More than one in three older adults report experiencing loneliness, and a similar share report feeling socially isolated. While loneliness is the subjective feeling of being alone, social isolation refers to having limited social connections with family, friends, or the broader community. The 2023 Surgeon General’s Advisory recognized both as major public health concerns, with research linking them to adverse outcomes including depression, dementia, disability, and premature death. Older adults are at increased risk of social isolation due to life changes such as bereavement, declining mobility, and shrinking social networks. Social isolation is also associated with higher rates of transition to costly nursing home care and higher Medicare and Medicaid spending.

To address loneliness and social isolation among older adults, health care, aging, arts, and community-based sectors  are increasingly turning to social prescribing, an approach that originated in the United Kingdom and has since gained traction globally, including in the United States. Also known as community referrals or non-medical prescribing, social prescribing involves identifying individuals who may benefit from non-clinical supports and providing guidance from health care providers or navigators to help them identify, connect with, and participate in community programs and activities. Providers or navigators then monitor participants’ progress to support continued engagement, social connection, and overall well-being. Research to date suggests social prescribing can improve social connection, reduce loneliness, and enhance quality of life among older adults and other populations.

How does social prescribing work in a health care setting?

Social prescribing typically begins when a health care provider or other member of a care team identifies an individual who may benefit from additional social support, community engagement, or assistance addressing non-clinical needs. The provider — or in some models, a community connector or navigator, often referred to as a link worker in the United Kingdom — works with the individual to assess their interests, goals, and needs to develop a personalized plan. The individual is then connected to an array of community-based activities that may include exercise or movement, group museum tours, gardening activities, arts and cultural engagements, resilience training, and social support services. The navigator also conducts follow-ups with the individual to monitor participation and perceived changes in health and well-being. While traditional resource referrals typically address immediate needs, social prescribing focuses on strengthening social connection, relationships, and community engagement. Yet, this distinction is not absolute. Some social prescribing programs also connect individuals to services that help address the individual’s broader health and well-being, such as food, housing, or transportation.

What is the policy landscape surrounding social prescribing?

As concerns about loneliness and social isolation among older adults grow, policymakers and providers have shown increasing interest in approaches that connect people with community-based supports. In the U.S., social prescribing programs for older adults are primarily grant-funded pilot sites with local networks of providers and community-based organizations, with some programs beginning to draw on other time-limited funding streams, such as opioid settlement funds. This differs from other countries, like the United Kingdom and Canada, where national and regional frameworks, as well as public funding streams, support large-scale implementation of social prescribing as part of broader efforts to promote healthy aging. While interest in social prescribing programs in the U.S. is growing, limited awareness, funding and reimbursement opportunities, and gaps in U.S.-based research as well as evidence of return on investment remain significant barriers to wider adoption.

Social prescribing is not reimbursed as a standalone Medicare or Medicaid service. However, states are increasingly using mechanisms including Medicaid Section 1115 demonstrations, 1915 home- and community-based services waivers, Medicare Community Health Integration services, and partnerships with managed care organizations to address social isolation. Although these initiatives have primarily focused on housing, food, and other health-related social needs, they can also support efforts to identify and address social isolation among older adults. Health plans and providers can use validated screening tools to identify older adults at risk and connect them to available services. Federal agencies have also demonstrated growing interest in addressing social isolation and strengthening connections to community resources through initiatives such as the  U.S. Department of Veterans Affairs’ Compassionate Contact Corps and the Administration for Community Living’s Commit to Connect initiative.

What is the evidence on social prescribing for older adults?

While most social prescribing research has been conducted outside of the U.S, qualitative and quantitative studies from multiple countries suggest that social prescribing can improve social connection, reduce loneliness, enhance mental health and quality of life, and support healthy aging. Emerging evidence in the U.S. is beginning to show similar benefits and identify implementation approaches that may be particularly effective for older adults. Because loneliness is often more readily measured than social isolation, many intervention studies use loneliness as a primary outcome or key outcome measure.

• The Effectiveness of Social Prescribing in the Management of Long-Term Conditions in Community-Based Adults: A Systematic Review and Meta-Analysis – A review of 12 studies from multiple countries reported that social prescribing program participation improved self-reported quality of life, physical activity levels, and some condition-specific outcomes for people with long-term health conditions, including diabetes.

• A Randomised Controlled Trial and Economic Evaluation of a Referrals Facilitator Between Primary Care and the Voluntary Sector – Participants of a primary care social prescribing program in England reported significant improvements in anxiety, perceived health, quality of life, emotional well-being, and ability to perform daily activities compared with those receiving usual care.

• Social Prescribing for Frequent Attenders in Primary Care: An Economic Analysis – A social prescribing pilot in Wales was associated with cost savings of approximately £78 per patient, largely due to fewer primary care appointments and prescriptions, with the largest savings observed among patients with more frequent primary care visits.

• Critical Components of Social Prescribing Programmes with a Focus on Older Adults – A Systematic Review – A review of 12 studies from the Netherlands and the United Kingdom identified three key components of social prescribing that were impactful in supporting older adults experiencing loneliness and poor health and well-being — completing assessments before making a referral, matching participants with appropriate activities, and ongoing support from link workers.

• Older Adults and Social Prescribing Experience, Outcomes, and Processes: A Meta-Aggregation Systematic Review – A systematic review of eight qualitative studies shared positive experiences of participants and social prescribing providers and noted the importance of person-centered, accessible, and focused programs in meeting the psychosocial needs of older adults.

• Effects of a Museum-Based Social Prescription Intervention on Quantitative Measures of Psychological Wellbeing in Older Adults – A museum-based social prescribing program for older adults at risk of loneliness and social isolation was associated with improvements in a well-being measure that captures changes in six positive emotional states: feeling absorbed, active, cheerful, encouraged, enlightened, and inspired.

• Social Prescription in the U.S.: A Pilot Evaluation of Mass Cultural Council’s “CultureRx” – An evaluation of the first U.S. arts-on-prescription program found that participants viewed arts and cultural experiences as beneficial to their well-being, while providers described the program as a valuable addition to their referral toolkit.

What resources are available to support social prescribing for older adults?

The following resources highlight the experiences of participants, providers, and community organizations involved in social prescribing programs and provide practical guidance for health care providers, health systems, aging services organizations, and community-based organizations interested in implementing social prescribing initiatives.

• Arts, Culture, and Social Prescribing in the United States: 23 Case Studies, 2023-2024 – A case study report of 23 social prescribing programs across 11 U.S. states highlights common implementation approaches, funding models, and barriers to scaling social prescribing in the U.S. Programs included cultural visits, arts, music-based activities, and other forms of engagement.

• SocialRx – A Unique Social Prescribing Model Built on Connecting Older Adults to What Matters to Them – This program spotlight describes a community-based social prescribing initiative that reduced loneliness and isolation among older adults by connecting them with meaningful resources ranging from social and cultural activities and chronic disease support to fitness programs and bereavement support.

• A Toolkit on How to Implement Social Prescribing – This WHO toolkit provides step-by-step guidance, case studies, and adaptable materials to support the implementation and scaling of social prescribing programs in community settings.