Rx Life: The integrative solution to keep kids healthy

 

This year marks my 20th as a pediatrician. Through these years, caring for thousands of children, I’ve been so fortunate to witness the vast majority grow into happy and healthy young adults. And, as the families who’ve worked with me since the beginning will testify, I’ve also evolved. Changes in how I practice are due, in part, to wisdom born of experience, but equally, I believe, as a reflection of the tremendous shift in children’s health.

I emerged from pediatric training extraordinarily capable of handling the most extreme emergencies. Put me in any acute care situation, I was your guy. I had a well established toolbox for any situation. Or so I thought. Once I started in primary care practice, I realized pretty early on that I was woefully unprepared for my chosen profession. Keeping children healthy, that was my main task; in fact, it was the very reason I chose (or was called to) pediatrics. I had no clue how to answer the most basic, common questions I faced. “Doctor, how and what do I feed my baby? He won’t sleep, what should I do? She seems to be getting sick all the time, can I do something to prevent this? He is not walking, she is not talking… now what?” I was also seeing a remarkable rise during my first decade of practice in the prevalence of many chronic conditions — autism, anxiety, ADHD, asthma, allergies, obesity, and diabetes. My approaches — simply mirroring the standard of care as I was trained in — were a carefully selected hodgepodge of quick-fix pharmaceutical solutions. This “one ill — one pill” paradigm stopped serving me, and my patients. The only credit I can take for changing course, upon reflection, is that I stopped long enough to listen to those particularly passionate families trying to teach me what physicians for thousands of years knew and, in the space of a couple hundred of years, forgot. The most effective, safe and cost-effective approaches to keeping our kids well remain the simplest and most accessible: a series of lifestyle prescriptions I began to call the “Rx Life” solution.

Why “Rx Life”? It was naturalist and author Rich Louv who I first heard co-opt the conventional prescription model, describing the healing power of nature as something doctors should literally prescribe for their patients. This was one of those “aha” moments for me, and I was immediately struck by the vast potential of his idea. What if we deliberately reframed the prescription model to teach children and families several simple yet incredibly powerful tools for living a healthy life? I thought about the basic approaches I discussed with my patients and their parents each and every day, the ones that I knew worked in practice. These lifestyle prescriptions are the pillars of an integrative paradigm that creates true health and wellness. Importantly, this approach is collaborative and actively encourages patient participation, putting kids back in control of their own health. I’ve profiled below the seven prescriptions I believe are critical in empowering families to make sustainable changes, inspiring all of us to create the future we deserve.

1. Rx Food: Eat real food, not a long list of processed ingredients mashed together. Teach your children that food comes from the earth, not from a can. Grow and prepare your own food. Cultivate a garden or a farm. Buy and eat locally-grown, chemical-free food. Teach your kids that eating is a mindful process, not only about ingesting calories but also about nourishing your body, mind and soul. Eating is and ought to be a community activity.

2. Rx Activity: Move your body. Start with something — any amount, as much as you are able, and build on that foundation. Get your heart rate moving and see what it feels like to be so active that even your hair sweats. Support school recess and encourage free, unstructured play.

3. Rx Rest: Make sleep a priority. Create opportunities for rest, especially for teens; they always need far more sleep than they get. Instill good sleep habits from the beginning. Create a quiet, calm place for restful activities. Take time to simply be. Unplug and recharge. Value downtime. Remind your kids — and yourself — that it’s OK to stop.

4. Rx Nature: Get outside. Take a hike. Go jump in a lake. Explore the nearest nature center or national park. Experience the transformative power of the natural world and refuse to suffer from nature deficit disorder.

5. Rx Mindfulness: Be here now. Pay attention to the process. Realize that the most important time is now, the most important person is the one you’re with and the most important thing to do is what you are doing right here, right now. Be willing to sit in the mud until it settles and the water clears. Accept that you will never make all the stress in the world disappear and help your children build their stress-coping toolboxes. Take time to look someone in the eyes, listen to her story, and let her know that you hear her.

