An ancient path to good health is making a comeback

Solitude has become such a widespread issue that the U.K. started appointing a minister for loneliness in 2018. That news piqued the interest of a student named Julia Hotz, who was pursuing a doctorate in sociology at Cambridge.
Inspired by her own curiosity, Hotz designed a study that explored public opinion on what this new bureaucrat should do. Respondents consistently wanted better infrastructure to help remedy their solitary lives.
“They said, ‘I wish the government would invest in third spaces and places for people to meet,’” Hotz recalls.
The thinking was that helping lonely people — primarily seniors — to gather with others who shared similar interests would take pressure off the overburdened physicians of the National Health Service. Waiting times had become notoriously long in a system bogged down by patients who needed attention as much as they needed medical care. A pill could often cure but rarely prevent the ailments that stem from loneliness.
Memories of those surveys resurfaced for Hotz when the COVID-19 lockdowns of 2020 put loneliness in the news.
She was back in the United States, pursuing a career with the Solutions Journalism Network, when she started writing about what communities were doing to address the health risks of forced isolation. That’s when she first came across the term “social prescribing,” where health care workers direct patients to take nature walks, tour art museums or volunteer in their communities to treat nonmedical, socially determined ailments — like loneliness. Suddenly, a bigger picture emerged.
“Oh, this is what people who were lonely called for years ago,” she realized. “So, why don’t we see what’s really behind this?”
Her journey of discovery took Hotz to several different countries over the next three years and is chronicled in her book, “The Connection Cure.” Her comprehensive story stitches together the history of a movement with origins that date back millennia up to its modern-day revival in the U.K. and discusses how it can address shortcomings in health care.
Deseret Magazine: Who coined the term “social prescribing”?
Julia Hotz: It’s not clear who came up with it, but the concept started in the mid-1980s in the U.K., where doctors realized a lot of the patients they were seeing were not in need of medical support. At the same time, community organizations were noticing that the people attending art class or a cycling group were less depressed or anxious and lonely afterwards. All those sectors mobilized to address a need that all of them faced. Eventually, they convinced the government that social prescribing could relieve pressure on the NHS and allow its physicians to better manage those needs that did require a medical prescription.
DM: How did it change the health care providers’ approach?
JH: The shift from “what’s the matter with you” to “what matters to you” was described by a founder of social prescribing in the U.K., Dr. Sam Everington. It resonates with people because nobody likes being defined by their symptoms. What I’d heard from a lot of patients was that when they just focus on the symptoms, providers start to view them through that lens and maybe limit what a person could do. But when you take the time to get to know a person’s unique interests or talents, that’s a much more accurate way of viewing them. And it’s actually better for their recovery when the patients themselves are focused more on what matters to them.
DM: You separate these prescriptions into five categories. How did you identify them?
JH: As I researched what was happening in different countries, it occurred to me that every single social prescribing program had elements of those five: movement, nature, art, service and belonging. And I think that’s true for a couple of reasons. No. 1, most of our daily lives back in the ancient, big, bad, wild times involved those things. We were moving our bodies. We were paying attention in nature. We were creating and consuming art, telling stories. We evolved to survive in groups. That’s why a lot of the research doesn’t study social prescribing in particular but the impact of nature or art on our health and that points to universally positive outcomes: It improves our mood, our attention, calms our nervous system, that sort of thing.
DM: Did any of the five surprise you?
JH: A lot of it is intuitive. I should be moving my body more. I should probably try to get outside. But the extent to which it’s helpful for symptoms of things like attention deficit, anxiety, depression, chronic pain, dementia, trauma, stress, surprised and excited me. And what most surprised me was service, and the story of a woman who had struggled with chronic back pain. Volunteering made her pain feel like less a part of her life. And that was so interesting. The research supports the idea that when we focus on other people or some other cause, we literally do feel better. Our bodies catch up with our minds.
DM: Is there a tension between this new treatment and respecting its ancient roots?
JH: I struggle with that. On one hand, this is based on millennia of science and theory. On the other, there’s something compelling in giving a name to what all of these disciplines are independently concluding about how our environments affect our health. And wouldn’t it be great if this wasn’t just left to art therapists and certain medical doctors? If this were mainstream so that every single provider who gets a standard education and works for a health care facility could start offering social prescriptions in addition to medical ones?
DM: Could this idea take hold in the United States, where there isn’t a national health care system like the U.K. or Canada?
JH: It’s already happening here, from the Cleveland Clinic to Boston Medical Center to individual doctors, because it is improving health outcomes. We’re seeing more private insurance companies such as Horizon Blue Cross Blue Shield getting behind arts prescribing for the same reason some are also starting to cover gym classes because of the way that it can reduce health care costs over time. And I think we’re seeing it because people are saying, “Do you have anything else besides taking a pill” or maybe “this procedure isn’t sitting well with me.” And I should also say here, the goal is not to replace those options. The goal is for this to be a complement on the menu for providers and patients alike.
DM: Who do you most want to read “Connection Cure” — the patient or the practitioner?
JH: If I had to pick, I would suggest that this is for the patient. There are some great books on the practice targeted at an audience of implementers. I would hope that this book could reach the everyday person who knows someone who is struggling with loneliness or depression or anxiety or ADHD or dementia and is curious about what else might help them. Change happens when there’s demand for it, when people mobilize around an idea, so I would hope that the everyday reader could read this book and talk to their doctor about social prescribing.
DM: What is your last word?
JH: Even if people don’t feel sick, social prescribing can help us because what it’s all about underneath the movement, nature, art, service and belonging is helping us to be more human.
This story appears in the November 2024 issue of Deseret Magazine. Learn more about how to subscribe.