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• THE BIG IDEA

Why travel should be considered an essential human activity

Travel is not rational, but it’s in our genes. Here’s why you should start planning a trip now.

In 1961, legendary National Geographic photographer Volkmar Wentzel captured two women gazing at the surf off Peggy’s Cove, Nova Scotia. This and all the other images in this story come from the National Geographic image collection.

I’ve been putting my passport to good use lately. I use it as a coaster and to level wobbly table legs. It makes an excellent cat toy.

Welcome to the pandemic of disappointments. Canceled trips, or ones never planned lest they be canceled. Family reunions, study-abroad years, lazy beach vacations. Poof. Gone. Obliterated by a tiny virus, and the long list of countries where United States passports are not welcome.

Only a third of Americans say they have traveled overnight for leisure since March, and only slightly more, 38 percent, say they are likely to do so by the end of the year, according to one report. Only a quarter of us plan on leaving home for Thanksgiving, typically the busiest travel time. The numbers paint a grim picture of our stilled lives.

It is not natural for us to be this sedentary. Travel is in our genes. For most of the time our species has existed, “we’ve lived as nomadic hunter-gatherers moving about in small bands of 150 or fewer people,” writes Christopher Ryan in Civilized to Death . This nomadic life was no accident. It was useful. “Moving to a neighboring band is always an option to avoid brewing conflict or just for a change in social scenery,” says Ryan. Robert Louis Stevenson put it more succinctly: “The great affair is to move.”

What if we can’t move, though? What if we’re unable to hunt or gather? What’s a traveler to do? There are many ways to answer that question. “Despair,” though, is not one of them.

In this aerial view from 1967, wall-to-wall seaside sunbathers relax under umbrellas or on beach towels in Ocean City, Maryland .

A 1967 fall festival in Guadalajara, Mexico , starred traditionally costumed musicians and dancers.

We are an adaptive species. We can tolerate brief periods of forced sedentariness. A dash of self-delusion helps. We’re not grounded, we tell ourselves. We’re merely between trips, like the unemployed salesman in between opportunities. We pass the days thumbing though old travel journals and Instagram feeds. We gaze at souvenirs. All this helps. For a while.

We put on brave faces. “Staycation Nation,” the cover of the current issue of Canadian Traveller magazine declares cheerfully, as if it were a choice, not a consolation.

Today, the U.S. Travel Association, the industry trade organization, is launching a national recovery campaign called “ Let’s Go There .” Backed by a coalition of businesses related to tourism—hotels, convention and visitor bureaus, airlines—the initiative’s goal is to encourage Americans to turn idle wanderlust into actual itineraries.

The travel industry is hurting. So are travelers. “I dwelled so much on my disappointment that it almost physically hurt,” Paris -based journalist Joelle Diderich told me recently, after canceling five trips last spring.

(Related: How hard has the coronavirus hit the travel industry? These charts tell us.)

My friend James Hopkins is a Buddhist living in Kathmandu . You’d think he’d thrive during the lockdown, a sort-of mandatory meditation retreat. For a while he did.

But during a recent Skype call, James looked haggard and dejected. He was growing restless, he confessed, and longed “for the old 10-countries-a-year schedule.” Nothing seemed to help, he told me. “No matter how many candles I lit, or how much incense I burned, and in spite of living in one of the most sacred places in South Asia, I just couldn’t change my habits.”

When we ended our call, I felt relieved, my grumpiness validated. It’s not me; it’s the pandemic. But I also worried. If a Buddhist in Kathmandu is going nuts, what hope do the rest of us stilled souls have?

I think hope lies in the very nature of travel. Travel entails wishful thinking. It demands a leap of faith, and of imagination, to board a plane for some faraway land, hoping, wishing, for a taste of the ineffable. Travel is one of the few activities we engage in not knowing the outcome and reveling in that uncertainty. Nothing is more forgettable than the trip that goes exactly as planned.

Related: Vintage photos of the glamour of travel

Travel is not a rational activity. It makes no sense to squeeze yourself into an alleged seat only to be hurled at frightening speed to a distant place where you don’t speak the language or know the customs. All at great expense. If we stopped to do the cost-benefit analysis, we’d never go anywhere. Yet we do.

That’s one reason why I’m bullish on travel’s future. In fact, I’d argue travel is an essential industry, an essential activity. It’s not essential the way hospitals and grocery stores are essential. Travel is essential the way books and hugs are essential. Food for the soul. Right now, we’re between courses, savoring where we’ve been, anticipating where we’ll go. Maybe it’s Zanzibar and maybe it’s the campground down the road that you’ve always wanted to visit.

(Related: Going camping this fall? Here’s how to get started.)

James Oglethorpe, a seasoned traveler, is happy to sit still for a while, and gaze at “the slow change of light and clouds on the Blue Ridge Mountains” in Virginia, where he lives. “My mind can take me the rest of the way around this world and beyond it.”

It’s not the place that is special but what we bring to it and, crucially, how we interact with it. Travel is not about the destination, or the journey. It is about stumbling across “a new way of looking at things,” as writer Henry Miller observed. We need not travel far to gain a fresh perspective.

No one knew this better than Henry David Thoreau , who lived nearly all of his too-short life in Concord, Massachusetts. There he observed Walden Pond from every conceivable vantage point: from a hilltop, on its shores, underwater. Sometimes he’d even bend over and peer through his legs, marveling at the inverted world. “From the right point of view, every storm and every drop in it is a rainbow,” he wrote.

