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Heart disease is the number one cause of death among American women. Most of us know the standard advice: Exercise more, eat well, quit smoking, and manage your stress. But even with the best intentions, these guidelines can feel abstract. This is especially true if you live in a neighborhood with no safe places to walk, don’t have easy access to fresh produce, or can’t go days without talking to someone. What if your health care provider could connect you to a local choir, give you a gift certificate to a farmer’s market, or sign you up for a guided walk through a local park and instruct you to call it medicine?
This is the idea behind social prescribing.
What is social prescribing?
Social prescribing is a referral system that connects people to non-medical, community-based resources and activities to address the underlying conditions that shape health. Think of it as a bridge between your healthcare provider’s office and the rest of your life.
Julia Hotz, journalist and author connection therapy, The first book on social prescribing followed the movement as it spread from the UK to more than 32 countries. “Social prescribing gets its name from the way it seeks to address social determinants of health,” she explained. “This means that people who don’t have access to green space, people who don’t have access to healthy food, people who don’t have access to strong social support are going to experience greater health inequalities.”
Hotz identifies five pillars of social regulation: movement, nature, arts, services and social connections. It is not a substitute for medication or surgery. However, it is a powerful complement to both, a method of treating the whole person as well as diagnosis.
Hidden Heart Dangers in 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. That means your social world shapes your cardiovascular health in ways that may surprise you.
A systematic review of 23 studies found that people with poor social health were 30% more likely to develop coronary heart disease and stroke. Adults who received little or no social support had nearly twice the risk of accumulating three or more cardiovascular risk factors, including high blood pressure, high cholesterol, and diabetes, compared to adults who received strong support. A 2025 study found that people who suffer from chronic loneliness have a 56% higher risk of stroke, even after adjusting for depression and social isolation.
Read: How to make connections when you’re lonely >>
The biology behind this is simple. Stress, loneliness, and depression are risk factors for heart disease known to increase cortisol and inflammatory markers, increase blood pressure, and disrupt sleep, respectively. This is why social prescribing began as a response to the mental health crisis, but is increasingly recognized as a cardiovascular intervention as well. In fact, a study published in 2025 found that Frontiers in Public Health Specifically, we examined social prescribing of heart health and found a strong relationship between nature exposure, physical activity, and healthy living plans, and prescribing associated with improved cardiovascular outcomes.
“It’s true that social prescribing has a track record of helping with issues like stress, loneliness, anxiety and depression, but it may also have heart health benefits given that exercise-related activities and activities related to nature are known to relieve stress on the cardiovascular system,” Hotz said.
Hotz highlights Walk with a Doc, started by a cardiologist in Columbus, Ohio, as a prime example. “I’ve talked to many people who have directly improved their cardiovascular health through these walks,” she said.
power of prescription
Why do patients need a prescription for something they can do themselves? Experts point out the ‘authority effect’ of formal prescriptions. When health care providers tell people that social activity is part of their treatment plan and not just a good idea, patients are more likely to take it seriously and follow it.
“If your doctor tells you this is an important part of your health and wellness journey, you’re more likely to follow through with it,” said Adrienne Hundley, director of community strategy at SocialRx, a nonprofit that connects patients with arts, culture and community-based experiences.
Having a prescription can also help ease the financial burden of participating in community activities by allowing you to be covered by health insurance, which can tie community activities into a formal treatment plan and partner with organizations like SocialRx. Additionally, Medicaid and Medicare Advantage programs are increasingly addressing social determinants of health through wellness initiatives that include social prescribing coverage. In addition to insurance companies, funds may also flow through hospitals’ health equity programs, public health grants, or community nonprofits.
SocialRx covers members’ participation costs, offers programming in Spanish and other languages, and often includes transportation assistance. Care navigators handle logistics, serve as accountability partners, check in after each experience and help keep patients on track. All of this helps remove barriers that may prevent patients from engaging on their own.
SocialRx’s model includes community experiences spread over 12 months over a year. Hundley tells the story of an elderly woman who almost became homebound for over six months. Her care navigator connected her with a local choir. She went once and then came back again, taking on the role of piano accompanist in her third month. Eventually, she took on the role of assistant director of a choir at a senior center several times a week. “I found my people, I found my community, I found a new opportunity in life,” she told the team. Such changes can have powerful physiological effects.
According to SocialRx, nearly four in five members with positive indicators of mental health issues (anxiety, depression or loneliness) showed improvement since their last dose as measured by the World Health Organization-Five Well-Being Index. Given the link between these conditions and cardiovascular risk, these levels may also affect your heart health.
Social prescribing requires a personalized approach
Social prescriptions can look very different from person to person, and that’s exactly the point. Hotz describes one of the most surprising cases he encountered while researching his book: a dementia care farm. “It kind of flipped the script and allowed people with dementia to have access to care,” she said. “Many people have found that being on a farm helps them feel healthier. Working on a farm makes them feel like dementia is not on their mind.”
Hundley has seen an equally unexpected shift through SocialRx, which takes an intentionally broad view of what counts as healing. “People love getting their hands on things,” she said, describing services ranging from hand-made pottery and expressive journal writing to architectural walking tours that help patients understand the history of their communities. In San Diego, children are connected to a local circus school. In Boston, participants design and model their own fashion creations using reused materials.
What ties it all together is the basic premise. In other words, prescriptions that are tailored to a person’s true interests and emotions are more likely to stick and lead to healing.
Changing the way you think about your health
Hundley sees the current moment as similar to the cultural changes that have already occurred through movements. “We often liken this to 50 years ago, when people didn’t think of their physical movement as an important part of their health and well-being. But today it seems absurd not to think about it. Hopefully, in 10 to 15 years it will be absurd not to think about how our social health affects our well-being.”
If you’re one of the millions of women trying to manage or prevent heart disease, these changes are worth taking note of now. It turns out that a healthier heart may require more than medication. Sometimes you need a choir.
This training material was created with support from:m Merck.
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