 As we start this, my name is Kate. I am a librarian here at West Vancouver Memorial Library. I'm so happy that you've decided to join us on this beautiful day to talk about nature and your health. I want to first begin by wishing you all a happy Indigenous History Month. I'm joining you from sunny West Vancouver today and I'd like to acknowledge that we are in the traditional, ancestral, and unceded territory of the Squamish Nation, Swaylatuth Nation, and Muskim Nation here. I recognize and respect them as nations in this territory, as well as their historic connection to the lands and waters around us since time immemorial. I think it's especially important to recognize their connection to the land around us today as we talk about our connection with the land as it is so beneficial to our health and well-being. It's important to acknowledge that many of the ideas of being connected to nature are also traditional Indigenous knowledge that the nations around us have been practicing for millennia. So I hope you guys think about that while we're learning about nature and our health. Just a couple of Zoom notes for you. This event will be recorded as it is a webinar. You as watchers will not have any video or sound reported. If you are having technical difficulties, please use the chat bucket button at the bottom of your Zoom screen and someone at the library will be happy to help you. Also, there is a Q and A button at the bottom of the screen where you can send in your questions for Dr. Melissa Lim and Dr. Kayleigh Byler. Now we have a short video about the West Vancouver Memorial Library Foundation. It is with their generous financial contribution that we can hold events like today. West Vancouver is a vibrant forward-thinking community and its diverse members share a spirit of striving for excellence with a cutting-edge neighborhood library to match. West Vancouver Memorial Library is known for our welcoming public spaces, the depth and breadth of our collections, our high-quality programming and also our early adoption of new technologies. This reputation is a direct result of the funding from the Library Foundation. I think the prime reason why people donate to the library is because of a direct personal experience and interaction with the library. The library has touched them in some way and they want to see that continue and they want to see other patrons benefit from that for the long term. Donations to the Foundation have been absolutely instrumental in building the kind of library that we have today, whether it's our collections or the programs or the access to new technologies that so many of us enjoy. Foundation-supported enhancements throughout the library create an immediate impact and a lasting legacy. What contribution do you want to make? Dr. Melissa Lim is a Vancouver family physician, president-elect of the Canadian Association of Physicians for the Environment and Director of Parks Prescriptions, Canada's national nature prescription program powered by the BC Parks Foundation. And she is also an internationally recognized expert on the nature health connection. She is also engaged in advocacy and policy work on a broad range of other issues from climate change and hydraulic fracturing and to sustainable healthcare and low-carbon transportation. She's a senior writer for the CBC. She was the resident medical expert on CBC's hit show Stephen and Chris for four seasons and continues as a regular contributor to CBC Radio's early edition and CTV News. Dr. Lim, it was the inaugural winner of the University College's Young Alumni of Influence Award at the University of Toronto, a 2021 World Parks Week Ambassador and is a clinical assistant professor at UBC. And in conversation with Dr. Lim is Dr. Kayleigh Byers. She is a one health scientist and health communications researcher investigating innovative ways to improve the health of people, wildlife, and ecosystems. She is the deputy director of the British Columbia Node for the Canadian Wildlife Health Cooperative and the University Research Associate at Simon Fraser University. For the past decade, she has been an active science communicator co-founding the Science Seminar Series, Nerd Night Vancouver, and it's been a podcast nerding about, that's how I found her. When she isn't thinking about or talking about science, you can find her paddle boarding, knitting, and a hammock or brainstorming her next pun. I really hope she brings a lot of those puns for today and our talk. And now I will turn it over to them. Thank you so much for that lovely introduction. It's funny thinking of puns. I just started doing this new podcast for Gino and British Columbia called Nice Jeans and coming up with genetics and genomics puns has been particularly challenging, actually. I've been having a really hard time. So if anyone has ideas, please put them in the chat. I would be very grateful for them. So we are gonna be in conversation today about nature and our health and how that intersects with climate change. But to start off, we thought we'd try something a little bit fun. And we'd like to generate sort of an understanding about what nature and spending time in nature means to you and how it makes you feel. So on your device that you have there, could be phone, could be your computer, whatever, you can go to www.menti.com and use this code 74681659 and tell us one word to describe how you feel when you spend time in nature. We're gonna generate a bit of a word cloud. So www.menti.com, M-E-N-T-I code 74681659 and we'll see what you generate for things, how you feel when you're in nature. Well, that's what comes to mind for you when you think about how you feel when you spend time in nature. These days, I think Kaylee, because of so much that's going on in the world, I would say my word is relief and I actually entered it into the Menti meter there because it just, I find it gives my mind a break. It gives my family a break, from running around from thing to thing. So yeah, relief, I would say these days would be what I feel. How about you? I think, yeah, I would say something similar. I feel often, I feel sort of revitalized when I'm in nature, like the week, years, months, sometimes you get a little bit long and you spend some time in nature and I just feel like I'm ready to tackle the next thing that's coming at me. I feel much more refreshed. So yeah, sort of somewhat similar. Okay, we've got some great words coming in here. So I'm going to stop sharing this screen. Please feel free to keep putting your words in. I'm gonna share my other Menti screen. Oh, there we go. Okay, let's present. This is what we have. What is one word? We've got happy, fresh, rounded, relief, sacredness, appreciative and wet. I really like wet, especially lately. I feel like anytime I'm outside, I am fully in all of my rain gear constantly. We had another that just came in alive. So I really liked that. Thank you everyone for sharing. I think that these are some really lovely thoughts. What do you think, Melissa, when you see these? It reminds me of how I feel and it reminds me of how we all have this intuitive sense that we feel better when we spend time in nature. I think it's something that's really common across ages, across cultures that we do feel better when we spend time outside and we're connected to the more than human world. Absolutely, and I realize that maybe I'm not even... Did you get to see this Menti briefly? Okay, I'm sorry, it came on and then went away. Here's your beautiful cloud everyone. It looks very lovely. So thank you everyone for putting in your word. We'll have one more word cloud coming at you later on at the end of the presentation. So maybe we could start there in this conversation around our relationship to nature and our health. So, Melissa, what do we know about the links between nature and our health? They are incredibly deep. And in terms of the research base behind how good nature is for our health, this goes back at least four decades. So as I was saying, we had this intuitive sense that nature is good for us, but it's backed up by a huge amount of evidence involving hundreds and hundreds of studies. And so from chronic