The health economics of social prescribing: systematic review of the international evidence

Background Social prescribing is an approach to improving health and wellbeing that links individuals to community-based supports, such as arts programs, physical activity initiatives, financial or housing advice, volunteering opportunities, and social groups. Although evidence supporting its effects on physical, functional, and mental health outcomes is expanding, no systematic review of the international evidence has yet assessed the health economics of social prescribing. Aim To systematically review evidence on the health economic methods and tools that have been used to evaluate social prescribing initiatives internationally. Methods A systematic search of seven electronic databases (PubMed, Embase, Cochrane Trials, APA PsycINFO, CINAHL, Web of Science, and Ovid Global Health) was conducted alongside gray literature and citation searching. Two reviewers independently screened titles, abstracts, and full texts using Covidence, with disagreements resolved with a third researcher. Data extraction followed a structured protocol, and thematic analysis informed a narrative synthesis of findings. Results Eighteen studies met the inclusion criteria: 5 randomized controlled trials, one quasi-experimental study, and 12 mixed-methods studies. Interventions reflected four main categories: exercise-based or loneliness-prevention initiatives ( n = 10), coaching programs ( n = 3), nature-based interventions ( n = 3), and dance or movement-based programs ( n = 2). Use of standard economic methods and tools was limited. Social Return on Investment analyses reported positive returns for interventions targeting mental health and loneliness. Conclusion Robust economic evidence on social prescribing remains limited. Despite the availability of established health economic methods and tools, these are rarely applied to social prescribing, limiting the usefulness of existing studies for healthcare planning and commissioning.