Nature Promotes Health: Findings from a survey of public health providers

Introduction: APHA recently adopted a policy to improve health and wellness through access to nature. This study aims to describe current beliefs and practices of health department staff about nature in order to inform trainings, resources and other policy implementation. Methods: A division of the San Francisco Department of Public Health received an anonymous, cross-sectional survey. Questions assessed knowledge, attitudes, and practices regarding 1) nature as a health intervention, and 2) conditions that can benefit from nature such as physical inactivity, stress, and social isolation. Results: 106 (64% of staff) responded. Sixty percent felt knowledgeable about physical benefits of nature, 61% about mental health benefits, and 44% about social benefits. Twenty-five percent felt familiar with a specific walk in nature they could recommend. Eighty-five percent agreed that clients would improve health by going to parks; 15% agreed that their clients currently visit parks. Fourty-four percent currently screen patients for physical activity, 45% for stress, and 44% for social isolation. Seven percent currently recommend a visit to a park to enjoy nature. Twenty-five percent agreed that their patients feel parks are welcoming to low-income and ethnic groups. Twenty percent thought their clients would follow the recommendation to go to a park. Conclusions: Staff believe clients can benefit from nature, but require training about specific health indications for which to screen and refer, and training about which specific parks or nature to refer to. Barriers to nature will need to be addressed when training public health staff as they expressed low confidence that indigent patients feel welcome in parks, or will follow through on recommendations to be in nature. Future research should delineate how public health systems can extend nature, a low-cost community public health resource, to the highest need populations.