Outdoors as Medicine: The Health Benefits of Nature are Numerous, Science Says

When Itzamary and Noe Caban attended their first Outdoors Rx event three years ago in Chelsea, Mass., they assumed the AMC program’s primary beneficiary would be their young daughter, Khalani.

After all, it was Khalani’s pediatrician who’d referred the family to Outdoors Rx—which organizes free, structured outdoor experiences for families living in several under-resourced Greater Boston communities—suggesting she could benefit from additional socialization and language development. Khalani, now 5, has certainly blossomed in the program, her parents say. But Itzamary and Noe say they could not have foreseen how their own health would benefit from those weekly, year-round trips to local parks and beaches with AMC.

Following her family’s move to Chelsea from Puerto Rico in search of medical care for Khalani, Itzamary says they knew no one except Noe’s mother. “I spent, with Khalani, that entire year indoors,” she recalls. “I was depressed. It was hard to get used to the weather, the new culture, the city. Being part of the Outdoors Rx program helped me a lot, mentally.”

For Noe, who had been severely overweight and had undergone a related surgery, being outdoors has helped him maintain a healthier lifestyle. In fact, on a July trip to AMC’s Cardigan Lodge with other Outdoors Rx families, Noe surprised himself: He summited Mount Cardigan.

“Never in my life did I think I’d be able to do a 4-mile hike into the woods and come out alive,” he says.

A growing body of research is putting actual data to what the Caban family and others have known for millennia: Being outdoors makes us feel better and helps us live longer. It’s something Outdoors Rx has touted for a while, as well. What began in 2013 as a program primarily aimed at curbing childhood obesity has evolved into one that treats and sustains the whole self: mind, body, and spirit.

And, as Itzamary and Noe discovered, nature’s benefits aren’t just for kids or for those who crave time outdoors. Even 15 minutes outside each day can elicit positive health results.

The alternatives are dire. More than 100 million American adults live with high blood pressure, according to the American Heart Association, and one in eight Americans over age 12 takes at least one antidepressant. Most of us spend more time on screens than outdoors—way more: as of 2016, a staggering 7 hours, 38 minutes for kids ages 8 to 18, and a daily average of more than 10 hours for adults. Meanwhile, only 10 percent of youth today have regular access to nature, compared to 40 percent of adults when they were young—a number that decreases precipitously the more underserved the neighborhood.

Dr. Gracia Kwete, a pediatrician at Massachusetts General Hospital’s (MGH) Revere Healthcare Center, routinely refers her patients to Outdoors Rx to address a host of challenges, including childhood socialization, language development, obesity, family bonding, and simply to help area families build healthier habits into their busy lives.

“More doctors should be looking to these interventions,” she says. “It’s one thing to say, ‘Be more active. I’ll see you in a year,’ but it’s another thing to give families examples. Recommended activity time for children is 60 minutes a day. How do we help families meet that and give them ideas for how to do that? That’s why I appreciate Outdoors Rx.”

How could time outdoors contribute to a healthier you? With pointers from Outdoors Rx’s director, Angel Santos Burres, and program manager, Emily Grilli-Scott, AMC Outdoors rounded up some of the most exciting and inspiring scientific research supporting the idea that, truly, nature is medicine.

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The outdoors improves attention & reduces hyperactivity

In a 2009 University of Illinois study, children diagnosed with attention deficit hyperactive disorder, or ADHD, were given a series of puzzles then taken on walks in one of three settings: a neighborhood, a park, or a downtown area. Post-walk, the kids were given a second test for concentration and impulse control. Those who’d walked in the park performed better on the second test than those who’d walked in the neighborhood or downtown.

TRY IT YOURSELF: A 2005 Italian study showed that simply viewing pictures of natural environments improves our ability to pay attention. Consider hanging nature posters where your kids do their homework or in your office to boost your attention span.

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The outdoors destresses us

According to a 2014 review of previous academic research, nature provides relief and recovery from stress and mental fatigue. That wouldn’t have been news to the psychologist Stephen Kaplan, who 30 years ago referred to the outdoor settings that improve a person’s emotional state, physiological activity levels, and behavioral and cognitive functioning, as “restorative environments.” MGH’s Kwete says the outdoors serves as a refuge for some of her youngest patients, who experience stress from academic demands and increased exposure to electronics. “Unfortunately, in this day and age, life has become a lot more stressful,” she says. “Time outdoors helps curb mood issues, anxiety, and helps kids relax to just get outside and play and have fun.”

TRY IT YOURSELF: Stressed out? Head to a local playground, field, or out the back door. It doesn’t take long for positive things to happen. “In the first five to 15 minutes, [nature] lowers your blood pressure, your heart rate, and your cortisol pressure—which is your stress hormone,” Santos Burres says.

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The outdoors boosts memory

In 2008, researchers at the University of Michigan gave study participants a tedious memory test before taking them on a walk. One group went to a tree-lined arboretum, while the other headed down a busy city street. The test was readministered when the groups returned, and guess what? Participants who walked through the trees improved their scores by nearly 20 percent, on average, while city walkers saw no uptick.

TRY IT YOURSELF: Instead of taking a memory-enhancing vitamin D supplement, head outdoors for 20 minutes a day. If you’re in the city, challenge yourself to find an especially tree-lined block.

