Green prescriptions and their co-benefits : integrative strategies for public and environmental health

There is a growing recognition of the links between the increasing prevalence of noncommunicable diseases, environmental concerns including biodiversity loss and ecosystem degradation, and socioecological issues such as ecological (in)justice. This has encouraged a number of recent calls for the development of integrative approaches aimed at addressing these issues—also known as nature-based solutions. An example of an emerging nature-based solution is a ‘green prescription’, broadly defined as a nature-based health intervention. Green prescriptions are typically designed for patients with a defined need and they have the potential to supplement orthodox medical treatments, particularly those aimed at addressing noncommunicable diseases. It is also thought that green prescriptions could bring about significant environmental, economic, and social co-benefits. However, researchers have recently expressed concerns over taking the ‘dose of nature’ approach, in that it may be too reductionistic for the complex social settings in which it is provided. Here we frame a holistic philosophical perspective and discuss green prescribing logic, types, mechanisms and fundamental remaining questions and challenges. We place a significant emphasis on the potential co-benefits of green prescriptions, and the importance of taking a planetary health approach. More research is needed to determine how this potential can be realised, and to further understand the complexities of the nature–human health relationship. However, with additional research and support, there is huge potential for green prescriptions to contribute to both reactive (health care) and proactive (health promoting) public health solutions whilst enhancing the natural environment.