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April is the first full month of spring; the time of year we dust off sports gear and head to practice, plant seeds for a summer vegetable garden, and pack snacks for hikes in nearby parks.

After our third winter navigating the COVID-19 pandemic, spending time outdoors feels especially important — not only for adults but for kids, too. Depression and a multitude of other behavioral health problems among children are on the rise. Remote learning caused some children to fall behind academically, and “only 1 in 4 U.S. adults and 1 in 5 high school students meet the recommended physical activity guidelines,” according to the Centers for Disease Control and Prevention
(CDC)
.

The good news is that simply getting outside and moving around can make a huge difference.


Why Getting Outside and Moving Is so Important

Studies suggest that spending time in nature is likely to have beneficial effects on brain development, symptom management for children with ADHD, and parent-child communication.
The many benefits of physical activity include reducing the risk of depression and cardiovascular disease, as well as supporting cognitive functions like learning and decision-making. As a nation, we stand to save $117 billion annually. This is the amount the CDC estimates we currently lose “due to inadequate levels of physical activity.”

With so much evidence about the power of physical activity and outdoor time, what prevents more children and their families from reaping these benefits?

Our reliance on and frequent, if not almost continuous, use of computers and smartphones isn’t helping. You’ve likely heard that “sitting is the new smoking.” Maybe you've purchased a standing desk or started taking more walking meetings to get more activity into your day. The same general concern about lack of physical activity applies to children. On April 5, an international panel convened by the Sedentary Behavior Research Network (SBRN) released specific recommendations for “school-related sedentary behaviors” among children. The recommendations include guidelines relating to movement breaks, incorporating movement into homework, and replacing screen-based learning activities with outdoor, non-screen-based lessons when possible.

Screens aren’t the only things keeping us from getting outside more often. As the CDC notes, “Many Americans live in communities that are not designed for physical activity.” For example, there may not be adequate sidewalks, bike paths, or safe crosswalks. Or, since trees clean and cool the air, (PDF) neighborhoods without adequate tree coverage can have measurably poorer air quality and warmer summer temperatures than their leafier counterparts.

If we think about this in terms of potential savings, one study found that “urban trees in 55 cities across the U.S. help avoid $4 billion in health care costs each year because they clean the air around them, keeping people’s lungs healthier. The Trust for Public Land estimated that the health benefits of natural spaces in just 10 U.S. cities combined could be valued as high as $69 million each year.”


A Green Prescription for Savings and Outcomes

Industrialist Alfred I. duPont, whose vision established Nemours, believed that “Old Dame Nature” was a superior physician. I imagine that duPont, who lived through the Spanish Flu pandemic of 1918-1920, would sympathize with the challenges we face after our third winter navigating the pandemic. He would marvel at the rapid development of vaccines to protect us against COVID-19. And he would be perplexed by our near-constant preoccupation with staring at screens instead of the green and blooming world beyond our doors.

I think that duPont would also be very encouraged by the East Coast Greenway, a 3,000-mile project that aims to connect a network of trails from Maine to Florida. The greenway is not far from either of the two estates duPont built and called home: Nemours Estate in Wilmington, Del., and Epping Forest in Jacksonville, Fla.

As the authors of a 2019 report on the Delaware River Watershed (PDF) portion of the greenway explain, “these findings project the Greenway would generate a more than ten-fold return of over $3 billion in public health, environmental, and economic benefits.”

Based on usage in 2018 in the Delaware River Watershed alone (which includes parts of Pennsylvania and South Jersey), the region benefited from an estimated $46,000,000 in preventive health care savings across just four existing trails for an average savings of $142 per person. The report also suggests that the region received almost $40 million in environmental benefits from existing trails in 2018 alone.


From Staring at Screens to Playing in Spring

More communities, health systems, schools, and businesses are recognizing that having access to outdoor space is part of creating and maintaining health – and in turn, reducing costs and improving health, education, and economic outcomes.

Here are three resources for finding free or low-cost ways to increase your family’s active outdoor time:

  • Find parks near you and programs for children and families.
  • State parks also offer a wide variety of outdoor recreational experiences. For example, in Florida, where I live, state parks offer activities like camping, fishing, kayaking and snorkeling.
  • Our KidsHealth.org provides free, physician-reviewed information, including how-to videos, about exercise and other health topics for kids, teens, parents and educators.

Now let's get outside and, as Alfred might say, enjoy Old Dame Nature this spring.

About Dr. Moss

R. Lawrence Moss, MD, FACS, FAAP is president and CEO of Nemours Children’s Health. Dr. Moss will write monthly in this space about how children’s hospitals can address the social determinants of health and create the healthiest generations of children.