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The outdoors helps overcome trauma and PTSD

War veterans and at-risk youth exhibited fewer symptoms of post-traumatic stress disorder upon returning from whitewater rafting trips than pre-trip, University of California–Berkeley researchers found in 2018. The study’s lead author says rafting produced a singular emotion among participants: awe. “It’s the active ingredient that explains why being in nature is good for us,” Craig Anderson, a postdoctoral researcher and fellow at UC Berkeley and at UCSF, told Berkeley News. “The more awe people felt during the whitewater rafting trips, the happier and less stressed they were a week later.”

TRY IT YOURSELF: Can’t get to a rushing river at a moment’s notice? Find an outdoor spot with an awe-inspiring perspective: a roadside scenic overlook, a public pier on a lake or harbor, or even the night sky.

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The outdoors increases happiness and overall satisfaction with life

Residents of a neighborhood in Ghent, Belgium, with an abundance of green space reported feeling happier than residents from a neighborhood with less green space. What’s more, a 2013 American Chemical Society study showed that feelings of happiness continue up to three years after a person moves away from a verdant area. If your neighborhood isn’t particularly green, don’t sweat it: As little as two hours a week outside can act as a mood enhancer—especially in winter. Noe Caban has seen this with his daughter, Khalani. “During the colder months, [Khalani] tends to be a bit groggy,” he says. “Spending so much time indoors frustrates anybody. We have noticed that once she’s outdoors, she changes her mood, the way she’s behaving, and she doesn’t want to come back inside. She’s happier.”

TRY IT YOURSELF: Feeling overwhelmed or sad this winter? Instead of reaching for a beer, a snack, or the remote, plan a weekend walk through a park that’s likely to have plowed sidewalks, cutting off any excuses at the pass.

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The outdoors is good for our hearts & blood pressure

Research suggests nature is great for our cardiovascular systems, whether we’re young or old. In one study out of Coventry University in the United Kingdom, two groups of schoolchildren exercised on a stationary bike for 15 minutes. One group was shown a film set in a forest, and researchers found that the children’s systolic blood pressure was significantly lower post-exercise than kids shown no video.

TRY IT YOURSELF: Enjoying nature doesn’t necessarily mean spurning technology. Pick up your smartphone and go geo-caching, identify bird calls, or report a plant observation as a citizen scientist. 

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The outdoors improves our sleep

Study participants in New South Wales, Australia, living in neighborhoods with ample green space reported fewer bad nights’ sleep (less than six hours) than participants living in neighborhoods with less green space. Similarly, in 2015, researchers from the University of Illinois found that men of any age and people 65 and older who enjoy regular access to natural environments sleep better than their peers without similar access.

TRY IT YOURSELF: Instead of scrolling through your phone before bed, take the dog outside for a brisk walk.

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The outdoors helps kids develop & grow

Norwegian kindergartners who were taken into the forest daily for recess during the school year had better motor strength, balance, and coordination than children who stuck to a traditional playground, researchers found. Kwete says she routinely recommends Outdoors Rx programs to her patients to encourage habits that will benefit children their entire lives.

TRY IT YOURSELF: If possible, walk your kids to school rather than driving. Pay attention to the power of nature en route, spotting winter-hardy plants and the magnificent complexity of snowflakes.

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The outdoors benefits our eyes

Scientists predict half the world will be myopic, or nearsighted, by 2050 from lack of exposure to natural light. Kids who spend time outdoors are less likely to be myopic—possibly thanks to outdoor light changing the development of the eye and releasing dopamine—every time they venture out. “Spending more time outdoors reduces the amount of time indoors,” Kwete says. “It’s one thing to advise families to not have their child spend as much time in front of the TV, but when you’re adding a new habit instead of fighting the old, you help curb some of the more sedentary activities kids are now engaged in.”

TRY IT YOURSELF: Sit the family down and come up with a list of “nature things” to find outdoors. Hold your scavenger hunt when the sun is at its highest to encourage eye health. 

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The outdoors prevents disease

If there was a magic pill that kept us from getting sick, most of us would probably take it. But what if the answer is as simple as walking outdoors? A 2015 University of Illinois review of hundreds of studies suggests that time in nature enhances the body’s immune system, protecting it against a range of diseases and conditions. Specifically, a sampling of Japanese nurses saw increases in anti-cancer proteins and cells that fight blood-borne illnesses after just three days of taking walks in the forest.

TRY IT YOURSELF: In addition to any supplements you take for immunity, consider rerouting part of your daily commute down a leafy street, breathing deeply as you go.

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The outdoors encourages prosocial behavior

Some scientists believe the awe we experience outdoors (as with the whitewater rafters, in the PTSD study) leads us to place a higher importance on other people (for example, fellow raftmates). Researchers refer to this as prosocial behavior. Family bonding occurs outdoors, too. At an Outdoors Rx activity on Revere Beach several years ago, Kwete watched as a daughter observed her mom overcome a challenge in a group game. “My mom is a genius!” Kwete recalls the child blurting out. “This might be the only time this child gets to play with their parent in this context,” Kwete says.

TRY IT YOURSELF: Join a group hiking or snowshoeing outing this winter, with a goal of making a new friend or two. Browse your local AMC chapter’s planned activities at activities.outdoors.org to connect with other outdoor lovers near you.

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The outdoors increases generosity to others

Researchers from the University of Rochester found that study participants who simply sat in a room with potted plants acted more generously than those who did not. In another study from the universities of California and Southern California, a group that was shown images of beautiful nature scenes offered more donations to help victims of a tsunami than participants exposed to less-picturesque scenes.

TRY IT YOURSELF: Planning a meeting or a retreat for your workplace or community group? Head outdoors, in formal sessions and during downtime, to increase participant enjoyment and to build team cohesion.

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