Thoreau never tired of gazing at his beloved pond, nor have we outgrown the quiet beauty of our frumpy, analog world. If anything, the pandemic has rekindled our affection for it. We’ve seen what an atomized, digital existence looks like, and we (most of us anyway) don’t care for it. The bleachers at Chicago ’s Wrigley Field; the orchestra section at New York City ’s Lincoln Center; the alleyways of Tokyo . We miss these places. We are creatures of place, and always will be.

After the attacks of September 11, many predicted the end of air travel, or at least a dramatic reduction. Yet the airlines rebounded steadily and by 2017 flew a record four billion passengers. Briefly deprived of the miracle of flight, we appreciated it more and today tolerate the inconvenience of body scans and pat-downs for the privilege of transporting our flesh-and-bone selves to far-flung locations, where we break bread with other incarnate beings.

Landscape architects work in their Rio de Janeiro, Brazil , studio in 1955.

A tourist photographs a towering century plant in St. Thomas, U.S. Virgin Islands, in 1956.

In our rush to return to the world, we should be mindful of the impact of mass tourism on the planet. Now is the time to embrace the fundamental values of sustainable tourism and let them guide your future journeys. Go off the beaten path. Linger longer in destinations. Travel in the off-season. Connect with communities and spend your money in ways that support locals. Consider purchasing carbon offsets. And remember that the whole point of getting out there is to embrace the differences that make the world so colorful.

“One of the great benefits of travel is meeting new people and coming into contact with different points of view,” says Pauline Frommer, travel expert and radio host.

So go ahead and plan that trip. It’s good for you, scientists say . Plotting a trip is nearly as enjoyable as actually taking one. Merely thinking about a pleasurable experience is itself pleasurable. Anticipation is its own reward.

I’ve witnessed first-hand the frisson of anticipatory travel. My wife, not usually a fan of travel photography, now spends hours on Instagram, gazing longingly at photos of Alpine lodges and Balinese rice fields. “What’s going on?” I asked one day. “They’re just absolutely captivating,” she replied. “They make me remember that there is a big, beautiful world out there.”

Many of us, myself included, have taken travel for granted. We grew lazy and entitled, and that is never good. Tom Swick, a friend and travel writer, tells me he used to view travel as a given. Now, he says, “I look forward to experiencing it as a gift.”

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6 Why Travel? The Sociological Perspective

• Published: July 2021
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This chapter explores sociological perspectives, demonstrating how travelling impacts social structures and well as mobility through class and social status. The examples of the search for freedom and social mobility show how mass movements have occurred due to the desire to move from the place and position in which people were born to different positions in the social structure. Moving from one socioeconomic group to another is strongly related with the ability to move jobs, housing, and social groups all of which are enabled by travel. The expansion of mass travel has enabled family structures to survive even though the traditional three generational family residing and working near to each other has largely disappeared. Of course, such ability to travel freely is not available to all equally and the chapter also flags up the disadvantages caused by lack of travel based on income, gender and disability. The chapter also considers the way in which travel shapes and reinforces political beliefs.

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Who’s a tourist? How a culture of travel is changing everyday life

Professor of Sustainable Tourism and Director Griffith Institute for Tourism, Griffith University

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Susanne Becken does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

Griffith University provides funding as a member of The Conversation AU.

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Every year, on September 27, the global tourism community celebrates World Tourism Day . This year’s theme is about community development and how tourism can contribute to empowering people and improve socio-economic conditions in local communities.

But who are the people who might visit “communities” and what does it mean – these days – to be a tourist?

There are many tourist stereotypes – an overweight Westerner in shorts with a camera dangling around their neck, or maybe a trekking-shoed backpacker hanging out in the Himalayas. Many people think of “tourism” and “holidays” as distinct times of the year when the family travels to the seaside or the mountains.

World Tourism Day is an opportunity to discuss how much more encompassing the phenomenon of tourism is than most people might think.

What is a tourist?

People are more often a “tourist” than they realise. The United Nations World Tourism Organisation broadly defines a tourist as anyone travelling away from home for more than one night and less than one year. So, mobility is at the core of tourism.

In Australia, for example, in 2013 75.8 million people travelled domestically for an overnight trip – spending 283 million visitor nights and $51.5 billion.

Reasons for travel are manifold and not restricted to holidays, which makes up only 47% of all domestic trips in Australia. Other reasons include participation in sport events, visiting a friend or relative, or business meetings.

Some of the most-visited destinations in the world are not related to leisure but to other purposes. For example, pilgramage tourism to Mecca (Saudi Arabia) triples the population from its normal 2 million during the Hajj period every year.

Travel, work and leisure: what’s the difference?

Tourists are not what they used to be. One of the most pervasive changes in the structure of modern life is the crumbling divide between the spheres of work and life. This is no more obvious than in relation to travel. Let me test the readers of The Conversation: who is checking their work emails while on holiday?

A recent survey undertaken in the US showed that 44.8% of respondents check their work email at least once a day outside work hours. Further, 29.8% of respondents use their work email for personal purposes.

Post-modern thinkers have long pointed to processes where work becomes leisure and leisure cannot be separated from work anymore. Ever-increasing mobility means the tourist and the non-tourist become more and more alike.

The classic work-leisure divide becomes particularly fluid for those who frequently engage in travel, for example to attend business meetings or conferences. Conferences are often held at interesting locations, inviting longer stays and recreational activities not only for participants but also for spouses and family.

