Nature-based Solutions 8
Integrating Nature-based Solutions into Healthcare Delivery Models:
Strengthening Community-oriented Primary Health Care and Integrated Systems of Health.
As global healthcare systems grapple with escalating climate threats, biodiversity loss, and the social determinants of health, Nature-based Solutions (NbS) are emerging as a critical frontier for growth and innovation. Rooted in the use of ecosystems and the services they provide to the natural world to address today’s societal challenges, NbS offer a profound opportunity to reimagine healthcare service delivery—particularly through Community-oriented Primary Health Care (COPC) and Integrated Systems of Health (ISH).
Why Nature-based Solutions Matter in Health.
Nature-based Solutions, as defined by the International Union for Conservation of Nature (IUCN), involve:
“actions to protect, sustainably manage, and restore natural or modified ecosystems that address societal challenges effectively and adaptively.”
With respect to human health, nature-based solutions (NbS) help mitigate urban heat, reduce air pollution, promote physical activity, support mental health, enhance overall well-being, and strengthen resilience to climate-related risks.
An ever-increasing foundation of empirical evidence demonstrates that green and blue spaces (i.e., forests, parks, rivers, wetlands) correlate with improved health outcomes—from lower rates of cardiovascular disease and obesity to reduced anxiety, depression, and stress-related illnesses. However, these solutions must be more intentionally woven into healthcare infrastructure, especially within community-oriented primary health care and integrated systems of health.
NbS in Community-oriented Primary Health Care (COPC).
Community-Oriented Primary Care (COPC) underpins universal health coverage and health security by advancing comprehensive, continuous, and coordinated, community-based, person-centered care that is locally accessible, affordable, and deliverable with cultural humility and empathy. NbS can powerfully augment COPC by:
Endorsing and Implementing Health Prevention, Promotion, & Protection: Community gardens, urban forests, and walkable green corridors provide low-cost, multi-disciplinary strategies that address chronic conditions such as hypertension and diabetes while promoting health and well-being before signs and symptoms of disease even emerge.
Improving Mental Health: Prescriptions for nature walks, gardening therapy, and green social prescribing are being integrated into COPC practices globally, offering non-pharmacological treatment options that improve mood, stress, and resilience.
Enhancing Health Equity: In underserved areas, NbS can reduce environmental injustices by improving access to clean air, shade, healthy food, and physical activity—all fundamental to ending the ever-widening gap of health disparities.
Integrating NbS into ISH: Systems Thinking in Action.
Integrated Systems of Health (ISH) encompass multisectoral, cross-disciplinary collaboration among healthcare systems, public health agencies, education, economics, social services, and the natural environment. NbS naturally align with ISH by requiring co-designed, place-based interventions for implementation.
Key strategies include:
Cross-sector Integration: NbS benefit from collaborative governance that connects health systems leaders, public health officials, environmental planners, urban developers, and community organizers.
Holistic Care Models: ISH frameworks can integrate NbS into care pathways—such as incorporating eco-therapeutic programs into recovery plans or aligning environmental monitoring with population health surveillance.
Digital Innovation: increased broad-band access, telehealth services, remote patient monitoring, mobile health, and GIS technologies can identify areas (e.g., hot spots) with limited green infrastructure, enabling ISH collaboration to prioritize and allocate scarce resources and care interventions where they’re needed most.
Case Studies in Action.
United Kingdom: The NHS has launched "green social prescribing" pilots linking patients with activities in nature to prevent or treat mental illness, demonstrating reduced medication use and lower healthcare costs.
South Korea: “Healing forests” are part of national health programs, with doctors referring patients for structured forest therapy to address stress, insomnia, and chronic fatigue.
Colombia: NbS have been embedded into urban planning in Medellín, where the “Green Corridor” project has lowered urban temperatures, reduced respiratory illness, and encouraged active transport.
Moving Forward: Policy, Practice, and People.
For nature-based solutions (NbS) to meaningfully transform COPC and ISH into active creators of health and well-being, three major fundamental shifts are required:
1. Policy Alignment: Comprehensive, multisectoral health strategies must explicitly recognize nature-based solutions (NbS) as health-promoting infrastructure. Their integration into multi-level healthcare delivery systems, public health frameworks and financing mechanisms is essential.
2. Workforce Education: Clinicians, community health workers, and allied professionals require immersive development and training in the evidence base and practical application of NbS, including green prescribing and ecological literacy.
3. Community Co-Creation: NbS should be tailored to local contexts and co-developed with the communities they serve, ensuring cultural relevance, meaningful participation, and long-term sustainability.
Conclusion
Integrating Nature-based Solutions into global healthcare service delivery is not just a visionary idea—it is a necessity in a world facing climate breakdown, rising chronic disease burdens, and worsening health inequities. By embedding NbS into COPC and ISH, we can build more resilient, equitable, sustainable, and ecologically-intelligent healthcare systems around-the-world for generations to come.