disease outcomes like high blood pressure, cholesterol issues and diabetes to prenatal outcomes, so better birth weights, healthier mental health than in moms who give birth. And then even other mental health outcomes in the non-prenatal period, anxiety and depression, eyesight in children, ADHD symptoms, there almost isn't any health condition that nature isn't good for. So whether that's living in an area with more nature in it or actually physically spending time in nature-rich environments. And the question I often have is, well, why is this? Is it because people are getting more active in nature? Is it something else intrinsic to nature? And there are lots of different theories, but I wanna delve into a couple of different psychological theories. So the first one that says why nature is so good for our brains is called attention restoration theory. And this speaks to how a lot of us spend time in busy urban environments that have lots of flashing lights and crowds and things that are constantly forcing our brains to focus, to navigate around these obstacles. And what this does is it depletes our powers of conscious attention and that increases our fatigue and irritability because our brains just get tired. Whereas when you spend time in nature it's this source of soft fascination. So it's interesting, but it doesn't require that constant directed attention. So this replenishes your powers of attention and reduces that fatigue and irritability. There's a second theory called stress reduction theory which says when we spend time in stressful situations being in nature at those times and after helps our brains recover faster because we're more resilient. And that kind of comes down to an evolutionary perspective, Kaylee, which I think you might know a lot about. But when you think about early humans when they spent time in biodiverse environments with lots of water sources, lots of sources of food, trees you could climb up to look for predators and look where your community was going to move to next. These were really a survival benefit. And so humans who lived in and grew to prefer these biodiverse environments survive longer and past their nature living stress reducing genes onto future generations. And so that's why a love for nature and biofilia is really hardwired into our brains. And then there are fight insides which are volatile organic compounds that plants and trees release that when you smell them they actually can boost your immune system and immunoproteins and natural killer cells which fight off viruses and bacteria. And then just the sound of nature as well. There's studies looking at when people would play bird song or the sound of water this would in fact improve mental health outcomes like stress and anxiety. So from your head to your toes, from your nose and to your ears spending time in and around nature is really one of the best things we can do for our health. This is so interesting to me. I mean some of these things I am a bit familiar with especially around access to wildlife which I'll have a few slides about later. But this idea of being able to smell at something and it boosting your immune system is so wild to me. I'm always curious who comes up with these ideas and then studies them, right? Those are like those are really interesting questions to have but come from some form of observation and the idea that it's like that linked through all of your senses is really powerful. Well, I think it takes an inquiring mind and I think it takes an orientation towards nature as well. So in fact, a lot of this cutting edge research is coming from Japan. So they in fact did this study where they had participants sleep in a hotel room actually the same kind of hotel room in the same hotel with these fight inside aerosolized into the air and then another similar hotel room without them aerosolized and then after three nights they measured their blood levels of immunoproteins and natural killer cells and found that it was just that smell. So if you think about like a pine forest or a cedar forest on a warm day that smell was actually boosted their immune system. They tried to control for a lot of different confounders and they found these, anyway they found these amazing findings. So I hope we see more and more of this research down the line. Well, I'm hoping that all the cedar chips I have interspersed in my knitting is actually then also boosting my immune system. I'm curious too about one of the challenges of doing this kind of research because as you were saying, right? You spend time in nature and often it also can be correlated with doing physical activity which we know is good for our health. So how do we tease those sorts of things apart? The smell study seems like a great example of that where you are literally sleeping and not running but how else do you do that? Yeah, so scientists have tried to do that. There's one really good example of that which was when in fact they had people walking on treadmills and looking at photos of either an urban environment or a natural environment and then measuring their levels of self-esteem and their blood pressure afterwards. And what they found was that even though they were walking on the same treadmill at the same pace, the people who looked at those nature photos in fact had greater drops in their blood pressure and greater improvements in their self-esteem. So yeah, I think one of the great benefits of spending time in nature is because we do naturally become more active and we know there's there are reams of evidence behind the health benefits of physical activity but nature seems to supercharge that activity. So it's a little something extra you can get when you're exercising, if you spend time outside. That's really exciting. I love the idea of like a policy change where all gyms now have to show like nature videos instead of reality TV or maybe survivor because you kind of get a little bit above. Okay, well, we're gonna transition to a quick video and Kate, if you wouldn't mind bringing up the YouTube video for the health benefits of nature, we'll show that. And we have some space for audience questions right after this video. So if you have any questions at all, please do stick them in the Q&A and we'll ask them. Hey guys, I've brought you here to my local park today to show you three easy ways you can connect to nature and the amazing health benefits you can get by getting outside. You know, a lot of us sort of feel good when we go outside into nature but now there's actually scientific evidence showing that our health benefits hugely when we head out into nature. Let's go. We all know exercise is great for the body but if it's a nice day in your neighborhood, why don't you head outside and do it outdoors? Getting active in nature improves your blood pressure even more than if you exercise on a city street. One study showed that people who exercised looking at nature had better moods and better self esteem. So to get the most bang for your buck when you're exercising, get outside to improve both your physical health and your mental health too. There was one major study looking at the amount of green space near where kids lived and kids who had more green space closer to their homes tended to be at a healthier body weight and the theory was that that was because they're more active and playing more in the screen space. So minimizing your screen time and increasing your green time is a great way to make sure that kids get more active. So many of us eat our lunch inside staring at a computer at work but if your boss is okay with it, why don't you take your lunch outside and eat it at a nearby park? Nature is actually a proven brain power booster that will help you focus through that long afternoon walking for less than an hour inside a park improves your memory and concentration and actually just 15 minutes sitting in nature lowers your stress hormone or cortisol levels as well as your heart rate. Studies show that just 20 minutes of walking in the park can improve ADHD symptoms just as much as prescription medication. So who doesn't love catching up with a friend over coffee? Next time you grab that coffee, get it to