Moving from “What’s the matter with you?” to asking “What matters to you?”
What is Social Prescribing?
Social Prescribing is a holistic approach to healthcare that brings together the social and medical models of health and wellness. It provides a formal pathway for health providers to address the diverse determinants of health, using the familiar and trusted process of writing a prescription.
Social prescribing bridges the gap between clinical and social care by referring patients to local, non-clinical services that are chosen according to the client’s interests, goals, and gifts. It allows doctors, nurse practitioners, and interprofessional health providers to formally refer patients through to community-based programs. It empowers clients to improve their health by developing new skills participating in meaningful activities, and becoming more connected to their communities. What does a social prescription look like? It could be participating in an exercise group, receiving a Good Food Box to support food security, taking an art or dance class, joining a bereavement network, getting one’s hands dirty in a community garden, exploring a local hiking trail with a group of peers, volunteering to visit older adults in the communities and much more.
Health equity is a cornerstone of effective social prescribing. It is not enough to simply refer a client to a recreational program or encourage them to visit an art gallery. Successfully implementing a social prescribing program means removing the barriers clients experience to doing these things. These barriers may be economic, geographical, interpersonal, or psychological. Social prescribing is about listening deeply, providing necessary supports, and empowering people to be co-creators in improving their own health and wellbeing.
Responding to the Social Determinants of Health and an Epidemic of Social Isolation
For the Alliance, transformative change in people- and community-centred care, health equity, and community vitality have always been guiding principles according to our Model of Health and Wellbeing (MHWB). Ensuring the best possible health and wellbeing of everyone in Ontario are key aspects of our foundational living document: the Health Equity Charter.
Beginning in the 1960s and 1970s, well before social prescribing, Alliance members championed these values through their strong focus on the social determinants of health in their community development initiatives and social programs. We have seen how these social factors affecting health – income, employment, self-confidence, housing, nutrition, education, the environment – all play strong roles in people’s overall wellbeing.
Increasingly, studies are recognizing social isolation and loneliness as significant risk factors that affect people’s physical and mental health. Public health measures during COVID-19, such as restrictions on gathering with friends and closures of community spaces, have been necessary to control the pandemic, but they have had unintended consequences. In two 2020 Angus Reid studies, a third of the population in Canada reported experiences of loneliness and social isolation, and half reported a decline in their mental health since the start of the COVID-19 pandemic. This mental toll has continued into 2021, where recent research published by The Public Health Agency of Canada has shown that the number of Canadians with major depressive disorder has more than doubled. And more concerning, people reporting a weak sense of community belonging were 10 times more likely to screen positive for depression.
On the other hand, having strong social ties in your community and being actively engaged in community-based programs contributes to increased self-esteem. Developing expertise through cultivating new skills and hobbies also gives people the chance to feel steady improvement in their lives. By integrating social support and care across the health system, we can help people safely reconnect to their communities and reverse some of the health impacts of the pandemic.
How Does Social Prescribing Work?
Social prescribing is a specially structured way of referring people to a range of local, non-clinical services. It complements clinical treatments and seeks to address people’s social needs through community partnerships that align with clients’ interests and goals. As an asset-based approach, social prescribing recognizes people as not just patients with needs, but as community members with gifts to share. It supports participating clients as they engage with and give back to their communities. The goal of integrated healthcare and social prescribing is to go beyond treating illness to focus on advancing wellness.
Social prescribing may look differently depending on the community, their local needs and capacity. Five essential components have emerged as the foundation of an impactful model of social prescribing: the individual or client, the prescriber, the navigator, the social prescriptions, and the data pathway.
The 5 Key Components of Social Prescribing at a Glance
Social prescribing is centred on the client, an individual with social and medical needs, as well as interests, goals, and gifts (such as skills or their own resources).
The prescriber, a healthcare provider with trusted relationship with the client, is key to leveraging healthcare appointments as an opportunity to identify underlying non-medical issues and making a social prescribing referral.
The social prescribing navigator catches the referral and connects the client to appropriate resources based on self-identified interests and needs, and supports their journey to full wellbeing.
Social prescriptions can include a diverse range of non-clinical interventions, such as educational classes food subsidy, housing navigation, arts and culture engagement, peer-run social groups, and nature-based activities. These prescriptions are most powerful when they include an invitation for clients to engage, co-create, and give back to their community.
Finally, a data tracking pathway follows the client’s journey throughout the social prescribing process. This enables the integration of meaningful data and lessons learned in real time to enhance quality of care delivery and monitor outcomes.
