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Heart disease is the leading cause of death among American women. Most of us know the standard recommendations: exercise more, eat well, quit smoking, and manage stress. But even with the best intentions, these guidelines can feel abstract. This is especially true if you live in a neighborhood where there are no safe places to walk, fresh produce is not readily available, or you go days without speaking to another person. What if your health care provider could introduce you to a local choir, give you a gift certificate to a farmer’s market, or tell you to sign up for a guided walk in the local park as if these options were medicine?
That is the concept of social prescription.
What is social prescribing?
Social prescribing is a referral system that connects people with non-medical community activities and resources to address conditions affecting their health. Imagine this as a bridge between your healthcare provider’s office and other aspects of your life.
Julia Hotz, journalist and author connection therapy, The first book written on social prescribing, it traced the movement’s spread from Britain to more than 32 countries. “Social prescribing gets its name from the way it addresses social factors that affect health,” he explained. “It notes that people without access to green space, healthy food, and important social connections experience more health care disparities.”
Hotz identifies five pillars of social prescribing: physical activity, nature, arts, services and social connections. It is not a substitute for medication or surgery. But this is a powerful supplement that doesn’t just address the diagnosis, it’s a way to treat the whole person.
Hidden Heart Dangers of Social Life
When most people think about heart disease risk, they think of cholesterol, blood pressure, and smoking. But decades of research point to a deeper truth. In other words, your social life affects your cardiovascular health in surprising ways.
A systematic review of 23 studies found that people with poor social relationships were 30% more likely to develop ischemic heart disease and cardiovascular accidents. Adults who received little or no social support had almost twice the risk of developing three or more cardiovascular risk factors, including high blood pressure, high cholesterol, and diabetes, compared to those with strong social ties. And loneliness causes significant harm. A 2025 study found that people experiencing chronic loneliness had a 56% increased risk of developing cardiovascular disease, even after adjusting for depression and social isolation.
Read: How to build social connections when you feel lonely >>
The science behind it is simple. Stress, loneliness, and depression are risk factors for heart disease that are known to increase levels of cortisol and inflammatory markers, increase blood pressure, and disrupt sleep. Social prescribing therefore began as a response to a variety of mental health crises, but is increasingly recognized as a cardiovascular intervention as well. In fact, a study published in 2025 Frontiers in Public Health We specifically examined social prescribing of heart health and identified a significant relationship between prescribing including nature exposure, physical activity, and healthy living plans with improved cardiovascular clinical outcomes.
“It is true that social prescribing has a history of addressing issues such as stress, loneliness, anxiety and depression, but it may also benefit heart health because physical activity and exposure to nature, which are known to reduce stress on the cardiovascular system, can be prescribed,” Hotz said.
Hotz highlights as an example Walk with a Doc, which was founded by a cardiologist in Columbus, Ohio and now has more than 500 locations worldwide. “I’ve talked to many people who have directly improved their cardiovascular health through these walks,” he said.
power of prescription
Why do patients need a prescription for something they can do themselves? Experts emphasize the ‘formal effect’ of formal prescriptions. If health care providers say social activities are part of the treatment plan, not only is it a good idea, but patients take it more seriously and follow the guidelines.
“If your doctor tells you this is an important part of your health and wellness journey, you’re more likely to follow through,” said Adrienne Hundley, director of community strategy at SocialRx, a nonprofit that connects patients with arts, culture and community experiences.
Having a prescription can also reduce the financial burden of participating in community activities because it can be included in a formal treatment plan, allowing you to receive health insurance coverage from companies that partner with organizations like SocialRx. Additionally, Medicaid and Medicare Advantage programs are increasingly addressing social factors in health through wellness initiatives that include social prescribing coverage. In addition to insurance companies, you may also be able to find funding through hospital health equity programs, public health grants, or community nonprofits.
SocialRx covers members’ participation costs, offers programs in Spanish and other languages, and often includes transportation assistance. Care coaches handle action plans, provide follow-up and motivation, talk to patients after each experience, and help patients continue their care. All of this is useful in removing barriers that may prevent patients from engaging in these activities individually.
The SocialRx model includes 12 months of community experience over the course of a year. Hundley told the story of an elderly woman who had not been able to leave her home for over six months. His treatment advisor connected him with a local choir. One time he returned and for the third month he joined as an accompanying pianist. By the end of the program, she had become assistant director of the senior center’s choir, which she attended several times a week. “I found a new passion for my people, my community, and life,” he told the team. Such changes can have powerful psychological effects.
According to SocialRx, nearly four in five members with factors associated with mental health issues such as anxiety, depression or loneliness showed improvement since their last dose, as assessed by the World Health Organization Wellbeing Index (out of five). Given the relationship between these factors and cardiovascular risk, these levels may also affect heart health.
Social prescribing requires a personalized approach.
Social prescriptions can be very different from person to person, and that’s exactly the point. Hotz describes one of the most surprising examples he discovered while researching his book: a therapeutic farm for people with dementia. “This changes the situation and allows people with dementia to take on the role of caregiver,” he said. “Many people find that being on a farm helps them become healthier. When they work on a farm, they feel like no one is there to remind them of their dementia.”
Hundley has seen equally unexpected changes through the SocialRx program, which takes an intentionally broad view of what counts as healing. “People like to keep busy,” he said, describing services ranging from pottery making and expressive writing to architectural walking tours that help patients understand the history of their community. In San Diego, children interact with local circus schools. In Boston, participants design and model fashion creations made using recycled materials.
What unites all of this is the basic premise. This means that prescriptions that match what a person truly cares about and motivate are more likely to be implemented and cure patients over the long term.
Changing perspectives on health
Hundley sees this moment as similar to the cultural changes that have already occurred through the movement. “It seems similar to 50 years ago when people didn’t think of their physical activity as an important part of their health and well-being. But now it seems ridiculous not to think about it. Hopefully, in 10 or 15 years it will be ridiculous not to know that our emotional health affects our overall well-being.”
If you’re one of the millions of women trying to manage or prevent heart disease, it’s worth taking note of those changes now. A healthier heart may require more than pills. Sometimes you need a chorus.
This educational material was produced with the support of . Merck.
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