go and hit up your local park for a stroll. Short trips to the forest actually increase your levels of natural killer cells which are your first-liner defense against pesky viruses. In fact, just breathing in the scent of trees has been shown to increase your immune function. I hope you learned some really interesting information that will motivate you to get outside and into your local green space. Imagine how healthy you could be if you added a little green time into your day every day. That was a total blast from the past. I think that video is from 2014. Is that right or anyway? When I was actually, no, I think before that, 2012 or something. When I was appearing on Stephen and Chris on the CBC which was a national lifestyle show and I was so into nature at that time that I pitched this segment to the producers and said I wanna do a segment on the health benefits of nature. And so yeah, thanks for showing me that. Well, and I love how it sort of was a bit of a broad overview of what we talked about more in depth with all of these benefits that you get from physical health benefits to mental health benefits and it's not just linked to exercise, it could be as simple as just going outside and spending some time outside. And one thing that does interest me is also this, I think we tend to, historically, we focused a lot on physical health, but have you seen an increased awareness around, especially this link between nature and mental health recently? Absolutely, for sure, Kaylee. And I think that is something that we've really tried to focus our program in on. People often ask us, well, who's your target audience? And really, I think there is a growing mental health epidemic, especially among young adults, even though it's among people of every age. But when we think about the way the resources are oriented, the app that we're developing to use for people to track and incentivize their nature time, it's focused on people who are increasingly stressed for a number of different reasons. And for sure, in my own practice, for example, a lot of my patients come in with concerns about mental health, especially during the pandemic. But the interesting thing I found was that those mental health presentations seem to be even more when we had issues like the heat dome, when we had issues like wildfire smoke, because they were able to cope up to a certain extent and then lack of access to feeling safe and refreshed outside was gone. And I think that just put a lot of people over the edge of that time. So absolutely, in my own practice, in overall trends, I would say nationally, mental health is definitely becoming more of a concern. Yeah, and I think I'm glad that you talked about the heat dome and the wildfires as well, because we are now understanding this link more and more every day and how it impacts all of our lives through nature, but also we are dealing with unprecedented climate change. And those actions will also change how we negotiate our time in nature. And so in light of that sort of renegotiating of time in nature, we have a question about barriers to getting out in nature. So what are those barriers? Even knowing all the benefits, what can we do to help people overcome those barriers and establish healthy habits mentioned? How can we reward them and to overcome those challenges? I find one barrier for myself anyway, in which a lot of patients record back is time. So we are incredibly busy people, especially when we live in cities. Often our schedules are kind of packed to the brim and we think, how can I fit nature time into my lifestyle? But I think it may be easier than you think. If you, for example, you're hanging out with friends, instead of hanging out with friends inside a cafe or inside something indoors, meet them outside. And I think one of the great things about Vancouver and the West Coast in general is there is this great outdoor culture, which I think has served us well during the pandemic. And that combined with the milder weather means that we've been able to connect outside a lot. So just finding ways to insert nature, whether it's through even house plants or photos on your wall or listening to nature sounds, that can be a way to make your life more nature rich without having to put a lot of effort into it. And then other barriers are transportation. This is often something that comes up is if you live in an area of the city that doesn't have as much nature, how am I supposed to get that nature experience? So I think about that issue in two different ways. One of them is in some ways it's possible to redefine what nature is. In some of the studies that look at health outcomes, they actually had patients self-define when they had a meaningful nature experience. And other research bears that out is when you feel like you've had a meaningful nature experience, that's when you'll experience some health benefits. So trying to find nature in your garden, in your backyard, if you're lucky enough to have one or in a community park, it doesn't have to be on the side of a mountain with no one around or in the backwoods, you can really find nature in unexpected places in your own neighborhood. And then the second thing is we have to reduce on, we have to work on reducing those barriers as well, right? Like we need to enshrine the right to access to nature, I think in the city planning to make sure that everyone in an equitable way experiences those health benefits. Absolutely. And those changes as well in terms of greening spaces and increasing access to them also helps mitigate some of these challenges of climate change, right? When we green aspects of cities, we decrease the overall temperature because canopies allow for cooling effects but that comes back to what you were just saying, it's really important that everyone has access to those things and that when we green cities, we don't push out communities as well. I have another question for you here around do you have any comments on the impact of densification of our cities on our health, physical, mental and emotional? So how might densification play in to play into our health as well? Oh, that is a very complicated question. I think that requires a city planner perhaps to answer but in general, I would say I am in favor of densification especially along major retail and transportation corridors because it makes our cities more walkable. And so one really important part of reducing our overall carbon pollution is getting people outside of internal combustion vehicles. So having grocery stores nearby, having schools and parks nearby where people can walk to instead of driving is really, really important. I might be showing my political leanings here but I also think we need to expand density in areas where people haven't necessarily, all kinds of people haven't necessarily been able to live. So especially near parks, right? Like I'm not saying pave over the green spaces but I'm saying we should be able to increase density of housing around them so more people have access to these green spaces. So yeah, in general pro density but when done properly and making sure it's equitable so people of all different income levels can live in these beautiful places. Absolutely, there are ways to densify areas that maintain nature, maintain access and it's about thinking of community services and how to maintain that for everyone. But not easy. So definitely coming back to that difficult challenge for sure. So I think what we'll do, I've got another question. I'm gonna save it for our next Q&A because this has come up and I have a little research in this area as well. I thought we'd just take a little bit of a sidestep and talk about nature and wildlife. Let's do, that was the wrong kind of screen share. It's okay. Let's try that again. Share, nope, there we go. Okay, so in my work, I've done a lot of research on urban wildlife, urban rats, I'm doing a lot more work around health. I'm actually writing a book chapter right now about urban wildlife health in relation to things like green spaces. And I thought it would be a nice time to talk about how greening spaces and keeping them healthy is not just good for people but it's also