For Medical Residents
Social prescribing is best understood as prophylactic care, targeting social conditions (e.g., disconnection from community, inactivity, isolation, precarious housing) that perpetuate adverse health outcomes. For residents trained to recognize risk conditions at the point of care, SP offers referral pathways for determinants that may be identified but not often directly addressed.
The World Health Organization (WHO) Commission on Social Connection issued a 2025 report highlighting that “social isolation and loneliness are widespread, with serious but under-recognized impacts on health, well-being, and society” (WHO, 2025). This report associated social isolation and loneliness with approximately 870,000 deaths per year, health care expenditure increasing by billions (e.g., €14 billion in Spain during 2021, contrasted with ~£2.4 billion in the UK and $6.7 billion U.S. in federal health expenditures) and cascading adverse effects on mental and physical health. In the same report, the WHO identified Canadians aged 45–85 commonly admitting to feeling “very lonely”—on top of increasing loneliness levels among Indigenous Peoples, newcomers to Canada, youth, and those commonly marginalized.
Though current evidence is mixed, SP is hypothesized to reduce repeat clinical visits through addressing determinants of health like housing precarity, inactivity, and isolation, and which often have patients return to their primary care practitioner. (Carnes et al., 2017; Loftus, McCauley & McCarron, 2017)
SP’s economic impact is promising, with social return on investment (SROI) analyses reporting favourable ratios—though more evaluation is needed across cost-benefit, cost-effectiveness, and cost-utility. (Lynch & Jones, 2022; Whiteley et al., 2025; Lynch et al., 2026)
Physicians in their residency years have an opportunity to build SP pathways into the quality improvement work residency programs require. This may involve community asset mapping, designing referral workflows, measuring local SP uptake, and more. (Chiva Giurca, 2018; Mazaheri et al., 2022; Paquette, 2024; Muhl et al., 2024)
SP Categories
Nature/Green SP
Nature/Green SP connects clients with outdoor activities to support their wholistic health. Outdoor time can help improve emotional regulation, lower clients’ distress, and reduce sedentary living patterns. (Maddock, 2019)
The successes of Nature SP may relate to associations between time in nature and reduced risk of adverse outcomes—which include but aren’t limited to alcohol use disorder, emerging adults’ high screen time, sleep disturbance, and more. Biodiversity especially has been demonstrated as protective against adverse mental health outcomes. (Ohly et al., 2016; Bratman et al., 2019; Lackey et al., 2021; Jimenez et al., 2021; Yeon et al., 2021; Almog et al., 2022; Deyo, Wallace & Kidwell, 2024; Hammoud et al., 2024; Ma, Zhao & Zhang, 2025; Barbett et al., 2026)
Building on the successes of initiatives like Healthy by Nature and PaRX, Nature SP in Waterloo Region can benefit from existing infrastructure. Local programs offer activities including community garden activities, conservation programs, nature walks, and outdoor and Land-based learning. These encourage people’s increased time outdoors, adding to the benefit of connecting SP clients to community members whose strengths and interests align with theirs.
Exercise SP
Exercise SP connects clients to structured physical activities via community facility referrals, supervised programs, walking groups, and more.
This works through specific referrals instead of general exercise advice. Primary health care practitioners must assess clients’ active and sedentary patterns before referring them to one or more tailored physical activity programs. Prescribers and programs then work with the client to arrange social support, co-develop coping plans, co-develop exercise goals, monitor progress, and recognize openness to behaviour change. Clients may attribute participation success to staff and other social supports, while also reporting improved mental, physical, and social health outcomes. As a result, social connection remains part of Exercise SP’s mechanism, especially in cases where collective movement is embedded in exercise practice. (NICE, 2014; Morgan et al., 2016)
Local options include community centre programs, equipment and health tools available at libraries, recreation and sports leagues, walking groups, and year-round outdoor programming.
Arts SP
Arts SP (a.k.a. “Arts on Prescription” or “Arts on Referral”) refers clients to creative activities (e.g., creative writing, dance, music, visual art, etc.) occurring in groups and over sustained periods, with clients referred toward programs often facilitated by practising artists.
Understood mechanisms for Arts SP involve creative expression, group belonging through shared creativity, and mastery development through sustained practice. Benefits may accrue with continued program participation. (WHO, 2019; Sumner et al., 2021; Jensen et al., 2024)
Local options include artist and maker programs, book clubs, creative equipment available from libraries, gallery and museum access, and group art courses. Cultural practices (e.g., beadwork, carving, drumming, storytelling, etc.) shouldn’t be treated as interchangeable with “Arts SP,” so prescribers must remain aware of programming that’s appropriate for the client.
More SP categories forthcoming as our research continues.