Further, city business hotels increasingly resemble tourist resorts: both have extensive recreational facilities such as swimming pools and spas, multiple restaurants and often shopping opportunities (e.g. Marina Bay Sands, Singapore ). And, of course, they offer internet access – to be connected to both work and private “business”.

Understanding how people negotiate this liquidity while travelling provides interesting insights into much broader societal changes in terms of how people organise their lives.

For some entrepreneurial destinations these trends have provided an opportunity; namely the designation of so-called dead zones – areas where no mobile phone and no internet access are available. Here the tourist can fully immerse in the real locality of their stay.

Fear of missing out

The perceived need to connect virtually to “friends” (e.g. on Facebook) and colleagues has attracted substantial psychological research interest, with new terms being coined such as FOMO (fear of missing out) addiction, or internet addiction disorder.

A recent Facebook survey found that this social media outlet owes much of its popularity to travel – 42% of stories shared related to travel. The motivations for engaging in extensive social media use and implications for tourism marketing are an active area of tourism research.

Thus, understanding why and what people share while travelling (i.e. away from loved ones, but possibly earning important “social status” points) might provide important insights into wider questions of social networks and identity formation, especially among younger people.

Tourism and emigration

The increasingly global nature of networks has been discussed in detail by sociologist John Urry and others. They note the growing interconnectedness between tourism and migration, where families are spread over the globe and (cheap) air travel enables social networks to connect regularly.

As a result, for many people local communities have given way to global communities, with important implications for people’s “sense of place” and resilience. The global nature of personal networks extends to business relationships where the degree to which one is globally connected determines one’s “network capital”.

Urry also noted that mobility has become a differentiation factor between the “haves” and “have nots”, with a small elite of hypermobile “connectors”. Thus travel and tourism sit at the core of a potentially new structure of leaders and influential decision makers.

The global ‘share economy’

Engaging in this global community of tourists is not restricted to those who travel actively. The so-called Share Economy , where people rent out their private homes (e.g. AirBnB), share taxi rides or dinners, has brought tourism right into the living rooms of those who wish to engage with people who they may not meet otherwise.

Potentially this parallel “tourism industry” provides a unique opportunity for bringing people together and achieving peace through tourism (see International Institute for Peace through Tourism ). A whole new area for research travellers, “guests and hosts” and their economic impacts, is emerging.

In a nutshell, tourism is much more than the service industry it is usually recognised for, both in practice and as a field of academic enquiry. Tourism and the evolving nature of travellers provide important insights into societal changes, challenges and opportunities. Engaging with tourism and travel also provides us with an excellent opportunity to better understand trends that might foster or impede sustainable development more broadly.

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In This Article Expand or collapse the "in this article" section Sociology of Tourism

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Sociology of Tourism by Erdinç Çakmak LAST REVIEWED: 23 August 2022 LAST MODIFIED: 23 August 2022 DOI: 10.1093/obo/9780199756384-0263

The sociology of tourism studies tourists’ relationships, roles, and motivations and the ongoing exchange among tourists, institutions, and host communities. Tourism cannot be treated in isolation since it embodies all tourism practices in a system they operate in. Thus, tourism is a complex sociocultural, economic, and political phenomenon and touches all levels of society. The investigation of tourism’s role in society, the tourism system’s effects on nature, tourism spaces, objects, practices, relationships, and the tourist typologies demand systematic sociological investigations. A researcher needs to consider the whole macro system through its members’ social, political, cultural, and economic interactions. In such a social context, both human and nonhuman actors continuously shape and reshape the tourism system, and the tourism system reshapes these actors’ values, attitudes, and behaviors. Researchers examining the sociology of tourism departed from several theoretical Perspectives , blended theory and method, and focused on sociological concepts to understand and explain the different aspects of tourism. This group of scholars has been working within the several cores of sociology (e.g., education, family, economy, development, religion, gender, language, migration, social inequalities, labor, art) and at the margins of emerging interdisciplinary formations, including those crossing many disciplines such as geography, anthropology, economics, political science, psychology, marketing, communication, women’s studies, history, and cultural studies. The sociology of tourism studies engendered transdisciplinary conversations both in academia and in practice, and the results of these studies have created pragmatic changes in tourism practices, habits, and governance.

Five scholars, judging from the Google Scholar citation counts of their critical works on the sociology of tourism, have contributed to the field in an original and pioneering way. These leading scholars’ abundant and consistent publications have provided the foundation for a sociological approach to tourism. They can be called the established leaders of the sociology of tourism, and are listed here alphabetically: Erik Cohen, Graham Dann, Marie-Françoise Lanfant, Dean MacCannell, and John Urry. Cohen 1972 opposed treating tourists as a homogenous mass and provided a heuristic tourist typology ranging from familiarity to strangeness. Later, Cohen 1984 classified tourism’s sociology into four main areas: tourist as a traveler, tourists’ relationships with hosts, the tourism system, and tourism impacts. MacCannell’s 1973 seminal article on staged authenticity spotlighted the relationship between tourism and (Western) modernity, which became an essential research agenda for the sociology of tourism in the last quarter of the twentieth century. MacCannell 1976 argued that alienated modern tourists are motivated by a quest for authenticity in their travels, but this quest is thwarted through a “staged authenticity” offered by host communities. Dann 1977 sought to answer the question “what makes tourists travel?” and employed the themes of anomie and collective representations in the sociology of tourism research. He combined anomie with status enhancement in a motivational study of tourists and provided the first empirical results of the presentation and profiles of anomic tourists. Besides this approach, Dann 1996 took a sociolinguistic approach and examined the promotional counterpart of tourist motivations in “the language of tourism” using semiotic analyses. Lanfant 1980 emphasized the international dimension of tourism. She argued that tourism is a “total social phenomenon” which challenges identity formation. Lanfant, et al. 1995 transcended the dichotomy between seeing tourism as either business or not business and suggested a novel approach reflecting the fundamental level of reality in tourism practice. Urry 1990 introduced Foucault’s concept of “gaze” into tourism discourse. Urry prioritized the visual sense of gaze and distinguished the tourist gaze as “romantic” and “collective” without concerning other Foucauldian issues of power and authority. By introducing the concept “gaze” into tourism, Urry made a crucial theoretical opening in the sociology of tourism, and other scholars followed him by focusing further on the body and other senses. Later in the decade, Urry 1999 proposed studying journeys, connections, and flows (both physical and virtual movements) as mobile theories and mobile methods and that this be placed at the top of the research agenda.