good for wildlife. And as Melissa was saying, there's also a link between human health and wildlife health and interacting with wildlife too. So there are studies that show that bird sounds can have been associated with decreased stress. And if you know a bird or in your life, you might know that they can be very excited about going out and seeing birds and hearing birds, which is mostly what you do. You mostly hear them and you don't see them. But there are links between seeing certain types of wildlife and decreased stress and increased happiness. I will say, as a resident rat researcher, it depends on the species. Many people don't enjoy seeing rats but that also has something to do with our own services that we have in the city and how we manage our waste. And so rats are often a symbol of other societal issues beyond just them as wildlife themselves. And our actions impact wildlife health. So in our own green spaces, the things that we do can in turn impact wildlife. You see this servant here chewing on what I must be a coffee cup or something. So our own waste management, the way we green our cities has impacts for wildlife as well. So if we go in and we create lots of small habitats that tends to have lots of wildlife really close together, sometimes it can mean that they have more disease because they can spread it. So that's another really important implication for when we think about where we create green space access and how healthy that access is. And as one example, this is a figure that we did for a paper and it just sort of shows how complex all of these things are in cities when we think about wildlife health. So you've got an adorable raccoon here in the middle and it's showing that in cities we have increased pollution often which can impact animal health and our health. So animals can often sort of be literally the canary in a coal mine for telling us about what is in the environment. So I think it's in New York where they found quite a bit of lead in pigeons as an indicator of lead poisoning in people. How we manage our garbage and put out resources for wildlife. For wildlife sometimes it's great that they can find food but that food's usually not very good quality unless they found your delicious backyard garden. But if they're chewing on a hamburger or just white bread or something like that that's usually pretty low in nutritional content and not actually very good for them. We have different species in cities. I mentioned rats, pigeons, all of that changes which changes how they spread disease. And that depends on how we create green spaces. And then there are these other aspects beyond greening of like noise and light pollution, right? Our cities are going 24 seven and we're exposed to all of this too. Increase light, increase noise, wildlife are too. It impacts their stress. It changes how they interact with the environment and impacts their immune system as well. And so what I liked about showing this is just it also goes towards thinking about how we engage with the environment is not just for us. It's for all of us. It's termed one health. Healthier environments are good for people. They're good for animals and they're good for our environment generally. So after that fun wildlife aside which was frankly mandatory, any thoughts about Melissa before I dive into our poll? I just want to mention that something people often think about nature prescriptions is it's very human focused, right? It really speaks to human health but we are just one species in a web of species. You know, as you've indicated in this there are so many different layers to life on this planet. And so part of what we want to do with nature prescriptions is to make people more aware of the other forms of life out there and to help them foster care for that. But I think we're going to talk about that a little bit more later. Yeah, I love that sort of the stewardship of natural spaces and the other species, non-human species that are in there. So we're going to have a little interactive break and launch a poll and we're going to ask you about how much time you spend in nature each week. So let's do that. So if you could tell us how much time do you think you spend in nature in a typical week? Less than 30 minutes, 30 to 60 minutes, one hour to two hours, two hours to three hours or more than three hours. How much time do you spend? I'll give you about a minute. It's always really fun watching these polls. It kind of feels like you're at the races. Kind of watch them creeping up. Less than 30 minutes, 30 minutes to one hour, one to two hours, two to three hours or over three hours in nature each week. What do you think, Melissa? What do you think the answer will be? I'm thinking D. Two to three hours? Yeah, I'm thinking that's what most people answer, but I don't know. I don't know where people are coming from. Okay, we're going to give 10 more seconds to get in your responses. Okay, here we go. Here are our results. So the majority, we've got most folks who are here in the two to three hours a week to over three hours a week. I was actually surprised by the more than three hours. It's very exciting. And we've got a lot of folks two down in the less than 30 up to two hours. So a real variety of the amount of time that we spend in nature. I'm really happy to see that poll results because it means that people are maximizing their health because they're spending more than two hours in nature each week. But again, I think we're going to be talking with that a bit more later. Yeah, I actually really wonder where people are from. Yeah. Because that determines how much access you have to nature and how much time you spend in it. Yeah, absolutely. If you're willing to share in the chat, you can tell us a little bit about what nature looks like near you. Actually, and we'll dive into that now, Melissa. So you mentioned PARX. I'll just stop share here. What is PARX? PARX is Canada's National Nature Prescription Initiative. And it's powered by the BC Parks Foundation. And we launched it in November, 2020. And since then we've spread to every province across the country. We have our final launch in Newfoundland happening this coming week. And then we'll be in all 10 provinces and are working on the North. And the point of it is for regulated health professionals like physicians, nurses, physiotherapists, registered clinical counselors, to be able to prescribe nature to their patients to improve their health. And it's been wildly successful. It really was... I mean, we started working on it before the pandemic. I became director in 2019. Plants initially launched in early 2020. We all know what happened in early 2020. Plants was delayed a bit until later that year. But it's just... Yeah, basically if you're a regulated health professional, you can register on our website to prescribe and you'll get a customized nature prescription file that you can use to prescribe nature to your patients with our standard recommendations of nature time of at least two hours a week and at least 20 minutes each time. And you can also log prescriptions on our website and one great feature that we announced at the end of January this year was that we have a new collaboration with Parks Canada where registered prescribers can now prescribe one free Parks Canada discovery pass for adults per month to their patients to reduce one major barrier to nature access. And we're asking that they prioritize patients who live close to Parks Canada administered sites and for whom the cost of a pass would be a major barrier to access because we wanna make sure that people who need them the most and will use them the most will use them. So we're working in a number of different ways to try to reduce those barriers to nature access. Yeah, and that actually raised a question for me around what a nature prescription does that just going to a doctor generally doesn't do. And it sounds like at least one of these things is that you may have access to something like a pass to the parks. There are other things? Well, I think at a very basic level prescribing something adds a little bit of oomph to the recommendation, right? If I know if I want a