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Can social prescribing reduce health inequalities in LGBTQ+ populations?

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Can social prescribing reduce health inequalities in LGBTQ+ populations?

Michał Czapla1,2,3

  1. Department of Emergency Medical Service, Faculty of Nursing and Midwifery, Wroclaw Medical University, 51-618 Wroclaw, Poland.
  2. Group of Research in Care (GRUPAC), Faculty of Health Sciences, University of La Rioja, 26006 Logroño, Spain.
  3. Nursing Care and Education Research Group (GRIECE), Department of Nursing, University of Valencia, 46010 Valencia, Spain.

Health inequalities affecting LGBTQ+ populations are well documented and arise predominantly from social and structural determinants rather than intrinsic biological differences. These include stigma, discrimination, barriers to affirming care, and limited access to culturally competent services, all of which contribute to poorer mental and physical health outcomes1,2. Experiences of healthcare discrimination among LGBTQ+ individuals have been associated with reduced trust in physicians and may contribute to avoidance of care3. These disparities highlight the limitations of purely biomedical approaches and support the need for integrated models addressing psychosocial determinants of health.

Social prescribing (SP) has emerged as a potential strategy to address such unmet needs by linking patients to community-based, non-clinical resources. Conceptually, SP may enhance social connectedness and perceived support, with proposed mechanisms including improved navigation and relational continuity4. These mechanisms align with key determinants of health in LGBTQ+ populations, particularly social isolation and fragmented access to supportive services. Empirical evidence from qualitative syntheses suggests that SP interventions may improve wellbeing and perceived social support, particularly among individuals experiencing loneliness or psychosocial distress4. Furthermore, broader literature demonstrates that social support and identity disclosure in healthcare contexts are associated with improved self-rated health outcomes among LGBTQ+ patients5.

Despite its theoretical relevance, the empirical evidence supporting SP in LGBTQ+ populations remains limited and methodologically weak. Current literature is characterized by a predominance of descriptive and qualitative studies, with minimal use of robust experimental designs6. Systematic reviews highlight a lack of randomized controlled trials and substantial heterogeneity in intervention design, outcome measures, and populations studied4. Importantly, most studies do not disaggregate outcomes by sexual orientation or gender identity, limiting the ability to draw conclusions about effectiveness in LGBTQ+ subgroups6. This evidence gap reflects a broader disconnect between policy enthusiasm for SP and the availability of high-quality data supporting its implementation.

The effectiveness of SP is also likely contingent on the broader healthcare context in which it is implemented. Research consistently demonstrates variability in healthcare professionals’ attitudes and competencies toward LGBTQ+ patients, with significant differences observed across countries and training backgrounds2,7. For example, higher levels of LGBT-related training are associated with improved clinical preparedness and more affirmative attitudes among healthcare providers. Conversely, lack of training and persistent heteronormative assumptions contribute to discriminatory practices and reduced quality of care7. In such contexts, SP interventions may be limited in their impact if embedded within systems that lack cultural competence and inclusivity.

From a critical perspective, SP should not be viewed as a standalone solution to health inequalities but rather as a complementary component within broader system-level interventions. While it has the potential to address non-medical determinants of health, its effectiveness depends on equitable design, appropriate targeting, and integration with inclusive healthcare practices. Without these considerations, SP risks reinforcing existing disparities by disproportionately benefiting individuals with greater social capital or access to resources6. This concern is particularly relevant for marginalized subgroups within LGBTQ+ populations, who may face compounded barriers related to socioeconomic status, ethnicity, or gender identity.

SP represents a promising but still under-evaluated approach to addressing health inequalities in LGBTQ+ populations. Its conceptual alignment with key social determinants of health supports its potential utility; however, the current evidence base remains insufficient to draw robust conclusions about its effectiveness. In this context, ongoing research, including the SP-EU project, may help to strengthen the evidence base by generating data on the effectiveness and implementation of SP across diverse European settings. By combining co-creation approaches with pragmatic randomized controlled trials, such studies aim to address existing evidence gaps and inform future policy and practice.

Further high-quality empirical evidence will be essential to determine whether social prescribing can move beyond conceptual promise and contribute meaningfully to reducing health inequalities in LGBTQ+ populations.

  1. Czapla M, Stefanicka – Wojtas D, Juárez-Vela R, et al. Social prescribing and health inequalities in LGBT+ populations: A narrative review. Adv Clin Exp Med. 2026;35(12):0-0. doi:10.17219/acem/217918
  2. Karniej P, Dissen A, Del Pozo-Herce P, et al. Gay affirmative practices among healthcare professionals in Poland and Spain: results of Health Exclusion Research in Europe (HERE) study. Front Public Health. 2025;13:1568486. doi:10.3389/fpubh.2025.1568486
  3. Henning T, Weinstock M, Mazzeo SE, Pham A. Experiences of discrimination in healthcare settings, trust in providers and disordered eating behaviors in LGBTQ+ college students. Eat Disord. 2025;33(1):120-137. doi:10.1080/10640266.2024.2416343
  4. Liebmann M, Pitman A, Hsueh YC, Bertotti M, Pearce E. Do people perceive benefits in the use of social prescribing to address loneliness and/or social isolation? A qualitative meta-synthesis of the literature. BMC Health Serv Res. 2022;22(1):1264. doi:10.1186/s12913-022-08656-1
  5. Kamen CS, Smith-Stoner M, Heckler CE, Flannery M, Margolies L. Social Support, Self-Rated Health, and Lesbian, Gay, Bisexual, and Transgender Identity Disclosure to Cancer Care Providers. Oncol Nurs Forum. 2015;42(1):44-51. doi:10.1188/15.ONF.44-51
  6. Czapla M, Stefanicka – Wojtas D, Juárez-Vela R, et al. Social prescribing and health inequalities in LGBT+ populations: A narrative review. Adv Clin Exp Med. 2026;35(12):0-0. doi:10.17219/acem/217918
  7. Karniej P, Dissen A, Pietrzykowski Ł, et al. Lesbian, gay, bisexual, and transgender clinical competence of health professionals in Poland and Spain: results of the health exclusion research in Europe (HERE) study. BMC Med Educ. 2025;25(1):144. doi:10.1186/s12909-025-06744-4

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