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Across the United States, physicians are prescribing patients nature. These "Nature Rx" programs promote outdoor activity as a measure to combat health epidemics stemming from sedentary lifestyles. Despite the apparent novelty of nature prescription programs, they are not new. Rather, they are a reemergence of nature-based therapeutics that characterized children's health programs in the late 19th and early 20th centuries. These historic programs were popular among working-class urban families, physicians, and public health officials. By contrast, adherence is a challenge for contemporary programs, especially in socially disadvantaged areas. Although there are differences in nature prescription programs and social context, historical antecedents provide important lessons about the need to provide accessible resources and build on existing social networks. They also show that nature-and its related health benefits-does not easily yield itself to precise scientific measurements or outcomes. Recognizing these constraints may be critical to nature prescription programs' continued success and support from the medical profession.

This paper examines a pivotal moment in the history of the built environment in America. At the beginning of the twentieth century, factions within the American paint industry fought in state and federal legislatures over the definition of paint: What was pure paint? Were new paint formulations to be encouraged, or labeled “adulterated”? Was the known toxicity of lead to be a consideration? Despite some opponents' recourse to a rhetoric of toxicity and public health, all sides agreed that the best paints contained a significant quantity of lead, and that government should stay out of setting industry standards. This accord all but assured that Americans would apply tons of lead paint on the walls of their homes.

Environmental historians, especially those working at the intersection of environment and health, talk about ‘human interactions with the built environment’; this is, strictly speaking, redundant, since, by and large, what has defined the species homo sapiens since its appearance 30,000 years ago is our steadfast manipulation of the environment, cleverly exploiting resources and altering surroundings to counteract deficiencies in brawn, speed or other innate physical abilities.1 Every technology we have adopted, from fire to stone tools, to agriculture and medicine, has enhanced our odds against the lions, tigers and bears. But we grew more dependent upon those technologies and came to rely less and less upon our bodies, our instincts and our knowledge of the natural world. The pace of this transformation has accelerated in the last two centuries, so that by the mid-twentieth century, careful observers worried that technological innovation was outstripping biological evolution in determining the nature of human existence, risking physical, social and psychic alienation from the natural order.2