Cohen, E. 1972. Toward a sociology of international tourism. Social Research 39:64–82.

This article stresses the travel dimension of tourism and devises tourist typologies along a continuum from familiarity to strangeness. It emphasizes the differences among tourists and calls for further examination of their travel types’ attitudes, motivations, and behavior.

Cohen, E. 1984. The sociology of tourism: Approaches, issues, and findings. Annual Review of Sociology 10.1: 373–392.

DOI: 10.1146/annurev.so.10.080184.002105

This is a crucial academic text for understanding the classification of the sociology of tourism. Cohen classifies tourism into four main areas: tourists, their interaction with hosts, the tourism system, and tourism impacts. Following this article, scholars have given more attention to systematic empirical research in the field.

Dann, G. M. 1977. Anomie, ego-enhancement and tourism. Annals of Tourism Research 4.4: 184–194.

DOI: 10.1016/0160-7383(77)90037-8

This paper maintains that tourists’ anomie (i.e., absence of the general societal and ethical standards) needs to be investigated at the pre-travel level. This sociopsychological research is the first empirical research of tourists’ attitudes and behavior and it provides a firmer theoretical and empirical footing to the literature on tourist profiles.

Dann, G. M. 1996. The language of tourism: A sociolinguistic perspective . Wallingford, UK: CAB International.

This book analyzes the verbal framing of tourists’ experiences. Paradigms on social control, the tourist as a child, and the tourism media from the printed word to television screen have been brought together with semiotic analyses at a quality level.

Lanfant, M. F. 1980. Introduction: Tourism in the process of internationalisation. International Social Science Journal 32.1: 14–43.

This article captures the multipolarity of tourism as a particular form of consumption. The author provides insights into world tourism organizations and the role of international bodies and tour operators by using the methodological principles of systems analysis.

Lanfant, M. F., J. B. Allcock, and E. M. Bruner, eds. 1995. International tourism: Identity and change . London: SAGE.

This book offers a novel approach in examining how tourism transcends individual societies and has become an international fact. It emphasizes the necessity of understanding the local and global developments simultaneously. The volume argues that local social practices cannot be understood independently of the global, and that the global practices are never independent of the local setting in which they operate.

MacCannell, D. 1973. Staged authenticity: Arrangements of social space in tourist settings. American Journal of Sociology 79.3: 589–603.

DOI: 10.1086/225585

This academic article and the ensuing book have dominated the discussions in the sociology of tourism in the last quarter of the twentieth century. This study describes the alienation of Western tourists and their search for authentic experiences in other times and places while hosts modify a cultural practice for tourism.

MacCannell, D. 1976. The tourist: A new theory of the leisure class . New York: Schocken.

This is the most influential book in the sociology of tourism and it portrays the role of tourists in postindustrial society. Tourists seek meanings to their deepest longings and travel as pilgrims to the secular world, paying homage to various attractions that are symbols of modernity.

Urry, J. 1990. The tourist gaze: Leisure and travel in contemporary societies . London: SAGE.

This book takes a postmodernist perspective and describes the foundation of tourist behavior in the form of a tourist gaze. Here tourism becomes a performance and acts as a central element in the broad cultural changes in contemporary society.

Urry, J. 1999. Sociology beyond societies: Mobilities for the twenty-first century . London: Routledge.

In this book, Urry suggests the necessity of replacing the examination of society as the traditional basis of sociology from bounded clusters and objects of a region to networks and fluids in the borderless world. The book studies the physical and virtual movements of people, ideas, messages, money, and waste products across international borders.

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Introduction

Sometimes travel confers status (the type of car you drive or travelling First Class) and at other times travel is a consequence of social status (travelling further and more often).

The latter has been the main topic of study by researchers and transport professionals. The factors by which we measure social class – personal and family income and employment opportunities – all influence travel patterns. Thus people have always wanted sunshine but this was only made possible by the appearance of budget airlines.

But we know less about the role of status in influencing travel choices – a problem well known to operators who struggle to persuade higher income groups to travel on bus and coach even when this is a sensible choice.

There are also other factors which can explain travel patterns such as age, gender and ethnic background.

While the rich may have always set the standards, the actual social competition used to be played out largely at the neighbourhood level, among people in roughly the same class. In recent years as people have become increasingly isolated from their neighbours, a media barrage celebrating the toys and totems of the rich has fostered a whole new level of desire across class groups. The old system was keeping up with the Joneses, the new system is keeping up with the Beckhams (Professor Juliet B Shor, Chair of Sociology, Boston College)

Key Aspects

Travel choice and social status.