6. Rx Creativity: Be silly. Dance like no one’s watching. Color outside of the lines. Build something with your own hands. Paint using every color you’ve ever known. Make up stories and tell anyone who will listen. Sing a song — any song — and sing out loud, proud and strong.

7. Rx Connection: Realize that we are all connected, and that our relationships make us stronger and healthier. Be courageous enough to be vulnerable, and let others see you for who you really are. Look through someone else’s eyes as if they are your own.

(originally posted for Thrive Global)

Greening Healthcare: Next Steps

Recently, I led a webinar for Practice Greenhealth detailing our efforts at The Deirdre Imus Environmental Health Center® to reduce the use of endocrine-disrupting plastics in hospitals. Reducing DEHP use in particular is one of our main current initiatives, given its adverse impact on health, especially in newborns. I was inspired by the hospital community’s engaged participation during and after the webinar. Healthcare Without Harm, in addition to Practice Greenhealth, provides terrific resources and opportunities for those dedicated to hospital sustainability. Novel initiatives addressing antibiotic overuse and climate change (emerging issues in pediatric environmental health) complement ongoing programs supporting environmentally preferable purchasing.

As I reflect, though, on the growth in hospital system efforts, I remain dismayed by the relatively slow adoption of green health principles in primary care community practices and clinics. Most of us receive care in these settings, and primary care should be synonymous with preventive care, arguably best represented by the environmental health “precautionary principle.” It remains evident that the safest, most effective and most cost-effective strategies to create and maintain optimal health are preventive in nature. Environmental factors contribute mightily to all causes of disease and may cost the U.S. in excess of $75 billion annually just for children’s health issues alone. Care delivered in primary care settings should be a role model for ecologically sustainable health practices, limiting rather than contributing to environmental hazards in our communities.

When I founded the Whole Child Center with a dedication to ecological sustainability, I learned what I needed to know by witnessing the creation of the Gabrellian Women’s and Children’s Pavilion at HackensackUMC. I understood that what mattered was both selecting the greenest building materials and furniture available as well as optimizing practices like recycling, reduction of material use, and green cleaning. Obstacles to practices like mine at the time included cost increases to build, though these were easily offset by reductions in energy and paper use. Most importantly, we adopted a philosophy of practice that reflected our mission – we serve as role models for our patients and their families, demonstrating that how and not just what we practice actually creates health. Yet in the decade since, very few practices and clinics have “gone green,” despite growing concerns for and increased awareness of environmental health harms.  What are the barriers? Why have primary care practices not followed the lead of academic institutions? In part, there remains a misperception that greening our offices costs much more than conventional building/operational practices. Perhaps of greater concern, community-based physicians are unable to locate resources to assist them even if they have the right intentions.  Creating online resources and practical, educational workshops for clinicians and administrators interested in developing eco-sustainable practices remains a priority.

(originally posted for the Deirdre Imus Environmental Health Center)

The Growing Pediatric Health Gap: Environmental Injustice Threatens Our Future

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The Deirdre Imus Environmental Center® at HackensackUMC publishes landmark paper on The Growing Pediatric Health Gap: Environmental Injustice Threatens Our Future

Deirdre Imus, president and founder of The Deirdre Imus Environmental Center® at HackensackUMC, andLawrence Rosen, M.D., the Center’s medical advisor, pediatrician and founder of the Whole Child Center, have co-authored a landmark paper entitled The Growing Pediatric Health Gap: Environmental Injustice Threatens Our Future, which was recently published in EXPLORE: The Journal of Science and Healing, a leading interdisciplinary publication in the field of integrative medicine.

Nine years after releasing their 2007 paper, Environmental Injustice: Children’s Health Disparities and the Role of the Environment, Deirdre and Dr. Rosen revisit the issue of children’s environmental health and its intricate relationship with childhood health disparities. The current paper highlights the latest trends and statistics in pediatric health issues, including the concerning high prevalence of childhood cancer, allergies, asthma, obesity, diabetes and developmental disabilities in recent years.

