Park Prescription programs are initiatives designed in collaboration among public land agencies, healthcare providers, and community partners to encourage people to utilize parks, trails, and open space for the purpose of improving individual and community health. National Geographic just wrote about Park Prescription programs and these programs have been recognized by the Surgeon General’s Office, the National Park Service, and the American Public Health Association as important tools to promote wellbeing.
This is all to say that Park Prescription programs have really flourished in the United States. One question still remains: “How do I build my own Park Prescription program?”
That’s the question that the Institute always receives. As the convener of the Healthy Parks Healthy People: Bay Area collaborative and the National ParkRx Initiative, it makes sense that we get fielded this question. Answering this question has been our guiding light for the past few years. We’ve led workshops, hosted webinars, and written reports, all in pursuit of finding out what makes a Park Prescription program work.
After years of observing programs, especially those in the Bay Area, we have created a Park Prescription program toolkit to guide the process of creating a program. This toolkit is a "program-in-a-box," curating examples, templates, and guidance for those interested in implementing Park Prescription programs. We know that there are a myriad of agencies interested in building these programs, so this toolkit was created with sector-specific guidance for clinicians, public health providers, community service providers, and parks staff.
I hope that this resource makes it easier for you to serve your community!
National ParkRx Initiative Convening Attendees
Last week, the Institute hosted the 3rd National ParkRx Initiative Convening in St. Louis, along with our partners: NRPA and NPS. At this convening, we discussed the next phases of development for not only the National ParkRx Initiative, but also for the ParkRx movement, as it relates to each individual program.
At the meeting, we discussed roles, responsibilities, fundraising goals, and communications plans for the National ParkRx Initiative. We were grateful to the dozens of people and agencies that came to the convening, as we were able to take a day to reflect on the collective goals of these many different organizations. At the National ParkRx Initiative, we know that there are many different ways that programs have started and we are interested in building up the Initiative to be able to support many different types of ParkRx programs.
When we had met in 2014 for the 2nd National ParkRx Initiative Convening, only a handful of ParkRx programs were on the ground; now, the US Surgeon General has approved of ParkRx and dozens of programs have started their second phase of development. It is quite a different landscape that we are working within now and the Initiative is excited to bolster its strategic direction. This strategic direction will bolster the National ParkRx Initiative’s role as the support system for different programs both in existence and starting up. We will reveal more information once the plans have solidified.
April 24th is National Park Rx Day and it is a day celebrated across the United States to promote the growing movement of prescribing parks and nature to patients to improve human health. Additionally, National Park Rx Day encourages everyone to start seeing visits to parks and public lands as very important parts of their health. Last fall, the U.S. Surgeon General released a call to action to promote walking and walkable communities. National Park Rx Day builds on this call to action and provides citizens with parks and green spaces to promote public health.
WHY A DAY TO CELEBRATE PARK RX?
One of the signature events will take place in Meridian Hill Park in Washington, DC. While the park has weekly drum circles and many different users, it is also a site that has seen it share of violence. When we talk about the health of a community, the violence within a community is just as important to curb as alcohol abuse or obesity rates. Although there is a lot of buzz and interest in Park Rx programs, it is a tactic to bringing forth larger changes in a place. It is also a tactic to bring in new sectors to look at the role that the built environment plays and our relationship to it.
I encourage us lovers of nature and Park Rx managers to think about the role that Park Rx has in combatting community violence so that others can have the chance to love nature and feel attached to their neighbors and neighborhoods. Park Rx programs and certainly National Park Rx Day cannot solve all of this in one fell swoop, but having a concerted effort to start and sustain these dialogues is a first step.
February is American Heart Month and to celebrate, we’ve asked Mike Gonzalez, Regional Director of Multicultural Initiatives at the American Heart Association to give us a few tips on how to celebrate.
Mike Gonzalez is the Regional Director of Multicultural Initiatives at the American Heart Association. His foray into public health started in school, but was solidified during his internship with a local public health department where he was working to improve and expand on healthy eating programs throughout agricultural communities in California. Through this internship, he saw first-hand the compounded effects that low access and low resources have on entire communities.
In his current role in the American Heart Association, Mike works to achieve the AHA’s 2020 impact goals by engaging in prevention and recovery for multicultural communities. Within prevention programs, Mike extolls the importance of knowing your biometric numbers, as well as the importance of healthy eating and active living. Within recovery education, Mike and his team help to ensure high survival rates for those who are affected by heart disease.