There are social status benefits from certain types of travel, such as gap year and tourist travel, and kudos stemming from second homes and distant or exotic holiday destinations. Even at a more prosaic level social mobility can be affected by modes of travel and the ability to ignore the constraints of time, distance and cost. First class travel by train, internal flights in the UK or the casual use of taxis rather than public transport all involve social status rather than solely instrumental benefits. In which case, travel in itself becomes an indicator of social status and enhanced social mobility. An interesting debate is currently taking place about the traditional role of the car as an indicator of status. As cities change, driving becomes less attractive and even rather passé, while consumers look to new symbols of status equally indicative of social class such as smart phones, bicycles or trainers.

The interrelationship between transport and neighbourhood status

Travel opportunity is not just an indicator of individual social status. The social complexion of a local area can be directly enhanced by the quality of transport provision. The proximity of underground stations and rail terminals can increase the social capital of groups who might not necessarily qualify at the individual level. The interaction between the social status of a neighbourhood and travel provision can be seen in parallel with developments in schools, housing and job creation. Advances in area social mobility can produce a ‘gentrification process’ and certainly increase house prices. This in turn can squeeze out the original residents and undermine social cohesion. This aspect of the social equity impact of transport development is difficult to take into account when assessing the impact of new transport infrastructure as against the overarching need for capacity and regeneration. An example is the strong increase in house prices around the Jubilee Line extension.

In the film of Billy Liar based on the book by Keith Waterhouse (1959), Billy realizes that his status will be enhanced by leaving Leeds and travelling to London. Indeed it could be argued that transport policy in UK is dominated by the pull of London. In the end his more ambitious girlfriend makes it and the final scene of the film shows Julie Christie catching the train and Billy (the loser) played by Tom Courtney left behind.

Practical Implications

Travel choice.

Research has shown that when people plan journeys, there are different ‘styles’ of travel choice ranging from very rational to habitual. These choice styles are closely related to social class with the more affluent groups generally making better informed decisions researching the best options and deals. As these choices become more complex it is likely that poorer people will miss out on travel opportunities and pay more pro rata.

Fair Transport Policies

Social scientists answer the question of ‘why travel’ in terms of lifestyle and social status. Understanding these issues is a prerequisite to developing fair transport policies and achieving behavioural change towards more sustainable transport.

Further Reading/Resources

Gary Runciman, Relative Deprivation and Social Justice: a study of attitudes to social inequality in twentieth-century Britain (1966). The key text raising the importance of reference groups in defining social class and status.

Billy Liar (1959) Keith Waterhouse

Department for Trasnport, Assessing Social and Distributional Aspects of Transport Appraisal (2009) http://webarchive.nationalarchives.gov.uk/2009050515223C

Stephen Bayley, Sex, Drink and Fast Cars (1986) Raises the influence of design and status in transport choice.

Key Questions

Do new transport links always result in local housing becoming unaffordable and traditional jobs disappearing?

Does the ability to make rational transport choices vary by socio-economic factors?

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• Anthropology
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• The Environment

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Social tourism

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Social tourism refers to initiatives aimed to include groups that would otherwise be excluded from tourism. Its earliest definition refers to “the relationships and phenomena in the field of tourism resulting from participation in travel by economically weak or otherwise disadvantaged elements in society” (Hunzicker 1951 :1). Other scholars have defined it as tourism with an added moral value, of which the primary objective is to benefit the host or the tourist populations (Minnaert et al. 2011 ). In practice, social tourism usually refers to budget-friendly domestic holidays. In some cases, day trips to themeparks, museums, and attractions are funded or made available at highly reduced rates by charities or agencies in the public sector.

Structure and operation

Social tourism initiatives can be provided by the public or the voluntary sector . In Anglo-Saxon countries, charities usually play a key role, whereas in mainland Europe and several countries in Latin America, the public sector...

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Family Holiday Association 2013 The Family Holiday Association www.familyholidayassociation.org.uk (5 March 2015).

Hunzicker, W. 1951 Social Tourism: Its Nature and Problems. Berne: International Tourists Alliance Scientific Commission.

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Imserso 2009 Instituto de Mayores y Servicios Sociales www.imserso.es (5 March 2015).

McCabe, S. 2009 Who Needs a Holiday? Evaluating Social Tourism. Annals of Tourism Research 36:667-688.

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McCabe, S., L. Minnaert, and A. Diekmann 2011 Social Tourism in Europe: Theory and Practice. Bristol: Channel View.

Minnaert, L., R. Maitland, and G. Miller 2011 What is Social Tourism? Current Issues in Tourism 5:403-415.

Minnaert, L., B. Quinn, K. Griffin, and J. Stacey 2010 Social Tourism for Low-income Groups. In Tourism and Inequality, S. Cole and N. Morgan, eds., pp.38-57. Wallingford: CABI.

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Minnaert, L. (2016). Social tourism. In: Jafari, J., Xiao, H. (eds) Encyclopedia of Tourism. Springer, Cham. https://doi.org/10.1007/978-3-319-01384-8_182

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What Does Social Tourism Mean and How it is Redefining Travel? 

What does social tourism mean? 

How is it usually financed , what is the objective of social tourism , how can we help social tourism , real-life examples, final thoughts .

The tourism industry offers an abundance of benefits. It encourages economic growth, creates jobs, and brings massive amounts of revenue to some of the most popular tourism destinations. However, it’s not always beneficial directly to the local communities, and it’s not always accessible to all . 

On average, from every $100 spent by travelers in developing countries, only $5 stays in the local economy , resulting in significant tourism leakage . The widely-adopted traveling practices such as booking hotel accommodations, buying mass-produced souvenirs, or choosing international food chains rather than local restaurants often cause long-term harm to the community. 