“Simply put, children are our future,” said Deirdre Imus. “An investment in the health of our kids is an investment in generations to come. This paper is a must-read call-to-action that emphasizes the steps we can all take to protect our children’s health.”

This new paper explores emerging environmental concerns that disproportionately affect the health and well-being of children, such as climate change, toxic stress, and electromagnetic radiation. It highlights eye-opening statistics about the impacts of these issues on our children’s health, such as toxic stress early in life leading to heart disease, depression, and substance abuse. Moreover, the paper focuses on the relationship between environmental issues and poverty, offering the sad truth that children living in poverty bear the greatest burden of environmental health issues, ultimately widening the health gap in America.

“What has transpired in the decade since our first paper is heartbreaking,” said Dr. Rosen. “It’s important to understand the full implications of these emerging threats and to discover what we believe are important strategies to reverse the worsening health trends affecting our children.”

(source: The Deirdre Imus Environmental Center®)

13 Inspirational Quotes From Your Favorite Children’s Books

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I have a profound connection to children’s literature. When I was young, my parents read to me often and instilled in me the joy of reading. I was transported by the tales, my imagination whisking me on amazing journeys to fantastic new worlds.

Even today, when books struggle to compete with movies, TV, the web, and mobile apps for our kids’ attention, reading to my children has taught me that there is still a tremendous, unique power in sharing stories.

That’s why, as a pediatrician, I’ve chosen to fill my waiting room and exam rooms with favorite children’s books rather than TV screens or toys. I love walking into a room and finding a parent sitting on the exam table, child on lap, reading together.

Below, I’m sharing some of my favorite inspiring quotes from children’s literature. I hope they inspire you to share one of these stories with a child in your life.

1. “And above all, watch with glittering eyes the whole world around you because the greatest secrets are always hidden in the most unlikely places. Those who don’t believe in magic will never find it.”

― Roald Dahl, “The Minpins

2. “You can’t stay in your corner of the forest waiting for others to come to you. You have to go to them sometimes.”

― A.A. Milne, “Winnie-the-Pooh

3. ” ‘Why did you do all this for me?’ he asked. ‘I don’t deserve it. I’ve never done anything for you.’ ‘You have been my friend,’ replied Charlotte. ‘That in itself is a tremendous thing.’ ”

— E.B. White, “Charlotte’s Web

4. “Today was good. Today was fun. Tomorrow is another one.”

― Dr. Seuss, “One Fish Two Fish Red Fish Blue Fish

5. “Not all those who wander are lost.”

― J.R.R. Tolkien, “The Fellowship of the Ring

6. “It is our choices, Harry, that show what we truly are, far more than our abilities.”

― J.K. Rowling, “Harry Potter and the Chamber of Secrets

7. “Why, sometimes I’ve believed as many as six impossible things before breakfast.”

― Lewis Carroll, “Alice in Wonderland

8. “I am not afraid of storms, for I am learning how to sail my ship.”

— Louisa May Alcott, “Little Women

9. “You must never feel badly about making mistakes … as long as you take the trouble to learn from them.”

― Norton Juster, “The Phantom Tollbooth

10. “All grown-ups were once children … but only few of them remember it.”

― Antoine de Saint-Exupéry, “The Little Prince

11. “I bet if you go through the rest of your life telling yourself, ‘I’m sparkling,’ you’ll have a whole different energy and experience.”

― Wendy Mass, “Heaven Looks a Lot Like the Mall

12. “I don’t understand it any more than you do, but one thing I’ve learned is that you don’t have to understand things for them to be.”

― Madeleine L’Engle, “A Wrinkle in Time

13. “Listen to the MUSTN’TS, child, Listen to the DON’TS

Listen to the SHOULDN’TS, The IMPOSSIBLES, the WONT’S

Listen to the NEVER HAVES, Then listen close to me—

Anything can happen, child, ANYTHING can be.”

