The keys to change are clear education about the benefits of nature exposure and reducing social and economic barriers to change. (Credit: Melissa Lem)

Melissa Lem is a Toronto family physician who also works in rural and remote communities across Canada. Much of her childhood was spent exploring the beautiful parks and green spaces of Ontario. She holds a faculty appointment with the Department of Family and Community Medicine at the University of Toronto, is a regular guest blogger on the environment and health for Evergreen, and enjoys being the resident medical expert on CBC television’s lifestyle show Steven and Chris. Docs Talk asked Dr. Lem how contact with nature can affect child development.

Docs Talk: What are some of the problems you are seeing in children who don’t have a strong connection to nature? How common are these kinds of health issues in children?

Dr. Lem: Time spent in nature is essential for healthy psychological and physical development in children. In fact, some researchers suggest that daily doses of “green time” can be used to prevent and treat many medical conditions.

Attention deficit hyperactivity disorder gets a lot of attention in the media and occurs in five to 10 per cent of Canadian children. Continuous immersion in urban environments can overstimulate youth with and without ADHD, leading to symptoms of inattention and impulsiveness. The substitution of active outdoor play with indoor sedentary behaviours is also a major culprit in weight gain and obesity, which affect one in four Canadian children. This is raising the childhood incidence of traditionally adult diseases like hypertension, diabetes and cholesterol issues.

Other ailments including myopia, asthma, depression and slower social and motor skills development have also been linked to reduced nature exposure.

Docs Talk: What kind of research has been in done in this area?

Dr. Lem: Green space exposure has a wealth of positive effects on pediatric health outcomes.

The existing research is impressive regarding mental health benefits. For example, ADHD symptoms improve significantly after children spend time in nature, with increased benefits seen in more green locations. Girls with greener views from their home windows score higher on measures of self-discipline. Also, depression and anxiety disorders are less prevalent in youth who have greater amounts of nature in their living environments.

Connection to nature also improves indicators of physical health. Studies show that children who spend more time outdoors and live closer to parks engage in more physical activity. It follows that proximity to green space significantly improves the likelihood that a child will maintain a healthy weight. What’s more, regular childhood exposure to green space fosters increased preference for nature-based recreation. Natural settings are ideal for children to cultivate creativity and social skills as they enjoy their recommended one hour or more of unstructured playtime per day.

Docs Talk: What kind of activities do you recommend parents do with their children to help them connect with nature?

Dr. Lem: There are two major concepts to consider: role modelling and active involvement of the child. One of the most effective ways parents can strengthen their child’s connection to nature is to minimize screen time and embrace green time themselves. The other is to promote a mix of both parent-supervised and independent outdoor play, which encourages children to form and build upon their own nature experiences.

Fun family activities can range from planting a garden to a weekend camping vacation in a provincial park. The backyard is a safe and stimulating place for younger children to explore green space. Encourage them to cloud watch, build a fort, collect stones or come up with their own nature-based games. Outdoor, environment-based volunteering can be an effective way for younger and older children to build self-esteem and strong family and peer relationships.

Docs Talk: What more needs to be done to convince parents, doctors and educators of the benefits of connecting children with nature?

Dr. Lem: It can be hard to see the forest — or the trees, for that matter — for adults who are accustomed to living in spaces defined by asphalt and concrete. The keys to change are clear education about the benefits of nature exposure and reducing social and economic barriers to change.

Doctors should remember to integrate counselling about screen time and outdoor activity into routine checkups. Nature prescriptions may also motivate children to increase their green time. If the pediatric obesity epidemic continues, scientists predict that this generation may be the first with a shorter life expectancy than their parents. This should be a huge wake-up call for all of us.

Author Richard Louv coined the term “nature deficit disorder” to describe the health issues linked to the modern divide between children and the outdoors. His award-winning book Last Child in the Woods is an important resource for parents and educators.

Docs Talk: What can we do to make our communities more “nature-friendly” for kids?

Dr. Lem: Our physical and cultural environments must be designed to allow children to benefit from natural settings during recreation and everyday life. Mixed-use residential areas with green corridors increase the likelihood that children will walk or bike to school and play. Protected urban green spaces have also been shown to reduce health inequalities between children from low- and high-income families. Communities can create natural playscapes that reflect the area’s environmental heritage instead of building artificial playgrounds.

Changes in school and educational culture are also vital. Simple measures like planting trees and grass in sight of classroom windows can promote more effective learning. Green time ought to be incorporated into physical education, recess breaks and even regular class hours.

The importance of childhood nature access should be reflected in government policy, whether it be through bylaws mandating child-friendly green space in new urban development projects, tax credits for enrolling children in nature-based recreational programs or ensuring affordable family access to national parks. Now is the time to invest in communities that will raise healthy and resilient stewards of the environment.