Heart disease is the number one killer of women in the U.S. Most of us know the standard advice: Exercise more, eat better, quit smoking, manage stress. But even with the best intentions, those instructions can feel abstract, especially if you live in a neighborhood without a safe place to walk, can't easily afford fresh produce, or go days without talking to another person. What if your healthcare provider could connect you to a community choir, give you a farmers market voucher, or tell you to sign up for a guided walk through your local park and call it medicine?
That's the idea behind social prescribing.
What is social prescribing?
Social prescribing is a referral system that connects people to non-medical, community-based resources and activities to address the root conditions shaping their health. Think of it as a bridge between your healthcare provider’s office and the rest of life.
Julia Hotz, journalist and author of The Connection Cure, the first book written on social prescribing, has followed the movement as it spread from the United Kingdom to more than 32 countries. "Social prescribing got its name from the way it intends to address the social determinants of health," she explained. "Meaning that people without access to green space, people without access to healthy food and people without access to strong social supports would experience further health disparities.”
Hotz identifies five pillars of social prescribing: movement, nature, arts, service and social connection. It's not a replacement for medication or surgery. But it's a powerful complement to both, a way of treating the whole person, not just the diagnosis.
The hidden heart risks in your social life
When most people think of heart disease risk, they think of cholesterol, blood pressure and smoking. But decades of research point to something deeper: Your social world shapes your cardiovascular health in ways that may surprise you.
People with poor social health were 30% more likely to develop coronary heart disease and stroke, according to a systematic review of 23 studies. Adults who rarely or never received social support had nearly twice the risk of accumulating three or more cardiovascular risk factors — including hypertension, high cholesterol and diabetes — compared to those with strong support. And loneliness carries its own toll: A 2025 study found that people with chronic loneliness had a 56% higher risk of stroke, even after adjusting for depression and social isolation.
Read: How to Make Connections When You’re Lonely >>
The biology behind this is straightforward. Stress, loneliness, and depression each elevate cortisol and inflammatory markers, raise blood pressure, and disrupt sleep, all recognized risk factors for heart disease. This is why social prescribing, though it originated as a response to mental health crises, is increasingly recognized as a cardiovascular intervention too. In fact, a 2025 study published in Frontiers in Public Health specifically examined social prescriptions for heart health and found strong relationships between prescriptions involving nature exposure, physical activity and healthy living initiatives and improved cardiovascular outcomes.
“It's true that social prescribing does have a track record of addressing things like stress, loneliness, anxiety, depression, but it can also help heart health in that it could be for activities involving movement, activities involving nature, which are known to de-stress the cardiovascular systems,” Hotz said.
Hotz highlights Walk with a Doc, launched by a cardiologist in Columbus, Ohio, and now operating more than 500 chapters worldwide, as a prime example. "I've spoken with lots of people who have directly improved their cardiovascular health through these walks," she said.
The power of the prescription
Why do patients need a prescription for something they can do on their own? Experts point to the "authority effect" of a formal prescription. When a healthcare provider says a social activity is part of your care plan — not just a nice idea — patients take it more seriously and follow through.
"If your doctor says this is an important piece of your health and well-being journey, you're probably more likely to follow through on that," said Adrienne Hundley, head of community strategy for SocialRx, a nonprofit that connects patients with arts, cultural and community-based experiences.
Having a prescription may also ease the financial burden of participating in community activities by tying them to formal treatment plans so they can be covered by health insurance, which may partner with organizations like SocialRx. Additionally, Medicaid and Medicare Advantage programs increasingly address social determinants of health through wellness initiatives that include social prescription coverage. Beyond insurers, funding can also flow through hospitals' health equity programs, public health grants, or community nonprofits.
SocialRx covers participation costs for members, offers programming in Spanish and other languages, and often includes transportation assistance. Care navigators handle the logistics and serve as accountability partners, checking in after each experience and helping patients stay on track. All of this helps remove barriers that may prevent patients from engaging on their own.
SocialRx's model involves 12 monthly doses of community experience over a year. Hundley shares the story of one older woman who had been nearly housebound for over six months. Her care navigator connected her to a community choir. She went once, came back and by the third month had stepped in as a piano accompanist. By the end, she was the choir's assistant director at the senior center multiple times a week. "I have found my people, I have found my community, and I have found a renewed lease on life," she told the team. That kind of transformation can have a powerful physiological impact.
According to SocialRx, nearly 4 out of 5 of their members with positive indicators for mental health concerns — anxiety, depression or loneliness — show improvement after their last dose as measured by the The World Health Organization-Five Well-Being Index. Given the links between these conditions and cardiovascular risk, those figures may carry implications for heart health as well.
Social prescriptions require a personalized approach
Social prescriptions can look wildly different from one person to the next, and that's exactly the point. Hotz describes one of the most surprising examples she encountered while researching her book: a dementia care farm. "It sort of flipped the script and allowed people with dementia to do the caretaking," she said. "Many of them found that being on the farm helped them feel healthy — they felt like when they were working on the farm, they weren't reminded of their dementia."
Hundley has seen equally unexpected transformations through SocialRx, which takes a deliberately broad view of what counts as healing. "People love to get their hands on something," she said, describing a range of offerings from hand-building ceramics and expressive journaling to architecture walking tours that help patients understand the history of their own communities. In San Diego, kids connect with a local circus school; in Boston, participants design and model their own fashion creations from reused materials.
What unites all of it is the underlying premise: that a prescription tailored to what genuinely interests and moves a person is more likely to stick, and more likely to heal.
A shift in how we think about health
Hundley sees the current moment as analogous to a cultural shift that already happened with exercise. "We often liken it to 50 years ago, people didn't think about their physical movement as such an important part of health and well-being. But today that seems silly not to think about it. Hopefully, in 10 to 15 years, it would be preposterous not to think about how our social health impacts our well-being as well."
For the millions of women managing heart disease or trying to prevent it, that shift is worth paying attention to now. A healthier heart, it turns out, might need more than a pill. Sometimes it needs a choir.
This educational resource was created with support from Merck.