Not to mention the issues of over-tourism that disrupts the daily life of the locals, increases pollution, and harms the environment. 

Fortunately, trends are changing in the tourism sector. Travelers are becoming increasingly aware of the consequences of over-tourism and how this issue is impacting the destinations they visit – which is why more and more people are starting to adopt social and sustainable tourism . 

Social tourism is a growing trend that prioritizes building positive relationships between visitors and host communities and developing “ programs, events, and activities that allow all population groups to enjoy tourism ”. 

Take a look below to learn what social tourism entails and how it’s redefining travel. 

Social tourism is a broad concept that encompasses countless events and activities. Different holiday types, such as working holidays , for instance, can fall under the category of social tourism. Activities you engage in at the destination, the type of destination you choose, and even the type of accommodation you book or some unique client group a tourism organization works with could all be labeled as social tourism. 

In a nutshell, social tourism focuses on providing economic, social, and cultural benefits to travelers and their host communities. 

On the one hand, travelers can participate in social tourism by contributing to their destinations – volunteering, participating in local projects, helping build homes for disadvantaged local groups, supporting local artists and crafters, donating, and more. 

On the other hand, some travelers can be the beneficiaries of social tourism . Countless government and private tourism organizations provide travel opportunities to those groups that wouldn’t otherwise be able to enjoy traveling – impoverished families, people with disabilities, children, and seniors, for instance. 

Moreover, some popular travel destinations are starting to invest in building a more accessible infrastructure that improves the traveling experience for all. You’ll find wheelchair-accessible beaches in Cyprus , braille-etched railings at Castel Sant’Elmo in Naples, and “ touchable paintings ” at museums worldwide. 

Considering that social tourism can take many forms, it’s not surprising that it’s known under many different names – sustainable tourism, accessible tourism, tourism for all, enlightening tourism, and responsible tourism , among others. 

Social tourism can be financed in one of several ways, depending on its particular type. If you want to contribute to the destination you’re visiting, you’d most commonly have to finance any activities and events you participate in out of pocket . 

You could join a charitable organization that covers expenses for certain activities, such as building homes for the locals, for instance, where it might cover the costs of the materials. However, you’d still likely have to pay for any other travel-related expenses yourself – accommodation, transportation, food, and more. 

Social tourism events and activities for children, impoverished families, people with disabilities, and others, on the other hand, are most commonly fully financed by local and federal governments , employers, non-profit organizations, and charities . On occasion, the participants could even receive a small spending allowance that enables them to fully enjoy their travels. 

The main objectives of social tourism include: 

• Supporting local communities – leaving a positive mark on the communities in your travel destinations; 
• Discovering new destinations – visiting places off the beaten path and going to less traveled-to countries; 
• Learning about new cultures – getting to know the locals, their languages, cultures, traditions, and history; 
• Providing economic benefits to host countries – shopping local, investing in arts and crafts from the local artists, improving the local economy; 
• Making travel accessible to all – allowing everyone to experience the wonders of traveling, regardless of their socio-economic group, age, health, or more. 

Ultimately, the main goal of social tourism is connecting travelers with their host countries, helping build international relationships, and making travel more enjoyable and more responsible. 

There are multiple ways to promote and support social tourism: 

• Support charities and non-profits – many social tourism charities rely on contributions from individuals to create immersive programs and activities that help tourists and host countries; 
• Make donations – donate to relevant organizations that support local communities in your favorite travel destinations or those that offer travel opportunities to underprivileged groups in your area; 
• Volunteer – join volunteer groups that connect you with locals; 
• Avoid popular destinations – go off the beaten path and travel to lesser-known destinations; 
• Talk to your local government representatives – as many social travel activities are government-funded, you can talk to the local representatives to find the best ways to support social tourism. 

You don’t have to go out of your way to support social tourism. Even minor changes to your typical traveling habits could help – booking accommodation with a host family instead of a hotel, buying souvenirs from local artists, eating at small local restaurants, recycling while traveling, and more. 

As evidenced so far, Social Tourist isn’t just a Charlie D’Amelio’s apparel brand. It’s an increasingly important concept that presents immeasurable benefits to travelers and their host communities. Therefore, it’s not surprising that we’re seeing more and more real-life examples of social tourism. 

Take a look at just a few organizations that are helping make social tourism mainstream. 

Make a Difference (MAD) Travels 

Make a Difference (MAD) Travels is a unique social entrepreneurship based in the Philippines. It offers sustainable, one-of-a-kind travel experiences to international tourists who want to make a difference. It focuses on building relationships between travelers and their destinations of choice , leading exciting off-the-beaten-path tours, introducing travelers to the local cultures, and offering educational courses and experiences. 

What’s more, MAD Travels enables you to support local communities even from a distance. You can support communities in Zambales or Rizal by gifting a tree planted on your behalf or shopping for local Filipino products like organic honey or bamboo straws directly from the Mad Travels site. 

Awaken 

Awaken is all about traveling with a purpose. Based in Ecuador, it started as an at-risk youth foundation and has evolved into a social tourism organization that helps you support the communities you visit while enjoying immersive travel experiences. 

The organization’s main aim is to support children and their parents who come from juvenile detention centers and immerse them back into society. By joining one of Awaken’s programs, you can travel to some of Ecuador’s most mesmerizing destinations, join volunteer groups, go on active tours, and learn all about the local people, culture, and history. 

