Green prescriptions: Should outdoor exercise be prescribed?

Patrick Coyne discusses what green prescriptions are and whether prescribed exercise would work in the UK.

This week the think tank, Policy Exchange, released a report which contained suggested policies to improve the UK’s urban green spaces.

This weighty report, entitled Green Society, has a number of interesting proposals to try and make urban green spaces work for more city dwellers including possible ways to utilize them in improving public health.

Policy Exchange is not alone in calling for green spaces to be used more in tackling public health – last year the Kings Fund said this was one of the most effective ways for local authorities to improve public health.

But one idea that stood out in this report was that of the wider use of green prescribing – prescribing exercise or physical activity in green spaces to treat ill health in place of pharmaceutical medicine.

Whilst this is a relatively new concept in the UK, green prescription has been used in New Zealand since 1998 where it supports the prevention and management of chronic disease and long term conditions like cardiovascular disease and diabetes.

Green prescriptions in New Zealand encourage patients to manage their own conditions by increasing their levels of physical activity alongside improving their diet. This prescription is then followed up via phone calls and meetings to try and help improve patient adherence.

Green Society suggests a different approach, one whereby patients are specifically referred to exercise classes in a local green space run by approved trainers. The report also stresses the potential for green prescriptions to be used to help a range of mental health conditions including depression.

At the Alliance we believe that getting people active has a big role to play in improving people’s mental and physical health. For us, as our Game of Life and Reconomics reports showed, the evidence is clear.

At the moment, prescriptions for antidepressants are at record levels in England – around 50 million dispensed in 2012 – and this astronomical figure is only likely to get even bigger given that the World Health Organisation has predicted that depression will be the second biggest cause of illness worldwide by 2020.

Prescribing physical activity in green spaces as a treatment could be a solution and the Green Society points towards some interesting case studies where local authorities have implemented schemes as proof of the potential efficacy of it.

This evidence on offer is perhaps anecdotal, but positively, that is acknowledged within the report which calls for a review by NICE to discover what green prescribing is ongoing in surgeries across the country.

This would help to discover what is being prescribed, by how many doctors and more pertinently, how successful they are.

Access to the Great Outdoors and increasing physical activity as a preventative measure should already be at the top of the public health agenda. Now with this report, it’s hard for government to ignore the need to explore its potential role in treatment too.

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