Intended for healthcare professionals

Rapid response to:

Editorials Christmas 2023: Nature and Nurture

Nature prescribing

BMJ 2023; 383 doi: https://doi.org/10.1136/bmj.p2745 (Published 13 December 2023) Cite this as: BMJ 2023;383:p2745

Rapid Response:

Re: Nature prescribing: we must make our cities as green as possible

Dear Editor,

Garside et al's editorial on "Nature prescribing" makes intuitive sense, even though, as the authors admit, the evidence for tangible health benefits are open to debate[1]. Most city-dwellers, like me, will know the mental health benefits of spending time in green spaces, be they urban parks or the countryside.

Assuming the health benefits of nature prescribing are real, this begs the question of why those who live in cities tolerate the implicit harms from living away from nature/green spaces in our proverbial "urban jungles". The obvious answer is employment and livelihood. What price are city dwellers paying for the financial benefits of city life?

If we accept that being in nature is beneficial, we should make our cities as green as possible. Few cities succeed in being green. The one exception that springs to mind is the tiny city state of Singapore.

Singapore is a modern metropolis, with skyscrapers & highways aplenty. Yet, it has abundant flora, seemingly in every corner. Indeed, Singapore is often referred to as a Garden City, or similar[2,3].

Singapore shows us that where there is a will, there is a way.

More broadly than our cities themselves, our Governments should do more to protect nature. In the UK, pressure to develop so-called Green Belt land should be resisted, to protect our dwindling natural heritage. If we do not, there will be no nature left for our urban patients to benefit from.

Shockingly, the UK is considered "one of the most nature depleted countries on Earth"[4]. We must re-prioritise all urban development towards making our cities and towns as green as possible and redouble our efforts to protect what little remains of our natural environment, our flora and fauna across the UK. We must do this not just to keep nature prescribing relevant in the UK. We must do this for everyone living in cities and towns. In the future, it should not be necessary to prescribe nature for good health, we should just be able to step outside.

References:
[1] Garside R, Lovell R, Huks K et al. Nature prescribing. BMJ 2023;383:p2745 doi: https://doi.org/10.1136/bmj.p2745
[2] Kolczak A. This City aims to be the World's greenest. National Geographic 2017. https://www.nationalgeographic.com/environment/article/green-urban-lands...
[3] 'A city in a garden': Singapore's journey to becoming a biodiversity model. United nations Environment Programme website 2018. https://www.unep.org/news-and-stories/story/city-garden-singapores-journ...
[4] Burns F, Mordue S, al Flaij N et al. State of Nature report 2023, the State of Nature Partnership. https://stateofnature.org.uk/

Competing interests: Any views expressed are my own and not those of any organisation I am affiliated with. I support various environmental and conservation charities, including those focusing on urban settings e.g. London Wildlife Trust, Trees for Cities etc.

26 December 2023
Gee Yen Shin
Consultant Virologist
UCLH NHS Foundation Trust
UCLH NHS Foundation Trust, London, United Kingdom