Thank you to Owen Wiseman, director of Nature Quant, for providing this post!

Beyond Access: Why Outdoor Play Needs Healthier Nature, Not Just More Space

As a healthcare provider, I spend a lot of time talking with families about the foundations of health: sleep, movement, nutrition, stress, social connections, and daily routines. But one theme continuously shows itself in ways that are harder to capture on a lab report or intake form. Namely, most kids aren’t getting enough time outdoors, and families don’t have equal access to outdoor environments that feel inviting and safe.

This isn’t news to my patients. Parents KNOW their kids need more play time outdoors.

They see the difference after a day at the park, a puddle-jumping walk, a weekend at the cottage, soccer practice, wandering the woods, you name it. Their kids sleep better. They regulate differently.(1) They take healthy risks and even have a chance to connect with other kids.

But I also witness the barriers. Many families live in neighbourhoods where outdoor play means traffic, heat, limited shade, poor air quality, and spaces that are, for all intents and purposes, generally inaccessible. Parents are exhausted from screen time battles and busy schedules, and the simple advice to “go outside more” isn’t as simple as it seems.(2,3)

This is why outdoor plays needs to be seen as more than a personal choice. It is a public health and planning concern, arguably above all else.

Outdoor Play as a Health Intervention

The science is catching up to what many educators, parents, and healthcare providers already see daily. A recent review led by de Lannoy and colleagues pulled together the best available research. Across hundreds of studies, outdoor play was generally linked with benefits for children’s bodies and minds. Even their relationships and sense of connection improved.(4) I often tell parents that time in nature acts a bit like a multivitamin for childhood development.

When a child climbs a log, balances on a rock, builds a fort, or digs in the dirt (clothes can be washed!), they are doing far more than physical activity. Their neurons are feeling out the world.(5) They are learning how to negotiate risk and solve problems. And at the same time, they learn how to relate to other creatures and build confidence.

That is why the multivitamin concept lends itself so well. Outdoor adventures are a whole-child experience involving movement, imagination, social learning, and quite frankly, joy.

From a healthcare perspective, we are seeing children and teens face rising concerns related to anxiety, loneliness, sleep issues, and an overall loss of confidence.(6-8) There is no single intervention that can solve all of this, but regular time in natural spaces is one of the most deeply human supports we can offer.

Access is Not the Same as Opportunity

But where do we send them?

A playground on a map is not the same as a healthy play environment. A schoolyard that is completely paved, next to a busy road, and prone to heat is a far cry from a shaded and nature-rich space. Kids may technically live near a park, but if the route or space feels unwelcoming, those practical opportunities for outdoor play decline.(9)

Looking Beyond Park Boundaries

Increasingly, researchers and planners are recognizing that access alone doesn’t tell the full story. New geospatial tools can help communities look beyond park boundaries by examining factors such as satellite-derived vegetation, water, parks, tree canopy, land classification, impervious surfaces, air pollution, noise, light, road density, building footprints, and computer vision elements from both aerial and street imagery.(10)

For outdoor play, this kind of tool helps community leaders answer the difficult question: Where are kids least supported by their surrounding environment, and where should investment be prioritized first?

Considering the Equity Perspective

In clinical practice, health advice can land flat when it assumes that every family has the same environment to work with. “Spend more time outside” is received differently if they live beside shaded trails compared to living in an urban heat island with limited shade and poor walkability. If outdoor play is health-promoting, then how do we bring the gaps to light?

New mapping tools can help identify communities where kids are nature-deprived, where play spaces are exposed to higher temperatures, and even where air and noise burdens are higher. A recent tool developed by Hanley, Minson & Bailey took this a step further to identify the associated health risks.(10) This may include diabetes, mental health concerns, cardiovascular disease, and even cancer. This type of lens can help planners, schoolboards, public health teams, and municipalities prioritize projects in nature-deficient neighbourhoods. Investments that help design environments that invite children to adventure.

Considering Heat, Shade, and the Future of Outdoor Play

Increasingly, heat is becoming the defining conversation.(12) Urban heat islands occur when natural environments are replaced by pavement and other impervious surfaces that absorb and retain heat. A 2024 brief from Harvard’s Early Childhood Scientific Council on Equity and the Environment reported that, on hot sunny days, shaded surfaces tend to stay close to air temperature, while paved surfaces can be 50–90°F hotter. That’s 10-32°C hotter for us Canadians. Asphalt-heavy schoolyards are a direct child-health and learning issue. The same brief notes that excess heat is coupled with slower cognition, reduced concentration, and poorer learning outcomes.(13)

Fortunately, several groups are working to address the impact of heat and climate change on children’s opportunities for outdoor play. For example, CAPA Strategies has launched its Heat Watch campaigns to help communities move beyond broad satellite estimates of urban heat by collecting hundreds of thousands of ground-level air temperature measurements. Its Heat Watch program has delivered high-resolution descriptions of extreme heat in more than 85 communities across North America and internationally, working alongside partners such as NOAA, the World Bank, and local governments.(14)

Such data tracking initiatives are essential if we are to identify where support is most needed and track progress. Such a need was identified in this year’s Healthy Environments for Learning Day (HELD) campaign(15), which highlighted the need to build more climate resilient outdoor spaces in schools and childcare spaces in Canada.

