Author Julia Hotz shares her reflections on writing her book, The Connection Cure.
Last month, I published The Connection Cure, a book chronicling two years of reporting through ten countries about the science, stories, and spread of social prescribing. But the real journey began six years ago, in 2018, when I was a sociology researcher at the University of Cambridge, and needed a dissertation topic.
Sir Sam Everington, Julia Hotz, Dr. Michael Dixon, and Ivory Rose, OTD
It happened to be the same year the UK became the first nation to appoint a Minister of Loneliness. I was curious: what is loneliness? And how could the Minister help people feel less lonely? And so, in focus groups of people who admitted they sometimes or often felt lonely, I decided to simply ask them.
As I waited for them, pacing outside of a Marks & Spencer in Cambridge Market Square, I kept an eye out for the passing pedestrians with frail bodies and mops of white hair, having read up on the prevalence of loneliness among elderly people.
But instead I met Abby*, a cheery, lipstick-wearing, kindergarten teacher in her twenties, who had just moved to the area and didn't know how to meet new people. I met Alex*, a bright-jacket-wearing cyclist in his thirties, who admitted he didn't know where or how to make friends anymore. I met Sanya*, the mom who'd linger at the bus stop in hopes of catching a deep conversation. I met Laila*, the newlywed who was so lonely that she went to work on Saturdays.
I learned, there and then, that loneliness affects all of us. It's not only about being alone. It's about feeling alone. And it affects all of us.
When the pandemic happened, more of us began to feel lonely, too. Except it wasn't just loneliness; all around the globe, more of us reported all kinds of unwellness: fatigue, boredom, stress, languishing. The pandemic also saw sharply rising cases of formal diagnoses, like depression, anxiety, ADHD, and lifestyle diseases. And the pandemic saw that health care couldn't keep up with this new disease burden: Different kinds of healthcare systems began reporting the same kinds of problems—doctor shortages, hospital closures, record patient waiting times and backlogs in the emergency room, unmet demand for mental healthcare, widespread professional burnout. What was going on?
The pandemic proved to be a breaking point for health and health care. But it also marked a path forward. For health workers, community leaders, researchers, and policymakers, the pandemic was the canary in the coal mine: a way for the world to understand just how profoundly social determinants affect our health. And so, too, was the pandemic also a global invitation: for more countries to mobilise around treating social determinants with social prescriptions.
My new book explores what those different social prescribing systems look like, through the lens of health workers designing them, community organizations implementing them, and patients themselves living out their benefits. These stories introduce you to the human faces behind the evidence that NASP and the Social Prescribing Network have spent years gathering. These stories personify what happens when health care flips the script on health to ask the cardinal social prescribing question —shifting, as pioneer Dr. Sam Everington describes, from "what's the matter with you?" to "what matters to you."
For Frank, a loving grandfather and ex-truck driver in Sheffield, "what mattered" was a prescription for a spot in Pedal Ready, a local cycling course, to re-learn a sport he loved as a kid. What mattered were the cheerleaders and accountability buddies he met in his "Chain Gang" of fellow riders. What mattered was the encouragement of his GP, Ollie Hart, who believed Frank could come off the insulin he was prescribed for his type 2 diabetes through lifestyle changes (Ollie was right).
For Akeela, a hardworking health worker and natural-born carer in Bolton, "what mattered" was a prescription to volunteer with a local charity. What mattered was still feeling like she had a purpose, even when her excruciating back pain made her doubt it. What mattered was the listening ear of her link worker, Joanne Gavin, who assured Akeela "there was nothing wrong with her," and believed she could feel physically better if she felt mentally better (Joanne was right, too).
For Nick, a fishing fanatic in Salford, "what mattered" was an invitation to join fellow anglers at Tackling Minds, a local angling group that meets on the river, every Thursday. What mattered was the warm and nonjudgmental vibe of the group's founder, Dave Lyons, who saw Nick not for his diagnoses of ADHD and social anxiety, but simply for his passion for fishing.
For Amanda, a bright-eyed, smiley researcher in Saunton, "what mattered" was her sea swimming lessons with Chill Therapy, and the confidence, talent and joy that her coach, Mike Morris, helped her rediscover. What mattered was the way both swimming and her fellow swimmers gave her relief from her depression, and, as she puts it, "a reason to wake up in the morning."
Last month, while at the International Social Prescribing Conference, I thought about Frank, Akeela, Nick, and Amanda, wishing they could see the movement they personify. And then I thought about the people I met six years ago — Abby*, Alex*, Sanya*, Laila* —and imagining what their lives might have been like if they had a GP like Ollie, or a link worker like Joanne, or a caring community leader like Dave or Mike all those years ago.
Maybe now they do.
After all, the social prescribing movement is spreading rapidly, between NASP’s new report exploring the adoption of social prescribing to 32 countries, and the newly launched statewide social prescribing pilot in my own country. There are so many reasons to be hopeful for the future of social prescribing in the UK. It’s time for social prescribing to spread even further.
Note: This reflection was adapted from a Social Prescribing Network blog post published on #SocialPrescribingDay
*Names changed