— Shel Silverstein, “Where the Sidewalk Ends

(originally posted for MindBodyGreen)

Antibiotic Overuse: A Worldwide Emergency

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For most of human history, infectious diseases have been the leading causes of illness and death.  Most ancient peoples used botanicals as the earliest antibiotics to combat various plagues, even without specific knowledge regarding the microbes responsible.  With the advent of modern pharmaceutical techniques, industrialized nations no longer rely on plants for cures, and millions of lives have been saved. However, we have now entered an age where the indiscriminate use of antibiotics in health and the food industries is causing significant harm to all living forms on Earth – and to the planet itself.  According to a Princeton Environmental Institute study published in The Lancet, worldwide antibiotic use increased an incredible 36 percent from 2000 to 2010.   The United States, sadly but not surprisingly, led the world in antibiotic use per person during this time period.  The report also noted the grave consequences of the escalation: rising resistance to many of our most commonly used life-preserving medications.

How profound is the resulting cost?  Staggering, both in terms of human health and healthcare costs.  One report, “A Brief History of the Antibiotic Era: Lessons Learned and Challenges for the Future,” notes, “The mortality rates due to multidrug-resistant bacterial infections are high. Each year, about 25,000 patients in the EU die from an infection with the selected multidrug-resistant bacteria (ECDC/EMEA Joint Working Group, 2009), and more than 63,000 patients in the United States die every year from hospital-acquired bacterial infections. Estimated economic costs due to infections by multidrug-resistant bacteria in the EU result in extra healthcare costs and productivity losses of at least EUR 1.5 billion each year (ECDC/EMEA Joint Working Group, 2009). The annual additional cost of treating hospital-acquired infections from just six species of antibiotic-resistant bacteria was estimated to be at least $1.3 billion in 1992 dollars ($1.87 billion in 2006 dollars) – more than the annual spending on influenza.”  A newly publishedstudy directly links antibiotic abuse in animals with significant pediatric health concerns.  The authors warn, “Antimicrobial resistance is considered one of the major threats to the world’s health. The use of antimicrobial agents in agriculture can harm public health, including child health, through the promotion of resistance. Because of the link between antibiotic use in food-producing animals and the occurrence of antibiotic-resistant infections in humans, antibiotic agents should be used in food-producing animals only to treat and control infectious diseases and not to promote growth or to prevent disease routinely.”

In addition to the surge of antibiotic resistant infections, other related health ills are of increasing concern.  Children regularly exposed to antibiotics gain weight faster than those never prescribed such medications and are atsignificantly higher risk of obesity later in life.  The mechanism is likely through altered metabolism caused by dysbiosis, or the imbalance of microbes in the gastrointestinal tract.  Antibiotics destroy not only harmful bugs but also the health-promoting bacteria that help regulate metabolic energy efficiency.  This disruption in the microbiome increases our likelihood of developing other metabolic diseases like diabetes and impairs our ability to defend against environmental toxins, thereby increasing risk for a whole host of other diseases like cancer and neurological disorders.  And we are not the only victims.  As I’ve previously written, the spread of resistant infections has also been tied to massive die-offs in various animal and insect species, in turn threatening the health of our planet and all who reside here.

The good news?  Finally, doctors are taking notice.  A 2014 Consumer Reports National Research Center poll found that greater than 95 percent of those surveyed are very concerned about antibiotic overuse.  Most are actively following CDC-recommended steps to prescribe only when medically necessary, not use broad-spectrum drugs when simpler options will work, and talk to patients about why these medications are not needed for all infections.  The CDC is also targeting consumers, in particular, parents who historically ask for and expect antibiotics for self-limited conditions like upper respiratory infections and non-streptococcal sore throats.