Making the Case for Investment

With all this data at our fingertips, what’s needed now is investment to promote, protect and preserve outdoor play spaces. Thankfully, the economic argument for why investing in outdoor play makes sense continues to grow.

For example, in a large individual-level study of more than 5 million people in Northern California, higher residential green cover was associated with lower direct healthcare costs. Individuals living in the highest decile of residential green cover had adjusted healthcare costs that were $374.04 lower per person per year than those in the lowest decile.(11)

As a clinician, I do not take that as a reason to reduce children’s outdoor environments to dollars and cents. But economic evidence can help open doors. It can help decision-makers see that parks, schoolyards, trees, and outdoor play environments are part of the infrastructure that supports healthier futures. For all.

References:

1. Yang, Xiaoyun, et al. “Short sleep duration and daytime outdoor activities effects on adolescents mental health: A stress susceptibility-recovery model analysis.” Journal of Affective Disorders 382 (2025): 428-437.

2. Larouche, Richard, et al. “Determinants of outdoor time in children and youth: a systematic review of longitudinal and intervention studies.” International Journal of Environmental Research and Public Health 20.2 (2023): 1328.

3. Ramsden, Rachel, et al. “Results from the PROmoting Early Childhood Outside cluster randomized trial evaluating an outdoor play intervention in early childhood education centres.” Scientific Reports 15.1 (2025): 1713.

4. de Lannoy, Louise, et al. “Association Between Active Outdoor Play and Health Among Children, Adolescents, and Adults: An Umbrella Review.” Journal of Physical Activity and Health 1.aop (2025): 1-16.

5. Festa, Felice, Silvia Medori, and Monica Macrì. “Move your body, boost your brain: the positive impact of physical activity on cognition across all age groups.” Biomedicines 11.6 (2023): 1765.

6. Anderson, Thea L., et al. “Contributing factors to the rise in adolescent anxiety and associated mental health disorders: a narrative review of current literature.” Journal of Child and Adolescent Psychiatric Nursing 38.1 (2025): e70009.

7. Odega, Amaka S., et al. “Sociodemographic Patterns in Mood and Anxiety Disorders Among Youth and Young Adults in Canada: An Analysis of the 2015-2021 Surveillance Data.” Cureus 17.9 (2025): e92238-e92238.

8. Craig, Wendy, et al. “The health of young people in Canada: Focus on mental health.” Health Promotion and Chronic Disease Prevention in Canada: Research, Policy and Practice 45.9 (2025): 391.

9. Larouche, Richard, et al. “Determinants of outdoor time in children and youth: a systematic review of longitudinal and intervention studies.” International Journal of Environmental Research and Public Health 20.2 (2023): 1328.

10. Browning, Matthew HEM, et al. “Quantifying nature: introducing NatureScoreTM and NatureDoseTM as health analysis and promotion tools.” American Journal of Health Promotion 38.1 (2024): 126-134.

11. Van Den Eeden, Stephen K., et al. “Association between residential green cover and direct healthcare costs in Northern California: An individual level analysis of 5 million persons.” Environment International 163 (2022): 107174

12. Early Childhood Scientific Council on Equity and the Environment (2023). “Extreme Heat Affects Early Childhood Development and Health: Working Paper No. 1.” Retrieved from www.developingchild.harvard.edu

13. Keith, Ladd, Sara Meerow, and Tess Wagner. “Planning for extreme heat: a review.” Journal of Extreme Events 6.03n04 (2019): 2050003.

14. Fuhrmann, Christopher, et al. “From data to action: How urban heat mapping campaigns can expose vulnerabilities and inform local heat policy.” Bulletin of the American Meteorological Society 105.11 (2024): E2078-E2084.

15. Canadian Partnership for Children’s Health and Environment. “A collective call for action for healthy, sustainable and climate resilient outdoor learning and play settings for all children in Canada.” Healthy Environments for Learning Day. https://healthyenvironmentforkids.ca/held/2026-campaign-call-for-action/