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A park prescription is a clinician’s recommendation to spend a specified amount of time doing specified activities in a nearby park or other public green space. It resembles a medication prescription in format—frequency, duration and follow-up—but the “dose” is time in a place rather than a pill.
The model is best understood as a way to connect clinical care with public-space planning, not as an established treatment for chronic disease. Its success depends on whether patients can reach a park that feels safe, accessible and suitable for the activity, and whether a provider can support follow-through.
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What a park prescription actually is
In the model described by Jared Green in the American Society of Landscape Architects’ April 26, 2019 article, a clinician directs a patient to a park near home and specifies how often and how long to use it. The recommendation might involve walking, active recreation, quiet contact with nature or social activity, depending on the person’s circumstances and the park’s features.
That distinction matters. A park prescription is not a diagnosis, a replacement for medication, or proof that a particular park will treat an illness. It is a care-planning device that turns a general instruction such as “be more active” into a location, schedule and set of activities. The referral only becomes practical when the health-care team and the public-space system work together.
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Green’s account credits Washington, D.C.-based physician Robert Zarr with helping spearhead the nature-based health-care movement and says more than 100 Park Rx programs existed in 2019. That was a historical count reported by ASLA, not a current total.
Why connect medical care to neighborhood parks?
The 2019 ASLA article framed park prescriptions as one response to a broad health challenge. The figures below are reproduced as the article reported them; the article did not identify the underlying publishers in the text reviewed, so they should not be treated as current estimates.
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| Figure reported by ASLA in 2019 | How to interpret it |
|---|---|
| More than 100 Park Rx programs | A historical count of programs cited by the article, not a verified 2026 inventory. |
| Americans spend 90 percent of their lives indoors | The article’s reported statistic; its underlying source is not identified in the article text. |
| 40 percent of adults do not engage in leisure physical activity | Another figure quoted by the article, without an underlying source identified there. |
| 90 percent of health-care costs go to treating 132 million Americans with treatable chronic diseases | A claim presented by the article, not an independently verified current allocation of spending. |
| 78 million obese adults and 12 million obese children | Counts reported by the article for its 2019 framing; they should not be updated or generalized without newer evidence. |
These numbers explain why the idea is attractive: a referral can connect a medical conversation to an ordinary setting that people may already know. But the numbers do not establish that prescribing park time produces a particular clinical outcome. They are context for the proposal, not an efficacy trial.
How the referral works in practice
A workable program has to answer six operational questions. The steps below describe the model as presented in the ASLA account and make explicit the decisions a provider and patient must share.
- Discuss the person’s goals and constraints. The clinician first determines what kind of activity or outdoor experience is realistic, taking account of mobility, schedule, transportation, confidence and any medical restrictions. The source does not establish a standard eligibility list, so this remains a clinical judgment.
- Write a specific recommendation. Instead of a vague instruction to “go outside,” the prescription states the intended frequency and duration and, where useful, the type of activity. A patient needs to know what to do, how often and for how long.
- Identify a nearby, suitable place. Distance from home is only one criterion. The provider or referral service should check safety, accessibility and amenities, and match the setting to the prescribed activity. A park that is close but unusable for the person is not a successful referral.
- Explain the available experiences. Some patients may benefit from active recreation, others from a contemplative connection with nature or a social setting. The prescription should point to features that support the intended experience rather than treating every park as interchangeable.
- Make completion feasible. The patient and care team can agree on a routine, a route and a way to record visits. The ASLA article described Park Rx America’s “Find a Park” tool as allowing filters for safety, accessibility and amenities, and described an app that tracked activity and communicated completion to a provider. Those were descriptions from 2019; current availability and functionality are not established here.
- Review what happened. At a follow-up visit, the clinician can ask whether the place was reachable, safe and appropriate, and whether the schedule was realistic. The recommendation can then be adjusted or stopped according to the patient’s clinical needs. The model does not justify promising a health outcome simply because a referral was issued.
The implementation problem: getting people to go
The ASLA article asks, “who’s going to get people to actually go outside to exercise?” That is the central implementation question. A prescription creates an intention; it does not create a safe route, open gate, accessible trail or welcoming social setting.
Henderson also reported that the question doctors most often ask about local parks is, “Are they safe?” Safety concerns can prevent use even when a park is geographically close. Accessibility barriers can have the same effect, as can a lack of the amenity the prescription requires. Program designers should therefore treat the park itself as part of the care pathway, not as a neutral backdrop.
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For a construction, landscape or public-realm team, this changes the brief. The relevant deliverable is not simply additional acreage. It is a network of usable places with clear access, appropriate amenities and different kinds of experience, maintained well enough that a clinician can refer a patient with reasonable confidence.
What makes a park suitable for a prescription?
Safety that can be assessed locally
Safety should be considered at the specific site and time a patient is likely to use it. A referral system needs a way to identify concerns rather than assuming that every public green space offers the same conditions. The source does not prescribe a universal safety standard, so local agencies and clinicians must define the checks that fit their community.
Accessibility for the intended user
“Accessible” has to mean more than appearing on a map. The entrance, route, facilities and activity area need to work for the people being referred. A park finder that filters for accessibility can help, but the provider still needs current, place-specific information. The 2019 description of Park Rx America’s tool should not be read as confirmation that the service or its filters operate today.