Invisible Cities 

Invisible Cities is a UK-based social enterprise that supports homeless people through travel. Currently available only in some of the biggest cities in the UK, including Glasgow, Manchester, Edinburgh, Cardiff, and York, it helps teach homeless people how to become walking tour guides in their cities. 

Invisible Cities offers comprehensive skill-building training and encourages its guides to deliver authentic tours focusing on the monuments and locations they have chosen. 

The organization aims to dispel myths and stereotypes regarding homelessness and improve the lives of those impacted by it. 

Operation Groundswell 

Operation Groundswell offers immersive programs across Central and South America, East Africa, and Asia, redefining backpacking experiences and allowing you to get truly immersed in the cultures you’re exploring. 

Started by a group of backpacking enthusiasts, it’s grown to be one of the largest organizations of its kind. You can join open, pre-planned programs or even design your own custom experiences. Choose the regions you want to visit, select the theme you’d like to learn more about (such as human rights, health, environment, or education), and design an active holiday you’ll never forget. 

Good Travel 

Good Travel promotes travel experiences that lead to a positive social, economic, and environmental impact. To that end, the organization collaborates with local businesses that give back to their communities, partners with international non-profit organizations, and donates to countless global charities. 

Each trip is designed to fit the Good Travels ethos, offset our carbon footprint, support marginalized groups, boost the local economy, and deliver memorable travel experiences. 

Although there are many pre-planned trips to countries like Peru, New Zealand, Fiji, and others, you can also develop a personalized itinerary that suits your traveling preferences. 

Okavango Craft Brewery 

Okavango Craft Brewery in Northern Botswana is a unique addition to the list. Not specifically created as a social tourism organization but rather a great local brewery with a cause, it enables you to support Okavango’s people and elephants and enjoy good beer made from locally-sourced ingredients. 

As you enjoy your dinner and drinks, you’ll help the brewery support the NGO EcoExist non-profit organization that helps promote a sustainable existence between farmers and elephants in areas with high elephant-human conflict. If you’re traveling in the area, pay the brewery a visit to help support the farmers that allow you to enjoy local beers. 

Have Fun Do Good 

Have Fun Do Good (HFDG) is an organization developed for adventure-seekers who want to do good on their travels. Whether staying close to home or traveling to far-off destinations, HFDG helps you create immersive travel experiences and join volunteer programs that enable you to make a difference. 

You’ll get to meet new people, explore beautiful locations, learn about new cultures, and support international charities. 

HFDG offers small group travel experiences and corporate events that can improve your team-building and help your business support good causes. 

International Social Tourism Organisation (ISTO)

International Social Tourism Organisation (ISTO) is one of the largest (and oldest) social tourism non-profits, established in 1963. It promotes responsible, accessible tourism for all that benefits individuals and communities across the globe. 

The organization has five primary goals to improve: 

• Accessibility; 
• Fair business; 
• Environment; 
• Solidarity; 
• Quality of life. 

ISTO aims to make leisure, holidays, and tourism accessible to all – the youth, seniors, people with disabilities, and others. It partners with local businesses and governments to create opportunities for everyone to enjoy tourism without limitations while simultaneously supporting and benefiting the local populations, their cultural heritage, and their environment. 

Elevate Destinations 

Elevate Destinations operates under the belief that travel is sacred, and as such, it should always have a positive social and environmental impact. Therefore, it offers memorable travel experiences that help you find greater meaning in the world while connecting with coglobal communities, supporting the environment, and preserving our natural surroundings. 

Elevate Destinations offers immersive, family-friendly trips, adventurous travels for adrenaline-seekers, learning journeys, charity challenges, donor travel experiences, and more for individuals and organizations alike. 

Moreover, it’s developed a new travel program, “Buy a Trip, Give a Trip”, that allows you to support local youths. The program gives local children an opportunity to visit some of the most popular tourist sites in their own countries. 

Responsible Travel 

Last but certainly not least is Responsible Travel , an organization that focuses on nature preservation and empowering local communities. It prioritizes responsible travel, reducing carbon emissions, developing accessible travel opportunities, and organizing volunteer events that allow you to give back to the communities you’re visiting. 

It also has a “Trip for Trip” program that allows you to send a disadvantaged child on a day trip when you book your own holiday, all at no additional cost. 

Social tourism is quickly taking off, becoming one of the biggest tourism trends of the decade. Allowing you to visit some of the most astonishing destinations, support your host communities, preserve nature, and make travel accessible to all, social tourism is making a world of difference one trip at a time. 

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Marc Truyols has a degree in Tourism from the University of the Balearic Islands. Marc has extensive experience in the leisure, travel and tourism industry. His skills in negotiation, hotel management, customer service, sales and hotel management make him a strong business development professional in the travel industry.

Mize is the leading hotel booking optimization solution in the world. With over 170 partners using our fintech products, Mize creates new extra profit for the hotel booking industry using its fully automated proprietary technology and has generated hundreds of millions of dollars in revenue across its suite of products for its partners. Mize was founded in 2016 with its headquarters in Tel Aviv and offices worldwide.

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What is social travel? Just ask our community

By Dominic Oliver

Lover of literature and all things travel. Probably happiest sitting on a tiny plastic stool on the side of a bustling Vietnamese street. Head of Creative Communications for Contiki. 7 years in the travel industry. Currently based in London.

Published on Jan 27, 2022 | 3 min

What is social travel?

