As recently as 1970, urban children spent most of their recreation time outdoors, playing anywhere they could go, on sidewalks, streets, playgrounds, parks, greenways, vacant lots, and any other available spaces. Suburban children did the same and spent time in the fields, forests, streams, and yards. Today nature-based activities have been replaced with video games, play stations, and television shows resulting in children and adults spending less time outdoors. Action figures, puzzles, and board games are not considered favorite toys of today's children; touch screens have taken over. Even though humans derive many benefits from nature, our lifestyles today are disconnected from the natural environment. Researchers estimate that today humans spend up to 90 percent of their lives indoors, missing out on the beneficial effects of nature. Because we do not spend time outdoors, we are less connected to nature and feel less responsibility to protect or preserve our environment.
Children need nature; they need to touch it, hear it, and taste it. They need sensory experiences like playing in fresh-cut grass, walking in soft mud, or experiencing a caterpillar wiggling on its finger. These are the types of sensory experiences many occupational therapists integrate into a child's treatment plan. Could the lack of time spent in nature contribute to sensory processing and modulation difficulties? Nature brings our senses alive; scientists recently discovered that humans could track by scent—some humans rival bats in echolocation or biosonar abilities. Military studies of soldiers in war zones revealed that some of them could see nuances others could not; some were even able to spot hidden bombs. The soldiers with heightened abilities grew more aware of their surroundings; they reported spending much time outdoors. Nature is reported to nurture our "nature neurons" and innate creativity. Researchers at the University of Michigan confirmed that memory performance and attention spans improved by 20 percent after just one hour in nature. When workplaces were "designed with nature in mind," employees were reported to be more productive and took less sick time. Pennsylvania researchers found that patients in rooms with tree views remained hospitalized for shorter durations, required less pain medication, and had fewer negative comments in the nurse's notes section of their chart compared to patients in rooms with views of a brick wall. Researchers in Sweden found that joggers who exercise in natural green settings reported feeling more restored and less anxious, angry, or depressed than people who burned the same amount of calories jogging in urban settings. Levels of neurochemicals and hormones associated with social bonding are elevated during animal-human interaction. Researchers at the University of Rochester reported that exposure to natural environments leads people to nurture close relationships with fellow human beings, value community, and demonstrate increased generosity with money (Sailakumar & Naachimuthu, 2017).
Research also indicates that spending time in nature provides protections against a startling range of diseases, including conditions such as depression, diabetes, obesity, ADHD, cardiovascular disease, and cancer, to name a few. Time spent in and around tree-lined streets, gardens, parks, and forest and agricultural areas has consistently been linked to long-term health outcomes. The less green in an individual's surroundings, the higher their risk of morbidity and mortality, even when controlling for socioeconomic status and other possible confounding variables (Kuo, 2015).
Participation in various outdoor activities can help strengthen children's social relationships, mental and physical health, creativity, and conservation orientations. An individual's outdoor time, particularly during childhood, can foster a connection to nature, yielding other benefits. Studies suggest that nature's "connectedness" or "relatedness" contributes to positive emotions, happiness, and subjective well-being. Screen time may be a key factor linked to declines in both outdoor time and time connecting to nature, even in rural populations, and it has been reported that as children age, the problem intensifies (Larson et al., 2018).
Natural environments are good for adults as well. They contain chemical and biological agents that have positive health implications. Many plants give off phytoncides that contain antimicrobial compounds that reduce blood pressure, alter autonomic nervous system activity, and support the immune system. The air in forest and mountain areas, and areas near moving water, contain high concentrations of negative air ions that reduce depression. These environments also encompass mycobacterium vaccae, a microorganism that appears to boost immune functioning. Environmental biodiversity may play a role in immune function by affecting microorganisms living on the skin and in the gut. The sights and sounds of nature have beneficial physiological effects on health. Window views and images of nature reduce sympathetic nervous activity, increase parasympathetic activity, restore attention, and promote faster healing after surgery. Blood tests before and after walks reveal that health-protective factors increased after forest but not urban walks. Dehydroepiandrosterone (DHEA) increases after walking in the forest; DHEA contains cardioprotective, anti-obesity, and anti-diabetic properties. Time in nature also increases adiponectin, which protects, among other things, against atherosclerosis. Walks in forest areas reduce inflammatory cytokines and elevated blood glucose levels. Inflammatory cytokines are released by the immune system in response to a threat and are implicated in diabetes, cardiovascular disease, and depression. Chronically elevated blood glucose carries multiple health risks, such as blindness, nerve damage, and kidney failure. The experience of nature helps shift individuals toward deep relaxation and parasympathetic activity, which improves sleep, boosts immune function, and counters the adverse effects of stress on energy metabolism, insulin secretion, and inflammatory pathways.
It appears that time spent in nature/outdoors benefits human health in various ways, and screen time appears to be limiting that time. Health care costs are rising, more and more people are presenting with chronic disease, and with an ever-increasing population, we are infringing on natural settings reducing this precious natural space. We as health care workers should take note and do what we can to educate our patients about the health benefits of being outdoors and, at the very least, for the health of our patients, we should consider outdoor treatment sessions whenever possible (Kuo, 2015).