patient to really remember something I'll write it down and hand it to them because so many different things are flying at us in an appointment. It's sometimes hard to remember everything but writing it down and having something physical and tangible to bring home does increase the chances that you'll actually do it. And this theory and this phenomenon is borne out through the exercise prescription literature which tells us that when a regulated health professional writes something down it increases patients motivation to do it. And so of course, if you're already spending time in nature you don't need a prescription from me or anyone else to do it. You know, it doesn't require permission but I think something about actually prescribing it and indicating that it should be one of the main lifestyle interventions to improve our health is that it does give you permission to make it an important part of your life. Like so many people, we feel like there are so many other things we should be doing so many other obligations we have but when you center time outdoors in nature as something essential for your health that makes sure that increases the chances that you'll prioritize it. Yeah, and I'm also curious about the time because you mentioned, you know so we looked at our range of how much folks spend in nature we've got less than 30 up to more than three hours a week and the recommended time is that two hour two hour chunk a week. So how did we get there and just putting it into 20 hour chunks make it seem more manageable or is there science behind the 20 minutes? So there's science behind both the two hour per week recommendation and the 20 minute recommendation. So these studies very conveniently came out in 2019 just as we were conceiving of the program. And so the first study for the two hour recommendation was a study of almost 20,000 adults in the UK and they asked them how much time they spent recreationally in nature each week and then also asked them about their health and wellbeing and after controlling for a number of different confounders like socioeconomic status and current health status and age and that sort of thing they found that people reported significantly higher health and wellbeing when their nature time hit two hours and this continued to increase until about the 200 to 300 minute mark per week. So that's why we recommend that you spend at least two hours of time in nature each week to maximize your health benefits. And then when it comes to the 20 minute recommendation this also came from a study in 2019 it looked at about three dozen adults and they measured their celebrated cortisol levels and asked them to have a nature experience a meaningful nature experience self-defined at least three times a week and at least 10 minutes each time. And they found that between the 20 and 30 minute mark was that when their cortisol or stress hormone level dropped the most efficiently so the steepest drop happened then. And so if you want the biggest bang for your buck that's why we say spend at least 20 minutes in nature but we're not gonna say, hey, stop the clock at 30 minutes you know, stop the clock at two hours and head inside the more the better to a certain extent but those recommendations are based in science. And that almost points to this sort of like a habit. So we have a question here around one of the positive outcomes of the pandemic is that it pushed the person to get outside and to get out of the house that it became a daily habit. So are there, have you found that developing habits such as these are consideration for people too to consider in facilitating sort of that stress and mental health and getting out into nature? Absolutely, if we schedule something into our agendas if we make it a priority the chances that you'll continue to do it are much higher. And what the great thing about nature is too is it actually makes people more likely to continue with certain habits. So for example, we know in, you know people make these new year's resolutions to exercise more it's like, okay well unless you actually detail how you're going to do it the chances that you'll continue to exercise for the whole year are lower but nature in fact increases people's motivation to continue with exercise programs. So again, it could be a variety of reasons it could be because you feel less stressed you feel more drawn to these natural spaces rather than inside a gym, you know running on a treadmill looking at a screen there's something added again about nature that draws us to it that increases our motivation to want to keep going back again and again and make it a healthy habit. And thinking about healthy habits sort of towards like as we age just getting out more help you be healthier as you age and is there any consideration with age when giving out a prescription versus just making a recommendation? The benefits of nature for health extend across the lifespan. So from the prenatal period and women who have not people have not yet given birth to baby's development there's research showing that kids who spend time in nature natural environments versus traditional playgrounds actually develop their motor skills faster and then all the way into elder health there's research showing that people elders who spend more time in nature live longer, have better cognition especially those who garden actually that's like a superpower for your brain is if you garden regularly. So yes, absolutely across the lifespan it is great for your health. And in terms of considerations for older adults the great thing about nature prescriptions is that they're very easy to fill like if you ever go outside you can probably safely fill your nature prescription which is different from other things right like for example medications that may cost money or even exercise prescriptions where you know the physician or person prescribing it has to think about the patient's abilities but with nature it's very accessible if you can get into a green space even into your backyard you can experience those health benefits. So I would argue it's actually a pretty easy prescription to fill. And is there any difference when we're thinking about the health benefits of being outside with our nature prescription? Is there any evidence that it's better for me to go with a friend versus by myself? Like have there been any studies sort of in that relationship piece too? You know like doing it with someone? Yeah. You know I don't know if there have been any studies looking at solo nature experiences compared to group nature experiences but I do know that that social aspect of connecting to other people can really help with health. So there's this great group of researchers in Australia that specifically look at loneliness and nature experiences and also even just tree cover and green space cover in cities in Australia. And they found that just having 30% tree cover versus less than 10% reduced people's feelings of loneliness. And I think it's because nature is this great way to connect with people. When you feel outside you're less stressed you say hi to someone walking by or smile at them versus if you're I don't know where you might be on a subway or a sky train or something people are actively avoiding looking at each other. Whereas our eyes are up unless we're looking at our phones or whatever but our eyes are up we're looking around when we're out in nature enjoying things. It really is a way to connect with other people and I think that social aspect absolutely is really important for reducing loneliness and making us feel more connected. That's interesting. I do find that people are more likely to say hello to me if I'm hiking than if I'm just walking down the street. We'll take one more question and then we're gonna skip to another short video and I feel like this question comes from a scientist because the question is what does research define as nature? Is there a significant difference between gardening under a couple of trees versus going for a hike? And I find this question really interesting because I've been working on this urbanization and health thing and we don't even really know what urban is. So are there