Social prescribing is a relatively recent term for making connections to activities and services that help improve the social determinants of health, challenging many people. Food insecurity, financial instability, housing challenges, isolation and lack of physical or social activities can be significant barriers for many vulnerable adults.
Social prescribing recognizes that not all health supports need to be medical. Referral to a housing worker who helps a client find safe, healthy housing may assist with physical, mental and emotional health. The person may need advice to deal with debt, or benefit from a rent supplement. It might mean helping a person with dementia join a dementia choir or a disabled person to receive meal delivery. Social prescribing will differ for each person it aims to help.
Four Pillars of Social Prescribing
The National Academy for Social Prescribing (NASP) identified four pillars to describe the various aspects of this work: Advice and Information, Arts and Heritage, Natural Environment and Physical Activity. Let’s take a brief look at these four areas.
Advice and Information
Many people are struggling with inflation, lack of affordable housing and an inability to access services. Applying for financial benefits and pensions, subsidized housing, assisted living and other programs can be a complex maze of forms and bureaucracy for many seniors and vulnerable adults. With the right assistance, they can apply for various benefits that are available in British Columbia and Canada, easing the stress that has an impact on their mental and physical wellness.
Arts and Heritage
The arts can be a means for someone to identify with their own story, expressing what they cannot do in any other way. While one individual may rediscover an old hobby or activity, another may learn something new. Others may volunteer at a museum, join a musical group or choir, or join a local history society.
Many studies have been written about the benefits of nature, forest bathing and watching wildlife. Not everyone has access to the outdoors, but luckily in BC even those in urban areas are often close to municipal parks. For those with long-term health challenges and for caregivers, even getting to a local park can be a challenge. Connections can be made to community groups that take people on short excursions, form walking groups or develop community gardens. It may be as simple as providing someone with a garden box and a few plants or seeds.
Exercise and other physical activities have far-reaching benefits for health, including mental and emotional health. NASP lists the following benefits to physical activity:
- Lowers risk of conditions including cancer, dementia, heart disease and stroke
- Reduces risk of type 2 diabetes by 30-40%
- Boosts mental wellbeing, reduces anxiety and depression, connects people, and enhances happiness and self-esteem
- Helps people living with chronic illness to manage their condition
- Plays a vital role in maintaining healthy body weight, getting a good night’s sleep and feeling more energized
- Can help with cutting back on unhealthy habits like smoking
Vulnerable adults may face barriers such as insufficient funds for activities or buying the appropriate clothing. They may lack the motivation or confidence to try something new. Connections may be made to local recreation centres or community groups with programs like Every Steps Counts, a running program for people with housing, mental health, addictions and other barriers in Victoria. The program partners with a local sporting goods store that assists with proper shoes for participants.
Addressing Social Determinants of Health in Canada
The Canadian Institute for Social Prescribing (CISP) is a “new national hub to link people and share practices that connect people to community-based supports and services that can help improve their health and wellbeing.” Launched in September 2022, the CISP aims to connect researchers, organizations and initiatives to share knowledge about social prescribing in Canada.
Currently, social prescribing programs are being developed and implemented in approximately 17 countries around the world. While similar models of connecting people have been around since the late 1990s, the term social prescribing is relatively new, according to Current State of Social Prescribing in Canada, a 2022 report by Bridgeable.
The report focuses on a few initiatives, three of which are in BC: Fraser Health Authority and Red Cross (regional), Whistler 360 Health Collaborative (local) and People for a Healthy Community on Gabriola Island (hyper-local).
Case Study: Social Prescribing in the Fraser Health Authority
Fraser Health has 10 divisions of Family Practice, each working with a community-based seniors-serving organization. In this model, each partner organization appoints a Seniors Community Connector (SCC), who does client intake, assessment and social care plan co-creation, and makes referrals to community services and supports. With an aging population, an emphasis on preventative care to avoid overburdening acute care services was required.
Among other positive metrics, the pilot project showed reduced frailty after six months, as reported by Bridgeable. The Health Authority and staff are embracing social prescribing as a positive initiative.
“When they are not connected in the community, [seniors] end up using the acute care system more […] the health authority realized there needs to be more upstream focus on prevention and health promotion,” said Dr. Grace Park, Family Physician and Regional Medical Director for Community Health Services at Fraser Health Authority.
April Provincial Learning Event on Social Prescribing
We are excited to offer a special presentation, Social Prescribing and Older Adults, on April 18 from 10:30am to 12 noon. Maureen Ashe, PhD, and Sanya Grover, UBC Medical Student, present an overview of social prescribing based on the results of their two recent systematic reviews for this topic. Learn more and register for this very timely session.