Amenity and activity fit
Different prescriptions require different settings. Trails, playgrounds, dog parks and outdoor exercise equipment were among the amenities considered in Montgomery County’s planning work. A site intended for walking may not meet the needs of someone seeking social contact, and a quiet nature experience may be undermined by a lack of places to pause.
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The Montgomery County example grouped public-space value into three experiences: contemplative connection with nature, active recreation and social gathering. Planning around these categories gives clinicians more meaningful choices than a simple calculation of park acres. It also helps a construction team explain why a small plaza, trail connection or amenity upgrade may fill a different need than a large but undifferentiated open area.
Proximity and continuity
A nearby park reduces the practical burden of a referral, but proximity alone does not guarantee use. A useful network offers more than one option when possible, so a patient can choose a setting that fits the prescription and continue using it if one location becomes inconvenient.
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Montgomery County’s planning example
Montgomery County, Maryland, provides the article’s clearest example of planning for park prescriptions without presenting a medical program as the sole solution. The county’s energized public spaces work combined geographic mapping with public surveys. Planners asked residents what amenities they wanted—including playgrounds, trails, dog parks and outdoor exercise equipment—and mapped where those amenities were missing.
The county evaluated whether spaces supported contemplative, active or social experiences. Using GIS, planners identified 12 “deficit clusters,” as reported by Montgomery County and the ASLA article. The plan then focused on improving amenities in smaller parks and creating new parks or plazas in underserved areas.
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Independent reader supportYour contribution helps us test, update, and keep practical guides available for everyone.What the health claims do—and do not—establish
At an American Planning Association conference in San Francisco, Park Rx America executive director John Henderson was quoted by ASLA as saying: “At the American Planning Association (APA) conference in San Francisco, Henderson explained that exposure to nature reduces the damaging impacts of chronic stress and improves mood and cognition.” The article also quotes him saying, “And exercising in nature amplifies the many health benefits of physical activity.”
Those are reported statements from a 2019 professional-association article. They are not a current clinical guideline, a systematic review or a finding that park prescriptions treat a named disease. The account does not establish which patients benefit, the dose required for a particular outcome, comparative effectiveness against other interventions, contraindications or a standardized safety protocol.
Readers should therefore separate three questions: whether outdoor activity is a reasonable topic for a clinician and patient to discuss; whether a particular park is usable and safe; and whether a program has demonstrated a measurable medical outcome. The first can be addressed in ordinary care, the second requires local information, and the third requires clinical evidence that the 2019 article does not provide.
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How to evaluate a park-prescription network
| Evaluation axis | Questions for a provider, planner or construction team |
|---|---|
| Proximity | Can residents reach the site from home or another routine destination without an unreasonable travel burden? |
| Safety | What current information supports a referral, and how are changing conditions communicated? |
| Accessibility | Can the intended users reach and use the relevant entrance, route, facility and activity area? |
| Activity amenities | Does the site offer the feature named in the recommendation, such as a trail or outdoor exercise area? |
| Experience mix | Does the network include contemplative, active and social settings, rather than only one type? |
| Provider workflow | Can a clinician identify an appropriate location, give clear directions and review progress? |
| Equity of investment | Are underserved areas receiving amenity improvements or new parks and plazas, as in the Montgomery County example? |
This framework is useful for capital planning because it links each physical decision to a referral need. It also prevents a common mistake: counting facilities without checking whether residents can use them.
A practical checklist for starting a program
For health-care organizations
- Define what clinicians may prescribe and what remains individualized clinical judgment.
- Create a current directory of nearby parks with verified information about safety, accessibility and amenities.
- Use a consistent format for frequency, duration, activity and follow-up.
- Give patients a way to report barriers, not just whether they completed a visit.
- Do not describe the referral as a cure or substitute for indicated medical care.
For municipalities and project teams
- Map amenity gaps and gather resident input before selecting projects.
- Assess access to contemplative, active and social experiences separately.
- Prioritize underserved areas and smaller parks where targeted improvements can close a specific gap.
- Keep park information current enough for a clinician to make a responsible referral.
- Coordinate with health-care partners so built improvements are matched to real use patterns.
For patients
- Ask the clinician to state the recommended activity, frequency and duration clearly.
- Confirm that the suggested park is reachable and suitable for the activity.
- Report safety, access or amenity problems rather than assuming non-use is a personal failure.
- Continue other prescribed care unless the clinician changes it.
What remains uncertain
The source does not provide program costs, a current count of Park Rx initiatives, validated outcome measures, a list of appropriate diagnoses or evidence that one park design is superior to another. It also does not confirm that the “Find a Park” tool or activity-tracking app described in 2019 remains available or functions in the same way.
Those gaps do not make the idea useless. They define what a responsible program must do next: maintain accurate site information, make access and safety visible, document participation consistently and evaluate health outcomes with methods appropriate to clinical care. Until that evidence exists, park prescriptions should be offered as a structured invitation to use local green space, not marketed as a proven treatment.
The practical conclusion
Prescribed time in neighborhood parks can give clinicians and communities a shared language for connecting health goals with the places people live. The strongest version of the model is specific about frequency and duration, matches patients to safe and accessible settings, and plans for contemplative, active and social experiences. Montgomery County’s example shows why that requires more than counting acres: it requires mapping what residents can actually do.
The model’s promise is therefore conditional. A prescription is only as useful as the park, information and follow-up behind it, and the 2019 ASLA account should be read as a planning and practice proposal rather than proof of clinical effectiveness.
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