Trails are shown to improve health both mentally and physically, yet the healthcare industry and the trails industry rarely work together. There are many reasons for this, such as logistics, bureaucracy, and communication issues. We asked some leading experts how we can begin bridging these gaps.
At the 2019 International Trails Symposium and Training Institute we hosted a forum entitled “Engaging the Health Community.” The forum featured panelists Torsha Bhattacharya of Rails-to-Trails Conservancy, Mikaela Randolph of the Children and Nature Network, John Henderson of Park RX America, and Elisa Sarantschin of NaturePHL, and was moderated by Jeff Olson.
As Olson pointed out when convening the panel, the trails industry and the healthcare industry have important overlap. When people have more outdoor opportunities they are healthier both mentally and physically. For this reason it is vital that these two industries have open communication and work together, and advocate together, when it comes to bringing these outdoor opportunities to as many people as possible.
Unfortunately, there are barriers that often prevent utilizing what could be a good working and symbiotic relationship between the healthcare industry and the trails industry. The panel audience when polled said they had experienced many of these barriers first hand, including examples such as lack of trust, lack of time, lack of interest by major healthcare institutions, difficulty finding the right person to talk to, poor coordination, and political limitations among others.
Panelist John Henderson agrees that these are issues, and something he sees first hand with the organization he works with, Park RX America. Park RX works directly with doctors to encourage writing prescriptions for outdoor activity, and currently has more than 500 doctors who are registered prescribers nationwide. Henderson shared that when talking to a new medical institution his team gets three questions, “What is our liability? Are these parks safe? What is the evidence this actually works?”
Henderson points out that this is a cultural issue with getting everyone to view parks on the whole as safe and necessary. If the doctors don’t think that parks are safe, families won’t think that parks are safe, and the issue spreads. Educating and building a trail culture, where outdoor activity and parks aren’t viewed with suspicion, will also help towards getting the medical community more engaged.
Panelist Mikaela Randolph agrees with this sentiment, and also points out that by developing a shared language between both outdoor advocates and healthcare advocates common ground can be easier to find. For example, by talking about cardiovascular benefits and how outdoor activity is a good way for patients to find motivation for exercise that they might not otherwise have, outdoor recreation advocates can reach doctors by speaking their language.
Panelist Torsha Bhattacharya built on this idea by tackling the idea of perception. The trails industry has a responsibility according to Bhattacharya to make sure trails aren’t seen as a niche, but rather an everyday feature. Additionally, with the medical community tackling the perception of treating a disease versus ongoing preventative care, and the importance of trails to that care, is important. Bhattacharya sees the value of trail prescription versus pill prescription, and believes that the trail community can help others see the value in that as well.
Panelist Elisa Sarantschin works not only in the outdoor community but as a clinical director at the Children’s Hospital of Philadelphia, and agrees with the other three panelist in that information dissemination is the most important aspect. Sarantschin says it can take years for doctors to get used to the idea of outdoor activity as prescribed preventative care, but it starts with information about why it is important, and building off of information they are already familiar with. Quantitative data is especially important.
In another audience poll over 90 percent of those participating in the poll said that the healthcare industry is not sufficiently involved in the trails community, to which the panel generally agreed. Sarantschin suggested one way to get the healthcare industry more involved in projects would be to bring them in to speak to the importance of health and safety related aspects. For example, when advocating for money for a trail to the city council a doctor might be able to talk about health benefits of cardiovascular exercise. Once that partnership is formed then it is easier to further work together. One main point is that it will be on the trail advocates to reach out to the healthcare industry and find ways to begin these conversations, because the healthcare industry likely will not be the ones reaching out.
According to both Bhattacharya and Randolph it is also important to keep in mind a broad view of what healthcare industry means. Doctors are not the only connection to the healthcare industry. Social workers, aide workers, and others can also be part of the conversation. Additionally university programs that are creating future healthcare workers can be a great place to get your foot in the door with building these connections. Henderson echoes this sentiment, saying, “If we are only trying to work with doctors and hospitals it isn’t sustainable, it has to be much much broader.”
When asked to name examples of programs and places where the outdoor community and healthcare community are working well together the panelists cited numerous examples. Rails-to-Trails has worked with the city of Brownsville, Texas in a nationally lauded program aimed at making citizens healthier through outdoor activity such as cycling. Nature PHL works with the University of Pennsylvania, including medical students, and other community groups in Philadelphia to encourage outdoor recreation. In California, the County of Los Angeles Healthcare Facilities and the Department of Parks and Recreation have worked together to bring things like walking trails to the grounds of the health facilities and build up a culture of health through outdoors. In North Carolina both the Appalachian State University and the North Carolina State University are working towards bridging gaps between the medical community and the parks and recreation community. These are just a few of the many examples out there, but great places to start when looking for examples.
The panelists also warned that without learning how to engage the medical community, and making trails a vital part of the conversation, that lives can be at risk. As Mikaela Randolph said, “We can’t keep looking at trails as a nicety, it’s a necessity. It can be life or death.” The other panelists agree on this count, pointing out that it isn’t only physical diseases like hypertension and cardiovascular disease that outdoor activity can help treat or eliminate, but mental health issues as well, which can get less attention and aren’t as often talked about. Additionally there can be economic benefits to communities in the form of lower insurance premiums, which doctors have leverage to negotiate based on preventative care, including prescribed outdoor activity.
You can view the entirety of this panel on our Facebook page, and tune in for our webinar on this topic (add webinar info in here with link).