Health Hero: Dr. Melissa Lem - Prescribing Green

Photo credit: kw'as park cortes island bc parks

In this Spotlight we meet Dr. Melissa Lem, who is a health hero to us due to her work to encourage prescribing nature and trees as an integral part of our healthcare system.

Dr. Lem is a B.C.-based family physician and climate advocate. She is also the Director of PaRx, a program she helped found in 2020. Launched through the B.C. Parks Foundation, PaRx encourages healthcare providers to prescribe time in nature to improve patient health. 

Modeled after other nature prescription programs in the U.S. and elsewhere, Dr. Lem’s PaRx program is now in its fourth year. Over that time, PaRx has been adopted nationwide boasting over 13,000 registered health professional prescribers and endorsement by the Canadian Medical Association, major doctor and nurses’ organizations, and other allied health professionals in every province.

Trees for Life chatted with Dr. Lem to learn more about where the idea for nature prescriptions came from, her inspiration to advocate for the planet, her proudest moments, why trees are good for our well-being and her hopes for future generations.

English Bay Vancouver, BC (Credit: BC Parks)

Where did your interest in nature and its impacts on health come from?

While there have been many influences, my interest first began as a kid growing up in the suburbs of Toronto where I experienced exclusion and racism because we lived in a majority-White neighborhood. Connecting to the green spaces in my area gave me a sense of belonging and solace that sparked my early interest in nature. As a child, I didn’t know anything about the research on the health benefits of nature, but I felt it intuitively.

After medical school and residency, whenever I experienced difficult cases in northern BC where I had my first job as a family doctor, and during locums in Northern Ontario communities, I would head outside, hike in the woods, or walk by the lake to de-stress. It all came together when I moved back to Toronto from northern BC and had my own nature-deficit experience, which led me to discover the massive body of evidence behind the health benefits of nature.

In addition to nature itself, my parents also influenced this journey. They grew an amazing backyard food garden, with everything from veggies to fruit trees. Watching the garden grow and being nourished by it connected me to the land.

I was and continue to be inspired by colleagues involved in nature and health initiatives. The first national nature prescription program was launched in the U.S. by Dr. Robert Zarr. I thought it would be cool if we had one of our own in Canada.

How did you become involved in climate advocacy?

When my son was a baby, I spent a lot of my time sitting and nursing him, so decided to catch up on some reading. When he was three months old I read “This Changes Everything” by Naomi Klein, which is about climate change and how capitalism is driving it. Having just brought a human into the world, and finally understanding the full potential impacts of climate change, the drivers behind them, and the need to turn the ship around to create a safe future for ourselves, our children, our patients, and our health, I asked myself what else I could do to protect him. Working against climate change was a vital part of that.

What are you most proud of in your work?

Helping to launch PaRx, Canada's National Nature Prescription Program, with an incredible team—and the impact we’ve generated. We got a lot of attention when we first launched because nature prescriptions were still novel in Canada. But when we announced our collaboration with Parks Canada in early 2022, the story went viral and was covered internationally.  Suddenly we had thousands of new prescribers signing on. 

We couldn't have launched in every province without support from provincial committee members of the Canadian Association of Physicians for the Environment, (CAPE), who helped secure endorsements and create regional relevance. Over the last few years, CAPE has grown significantly. We’ve been talking about the connections between the environment and health for 30+ years, and our spokespeople are some of the most trusted advocates in the country. The timing of the launch of PaRx colliding with the COVID-19 pandemic and the effects of climate change as we’ve seen summer after summer, really helped people realize the importance of the relationship between nature and health. The fact that there's also this massive body of evidence behind it helps. Plus patients are increasingly looking for non-pharmaceutical ways to improve their health.

I’m grateful for and proud of the number of supporters of our program, and how we’re able to advance the concept that connecting to nature is vital for not only human health, but also for increasing biodiversity values, and pro-environmental behaviours.

How does it feel to know that people are planting trees in honour of you and other health workers?

It is an honour to be honoured. It’s gratifying to know that people are planting trees in honour of healthcare workers because many workers who ensure that our health systems run properly are not always recognized.  During the pandemic, when emergency rooms were overrun, when the dual threats of COVID-19 and climate change hit, and when smoke or heat would roll in, we saw massive influxes of patients having mental health and cardiovascular and respiratory issues that needed all of us to mobilize together to keep patients well. It's poetic to plant something so good for people's health in honour of healthcare workers.

Why is tree planting good for our well-being?

Like a prescription for nature, planting trees gives people something tangible to do. When you hand a patient a piece of paper that comes with benefits that reduce barriers to nature access, or when you dig a hole in the ground and plant a tree, then watch it grow near your healthcare facility or in your neighbourhood, you feel like you're participating in the solution. Policy and systemic changes are important, but there's nothing like the immediate experience of holding something in your hand, and seeing the benefits to a patient or to the community that you live and work in. 

Not only is it important for us to be able to prescribe nature, but we also need to be able to have those green spaces to go to. Tree planting around healthcare facilities or in urban areas is a vital part of this work to increase the amount of nature people can connect to. 

In the long term, you’re also reducing the urban heat island effect and making urban infrastructure healthier for people.  It’s good for everyone’s well-being on multiple levels!

What does the term “nature deficit disorder” mean?

Richard Louv coined the term in his book “Last Child in the Woods”.  It's not an official medical diagnosis but describes a constellation of different symptoms and conditions kids might have when they're deprived of nature and spend too much time indoors on screens. I like the concept because a lot of the issues plaguing children today do have something to do with a lack of connection to the outdoors—from obesity to not meeting physical activity guidelines, to attention deficit hyperactivity disorder, to nearsightedness because they're staring at screens and not focusing into the distance as they would when they play outside. 

How has your work influenced your son and what do you hope for, for future generations?

Whenever I can I bring my son to my climate and nature talks and events, and we often discuss these concepts at home. My work on nature prescriptions was even featured in one of his favourite book series! He’s absorbed a lot.  While he’s a long way from choosing a career, I want him to be happy and to choose to be a part of the solution in some way. Every one of us has a role to play, whether it’s through communications, caregiving, working on technical solutions, or advocacy around the health impacts of climate change.  By supporting organizations on the front lines of climate mitigation and adaptation, we can all advance sustainability. I hope that my son and every kid today will ultimately find jobs in and support and invest in initiatives that make the planet a healthier place for us and all the life we share it with.