definitions for what would constitute as nature? This is a great question and in many of the studies that have been done they had participants self-defined nature experiences so it could have been in your garden it could have been in your community park it could have been at the beach. And what they found was the self-defined nature experiences actually improved people's health outcomes. There's been a study done I think it's a group in Alberta who's looked at nature experiences within parks and what they found was that over and above biodiversity in fact what mattered for people's health outcomes and kind of mental health reports was their experience of feeling like they had a nature experience. So it just tells us how powerful our minds are if we can rearrange our ideas of what nature is we can find more nature in our cities but of course it's easier to have that profound nature experience if you're in the middle of the backwoods if you're in a mossy old growth rainforest but I think if we can stretch our minds we can still find nature in somewhat less than traditionally natural places. And at least then you might not have to deal with the mosquitoes there might be some benefits to not being fully in the backwoods. Thank you. We're gonna dive into a quick video that goes over these prescriptions again and then we're gonna come back and do a poll and have another discussion. So Kate. About a year ago now I was in talking to my doctor and I just said I can't shake this depression. He says I've got just the prescription for you. Oh goody, one more pill. He says no, no, no, no I want you to spend two hours during the week outdoors. Minimum 20 minutes each time. And the more I did it the better I felt. So it all came together way better than any medication I've ever had. Now you know she's 75 so I'm gonna tell you that I'm 91. So that's why she takes care of me. I try, I do try. Nature is everywhere. We can find it in the most unexpected places and nature is health. Park Prescription or PA or X is Canada's national nature prescription program. What the physician or nurse does is they sit down with the patient and they figure out what kind of nearby nature is in their community and then they work with them together to come up with a plan where they can incorporate nature time into their everyday lifestyle. Some cherry tomatoes. So this is the prescription and it just gives my name and it says my outdoor activity plan. In 2022 we announced a new collaboration with Parks Canada where licensed health professionals can now prescribe national discovery passes that give you entry to national parks. There are only two national nature prescription programs in the world and the first one was actually founded right in the US. Cost can be a barrier where there are day use fees. So we're hoping that by prescribing these Parks Canada's discovery passes that that will reduce that barrier to nature access in a significant way. Well there are two major theories as to why nature is so good for our brains and the first one is called attention restoration theory. When we spend time in busy urban environments all the hard edges and traffic and lights and people everywhere really make us have to constantly focus our attention to kind of navigate around those obstacles. Whereas when you spend time in nature it's really this source of soft fascination. So what that does is it restores your powers of attention and it reduces that fatigue and irritability. The second major theory is called stress reduction theory. So basically when we spend time in nature after stressful events it helps us be more resilient and recover faster. When I recommended nature for the first time to a patient of mine I thought he's going to look at me funny and he's gonna laugh at me but he actually just nodded his head and said you're absolutely right. When I spend more time in nature I feel better and so I think healthcare providers sort of have to get over our own mental biases against new sort of lifestyle interventions and prescribe something evidence based like nature time more often. 50 days from seed to vegetable. I think the prescription helps in that it says this is a good thing to do. This is worth the effort to do. You need to get out of doors and just be surrounded by the greenery and by nature. I want people to know that nature should be a non-negotiable. The thing about heading outside is that you tend to start to naturally be more active. You'll feel calmer. You'll feel less depressed, less anxious. I think it's just a great way to deal with the stresses of modern life. So there we saw another great clip of what PARX actually is and linking back to some of those earlier theories we discussed at the beginning around the value of nature for our health. And we also talked about some of the barriers about getting outside and rethinking about what nature is. And I guess one question I have is around other barriers in terms of healthcare providers actually prescribing this. So do you find that there's been an excited uptake around the health community or is it not so widespread yet here in Canada? Kayleigh, I would say the uptake has exceeded my expectations. So in the first year after we launched from November 2020 to November 2021, we had about 1,000 prescribers sign up. And in fact, that's pretty good because our major sister organization in the U.S. PARX America took three years to get to 1,000 and we're obviously they have a much larger prescriber and patient base. But then after we made that announcement with PARX Canada in January, it's been an exponential increase. So I think at this point we have close to 9,000 registered prescribers. So in just the few months afterwards, it exploded. And I think it was because prescribers now had the ability to prescribe something tangible to their patients to actually reduce their barriers to nature access because it's one thing to just say, hey, do this thing, here's a piece of paper. But to hand them something of value that makes it easier is something very compelling, I think to prescribers. And so yeah, the uptake has been amazing. And in fact, I think the majority of prescribers are physicians and in fact, over 5% of all practicing doctors in Canada are now prescribing nature through our program. And so for a program that's one and a half years old and something that's quite a new innovation the uptake has been incredible. Yeah, that does sound phenomenal. And I'm curious about the, it seems to me the biggest barrier, both for people even knowing that they could get a nature prescription or for physicians offering them would be knowing that link between nature and mental health and physical health. So is there a program that does some of that education or how do folks even become sort of aware of it? Head to our website, www.parkprescriptions.ca. So we have a website that's laid out to be very attractive to both prescribers and patients. And there's a section called Why Nature that has some funny cute little animations that look at health benefits in adults and health benefits in kids and health benefits for the planet of connecting to nature. And then if you click on them there are these 14 different fact sheets all cited with lots of up-to-date studies that indicate the health benefits for different conditions like respiratory and immune health like cardiovascular disease like ADHD in kids, work satisfaction in adults. So check out that website, it's a nice evidence-based but easy to navigate resource. So I think I feel like this idea has become mainstream enough that people aren't questioning it as much anymore. I think one of the reasons is the fact that we had to head outside all mass during the pandemic, right? Like we inside wasn't safe to be being inside wasn't safe anymore, right? We kept hearing from our public health officers outside is better than inside. Spend more time outside for your health and also to reduce infection transmission. And I think people experienced that. We saw really huge rises in park visitation during the pandemic in parks across the country. And so I think armed with this feeling that nature is good for us and then this increasing awareness I think