"Everybody needs beauty...places to play in and pray in where nature may heal and cheer and give strength to the body and soul alike."
― John Muir
No doubt humans need Nature, and according to the Wilderness Society,
The most nature-deprived Americans are those with barriers to access due to limited transportation, disability, live in care facilities (skilled, assisted, and memory care), and the 100 million Americans living in food and park deserts.
There are significant disparities in who does and does not have access to the outdoors in America. An astounding 70% of low-income communities are nature-deprived. Our neighbors who identify as Black, Hispanic and Latinx, American Indian/Alaska Native or Asian American, and Pacific Islander have extraordinarily less access to green space, with an average of 44 percent less park acreage than predominantly white neighborhoods!
Living in an affluent white neighborhood does not guarantee accessibility for everyone.
Last year I assessed walkability in Carmel-by-the Sea, CA, where the median home price is currently 3.4 million (2022), with a median age of 65.
Using a walker, I attempted to walk to the famous nearby beach and realized early on why I never see people with mobility aids enjoying the abundance of green and blue space in their neighborhoods.
There are numerous cracks in the sidewalks, many areas do not even have sidewalks, benches are on top of curbs, and overgrown trees cover stop signs.
As I was using the crosswalk, a local senior living car, an assisted living and memory care facility I worked at a few years prior, was driving by.
I yelled, "stop!" they rolled down the window, and the passenger was a resident who uses a walker. She shared her sadness that she couldn't walk to the beach safely. Walking to the beach is unsafe for someone using a mobility device, which is why they were out for a nature drive versus a walk.
Ensuring a neighborhood is Walkable for All, while ensuring we all have Access to green and blue space is good for all of us!
Can a Green Care Movement shift our thinking
about Nature and Accessibility?
The therapeutic benefits of Nature are well known. From boosting immune function to promoting inner peace, it is hard to find any adverse side effects of the Nature prescription.
In the last 15 years, 'Green Care' has emerged as an evidence-based therapeutic practice for health promotion and disease prevention in European countries, largely due to the information-rich book:
"a range of activities that promotes physical; and mental health and wellbeing through contact with Nature. It utilizes farms, gardens, parks, and other outdoor spaces as a therapeutic intervention for vulnerable adults and children."
- Green Care- A Conceptual Framework, 2010
It is important to note that Nature is not just a backdrop in green care; Nature is used to produce health, social, educational, and environmental benefits.
Green Care Includes:
Therapeutic horticulture, animal-assisted therapy, social and care farming, healing gardens, wilderness and ecotherapy, environmental restoration, green exercise, Nature, and the natural environment link these active approaches as a framework.
"Reconnection to the natural world is fundamental to human health, wellbeing, spirit, and survival."
― Richard Louv, The Nature Principle: Human Restoration and the End of Nature-Deficit Disorder
California's Master Plan for Aging 2021-2022 includes Strategy C:
Outdoor & Community Spaces for All Ages.
These goals target all ages, including Initiative 23, promoting Blue Zones for dementia-friendly communities.
An example of a dementia-friendly community program is The Momentia Movement,
co-founded by Marigrace Becker, the program manager for the University of Washington Medicine Memory and Brain Wellness Center. Momentia connects people living with dementia with community members, and together they explore, share adventure, joy, and conversation.
Access to Nature and the outdoors is an essential remedy for people living with dementia and their care partners. Here in the U.S., more than 21 million people provide unpaid care for someone living with dementia.
While half of nursing home residents in the U.S. have dementia, more than four times as many people with dementia live at home, not in care facilities. Dementia care in the U.S. is costly, with annual out-of-pocket costs averaging $50,000.
Research has shown that access to 'green care' and the outdoors significantly improves the quality of life of people living with dementia by alleviating agitation, pain, and anxiety that cause discomfort while reducing caregiver burdens.
Meet Dementia Adventure, a multi-award-winning charity devoted to
"enable people living with dementia to get outdoors, connect with nature, themselves, and their community, and keep a sense of adventure in their lives."
In 2012, Natural England commissioned Dementia Adventure to review evidence of the benefits and barriers people living with dementia face in accessing the natural environment.
The 'Greening Dementia' project raised awareness among dementia specialists and organizations, including the wider health community, local authorities, and policymakers, on the potential cost savings from improved access to quality green space and evidence-based health benefits.
Key general findings on the benefits of people living with dementia from access to the natural environment include:
Improved emotional state: reduced stress, agitation, anger, apathy, and depression
Improved physical health: skin, fitness, sleep, eating patterns
Improved verbal expression
Improved memory and attention
Improved awareness- multisensory and joy
Improved sense of wellbeing, independence, self-esteem, and control
Improved social interaction and a sense of belonging
Common barriers found affecting people living with dementia include:
Lack of transportation
Concerns about how they will be perceived
Lack of awareness of the needs of people living with dementia among greenspace organizations (public park staff)
Costs of resourcing visits
Risk aversion among people living with dementia and their care partners
Dementia-friendly communities can help remove these barriers, creating more green space accessibility for not only people living with dementia but also for others who struggle with similar obstacles.
Access to Nature enables people living with dementia and their care partners to live well in their homes and delay costly health interventions.
In 2020, Public Health England reported that if all households in England had access to quality green space, health care costs could be reduced by £2.1 billion!
Currently, the U.S. Senate Energy and Natural Resources Committee is developing a legislative package focused on outdoor recreation:
Outdoors for All Act
Parks, Jobs, and Equity Act
Simplifying Outdoor Access for Recreation Act
Environmental Justice in Recreation Act
This legislative package is an excellent start toward Nature accessibility for all ages.
It is clear: All Ages Need Nature Always.
Can we inspire a Green Care Movement here in the United States?
I think we can, starting with encouraging our health care partners, policymakers, and people in all sectors to take eco-conscious baby steps and Unearth the 5 A's.
We all benefit from access to Nature.