Frumkin's Rx: Intense exposure to natural elements

By Sarah Goodwin

When physicians and scientists talk about the health effects of environmental exposures, most people think of air pollution and pesticides, bee stings and sunburns.

But Howard Frumkin, professor and chair of environmental and occupational health in the School of Public Health, believes many environmental exposures may have positive health effects and could actually help prevent and treat illnesses. Frumkin discusses his hypothesis in the April 2001 issue of the American Journal of Preventive Medicine.

“Unfortunately, the idea that exposure to nature can be restorative is almost invisible or nonexistent in health care,” Frumkin said. “Our standard clinical paradigm involves medications more than non-medical approaches, treatment more than prevention. But many people are intuitively drawn to this idea. They feel restored and healthier in a beautiful landscape, for example. And on the other side, many environmentalists work to preserve nature for a range of very good environmental reasons, but forget that one of the major benefits may be human health.”

Frumkin cited the work of Pulitzer Prize-winning author and scientist E. O. Wilson, whose “biophilia” hypothesis posits that humans are attracted to other living organisms and that this contact with the natural world may benefit health.

“It should come as no great surprise to find that Homo sapiens at least still feels an innate preference for the natural environment that cradled us,” Wilson stated in response to Frumkin’s article. “Frumkin points to a mass of evidence that such is indeed the case. He argues persuasively for closer attention in preventive medicine of the role of the habitat-seeking instinct by encouraging the union of environmental psychology with medical research.”

Frumkin presented evidence for health benefits of four kinds of contact with the natural environment: contact with animals, contact with plants, viewing landscapes and contact with wilderness. For the first, Frumkin points to research that concludes pet owners have fewer health problems than non-pet owners. Examples include lower blood pressure, improved survival after heart attacks, and enhanced ability to cope with life stresses.

Contact with plants, from gardening to looking at trees, could also contribute to healing physical and mental ailments, Frumkin asserted. For example, office employees report that simply having plants in the workplace makes them feel calmer. Although solid evidence is unavailable, Frumkin said, this may be the basis of traditional “healing gardens” in hospitals, and of horticultural therapy that is now widely used in acute hospitals, children’s hospitals, nursing homes, psychiatric hospitals and hospices.

Frumkin said evolution may have “hard wired” humans with a preference for specific natural settings. “Early humans found that places with open views offered better opportunities to find food and avoid predators,” he said. “But they needed water to survive and attract prey, and groups of trees for protection. Modern research has shown that people today, given the choice, prefer landscapes that look like this scenario.”

Frumkin noted that exposure to African savanna-like settings is associated with self-reported feelings of relaxation and have been shown by psychological testing to enhance mental alertness.

In one study, prisoners living in cells facing a prison courtyard had a 24 percent higher frequency of sick visits than those in exterior cells that looked out at rolling farmland. Likewise, postoperative patients with a view of trees were found to have shorter hospital stays and require less pain medication than patients facing a brick wall.

Frumkin said the wilderness experiences such as hiking may also have health benefits, such as the feelings of vigor and appreciation for others often reported by participants in so-called wilderness therapy programs. He said many of these principles are known to architects and planners, who have long used them in designing buildings, parks and other places.

“We physicians have a lot to learn from professionals in other disciplines,” he said. “We need to identify which kinds of nature contact are most helpful, for which patients, and for which medical conditions. One day, we may return to building hospitals with healing gardens. Or we may find we can help prevent or treat illness by prescribing gardening or pet ownership or vacations in beautiful places.”