Your doctor can easily write a prescription to treat everything from asthma to a zinc deficiency. Yet curing a health issue often requires more than a pill. Things like social isolation, homelessness and poverty, known collectively as social determinants of health, can greatly affect bodies and minds.
Enter social prescribing, a relatively new medical intervention that allows doctors to “prescribe” social time to patients, such as a dance group or a social club, to help with various ailments.
This practice encompasses more than just activities. A doctor might screen patients for other social risks, like food and housing insecurity, that impact their health and prescribe nonmedical interventions. Say a patient is suffering from headaches following their family’s recent eviction. In addition to medication, a doctor could also prescribe a social support system to help that patient navigate this stressor.
These kinds of interventions give health care professionals more potential solutions to complement our familiar treatment model. This allows both medical providers and patients to embrace a holistic vision of good health, built on meaningful social connections and fresh air as much as on pharmaceuticals.
The COVID-19 pandemic threw hundreds of millions into isolation and exposed rampant health disparities in communities plagued by social inequities. While providers in the UK began investing in social prescribing around the turn of the millennium, in the United States, healthcare systems are just starting to integrate social care into their patient care.
What do doctors treat with social prescribing? Does it work?
Providers use social prescribing to address a wide range of ailments, from heart disease to mental health issues like anxiety and depression.
James Woodall, professor at the UK’s Leeds Beckett University, explains that social prescribing is built on “the understanding that health is more than just biology. It’s a recognition that actually, health is determined by people, environment and social circumstances.”
For instance, social isolation is linked to greater risk of heart disease and stroke, weaker immune response and mental health issues like depression, decreased cognitive functioning and dementia. Living in crowded, unsafe or unsanitary housing can lead to asthma and other respiratory illnesses, brain and nervous system damage in children and exposure to infectious disease.
Because social prescribing programs vary so much across health systems and regions, experts are still quantifying the effectiveness of this model. Still, one 2019 study found that patients who participated in a social prescribing program saw improvements in BMI, cholesterol, levels of smoking and physical activity. In an October 2020 study, more than 70 percent of participants in social prescribing programs for social isolation and loneliness experienced a reduction in loneliness.
“The pandemic has been a really good opportunity to highlight the importance of social prescribing,” says Woodall. “People were by themselves, experiencing anxiety and mental health issues. People really did want that connection with other people.”
But researchers caution that we need more work done to determine best practices in this still-emerging field. Woodall, who’s published several studies on social prescribing, says that programs vary wildly depending on where they’re located, who is participating and how deeply participants engage. “It’s difficult to say with confidence whether Model A is better than Model B, because we just don’t know yet,” he says.
How does social prescribing work?
At the end of the day, effective social prescribing is more than just telling people to “go hang out with friends.” It relies on strong community support to work; a provider can only prescribe an affordable community fitness program, for instance, if such a program exists in the first place. Woodall says there needs to be “more investment in our voluntary and community sector services” across the world to support the social prescribing model.
In some cases, the first hurdle is identifying which services exist, in order to refer patients to them. In 2012, Dr. Stacy Tessler Lindau, an ob-gyn and professor at the University of Chicago, began creating a digital platform that connects health care systems to these much-needed local organizations.
“Most of what drives health is actually not medicine,” she says. “It’s everything else. If we can digitally prescribe medicine, why shouldn’t we also be able to digitally connect people to critical community-based supports for health and well-being?”
She helped launch the Chicago nonprofit MAPSCorps, which compiles databases of community resources across the country. Another of Tessler Lindau’s organizations, NowPow, now part of Unite Us, partners with hundreds of medical providers ranging from large regional hospitals to individual practices. Unite Us has helped more than 2.1 million people through referrals to community support sources, including everything from financial support services to social gatherings.
So the next time you visit your primary care provider, don’t be surprised if they hand you a prescription for a long walk with a good friend — it really is just what the doctor ordered.