While we may be making progress in reducing antibiotic demand and prescribing, we are failing miserably in another industry, one that is responsible for about 80% of antibiotic sales in the U.S.  According to a 2014 report by the FDA, “the amount of medically important antibiotics sold to farmers and ranchers for use in animals raised for meat grew by 16 percent from 2009 to 2012.”  The meat and poultry industries are now increasingly feeding broad-spectrum antibiotics to healthy animals to not only prevent disease but primarily to promote growth.  Ironically, this rampant overuse has been linked to increased transmission of resistant organisms (causing life-threatening infections) to humans eating meat from antibiotic-fed animals.  The CDC now actively supports the FDA’s call for “the judicious use of antibiotics that are important in treating humans (and) recommends that such antibiotics should be used in food-producing animals only under veterinary oversight and only to address animal health needs, not to promote growth.”  Healthcare professionals are urged to petition food industry organizations responsible for antibiotic misuse to change their practices, citing evidence of human harm.  Other strategies to limit antibiotic resistance include reducing or eliminating meat consumption and only purchasing meat and animal products (milk and eggs) that come from animals not exposed to antibiotics.

(originally written for the Deirdre Imus Environmental Health Center)

School Stress: Rescuing Our Children

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Stress, according to noted Slovakian researcher Hans Selye, is neither good nor bad. Instead, it is defined as “the non-specific response of the body to any demand for change.” At some point, though, stress ceases being an impetus for productive effort in the service of positive performance and instead overwhelms our bodies, minds and spirits. The result? Fatigue, withdrawal and, ultimately, breakdown. As a pediatrician, I witness this phenomenon regularly in the form of the American adolescent, one after another, coming to me with debilitating migraines, chronic abdominal pains and severe depression.

The daily life of a high school student is marked by poor eating habits, limited physical activity, lack of adequate sleep, no outdoor time and not one minute of downtime. Any time not spent being “productive” inevitably involves a screen of some sort. According to a recent study, teens manage stress predominantly by playing video games, surfing the internet and watching TV/movies. Snapchat, Netflix, Mortal Kombat… take your pick. These diversions are our kids’ stress coping skills. Sadly, it appears they’re learning well from their parents. While 43 percent of adults report exercising to alleviate anxiety, a whopping 62 percent claim their go-to stress reliever involves screen time. When I ask kids how they believe their parents are coping, most say “poorly.” We clearly need to be better role models for our children. The good news is there are alternative stress-coping methods that are inexpensive, accessible, safe and effective. In a newly published systematic review, my colleagues and I concluded that yoga has a significantly positive effect on pediatric psychological functioning. Specifically, educational programs incorporating yoga in stress management programs improved academic performance, self-esteem, classroom behaviors, concentration, and emotional balance. Mindfulness training for students and teachers is now widely recognized as a valuable tool to improve stress coping, improve focus and complement social-emotional learning initiatives. Pediatrician Dzung Vo, author of The Mindful Teen, has created a wonderful resource for teens to explore and integrate mindfulness meditation in their lives. Finally, kids who spend more time in natural settings have measurable improvements in health, cognitive functioning, and classroom behavior. The Children and Nature Network has compiled a thorough review of research on how nature impacts our children’s well being.

School stress — both academic and social — is a major contributor to deteriorating adolescent health. According to a recently published landmark study, nearly half of 11th grade students surveyed reported “a great deal of stress” on a daily basis. They declared “schoolwork, grades, and college admissions constituted their greatest sources of stress.” While some in the study found moderate amounts of stress could be motivating, an astonishing one in four subjects was suffering with symptoms of clinical depression. So here is the rub — how much stress is the right amount?

Dr. Mary Alvord and Dr. Marya Gwadz are psychologists, experts in the field of adolescent stress. Both were quoted in The Atlantic’s piece profiling Gwadz’s study.

“[T]oo much stress has many effects on the body and mind, Alvord says. In the short term it can cause anxiety; over long periods of time, elevated levels of stress hormones can degrade the immune system, cause heart problems, exacerbate respiratory and gastrointestinal issues, and bring on chronic anxiety and depression. That’s bad for anyone, but it can be especially bad for high schoolers: “Colleges are complaining that kids are disengaged, they’re dropping out, taking a long time to graduate. It’s not developmentally appropriate for them to work so hard,” says Gwadz, one of the authors of the recent study. And since everyone has a different psychological capacity for stress, it’s hard to know when a student is pushed to the point of degrading his or her health.”