American Heart Month is an entire month dedicated to talking about heart health. Heart disease is one of the top chronic diseases affecting Americans and disproportionately, it affects communities with low resources and low access to healthy food or physical activity. February gives Americans the opportunity to raise awareness for this disease, as well as opportunities to advance our knowledge and understanding of how it can be prevented and treated. Multicultural communities should take special care to celebrate during this month because African American and Asian communities have higher rates of stroke and Latinos have higher rates of heart disease.
American Heart Month starts the discussion for all partner agencies to bring heart health into the conversation, but presents specific actions for individuals to take in order to ensure their own heart health.
Ways to celebrate American Heart Month
To learn more about Mike Gonzalez's work at the American Heart Association, visit the American Heart Association of the Greater Bay Area online.
On September 9, the U.S. Surgeon General, Vice Admiral Vivek Murthy, launched a nationwide Call to Action on Walking. As chronic disease, depression, and obesity rates in the country soar, “America’s Doctor” is extolling the health benefits of walking.
The “Step It Up!” campaign challenges the nation to make walking a national priority in all facets of American life. Dr. Murthy’s Call to Action seeks to promote development of communities where it is safe and easy to walk, launch walking programs, and conduct research on walking.
As lovers of parks and open space, we at the Institute at the Golden Gate (a Parks Conservancy program in partnership with the National Park Service) are doing our part to answer the Surgeon General’s call. In fact, our belief in the health benefits of parks is so great that we’re taking many approaches to promote parks as places to walk and recreate.
Take the first step, and reconnect with the physical, mental, and social benefits of visiting a park. Attend a Healthy Parks Healthy People: Bay Area program this Saturday, October 3rd. There are over 10 family-friendly, easy, and fun walks all over the Bay Area to get you started.
Pass by corner of Drake Avenue near Phillips Drive in Marin City and take in the sights and sounds of George “Rocky” Graham Park. Initially built in the 1940s, the park had been dismantled in the 1990s due to maintenance issues. Rocky Graham Park had its official reopening on July 11th, 2015, and its vibrant green turf and nature-themed playgrounds have been in continuous use since.
The story of Rocky Graham Park not only encompasses a community’s tireless advocacy for a public good, but also the bringing together of different partners, agencies, and stakeholders to make it happen. To sustain the use and enjoyment of this beautiful, community-built space, Rocky Graham Park will be a pilot site for park prescriptions programs.
In partnership with the Marin Health and Wellness Center, the Marin City Community Services District will be offering a plethora of free programs in Rocky Graham that will help to promote the wellness of the community. For most fitness levels, the programs range from guided gentle walks around the park and neighborhood to martial arts on the turf. These programs not only encourage physical health, but also usher in the mental and social health benefits that being in nature and learning about one’s own community offers.
Check out Marin City Community Services District’s website for more information on the programs being offered. If you are client of the Marin City Health and Wellness Center, be on the lookout; your health care providers will be prescribing park programs to you very soon!
If you do find yourself wandering around the park before you receive a park prescription, fear not! Here's a prescription for activities that you can already do in the park without attending a program:
This year, May 10-16 is National Women's Health Week, as designated by the US Department of Health and Human Services.
Park use is not gender-neutral. Slide from Deborah Cohen et al. (Rand Corporation) presentation at Greater and Greener.
In honor of National Women's Health Week, we're shedding light on a structural issue that comes at the intersection of women's health and park use. Namely, we're wondering where are all the women in parks.
Park use equity is disparate among many different facets, especially for ethnicity and socio-economic status. However, new research is revealing just how disparate park use is between male and female constituents. Deborah Cohen and her team at the RAND Corporation is a year into their study of measuring park use through the SOPARC method. At last month's Greater and Greener Conference in San Francisco, Deborah shared preliminary results from the study and the results show a large rift in park use between these two genders.
Of course, the health benefits of being in nature have been stated many times on this blog, but the ramifications of having park use disparities is that parks' health benefits are disproportionately widening the gap of health equity. Collectively, women are already facing more adverse social determinants of health than their male counterparts. For women of color and lower socio-economic status, their gender is further compounded with other factors that limit their utilization of parks.
What does park use disparity have to do with women's health? Besides the fact that women are not getting as many of the health benefits of nature, the differences in use signal an underlying question of park design and programming. Why are women not in parks as much as men? Responses that suggest time constraints with motherhood and family obligations fail to address the larger role that parks and policies have to do with encouraging women--especially those with familial obligations--to go to their parks.
As we celebrate National Women's Health Week, we as park advocates must look at ways that we can reach out to women and especially women of color to bring them into parks in more substantive ways. Letting parks continue along the path of the status quo can lead to a further rift in women's health.
At this point, is it safe to assume that the term “social determinants of health” is readily understood? What about “social determinants of park use?” Can we also work towards consensus that these two terms describe the same barriers, for both health and parks?
