Social offering may sound like a welfare burden, but the economic implications are real. Social isolation among older adults is associated with $6.7 billion in additional medical costs annually, while stress-related absenteeism linked to loneliness costs American employers $154 billion annually.
As hospitals, communities, and employers seek practical ways to reduce these costs, social prescribing is gaining momentum as a potentially useful public health tool.
While this change may seem innovative, it is an example of a model that Europe has been practicing for centuries.
What is a social offering?
Social referral is when a health care professional recognizes that a person has non-medical needs related to stress, burnout, social isolation, or loneliness and recommends group activities, such as art programs, nature groups, or social services, to improve their health.
One example is SocialRX, formerly known as Art Pharmacy, which uses custom-built software to match participants with arts and cultural activities that support their health goals.
Stanford University is one of SocialRX’s more than 400 partners. The Stanford Arts Offering Program, launched in 2024, connects undergraduate students to campus-based arts activities, including dance, singing, visual arts, crafts, museum visits, literary readings, and live performances.
Loneliness is an economic problem, not just a social one
The US Surgeon General’s headline, “Our Disease of Loneliness and Isolation,” notes that in recent years, one in two adults in America has experienced loneliness, which has directly contributed to lower academic achievement and poorer performance at work.
Loneliness is not only a lifestyle but also a health care concern. The advice notes that the health effects of a lack of social contact are comparable to smoking up to 15 cigarettes a day.
The Canadian Institute for Social Sciences found that every $1 invested in programs targeting loneliness and social isolation can generate about $4.43 in health savings.
For older adults, the report projects 245,400 fewer hospital days per year due to falls at home, resulting in savings of $296 million from fewer hospitalizations, ambulance calls, and emergency department visits. It estimates 16,900 fewer cases of heart disease, 7,600 fewer cases of dementia over the next 10 years, 6,500 fewer lifetime strokes, and 2,000 fewer preventable deaths.
For youth mental health, the report estimates an annual increase in employment income of $59.9 million and 1.9 million fewer primary care visits, which could save the health system $114 million in annual costs.
2000 years of health experience in European spa towns
Before modern healthcare systems began experimenting with social versions, European spa towns built entire urban environments around the concept.
“Historic spa towns have never been just places of treatment: they were – and remain – places where the care of the body interacts with culture, environment and social life,” says Chiara Roncini, Secretary General of the World Heritage Sites of Europe’s Great Spa Towns, in an official statement.
Europe’s largest spa town, one of the UNESCO World Heritage Sites, includes 11 historical towns: Baden bei Wien, Spa, Františkovy Lázně, Karlovy Vary, Mariánské Lázně, Vichy, Bad Ems, Baden-Baden, Bad Kissingen, Montecathrim, A Belustria Baden. Republic, France, Germany, Italy and England.
While these cities are famous for their mineral springs and baths, their health philosophy extends beyond water therapy.
Here visitors can combine medical treatments with social activities such as walking in scenic parks, attending concerts or gathering in cafes for conversation.
The architecture of spa towns reflects this philosophy. Promenades, landscaped parks and beautiful colonnades surround the baths and spa facilities, designed for daily strolls and social interaction. The sprawling city features theaters, scenic hotels, cafes and cultural venues, creating additional spaces for the community to meet and interact.
Why models matter in 2026
As Europe’s major spa towns mark five years since their UNESCO designation, their legacy is once again in the spotlight.
“Today, European thermals are experiencing a new phase: no longer limited to balloonological treatments or medical rehabilitation, but an integrated offer known as thermal health – a holistic experience that combines preventive health, outdoor activities, cultural offers, and personal services,” explained Roncini in an official statement.
The report calls it an “overcorrection reaction.” People are moving away from stressful, information-driven comfort and toward experiences rooted in joy, tradition, emotional repair, and social connection.
In this context, European spa towns look less like artifacts and more like templates to be revisited in 2026. For example, in Germany, this concept has existed for a long time in the form of a “home” that supports physical or mental health recommended by a doctor, financed by insurance.
Should US health care include what spa towns have known for so long? The most powerful medicine exists only in society.