 We want to prepare our children for the real world, allowing them to experience challenges and even (yikes!) fail at times, developing resiliency. We must, however, find a better balance, evaluating common stressors, and ask ourselves — what in the educational environment no longer serves us?

Vicki Abeles, director and producer of the seminal educational documentary, Race to Nowhere, and a just-released sequel, Beyond Measure, believes the answers to this question are in fact many of the strategies we are employing to fix a broken-down educational system. Standardized common core curricula and testing measures are contributing unnecessarily to stress while failing to create a productive and healthy educational environment. Abeles challenges our preconceptions with a barrage of thought-provoking questions.

“Rather than ask why our students fail to measure up, the film asks us to reconsider the greater purpose of education. What if our education system valued personal growth over test scores? Put inquiry over mimicry? Encouraged passion over rankings? What if we decided that the higher aim of school was not the transmission of facts or formulas, but the transformation of every student? And what if this paradigm-shift was driven from the ground up? By students, parents, and educators? By all of us?”

The film (and its accompanying book), thankfully, does not simply point out what’s gone wrong but also offers us models that could serve as templates for a brighter future. The schools profiled in Beyond Measure nurture creativity, collaboration, persistence and resiliency as critical life-long skills. They provide for us a much-needed road map to a different kind of success — one that does not sacrifice our children’s well being in the process.
(originally written for the Huffington Post)

9 Foods With Amazing Healing Benefits

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Dealing with a minor illness? Before heading to the medicine cabinet, I recommend considering remedies in your kitchen cabinet first.

There are many safe and effective natural cures hiding in plain sight in your spice rack and among your baking supplies. Of course, these aren’t meant to replace necessary prescription medications. Always consult your physician first to make sure these treatments are right for you and your family.

As an integrative physician, I researched natural therapies for my book,Treatment Alternatives for Children. As I discovered, food-based remedies generally have fewer potential adverse effects than conventional over-the-counter medications — and they can be just as effective. Here’s a list of nine of my favorites, and how they can help you heal:

1. Apple cider vinegar

Traditionally, apple cider vinegar has been used to help alleviate constipation and indigestion. Research also suggests it can balance blood sugar and lipid levels. Most people who use it in this way drink 1 tablespoon daily, diluted in water.

2. Baking soda

Baking soda can have a soothing effect on irritated skin, relieving itching and irritation from insect bites and stings. Apply a small amount mixed in any natural moisturizing cream or ointment as needed.

It can also help clean teeth and eradicate bad breath when mixed with water — simply rinse as you regularly would and spit out.

3. Cinnamon

Research shows this spice can help improve cognitive skills like memory. Cinnamon may also assist in regulating blood sugar and cholesterol. Use it liberally in cooking or baking, or sprinkle onto your morning coffee.

4. Coconut oil

Coconut oil moisturizes the skin and helps heal inflamed skin conditions like eczema. I also recommend it as a great topical treatment for babies with cradle cap. Coconut oil has both antibacterial and antifungalproperties.

5. Ginger

Ginger is one of my favorite anti-nausea and anti-motion-sickness remedies. You can find it in chewable form, or simply dice fresh ginger and mix it in hot water as a tea to sip. Ginger has anti-inflammatory properties, so people sometimes use it to help with arthritis.

6. Honey

Honey is truly magical, with research showing it’s an effective cough remedy. It also has antimicrobial properties – especially New Zealand’s Manuka variant – and is useful as a topical agent to combat minor skin infections. Finally, locally cultivated honey has been proven useful to prevent seasonal allergies if ingested in small amounts prior to developing symptoms.