Social determinants of health (SDH) are factors outside of an individual’s genetic makeup that influence a person’s entire health. SDH focus less on DNA factors, but more on the societal, community factors that determine access, amount, and quality of prevention and treatment a person receives. Not having health insurance covering the cost of treating an overactive thyroid problem is an SDH. Not being able to find a therapist who speaks the same language as you is an SDH.
As parks inventory their programs and activities to figure out how to bring more residents to the great outdoors, they are finding more and more that there are a set of barriers that create social determinants of park use (SDPH). Uncoincidentally, these barriers look very much like SDH. Here are a few examples that illustrate the convergence of SDH and social determinants of park use:
Capital: Families that are middle class or above are more likely to be healthier and live longer lives. Additionally, most park users (especially for national parks) are middle class and can afford the time and travel costs associated.
It is not a coincidence that SDH and SDPU are aligned in these substantial ways. Most parks were built around the idea of improving community health; Central Park in NYC was intended to be a natural refuge from the mechanical toils of factory work.
As National Public Health Week focuses on positioning the country to be the healthiest nation by 2030, we should pay special attention to nontraditional community health stewards that are already part of the community infrastructure. Mitigating social determinants of park use will be much like mitigating social determinants of health; we will have to be diligent about using resources to uplift the communities especially suffering from these social determinants.
Taking care of a community's health starts at making sure everyone has health coverage, but it doesn't end there. Giving all fourth graders a pass to visit America's national parks is a great first step, but it doesn't end there. To ensure that communities especially feeling the compounded effects of social determinants use their parks and live their healthiest lives, we have a special obligation to dedicate more resources to these specific communities. For a healthier nation in 2030, the onus cannot be on a single mother of two to wait 2 hours in a waiting room to be seen by a physician. As well, the onus cannot be on families living in neighborhoods plagued by gang violence to seek out safer parks.
To create a healthier nation by 2030, systems of care need to be changed and improved so that everyone gets timely care from health care providers, and cities need to work together to reduce gang activity and ensure that every park, no matter their location, is a safe park.
Bonus activity: Can you think of anything that could not be considered a social determinant of health or park use? It's harder than you'd think.
Last Thursday, Institute staff and Healthy Parks Healthy People: Bay Area (HPHP: Bay Area) champions made the trek to Microsoft’s offices in Mountain View to attend a “Collaboration for Great Impact” workshop. We joined our friends who have been working on environmental and climate change initiatives to reflect on the Collective Impact model’s role in our own work with HPHP: Bay Area. Pioneered by the social impact consultants, FSG, Collective Impact is a framework to align the work of different organizations into a single goal. Briefly, the five pillars of Collective Impact are: (1) a common agenda, (2) shared measurement, (3) mutually reinforcing activities, (4) continuous communication, and (5) backbone support.
When the HPHP: Bay Area program started in 2012, the Institute was under no illusions that this would be anything but a seriously complicated endeavor. Not only were we asking for help to create more public programming in the park, but we were asking the collective Bay Area to see nature and parks through the lens of wellness. In working with physicians to prescribe nature and encouraging parks to pave more trails in underserved communities, we have been making small steps towards a change in the broader culture of health, wellness, and parks.
Thankfully, we at the Institute are not doing this alone. Through the years, the HPHP: Bay Area program has cultivated a group of organizations and advocates that is engaged in bridging public health and public parks. As we continue to roll out the HPHP: Bay Area programming and bring more healthcare advocates to the fold, this workshop was a time for us to think critically about the future of HPHP: Bay Area through the lens of Collective Impact and its five pillars of success. Often, we are so wrapped up in the day-to-day operations that it is hard to find the time to reflect and learn from our past efforts.
During the workshop we participated in an exercise that had us imagine what HPHP: Bay Area would look like in 2025 and what would be telltale signs of its success. One partner answered that all awareness campaigns about the significant linkages between nature and wellness are obsolete because communities in 2025 will see that as blatantly obvious. Another partner highlighted the potential lessening of chronic diseases in 2025 as a measurement of success. Working backwards from these visions for the future, our group looked at potential steps we could take in the next month or year to make these goals a possibility. We listed different sectors we wanted to bring into the world of HPHP: Bay Area, as well as plans to create ongoing communication and dialogue within the group. We are still digesting all of the different ideas related to the five pillars that we came up with and will be eager to share them with you soon!
The year 2025 might be over a decade away, but we at HPHP: Bay Area know that change does not happen all at once. We are amplifying our efforts today in order to make sure that communities in 2025 have the motive, means, and opportunities to visit parks and increase wellness.
Special thanks to our friends at ChangeScale for hosting such a great event!