Public Land Management

Winner

OrganizationEast Bay Regional Park District 
InitiativePark RX and SHINE Program
LocationSan Francisco Bay Area, CA
Founded1994
LeadershipMona Koh, Community Relations Manager
Carol Johnson, Assistant General Manager, Public Affairs
Dr. Nooshin Razani, Director, Center for Nature and Health
ContactMona Koh, mkoh@ebparks.org

Initiative Overview

To improve health outcomes in two of the largest counties in CA with 2.7 million residents, EBRPD has integrated community health into its parklands. We’ve collaborated with 15 health clinics and 80 multicultural community organizations to educate, motivate, and prescribe nature to under-resourced patients/members to walk in our parks. We’ve partnered with 15 school districts in our Kids Healthy Outdoors Challenge program by providing transportation and curriculum books. Annually, 4,000 third grade students and their teachers visit our parks for Nature Study and a healthy outdoor experience. Our signature self-guided Trails Challenge program brings 10,000 people annually to hike our regional trails.  

Impact

EBRPD’s mission to connect health and nature in public lands has benefited thousands of children and adults who historically have underutilized parks. By participating in our wellness walks and outdoor programs, they have increased their physical activity and social connection while reducing mental and emotional stress. EBRPD’s 2017 Economic Impact Analysis concluded that we contribute a range of benefits totaling $500M annually to the local economy, including $20M towards healthcare cost savings through presence of parks, trails, walks and programs. 

Impact by the numbers

  • Park Rx and SHINE: 5 years, 3,000 participants/year
  • Kids Healthy Outdoors Challenge: 7 years, 4,000 students/year
  • Trails Challenge: 25 years, 10,000 participants/year
  • EBRPD park system comprises 121,397 acres in 73 parks with 1,250 miles of trails in Alameda and Contra Costa counties

Innovation

In 2014, EBRPD and UCSF Benioff Children’s Hospital Oakland (UBCHO) launched the SHINE (Stay Healthy in Nature Everyday) program to bring their underserved patients with chronic illnesses to our parks for health intervention. Every month, EBRPD provides staff, transportation, healthy snacks and a day of outdoor activities for the children and families. The first randomized clinical study on health and nature, conducted by UBCHO in 2015, determined that cortisol levels and feeling of loneliness decreased by 28% and 20% respectively for SHINE participants. Over 100 physicians in UBCHO now prescribe SHINE, and new doctors receive training modules and toolkits. EPRPD has also installed park posters throughout the clinic to connect patients to nature. 

Replicability

The UBCHO study and mounting scientific evidence substantiate that time spent in nature has measurable physical and mental health benefits. The SHINE program – an integration of nature into the medical care system – is replicable. This interdisciplinary intervention between parks and health clinics increases patients’ access to nature; provides consistent programming to serve patients’ health needs; and informs park administrators about public healthcare priorities. 

Biggest Challenge to Advancing This Work

Establishing Park Rx/SHINE partnerships with more diverse health clinics and community groups, and supporting them to lead walking programs. Expanding training for healthcare providers on the benefits of nature; developing evaluation instruments and toolkits. Enabling physicians to bill Park Rx trips to insurance carriers.

Official Selections

OrganizationNational Park Service Rivers, Trails & Conservation Assistance Program
IndividualAttila Bality
LocationAlbuquerque, NM

Description

The RTCA program addresses the challenges of collaboration and partnership in conservation and outdoor recreation. More specifically, Attila Bality’s work has helped the NPS, the RTCA program, its partners, and the field of outdoor recreation to address the challenges of incorporating health professionals and health considerations into outdoor recreation planning to improve quality of life in communities across the U.S.

Through his work managing RTCA projects in New Mexico and providing support to project partners and national partners alike, Attila is a proven leader in the NPS and his field. He has provided many contributions toward incorporating health considerations in outdoor recreation, particularly through his help in developing the first-of-its-kind park prescription program for NPS partners in the mid 2000’s. Attila is also seen as an on-the-ground field leader for his colleagues and staff, and has co-authored the “Parks, Trails, and Health Workbook” and “Improving Public Health Through Parks and Trails: Eight Common Measures”, both with the Centers for Disease Control.

OrganizationBarton Health & USFS
InitiativeWellness Outings, Prescribed By Nature
LocationSouth Lake Tahoe, CA
Founded2016
LeadershipStephen Bannar, MD
Khristy Gavigan, RN
Joseph Flower, Wildlife Biologist, USFS
ContactStephen Bannar, sbannar@bartonhealth.org

Initiative Overview

In 2016, Barton Health, a not-for-profit health care facility, partnered with Lake Tahoe Basin Management Unit, South Lake Tahoe’s local United States Forest Service (USFS) branch, to host cooperative Wellness Outings: guided walks that promote nature as medicine by teaming patients with a U.S. Forest Service ranger and physicians or nurses from Barton Health for guided outings in the national forest. In South Lake Tahoe, CA, a town of less than 22,000 people, hundreds have participated in the Wellness Walks, including the general public and target audiences such as the chronically ill, those recovering from surgery, and at-risk youth.

People are spending less time out in nature despite the significant health benefits nature provides. Patients suffering from physical and emotional ailments are at the highest risk to not go outdoors and enjoy nature despite being the population who could benefit the most from nature’s healing effects. The barrier for most patients is not knowing where to go or not feeling safe going out to explore. The partnership between Barton Health and the USFS provides this at-risk population with guided outings in nature with the safety net of healthcare providers accompanying them.

Impact

The comprehensive program includes options for people with chronic or terminal illness, patients recovering from surgery, and at-risk youth. Research indicates that time in nature lowers blood pressure, heart rate, and cortisol levels; it increases concentration, memory, and attention spans; it has been shown to boost immunity and is particularly beneficial for at-risk populations, such as those recovering from surgery, who often spend less time outside. This partnership is improving community health, one walk at a time.

Impact by the numbers

  • Objective Measurement for Impact of Nature on Health
  • Lowers the stress hormones cortisol and adrenaline
  • Suppresses the sympathetic, or “fight/flight,” system
  • Enhances the parasympathetic, or “rest and recover,” system
  • Lowers blood pressure and increased heart rate variability
  • Immune Function after 3 days, 2 nights in the forest:
  • Natural killer cell numbers increased by 50%; NK cell activity increased 53%
  • Anticancer proteins granulysin, granzyme, and perforin increased 28-48%
  • Increase lasted for 30 days

Innovation

There is a direct connection between community wellness and ecosystem health. USFS provides the interpretive piece supporting logistics and identifies appropriate outings and Barton Health provides the medical support to share the healing power of nature with patients to promote the improved well-being of the community.

Replicability

With the model established between Barton Health and the USFS, this can be replicated with healthcare systems throughout the country to promote wellness. The partnership between healthcare systems and land management promotes a shift from healthcare just treating illness to now promoting wellness.

Biggest Challenge to Advancing This Work

The biggest challenge is the shift in our culture from pharmaceutical prescriptions to a prescription for nature. In order for this program to be successful on a large scale, healthcare systems around the country have to be on board to promote wellness in their patients and create healthier communities.

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