7. Turmeric

Turmeric, a spice often used in Indian dishes, has powerful anti-inflammatory and antibacterial properties. Often combined with other spices like ginger, it can help relieve joint pain from inflammation.

8. Olive oil

Olive oil is a key ingredient in the heart-healthy Mediterranean diet, so use it as much as you can while cooking. It also happens to be useful as atopical oil, with anti-inflammatory properties to help address skin conditions like eczema, seborrhea, and psoriasis.

9. Sea salt

Sea salt is not only a healthy alternative while cooking, but it can also be mixed with distilled water to make a DIY saline solution to relieve nasal congestion. When added to warm water, sea salt can also help soothe aching feet at the end of a long day.

 

(originally posted for MindBodyGreen)

7 Science-Backed Reasons To Get Your Kids Outside

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(Originally posted for MindBodyGreen)

Most of us intuitively know that we feel better when we spend time outside.

But sadly, as our lives become more dependent on technology, we are increasingly disconnected from the Earth — and this disconnect could be harming our children more than we think.

Acknowledging the adverse effects on children’s well being, author Richard Louv coined the term “Nature Deficit Disorder.” His research has led pediatricians like myself to prescribe time in nature as a way to combat the health ills associated with lack of free outdoor play.

Looking for encouragement to get your kids off the couch this summer? Here are seven research-based reasons to venture into the Great Outdoors:

1. It encourages exercise.

The closer kids are to green spaces, the more likely they are to run around outside: a recent Canadian study found that the physical activity of 11 to 13 year olds rose relative to the amount of tree-filled space in their neighborhoods. Of course, this doesn’t mean you’re out of luck if you’re a city dweller — simply make time for play in a shaded public park.

2. It reduces anxiety.

Children in Maryland and Colorado who played in green schoolyardsreported less stress compared to their peers. They also showed an increased sense of competence, as well as ability to form supportive social groups.

3. It improves focus.

One study of kids in Illinois found that even just a twenty-minute walk in the park led to a substantial attention boost. As the researchers note: ” ‘Doses of nature’ might serve as a safe, inexpensive, widely accessible new tool in the tool kit for managing ADHD symptoms.”

4. It makes kids smarter.

Researchers found that Barcelona school children with more exposure to outdoor greenery performed better on cognitive testing. The effect was greatest when both home and school environments provided “green” time.

5. It builds a sense of community.

Canadian adolescents living in greener environments reported a stronger sense of “place,” or belonging to a healthy community. This finding has important ramifications, as these emotions might also increase kids’ engagement and involvement in keeping their neighborhoods safe and healthy.

6. It helps them develop deeper connections with family.

In a survey of 60 American families, participation in camping experiences was found to improve family relationships.

7. It raises their interest in the environment.

Childhood exposure to natural settings is associated with a greater interest in environmental stewardship — and ultimately with pursuing professional careers and adult hobbies connected to nature and the environment.

HCWH: A Conversation with Pediatrician Lawrence Rosen

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Health Care Without Harm’s Safer Chemicals Program seeks to eliminate dangerous chemicals in the health care setting that can adversely affect patient health and employee safety without sacrificing quality of care. To achieve this goal, we focus on promoting a “green” approach to health care that prevents or reduces exposure to toxic chemicals among patients and staff, while also taking into consideration health care’s impact on the environment.

To learn more about the leadership role that physicians play when it comes to greening health care, we spoke with Dr. Lawrence Rosen, a pediatrician and founder of The Whole Child Center in Oradell, New Jersey. Taking a more holistic approach to health care delivery, Dr. Rosen set out to practice an integrated style of medicine that takes environmental exposures into consideration when treating his patients. The Whole Child Center is also a leading example of ecological sustainability in health care, designed in a way that minimizes impact to the environment while promoting health for staff and patients.

