxiety. They also rarely visit parks, consistent with broader findings about socioeconomic factors and access to green spaces. "I have many, many patients who spend little to no time outside," he says.
While Zarr has yet to formally evaluate the health effects of his park referrals, he recently performed a study of 212 patients, currently under review at the Journal of Physical Activity and Health, that he says shows a statistically significant increase in time spent outdoors following a prescription.
Gilbert Liu, a pediatrician and associate professor at the University of Louisville, recently completed a 20-month pilot park-prescription program of his own and a concurrent study to determine if park referrals changed patients' behavior. Like Zarr, Liu developed a GIS-based map that could interface with patients' medical records and automatically provide a list of nearby parks and other resources such as dance studios and martial arts dojos. Unlike Zarr, however, Liu's unpublished findings showed that pediatricians' referrals to visit parks were ineffective. The system was well received by providers, he says, but it turns out that families didn't use community resources or change their behaviors any more than a random sample of families who didn't use the system.
"It's clear that you can't just tell somebody, 'Hey, you really need to go to a nearby park and exercise more,'" Liu says. "You need to figure out what exercise is attractive to patients, then identify barriers and overcome those."
Prescription Trails, based in Albuquerque, New Mexico, and likely the nation's longest-running park-prescription program, has since 2008 refined and expanded its own approach to encouraging physical activity. Detailed park descriptions and an electronic, customizable "prescription" serve as tools for physicians and other healthcare professionals to encourage patients to be active outdoors.
While the New Mexico program's grassroots approach has inspired similar efforts in other cities and states, executive director Charmaine Lindblad says she hasn't yet found funding to assess how many local physicians have embraced park prescriptions, let alone health outcomes for the patients of those who have. "It kind of just exploded, and we've never been able to really keep track of who's using it," she says.
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