Photograph by Jeremy Kramer
Standing atop the pavilion in Ault Park, Sian Cotton, Ph.D. and Sanjay Shewakramani, M.D., each take a deep breath and survey the surrounding landscape, rich in the oranges, yellows, and reds of peak fall. “The science is strong, particularly as it relates to anxiety and depression,” says Cotton, director of the Osher Center for Integrative Health at the University of Cincinnati. “Both the psychological markers, like mood and quality of sleep, and the physiological markers, like blood pressure and immune response, tell us it’s a good thing to be outside.”
Research shows that as little as 20 minutes a day outdoors can have lasting effects on our health, Cotton says, and that’s why she and Shewakramani, an emergency physician at UC Health, are thrilled to participate in a new Osher program called Nature As Medicine, which allows UC physicians to prescribe time outside.
To date, more than 100 referrals have been made from UC departments including oncology, family medicine, neurology, psychiatry, the Lindner Center of Hope, and the emergency department, where Shewakramani has personally made several referrals. He’s one of the program’s “nature champions” and says he learned the power of nature first-hand about eight years ago. “I wasn’t actually a healthy person before,” Shewakramani says of a difficult period of his life. “As an emergency physician, our jobs are pretty stressful, as people might imagine, and we have weird hours. I found that in my off-time walking was good for me.”
Frequent hikes in Alms Park, near his home, helped Shewakramani feel better and become healthier. He became determined to share that relief with others. He joined Osher’s Academic Advisory Council to support the center’s mission of transforming the American healthcare system from being centered on treating sickness and disease to a model that prioritizes and pays for well-care, self-care, and prevention.
More than one-third of Cincinnati residents live with obesity or hypertension and one-third report doing little to no physical activity, according to the most recent Cincinnati Public Health Department Community Health Needs Assessment. Cincinnatians have higher rates of poor mental health compared to other parts of Ohio and the U.S., according to the same report.
“Nationally, we spend 17.6 percent of our GDP on healthcare, and we get some of the worst health outcomes,” says Cotton. “If we’re going to transform a system, we must lean in. Food is medicine. Exercise is medicine. Nature is medicine. Arts and movement are medicine. Mindfulness is medicine.”
Soon after joining Osher’s advisory board, Shewakramani decided to get further involved by joining the Cincinnati Parks Foundation executive committee, and he quickly realized the two organizations were pursuing similar visions. If 90 percent of Cincinnatians lived within walking distance of a park, he thought, what part could parks play in the wellness and health of city residents?
Osher and the parks foundation joined forces, enabling UC clinicians to prescribe nature through UC’s medical electronic health record system while the foundation built out a new Cincinnati Parks + Rec for Wellness program. That involved creating a Wellness Field Guide, which highlights which parks are ideal for hiking, respite, or fitness and allows participants to track their progress as they explore.
The parks foundation built upon its existing calendar of free programing, mainly April through October, including yoga, Tai Chi, line dancing, guided hikes, and other activities. More than 12,000 people participated in the program’s first year, and Cincinnati Parks was able to remove barriers by providing complimentary bus passes, recreation center passes, and connection to Findlay Market’s Food Rx program where needed for patients.
“It’s connection that this partnership creates,” says Shewakramani. “It will sound a little bit fluffy, but it’s a connection to Earth, a connection to other people, a connection to ourselves.”
UC Health CEO and President Cory Shaw has said he’s committed to making Cincinnati the healthiest city in the U.S. With this program, maybe more of that work can happen outdoors, says Cotton. “We want to use the power of the healthcare provider to say, In addition to the medicine you take for your sleep or for your anxiety, we really encourage you to get outside,” she says. “We’ve built connections that I haven’t actually seen in any other health system.”
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