Social prescribing is often celebrated as a tool for tackling health inequalities. By connecting people with community-based supports—like exercise groups, financial advice, arts activities or befriending—it aims to address the root causes of poor health. But a new study from the UK has me asking: Is social prescribing always living up to that promise?
In a landmark study of over 160,000 patients across 26 general practices, Dobson and colleagues (2024) explored who actually gets referred to social prescribing. The results were both illuminating and concerning.
What the Study Found
The data revealed clear inequalities in referral patterns. For example:
- Older adults were much more likely to be referred than younger people.
- Women were referred more than men.
- People from ethnic minority groups, including Black and South Asian communities, were significantly less likely to be referred—even when they had higher levels of need.
- Patients living in more deprived areas were underrepresented in referral numbers, despite being at greater risk of poor health outcomes.
Put simply, the people who might benefit most from social prescribing were less likely to receive it.
Why This Matters
If social prescribing is meant to reduce health inequalities—but ends up reinforcing them—we need to seriously rethink how it’s being implemented.
As a GP working in both urban and remote Australian settings, I’ve seen the transformative potential of social prescribing. But I’ve also seen the subtle biases—who gets offered support, who gets missed, who is assumed to “engage.” This study puts hard data behind those observations.
Are We Gatekeeping Support?
One of the key insights from Dobson et al. is that referrals are shaped by practitioner judgment. That means the process is vulnerable to unconscious bias, structural racism, and assumptions about who is “appropriate” or “ready” for support.
The authors argue that the current model may be inadvertently exacerbating existing inequalities. Social prescribing services are often located in areas of greater need, but the people most likely to be referred are those who are already more empowered, engaged, or easier to work with.
What Can We Do?
This paper is a call to action—not to abandon social prescribing, but to make it better.
- We need equity-focused training for referrers, so that unconscious bias doesn’t shape access.
- We need to co-design referral pathways with communities who are underrepresented.
- We need better data, disaggregated by ethnicity, deprivation, and gender, so we can monitor and respond to inequalities.
- And above all, we need to treat social prescribing as a structural intervention, not just a service add-on.
Final Thoughts
Social prescribing holds real promise. But like any intervention, it’s only as fair as the system that delivers it. Dobson et al. have given us the evidence—now it’s up to us to act on it.
Reference:
Dobson, R., Pollock, K., Ramsden, R., Bower, P., Sutton, M., & French, C. (2024). Equal, equitable or exacerbating inequalities? Patterns and predictors of social prescribing referrals in 160,128 UK patients. Social Science & Medicine, 345, 116559. https://doi.org/10.1016/j.socscimed.2024.116559
Dr. Katie Zippel 
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