(Continue reading on HCWH’s site)

Bats, Birds, Bees and Butterflies In Crisis: What It Means For Us

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One of my strongest memories of summers past, despite my lack of affection for insects in general, is the steady buzzing of bees and fluttering of butterflies in my mom’s garden.  These sounds and visions, along with the heat and abundance of time to play outside, were simply what made up “summer” as I knew it.  Adults, as we age, have a tendency to romanticize the “good old days,” yet the truth is – in some ways – things have indeed changed for the worse.  In a major environmental shift now recognized officially by the White House, we are witnessing catastrophic and accelerating declines in the honeybee and butterfly populations.  Furthermore, strange illnesses are increasingly reducing specific bat and bird populations.  What are the causes of these changes?  And why should we care?

The Washington Post notes, “…over the past five years, winter losses of commercial honeybee colonies have averaged roughly 30 percent. A consortium of universities and research laboratories announced last week that beekeepers lost 42.1 percent of their colonies between April 2014 and 2015, an 8 percent spike from the previous year, and that the number of summer deaths exceeded winter deaths for the first time since the survey began in 2010.”  Additionally, the monarch butterfly population now covers only a small fraction of the forest area in Mexico compared with their activity twenty years ago.  Little brown bats, at one time the most common bat species in the U.S., are dying off by the thousands, affected by the fungal “White Nose Syndrome.”  Mortality rates are greater than 90% in many states.  Finally, we are hearing more and more about large-scale bird flock deaths – in some cases, up to thousands at one time.  Most recently, sea birds along the California coast up to the Pacific Northwest have been dying in increasing numbers.

Why are we seeing these dramatic population shifts in such a short period of time?  Scientific evidence points to several potential causes.  Initial concern centered on increased exposure to pesticides, though more recently, a complex multifactorial answer is emerging – one that has direct relevance for human health.  Possibly related to climate change, a variety of infectious agents (parasites, viruses, bacteria and fungi) are killing the animals and insects noted above.  Circularly, some of the treatments used to limit these infestations are making things worse.  Loss of botanical food sources and habitats are some of the indirect sources of deaths, and each loss of population is compounding the others.  What we have is a complicated cyclical impact of change in climate conditions (air and water temperatures, pollution, effect on food sources) leading to new infectious agents affecting immune health, and the treatments themselves potentially causing further harm to natural immune system repair mechanisms.  Does this sound vaguely familiar?

Concern related to the massive deaths of these species has historically centered on the impact on our economic well-being.  It is estimated that, through direct affects on pollination and crop development, the loss of bees, birds, bats and butterflies could cost the US roughly $15 billion a year.  While the direct costs involved are substantial and deserve our attention, what is especially eerie is that notion that the increase in health morbidities we are witnessing, particularly in children (e.g., immune and inflammatory disorders), may be caused by the exact same sequence of events described above.  Activists have pointed out that climate change will potentially affect human health via an increase in vector-borne infectious diseases, like Lyme disease or malaria.  However, little attention has been paid to how subtle shifts in direct viral, bacterial, fungal and parasitic pathogens will alter the human gut microbiome and its ability to modulate immune function and detoxification.  Disruption in the human microbiome, connected to environmental toxins, then worsened by the overuse of antibiotics, could be seen as the human model of what we’re witnessing in bats, bees, butterflies and birds.

What can we do?  We must devote resources to better understanding the complex infectious etiologies of catastrophic species death.  Reversing true root causes, if climate change is the major culprit, is essential but will take time.  Today, we must develop safe and effective ways to protect these species, perhaps through microbiome modulation (using probiotics, for example, to change microbiota balance). Probiotics for bats, anyone?  In fact, researchers have not only used metagenomic methods to sequence the bat microbiome, they have found some bats are resistant to White Nose syndrome, perhaps due to variations in microbiota on their skin.  Similar work is being done in bees, demonstrating a relationship between levels and types of probiotic organisms and hive health.  Perhaps we can learn something from these experiences that would be adaptable to human health concerns.  Ultimately, addressing the needs of the birds and the bees (and the bats and butterflies) is a win-win situation for all of us.

(originally written for the Deirdre Imus Environmental Health Center)