through both the efforts of our program and other people who are more interested in how in communicating the benefits of nature I think people are becoming more and more aware. I think it is becoming more mainstream. Yeah, I love that. Well, and on that note of mainstream let's do a second poll. So for everyone I'm gonna launch this poll and we're curious to know if you were prescribed nature would you be more likely to spend time outdoors? Absolutely, a little more maybe or no. So I'm gonna launch that poll and please let us know if you were prescribed nature would you be more likely to spend time outdoors? I'd like to think I'd be better at this than other prescriptions. More motivated. Do you know what is really funny is this was a poll that was done recently in Australia. So it'll be really interesting to see how local Vancouver results compared to people down under. And so they don't have a system like this yet? They don't. There are actually only two national nature prescription programs in the world in the US and here in Canada. Great. Okay, I'll give you everyone another few seconds to put in your responses and then I'll share them. Yeah, so are there many other countries that are considering it right now? I would imagine that there's lots of countries that would be interested. They're trying. Kaylee people from, for example, I'm trying to think now the Netherlands, Pakistan actually, Australia are all reaching out to kind of talk to us about how we launched it and how they can do a similar thing in their own country. So there's a huge appetite for it. Nature prescriptions were named one of the top eight global wellness trends in 2019. And so, which is interesting because it makes me think it was being done more on a local, smaller scale. But in terms of these large scale programs that really try to connect a broad swath of the population to nature, it's very unique here in North America. Well, those are the kinds of health trends I like to see publicized instead of like diet teas. So that's great, very excited about that. Okay, thank you everyone for answering. Here are the results. Most folks saying, absolutely. We've got a little more and maybe, but nobody in the knows. So we'll consider that a win. So in Australia, the stat was actually 80% of people said they would spend more time in nature if their doctor recommended it. So if you add the absolute thing a little more up, that's like about 80, you know, that's close to 80%. Yeah, that's really interesting. So Melissa, one thing that you mentioned as well earlier was around sort of the environmental impacts of PARX. Like we've spent this time thinking about what does nature do for us? But let's flip it for a second and think about what we do for nature. So how might something like this program actually help us to improve our environments or support our environments now and in the future with climate change? Well, number one, just the fact that health professionals are saying this means that people are going to take it more seriously. And I'm not just saying this because I'm a health professional myself, but there's a study that's done every year, well, within Canada survey and in the UK that looks at kind of this global trust index. And in fact, nurses consistently come out on top, doctors consistently come up second in terms of professionals that we would most trust. So when a health professional says something, this increases the chances that we're going to listen to it. And also I think it's been, I don't know if we mentioned this already, but people who are more connected to nature are more likely to engage in pro-environmental behaviors. And this is something that's been shown in research. So this goes just beyond conservation because it totally makes sense that we want to protect what we love. But people who are more nature connected tend to recycle more, they tend to conserve more energy, they tend to vote for climate advocates and engage in more other kinds of climate action. So by having health professionals stand behind the health benefits of nature or stand behind the benefits of nature. And then also in increasing the proportion of the population who will be more pro-environmental, I think this is a way to really create a movement of people who are concerned about the planet, concerned about health and connected to each other. And something else I want to mention too is that there's no pathway to net zero without nature-based solutions for climate change. In fact, it's estimated that if we fully embrace nature-based solutions for climate change, that focus on restoring and expanding natural ecosystems while dealing with human issues at the same time, this could get us over 30% of the way towards our 2030 Paris Agreement targets. Right now globally, I think the statistic is about 5% of climate investments are made in these nature-based solutions for climate change. And if you think about the potential of over 30% of reductions versus 5% of investment, by again engaging the trusted health voice and making people realize how important nature is for their own health, I think there's a big potential to close that gap. So anyway, there are a number of different ways I think an initiative like this can improve our awareness about the importance of nature for our health and our planet's health. And in fact, we're really proud when at COP26, the World Health Organization recognized our program, APARX as one of only two case studies from North America in their whole special report on climate change and health as a way to inspire protection and restoration of nature as the foundation of our health. So nature prescribing is starting to get noticed by global bodies like the WHO as well. That's so exciting. And you mentioned sort of a movement and how we all need to be on board. And I'm curious about how we make sure that everyone has access to nature and that everyone can be a part of that movement because as we were discussing earlier, green spaces aren't evenly distributed. They often, there's a term called the luxury effect where you end up having more green spaces and more affluent areas where more under resourced areas of marginalized communities have less access to green space and are probably going to experience more negative effects from climate change because of those environments. So how do we also then make sure that everyone has access to nature and that everyone can be a part of this movement? I think we have to enshrine the right to nature in public policy. So there is this rule called the 33300 rule that was coined by my colleague Dr. Cecil Kanine and Dyke who used to be at UBC and now works in Europe. But he says that we'll know that our cities are green enough when in every neighborhood across the city, so not just the well to do ones, but when everyone in every home can see at least three trees from their windows that there's at least 30% tree cover if it's an equally appropriate area and that everyone is within 300 meters walking distance from a community park or a larger green space. And so we know when those metrics are reached, we'll know we have healthy cities from a green space perspective. And that's something that we're pushing for too. We're not only prescribing nature, but a lot of the physicians and health professionals who prescribe nature through our program are part of other environmental organizations like the Canadian Association of Physicians for the Environment or the Canadian Association of Nurses for the Environment. And they realize they know that nature access is an equity issue. When we think about what happened with the heat dome that happened about a year ago, the majority of hospitalizations in Vancouver Coastal Health came from the downtown East side. And it's not coincidental that along with being one of the most materially and economically deprived areas of the city, it also has some of the least green space. And so the infrastructure, the roads, the homes were physically hotter. And in fact, lack of access to green space was one of the main risk factors for mortality during the heat dome, right up there with age, with being isolated. And so really access to nature is an equity