A Natural Health Service

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Ananth Somaiah

A recent MORI poll commissioned by Natural England found that 94% of the population thought it a good idea to refer people for outdoor exercise rather than medication. The FDA (the pharmaceutical regulator in the US) has been handed evidence that antidepressants may be no better than a placebo in the treatment of mild to moderate depression. And Britain’s Chief Medical Officer has stated that being active has the same anti-depressant effect as taking tablets.

Could this be the moment when we realize that the reason that one in six adults and one in five children have a mental disorder isn’t due to a lack of anti depressants, but more because we have drifted away from how we were designed to live?

Mental health is a rising problem and costs the UK economy £75 billion a year due to loss of earnings and health care. The World Health Organization predicts that by 2020 depression will be the second biggest cause of ill health worldwide.

We are designed to be on the move much of the time and this helps keep our blood pressure down, generate good cholesterol, allow more oxygen to the heart and muscles, and keep our joints healthy and free of pain. Just a thirty-minute bout of exercise will boost our immune system for the whole day, helping to keep away infection and mop up any stray cancer cells.

However, 70% of us don’t achieve this. Yet lack of activity has the same effect on heart disease as smoking twenty cigarettes a day. It increases the risk of diabetes, colon and breast cancer, osteoporosis, arthritis, and of course, the obesity that will affect 60% by 2040.

So, why not install a treadmill in your garage or join a gym and keep fit that way? We were never designed for treadmills, and although the gym can help some people, for many it simply isn’t suitable. We were once firmly connected with the natural environment. Just watch children playing outdoors on logs and in streams and you can see that they are not doing it to promote their health but because they love it. The eminent Harvard Zoologist E.O. Wilson termed this link ‘biophilia’ – an innate affinity for Nature.

Linking health with Nature goes back a long way. Monasteries once had healing gardens, and a thousand years ago St. Bernard was enthusiastic about his: “The sick man sits upon the green lawn….” he wrote. “He is secure, hidden, shaded from the heat of the day. For the comfort of his pain, all kinds of grass are fragrant in his nostrils. The lovely green of herb and tree nourishes his eyes … the choir of painted birds caresses his ears… the Earth breathes with fruitfulness.”

Take a look, too, at the gates of Victoria Park in Bethnal Green, and you will learn that this oasis of green in the East End of London was created not for environmental reasons, but after the Registrar for Births, Marriages and Deaths noted that the death rate in Bethnal Green was much higher than elsewhere due to

overcrowding, unsanitary conditions and polluted air. In his annual report of 1845, the Registrar wrote: “A park in the East End of London would probably diminish the annual deaths by several thousands… and add several years to the lives of the entire population.” Queen Victoria agreed and a brand new park opened in 1850.

 

Octavia Hill, one of the founding members of the National Trust, was also famously enthusiastic about open space being available for the poor. Keen to save some fields near Marylebone, she wrote: “They are the nearest fields this side of London and on a summer Sunday evening you might see hundreds of working people who have walked from the very poor neighborhoods of Lisson Grove. Fathers with a little girl in each hand, the mother with baby… they enter the small white gate and spread over the green open space like a stream that has escaped from between rocks. These fields may be bought now, or they may be built over: which is it to be? …. To my mind they are even now worth very much; but they will be more and more valuable each year – valuable in the deepest sense of the word: health-giving, joy-inspiring, peace-bringing.”

When I was a General Practioner in Oxfordshire, the same patients with diabetes would return time and again, having exercised no more than the last time we met. We would despair together. Each patient would have a similar reason: “I feel out of place in gyms or swimming pools.” Our solution was to set up health walks and the Green Gym, so that local people were introduced to exercise in their local environment with the help of local volunteers.

Health walks are now taking place across the UK. There are 4,000 walks a week, and the aim is to quadruple this by 2021. Anyone can set up a health walk, and 6000 people are being trained each year to lead them. Two surveys of the walks found that the reasons people gave for walking were keeping fit, being in the countryside, watching the seasons change and socialising. Health factors such as weight loss, sleeping better and being told to exercise by your GP were at the bottom of the list.

The natural environment has a powerful effect on us, encouraging us to become more active and be less stressed. In fact, the changes in the brain waves can be measured, showing an increase in alpha waves, which indicates more calm. Children become less hyperactive, can concentrate better and play more creatively and independently with greater co-ordination and balance. They develop a lifelong ability to connect to Nature, but only if they are allowed to play freely in streams and woods before the age of twelve. After this age, research has shown the effect rapidly diminishes.

As we get older, the ability to concentrate and cope with stress is enhanced by regular contact with Nature. Research in Tokyo and Holland shows that people are more likely to walk or cycle to work if the streets are lined with trees and other greenery, and they live longer and feel better. Regular contact reduces the underlying chronic stress.

Given this mounting evidence for the good of regular contact with the natural environment, we perhaps should look to examples set in our past. We should follow the practice of St. Bernard and have green space around our hospitals, residential homes and schools. We should look to the seminal moments of health care: the 1848 Public Health Act, passed after 14,000 people died from cholera in London; the 1956 Clean Air Act, passed in response to the great smog of 1952. In the 21st century, we have towns and cities that are home to 80% of the population in the UK, and yet green spaces in and around these towns have to be campaigned for to maintain their quality or very existence. Their true value to society is not understood.

The good news, though, is that the concept of a Natural Health Service is being developed in both England (by Natural England) and Scotland, to supplement the work of the NHS. This service will represent the green open spaces surrounding health centres and hospitals including parks, community gardens, allotments and trees in the street. There are plans to create the NHS Forest, in which 1.3 million trees will be planted, one for each NHS employee, to cool the urban heat of our island, provide shade, reduce stress and increase activity.

The Department of Health has launched a physical activity plan in which the opportunities offered by the natural environment are central to getting the whole nation more active.

So we look to 2010 to be the time to return to lifestyles for which we were originally designed. It’s a simple concept, but, as with clean water and clean air, we will need to undo many of the human – made interventions to reveal that original intended relationships with a healthy natural environment.

This article has been reprinted with permission from Resurgence Magazine, UK.