Prescribing parkrun: medicalising a walk in the park
BMJ 2025; 389 doi: https://doi.org/10.1136/bmj.r670 (Published 08 April 2025) Cite this as: BMJ 2025;389:r670
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Dear Editor,
Let’s not get caught up in the terminology “prescribing,” although perhaps the expression “community referral” may be more appropriate in some cases (Napierala et al., 2022). As a clinical pharmacist who has studied and researched health promotion, including community initiatives such as parkrun (Dunne et al., 2024), I would like to apply a health promotion lens rather than the traditional bio-medical model to this issue.
One of the tenets of health promotion is “re-orienting the health services” (WHO, 1986). An important part of this re-orientation is developing and using community initiatives to promote physical and mental health and wellbeing. In my experience, the parkrun practice initiative is so much more than just “prescribing parkrun”. It allows healthcare professionals to model healthy behaviour by attending parkrun themselves. It may also involve referring patients to community initiatives that they may not be aware of and supporting patients who may need that little bit of extra help to attend activities that are available in the local community. Not forgetting that referral may include suggesting that patients can volunteer at parkrun, which has health benefits in it’s own right (Haake et al., 2022).
Whether we refer patients to parkrun, a community choir, gardening group or book club; as healthcare professionals we should look beyond the traditional prescribing model and do whatever we can to support the health and wellbeing of our patients and community members, regardless of what label we use to describe that process.
Dunne, A., Quirk, H., Bullas, A., & Haake, S. (2024). 'My parkrun friends.' A qualitative study of social experiences of men at parkrun in Ireland. Health promotion international, 39(3). https://doi.org/10.1093/heapro/daae045
Haake, S., Quirk, H., & Bullas, A. (2022). The health benefits of volunteering at a free, weekly, 5 km event in the UK: A cross-sectional study of volunteers at parkrun. PLOS global public health, 2(2), e0000138. https://doi.org/10.1371/journal.pgph.0000138
Napierala, H., Krüger, K., Kuschick, D., Heintze, C., Herrmann, W. J., & Holzinger, F. (2022). Social Prescribing: Systematic Review of the Effectiveness of Psychosocial Community Referral Interventions in Primary Care. International journal of integrated care, 22(3), 11. https://doi.org/10.5334/ijic.6472
WHO. (1986). Ottawa Charter for Health Promotion, World Health Organization, Geneva.
Competing interests: No competing interests
Dear Editor
We thank the authors for their thoughtful analysis and welcome the chance to discuss the broader implications of “prescribing parkrun” within the context of social prescribing. We agree that parkrun is a remarkable community‐based initiative that demedicalises health promotion, shifting focus away from traditional, command‐driven models toward an empowering, participatory approach. We address several key points raised in the article.
Demedicalising and Empowering through Social Prescribing
Critics argue that using the term “prescribing” implies a top–down model of authority, yet this view overlooks how social prescribing is practised in clinical discussions about group physical activity such as parkrun. The term “prescribing” is aimed at clinicians, legitimising evidence‐based treatment options beyond medications. There is robust evidence that group physical activity improves health outcomes (1), although many clinicians and patients remain unaware of its efficacy compared to medication. By framing physical activity like parkrun as an added treatment option, clinicians support demedicalisation by avoiding unnecessary prescriptions—a practice preferred by patients. Just as forcing medication would be poor practice, dictating behavior is similarly inappropriate and unlikely.
From a patient’s perspective, calling parkrun a prescription is misleading because the event remains free and accessible to all. The term ‘prescribing’ here is meant solely to encourage clinicians to signpost it as a valid option. Facilitating access to this community‐led opportunity to enhance physical and mental health is sound practice, regardless of semantic debates. This aligns with evidence that community‐focused interventions can transform patient engagement by promoting autonomy and self‐directed improvement, especially among marginalised and deprived groups (2).
Evidence of Impact and Cost-Effectiveness
Recent research, including a study by Haake and colleagues from Sheffield Hallam University (3), shows that parkrun participation is linked with statistically significant improvements in life satisfaction over six months. The study reported a weighted, seasonally adjusted increase of 0.26 points in life satisfaction among new participants, with the greatest gains in those previously inactive. The cost‐effectiveness analysis is compelling; benefit‐cost ratios range from 16.7:1 with a conservative estimate to as high as 98.5:1 when broader wellbeing impacts are included. These figures underscore the economic and public health benefits of incorporating social interventions like parkrun into primary care.
Primary Care Engagement and Adoption
It is important to clarify that over 2000 general practices now participate in parkrun practices, not merely 1800 as previously suggested (4). This level of engagement demonstrates that GPs recognise the value of linking patients to community assets. Primary care professionals are championing a shift toward a holistic and preventative approach that de‐emphasises traditional pharmacological treatments in favour of community participation and self‐care.
Countering the Misconception of “Medicalising” Exercise
Critics claiming that “prescribing” parkrun reinforces a hierarchical framework misinterpret social prescribing. Integrating parkrun into primary care promotes a model where community resources, not medications, take centre stage. This approach does not reduce patient autonomy; it provides a flexible, enjoyable option for self‐directed health improvement supported by professional advice. Rather than undermining community exercise, it legitimises parkrun as a vital component of modern, patient‐centred health promotion.
