| …and Why Does it Matter to Older Adults?

| Allison Cook

| A growing model connects older adults to community—and it may be as important as the medicine they take. 

When George was diagnosed with Parkinson’s disease, he and his wife Marla—a couple from Long Island, NY in their late 70s—felt frightened and increasingly isolated. Their children live out-of-state and they lost many of their long-time friends to death or relocation. George’s doctor didn’t just adjust his medication. He referred the couple to their local social prescribing program, run by a Jewish community center funded by UJA-Federation of New York. After an intake assessment, George was connected to a Parkinson’s support program. Marla joined a painting class, where she made friends who she now has lunch with regularly. Both feel less lonely, more supported, and better equipped to handle what lies ahead.

This is social prescribing in action—and it addresses something our healthcare system has long overlooked.

More Than Medicine

Social prescribing is exactly what it sounds like: a structured process by which a person is “prescribed” activities to address their non-medical needs alongside any clinical care they receive. Depending on their situation, someone might be connected to a support group, a cycling club, a volunteering opportunity, or a pottery class (among many other community-based activities). What makes it distinct from simply “getting people out of the house” is the structure behind it: a formal needs assessment, and a person or organization dedicated to connecting individuals to tailored activities that match their goals and build social connection.

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The rationale is grounded in evidence. Research shows that socioeconomic, environmental, and behavioral factors account for roughly 80% of a person’s health—while medical care accounts for only about 20%. “The benefit of the term,” said Dr. Ashwin Kotwal, Assistant Professor of Medicine in the Division of Geriatrics at University of California San Francisco, “is it brings in the health system to try to elevate non-medical health needs into something the health system can do something about.”

A Particular Urgency for Older Adults

Older adults are disproportionately vulnerable to social isolation and loneliness. For many, a doctor’s appointment is their primary opportunity to interact with another person. The health consequences are severe: research has shown that chronic loneliness is as damaging as smoking up to 15 cigarettes per day. And, as the U.S. population ages, the scale of the problem will only grow.

“We just can’t afford to do things the way we’ve been doing it,” said Dr. Alan Siegel, executive director of Social Prescribing USA and a family physician. He points to what’s possible with earlier, sustained intervention: “If you can save people seven or eight years of dementia—and all the things the social isolation research is showing—social prescribing becomes a very worthwhile investment.”

The Evidence is Building

Social prescribing is most established in the UK and Canada, where studies have found that for every $1 invested, approximately $4 is saved by the healthcare system through better outcomes and lower utilization. In the U.S., the evidence base is still emerging, but momentum is growing. UJA-Federation of New York has funded 10 Jewish community centers to implement social prescribing programs for older adults, with some starting to build formal partnerships with major healthcare systems. Start-ups like Vermut and Social Rx are scaling the model nationally. Research centers like the UCSF Social Connections and Aging Lab, where Dr. Kotwal works, are creating technical assistance and implementation guidance. And new partnerships are emerging, such as the newly announced Creative Aging on Prescription program, which includes a partnership between a health system, creative aging providers, and researchers who will look at health outcomes. 

Institutional investors are taking notice. The John A. Hartford Foundation has made social prescribing central to its age-friendly health systems work. “Maintaining our health as we age takes more than good medical care,” said Rani E. Snyder, the foundation’s president. “The best medicine is sometimes not in a pill, but in community.” Through Hartford’s support, USAging has issued social connection seed grants, and Dr. Siegel is launching a pilot with the Kaiser health system. Separately, the Federal Reserve Bank of New York is exploring sustainable funding models for social prescribing through its Missing Markets initiative.

Who Pays?

The honest answer, for now, is philanthropy—which Dr. Siegel emphasized is how most health innovations take root in the U.S. We already know the cost savings internationally. The goal is to build a sufficient evidence base with U.S.-based initiatives to make the case to payers like Medicare and Medicaid. Researchers, including Dr. Kotwal and Dr. Siegel, are working toward exactly that: generating the data that will demonstrate their value to health systems and insurers.

The path from philanthropic pilot to sustainable funding is rarely quick, but as the evidence accumulates and as programs like the one that helped Marla and George demonstrate real-world outcomes, that case becomes easier to make.

A More Holistic View of Health

Social prescribing won’t replace clinical care. Instead, it fills the space between a medical intervention and what a person actually needs to live well. For an aging population grappling with loneliness, isolation, and health issues that come with growing older, community may be exactly the right medicine. 

Allison Cook is founder of Better Aging and Policy Consulting.

Support for this reporting came from the Better Life Lab at New America.