Watch This Introductory Video on Social Prescribing
Social prescribing has gained widespread recognition in the UK with prominent figures in their healthcare system pioneering the change. Hear from the “godmother of social prescribing in the UK” – General Practitioner Dr. Marie Anne Essam in the video below about her experiences with social prescribing, and how she suggests healthcare providers can get involved:
Watch the full Summit Preview Keynote: What is Social Prescribing? webinar here.
Rx: Community: Research pilot on Social Prescribing
From 2018 to 2020, the Alliance for Healthier Communities implemented Rx: Community – Social Prescribing, the first-in-Canada social prescribing research project. This pilot project included 11 Alliance member organizations, including urban, rural, and Francophone centres from across Ontario. This project emphasized the importance of an asset-based approach. Social prescribing navigators connected clients to their social prescriptions through a co-design process that highlighted the clients’ goals and gifts.
Key findings from Rx: Community speak to the deep impacts social prescribing can bring. Participating clients reported feelings of loneliness decreasing by 49%, with self-reported mental health improving by 12% and sense of community belonging increasing by 16%. They noted that being supported to connect with non-medical interventions reduced stress and anxiety, increased sense of self-confidence and purpose, and gave them the knowledge and tools to better manage their own health.
Participating health providers saw social prescribing improve their clients’ health and wellbeing, and decreased the number of inappropriate repeat visits over time. These positive changes also extended to strengthening collaboration across health and community service providers and making communication easier – in turn, making delivery of care more effective.
Find more details by visiting our Rx: Community project page, and other related resources and publications:
- Read the final report (EN|FR)
- Read the social prescribing guidebook for teambased primary care providers
Links2Wellbeing: Social Prescribing for Older Adults
In partnership with the Older Adult Centers’ Association of Ontario (OACAO), the Alliance is building on the success of Rx:Community with a new project, Links2Wellbeing (L2W) (EN|FR). OACAO supports a network of 200 community-based older adults’ centers and seniors-serving organizations across the province. Participating Community Health Centers (CHCs) and clinicians will be able to prescribe social programs offered at participating Seniors Active Living Centers (SALCs). By increasing access to social prescribing for older adults and creating new links to social interaction, L2W aims to reduce barriers and rebuild capacity in local communities. These ongoing efforts to revitalize wellbeing and empower individuals will continue as the Alliance pushes forward to ensure no one is left behind throughout a post-pandemic recovery.
- Social Prescribing Guidebook for Team-based Primary Care Providers in Ontario(link is external), September, 2020
- Poster: Social Prescribing as a tool for building climate resilience, OPHA Fall Forum, November 23, 2019
- Connected Communities: Healthier Together(link is external), Annual Report of the Chief Medical Officer of Health of Ontario, February 2019
- Fact Sheet: Spotlight on Reducing Social Isolation ( English | French )
- International: Social prescribing stimulus paper by the Royal Australian College of General Practitioners and Consumer Health Forum of Australia, November 2019
- Social prescribing: A call to action(link is external), Canadian Family Physician, February 2021
- Using Self-Determination theory to understand the social prescribing process: a qualitative study(link is external), British Journal of General Practice, January 2021
- Social Prescribing: Creating Pathways Towards Better Health and Wellness(link is external), Journal of the American Geriatrics Society, December 2019
Presentations and Webinars
- Webinar: Summit Preview Keynote: What is Social Prescribing? (with Sonia Hsiung), October 21, 2021 - Recording
- Event: Meeting Social Needs in an Integrated Health System: Social Prescribing During COVID-19 and Beyond, May 27, 2020 - Slides(link is external) | Recording(link is external)
-- Follow-up webinar: Social Prescribing in Practice, June 17, 2020 - Slides(link is external) | Recording(link is external)
-- Follow-up webinar: Social Prescribing in Research, June 25, 2020 - Slides(link is external) | Recording(link is external)
- Webinar: Arts on Prescription: Improving health and wellbeing through arts participation, October 6, 2019 - Recording(link is external) | Slides(link is external) | Resources(link is external)
- Webinar: Connectedness, Purpose, and Belonging: Role of Social Prescribing in Integrating Health Care and Social Supports for Older Adults(link is external), April 29, 2020
- Webinar: Lunch ‘n’ Learn: Social Prescribing - Collaborating for Systems Change(link is external), December 6, 2019
- Presentation: Social Prescribing Boot Camp(link is external) presentation, Community Health Connections Conference, June 11, 2019
If you would like to learn more, please contact:
Sonia Hsiung, Social Prescribing Lead
Alliance for Healthier Communities