In Summary
In summary, the evidence affirms that parkrun is a paradigm of demedicalisation rather than an overly medicalised intervention. It embodies social prescribing by connecting patients with their communities while delivering measurable improvements in life satisfaction and wellbeing. With over 2000 general practices involved, ‘prescribing’ parkrun is a justified, cost‐effective public health strategy that merits ongoing support and expansion. These findings and practice insights not only reinforce the validity of social prescribing models but also highlight the transformative potential of community‐based health initiatives in reshaping modern primary care. Overall, parkrun integration into primary care offers significant, measurable, and enduring public health advantages globally.
1) Burke, Shauna M., et al. "Group versus individual approach? A meta-analysis of the effectiveness of interventions to promote physical activity." Journal of sport & exercise psychology 2 (2006): 19-35.
2) What works: Community engagement and empowerment to address health inequalities - Health Equity Evidence Centre
3) HAAKE, Steve, QUIRK, Helen and BULLAS, Alice (2024). The impact of parkrun on life satisfaction and its cost-effectiveness: A six-month study of parkrunners in the United Kingdom. PLOS Global Public Health, 4 (10).
4) Royal college of GPs 2000 GP surgeries in the UK now registered to parkrun practices 28 March 2025 https://www.rcgp.org.uk/News/2000-GP-surgeries-registered-parkrun-practices
Competing interests: Dr Hussain Al-Zubaidi: Royal College of GPs Lifestyle and Physical activity champion; parkrun Health Partnerships Lead. Dr Ellen Fallows: British Society of Lifestyle Medicine Vice President.
Dear Editor
The word prescribing is wrong in my view. But there is a lot of evidence that GPs can nudge people to healthier activities. In our local park runs we also have a sub group of C25K (couch to 5 K as per the NHS app) supportive people who help encourage people to gradually get more active, park walkers for those who don't want to or can't run, once a month cancer survivors etc. I assume many other park runs do the same. We also have many non running volunteers who come out and help at the same time as combating social isolation and loneliness. As we get more evidence that exercise is the best medicine for knee pain, COPD, back pain and depression let's not get stuck on the word prescribe but share our hobbies and nudge/encourage others to join. I thought vitality was a supplement till I read this article!
Competing interests: I have taken up running since stopping full time work (couch to 5 k, park runs and now age 69 my first marathon) and love adult and children park runs
Dear Editor
I am a keen parkrunner and thoroughly enjoy the sense of community and camaraderie created by all the local enthusiasts who volunteer and encourage sprinters, runners, trotters and walkers to complete the 5k course each week. There is a great sense of satisfaction in taking part as a runner or as a volunteer - there are not many places where you can stand wearing a crimson hi-vis gilet directing people where to go and get thanked for your efforts several hundred times. Afterwards, I feel better for having participated and know that I have earned my post-run coffee and cheese scone.
Initatives encouraging healthcare professionals to prescribe exercise have been around for years [1] but like Margaret McCartney I think that we need to avoid using 'prescription' or 'prescribing' when encouraging people to take part in parkrun or other forms of exercise. Indeed, the same can be said for the concept of social prescribing. In an editorial published in the Drug and Therapeutics Bulletin in 2019 I wrote:
'The idea of supporting people to find and access non-medical interventions that could help them manage their health and well-being seems eminently sensible. Unfortunately, social prescribing and the individual interventions are still hampered by a lack of robust high-quality evidence of efficacy and cost-effectiveness. Despite this, there is a risk that social prescribing will be expected to provide a low-cost solution to many complex societal problems. A DTB assessment of social prescribing would highlight the paucity of evidence, urge caution in over-extrapolating from the results of small-scale pilot projects and take the name to task. The use of the words ‘prescribing’, ‘prescription’ and ‘referral’ reinforces the medical model, suggests that healthcare professionals and social prescribers are also gatekeepers to a menu of interventions, and perhaps perpetuates an expectation that every problem requires a prescription. If our aim is to link people with non-medical sources of support within the community, do we need to medicalise both the process and its name?'[2]
Parkrun is a great initiatve to recommend, promote and tell people about but it doesn't need to be prescribed.
1. Sallis R. Developing healthcare systems to support exercise: exercise as the fifth vital sign. Br J Sports Med. 2011;45:473-4.
2. Phizackerley D. Social prescribing: right idea, wrong name? Drug and Therapeutics Bulletin 2019;57:130.
Competing interests: I have been taking part in parkrun for nearly 10 years and have completed 282 runs and volunteered 31 times.
Re: Prescribing parkrun: medicalising a walk in the park
Dear Editor
I find the term 'nudge' quite offensive as being deliberately covert. 'Prescribing' is mainly understood as a medical term which although becoming more accepted as part of the role of health workers undermines the autonomy of people who should be given information and evidence of the benefits of exercise by health workers and information as to where they can be accessed in the so called 'community'. Running has provided a cheap and for many enjoyable activity but it would be nice if all had equal access to decent well kept parks or runs through the lovely countryside or posh areas of the cities, The environment matters. How many people from 'deprived communities' by the way are prescribed a ski trip or nudged into payed for surfing lessons.
There is another important aspect to happiness and well being. That of learning the joys of just wandering about and strolling, alone (what!) or with others. As the poet once said: What is this life if full of care we have no time to stand and stare'. Give the running shoes a rest sometimes.
Competing interests: No competing interests