issue. And so I think by getting more nature into people's faces by communicating the absolute importance that we need access to nature for our health, that will be a way to reduce those barriers and also make sure that everyone can have access to nature and come along with us in this movement. Yeah, I think that's a really important point. And it really hints at how we need systemic change. And we really need to be thinking about this in terms of urban planning and bylaws and all those sorts of things to make sure that our communities are healthier and that we're not leaving any communities behind. So we're gonna take, anyone who has any questions, please do put them in a Q&A. We will have a bit of a Q&A session here at the end. We're about to wrap up, but we have one more word cloud for you because word clouds are very fun. So let's just do this again, little screen share. To participate in our final word cloud of the event, please tell us about your favorite nature space. If you go to www.menti.com and enter the code 74681659, you can tell us what your favorite nature space is and we'll create a little bit of a word cloud so we can look at it. So www.menti.com code 74681659. I'm gonna be really excited to see what you put. Melissa, what's your favorite nature space? Kaylee, I'm trying to enter it here and it still says what is one word to describe how you feel when you spend time in nature. Well, let you go to the, oh, I wonder if I, this would, yeah, that seems like something that is my fault. One second, one second. I mean, we can just put our favorite nature spot in that. You could, but there's such a beautiful photo of rocks that I put seven, oh no, it says it's the same one. So there might be another, can you click to the right to the next question? Huh, mine doesn't do that. Maybe it's an issue with my computer anyway. Okay, well yeah, put your favorite nature space in there. That's totally fine. We'll just have a beautiful composite word cloud. Why not? Yeah, so in terms of my favorite nature space, I would say, I mean, it depends, right? My everyday nature space or my all-time world's favorite nature space. Let's do both. Okay, well in my own neighborhood, I would say a specific spirit regional park and because that's somewhere my family really grew to love during the pandemic, we would go there constantly, touch the moss at all times of the year and feel safe and connected. But in terms of my all-time favorite space, I would say Pacific Spirit, or sorry, not Pacific Spirit, Pacific Rim National Park Reserve near Tafino, just because I still remember stepping out onto that beach for the first time. This was in residency. I did my family medicine training in Victoria and heading up there for the first time. I'd heard how Tafino was great at that, yeah, whatever, okay, I've been to beaches, but just the sight of a beach that disappeared into the distance and you couldn't see the end of it and the massive rolling waves, it's just, it's the same feeling I got when I stood in front of mountains for the first time, just small but connected. So yeah, I would say those are my two. How about you, Kaylee? Yeah, I don't know. My favorite nature space of all time is linked to family and it's the Ocean Nova Scotia, absolutely. I spent a lot of time swimming around, looking at jellyfish with my aunt and that was definitely my favorite of all time. My favorite local nature space is probably down, just down by like La Carnault, if I like to jog down in that area and it's nice to, you know, I've been here for a decade and the ocean and mountains never gets old. It truly doesn't. Every time I see them, they are spectacular and I feel so much better. So I think that that's probably it. And I'm sorry everyone, because I realized that you probably weren't able to enter or enter in anything if you had already entered a response. I'm not sure about the code, but if you'd like to share your favorite nature space, you can also put it in the chat and we can have a little look at them there. Does anyone have any other questions? If you have any at all, please do put them in the Q&A and we can ask them. Okay, here is, we have one question here. So what's the experience or do you have any experience around the aspect of plants? So we've talked about experiencing plants as a benefit for health, but what about when we think about actually consuming plants for our health? Is there much research around the plants as medicine, whether or not there's any partnership with medically trained phyto therapists? I've actually never heard that term before and that's quite exciting to help empower patient prescription and sort of that Western to herbal medicine link. First of all, from a just a general dietary perspective, the research is pretty slam dunk that plant forward diets are the healthiest diets for us. And in fact, Canada's fairly new food guide is an example of that. So it's very evidence-based. We say half your diet should be fruits and vegetables, a quarter, some kind of lean protein and a quarter whole grains. So yeah, absolutely. Eating tons of plants is good for us and the planet also because it reduces carbon pollution. But in terms of plants as therapeutics, I unfortunately don't know that much about it because I've been trained in the Western medical system, but we do know that there's a huge amount of evidence that connecting to nature in different ways is good for us. So I think anything that encourages us to spend more time in nature, spend more time touching, smelling plants is going to be a good thing. All the plants, touch all the plants. We've got a few favorite spots I thought I'd share, Himalayan Mountains. That sounds, I've never been, that sounds fantastic. Locally Centennial Beach, I think I've been to Centennial Beach and Stanley Park and Lighthouse Park, of course, local favorites. I think those are all the questions I have queued up. We don't have anything else in the Q&A, but Melissa, was there anything else you thought would be worth chatting about before we close up today that we didn't already speak about? Oh, I love that question because it's so open-ended. I think we covered a lot of it, but I just want people to know, I think also, spending time in nature is good for us as people who are concerned about the planet because it makes us more resilient. I spend a lot of my time, a lot of my mental effort, physical effort, being a climate advocate, being an advocate for planetary health. And I know it's based in science, it's based in my intuition that spending time in nature connecting with friends and family or even by myself is going to give me the resilience that I need for the long haul because this fight to preserve biodiversity, to protect our planet is not a sprint, it's going to be a marathon. So I think for, even if you're not a planetary health advocate, just making sure that you have enough energy, making sure that your bucket is full enough to do what you need to do in life, spending time in nature is an essential part of self-care. Absolutely, and for folks who are curious about the PARX prescriptions, you can find that at parkprescriptions.ca. Is that correct? The website parkprescriptions.ca. That's all right. Well, thank you so much for taking the time to share your knowledge about this with all of us and especially with me today. This was a lot of fun and I learned a lot about our connection to nature and our collective health. And thank you everyone so much for joining us on a beautiful day when you might otherwise actually be outside enjoying it. So maybe you're sitting under a tree with your laptop. Yep. Thank you both so much for joining us and having this beautiful conversation. I really enjoyed all the little bits, the polls and all of the videos and all of the information. I really want to go outside now. So I just thank you again for being part of us, part of this. And if you haven't been yet, we do have a rooftop patio that you can go and spend in the garden and outside in the sun at the library. So I hope you come and enjoy your nature here. Bye everybody. Thank you so much for getting here. Take care. Have fun outside this weekend. Yeah, you too. Bye. Bye.