Social travel . It’s the thing we’ve been perfecting for 60 years: the Contiki magic that makes people fall in love with each destination, each experience, and each other.  It’s an amazing feeling. But like all the best feelings, it’s sometimes difficult to put into words. So, with a bit of help from you, our travelers, we’re here to explain all.

“I made unforgettable memories, with unforgettable people, in the most unforgettable places! This trip has given me friends that I will hold onto for the rest of my life.” Alexa C

Social travel is friendships like these

Social travel isn’t group travel (ie. retirees trudging around after a tour guide with a plastic flag). It’s like-minded travelers around the world, getting together, expanding their social networks, sharing experiences, pushing away from their comfort zones and becoming part of a global community.

Because when you’re young and hungry for adventure, don’t you want to explore with people looking for the same things? That’s how you make friends you’ll hold onto for the rest of your life. We couldn’t have put it any better ourselves, Alexa C… (Chung?)

“It’s been 2 months since I went on my trip. Not a day has gone by that I haven’t recalled a fond memory, told a funny story or looked at the hundreds and hundreds of photos I took.” Anon

Social travel is memories like this

The great thing about social travel, is that it continues when the trip ends. It lives on in the lifelong friendships you’ve made. But more than that, it lives on in the memories that’ll still make you smile/laugh/cry in 10 years time.

Sometimes these memories are the big things, like hiking the Inca Trail with your Peru Contiki Crew. Sometimes it’s the silly stuff: when you nearly missed the coach because of the night before, or belted out Alicia Keys all day in New York, or when you completely messed up making your own pasta in Rome. Because when you remember those songs, smells or sights, you also remember the people you shared them with. That’s what social travel is all about.

“I’ve always said the my travelers start a trip as strangers, become friends then leave as family.” Dylan – Contiki Trip Manager.

Social travel is experts like these

If social travel is Contiki magic, our Trip Managers are the mages. They don’t just know everything about the places you visit, and the travel experiences you’ll do. They’re also experts at bringing a group closer together. Whether it’s icebreakers, games, expert travel planning, or just a commitment to having a good time, they’re never happier than when watching a group of strangers turn into the tightest of travel families. Good on ya, Dylan.

“I made a whole bunch of new friends from other countries, which was a nice surprise as I was traveling alone. Would recommend!” Lianne

Social travel is solo, without the oh no

You can join Contiki trips as a solo traveller (in fact almost 60% of our travelers join solo). Our trips are creatively designed to construct group dynamics fast so believe us: it won’t feel like you’re solo for very long.

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How the Social Travel Trend Has Changed Solo Travel

Social travel is a great way to interact with locals and fellow travelers. But you may wonder what exactly this is! If so, learn more here!

Many moons ago, solo travelers, especially women traveling alone, were looked at with a mix of pity and awe. Overall, people weren’t exactly sure why anyone would choose to travel solo. Luckily, the perception and experiences of solo travelers have changed significantly over the past few decades. Much of this has been due to the rise of social travel.

Social travel has been able to bring people together from around the world. This includes not only locals in a destination but other travelers as well. It helps cultivate a situation where people can learn from one another and about themselves. In many ways, social travel can be seen as an equalizer when approached responsibly. It’s had a major impact on solo travel by giving people tons of great opportunities for interaction and engagement. This can be “formal” like staying in homestays or Airbnbs or “informal” like meeting a random traveler at a hostel and traveling together for a while. 

Come together with Let’s Roam .

Here at Let’s Roam, we know how incredibly important relationships are. One of our main goals is to bring people together! We’ve created a wide range of scavenger hunts , virtual games , and adventure books to help you turn the ordinary into the extraordinary! To learn more about all of these great products, make sure to head over to our website or download the Let’s Roam app for more details!

The Impact of Social Travel on Solo Travelers (Written by a Solo Traveler )

Disclaimer: I’ve been a solo traveler for 20 years with more than 150 countries and seven continents under my belt. The interactions that I’ve had with other travelers and with locals have shaped my best travel experiences and my everyday life in immeasurable ways. I have met some of my favorite travel buddies in the world while traveling, one of whom is now a fellow Let’s Roam writer. We met at a bus stop in Mexico and ended up doing a road trip through Turkey a few months later! My experiences have been so enriching and life-changing that I strongly believe that social travel makes you much, much more open-minded and knowledgeable about our world.

What is solo travel?

Before I get into social travel, I also want to clarify what we mean by solo travel. To start, solo travel does not mean traveling alone all of the time. This is a common misconception I think makes people nervous about traveling solo. What solo travel ACTUALLY means is setting off on an adventure by yourself rather than with a group or as a couple. 

What is social travel?

Okay, okay, I know. After talking about how great social travel has been for me, it’s probably high time to explain what exactly it is! At its most basic, social travel focuses on supporting local communities, learning about new cultures, and making travel accessible to all. One thing that makes social travel a bit different than other types of travel is that it also places emphasis on the relationships you develop with other travelers along the way. These relationships can last a few days or a lifetime. The important thing is you’ve learned from one another. 

This doesn’t mean simply spending your study abroad time hanging out with other American students and traveling on the weekends. This means talking to the people in the hostel that come from a wide range of ethnic, religious, and economic backgrounds to get a better understanding of the world around us.

What are the benefits of social travel?

For most people, the biggest benefit of social travel is the opportunity to learn more about a destination than what you would if you were a “regular” tourist. The interactions you have can completely change the way you view a country or city. This seems especially at a time when the world feels like it is de-globalizing. For solo travelers, it could mean having someone to go to dinner with, being able to get an in-depth look into their everyday life, and getting to know how they feel about the issues affecting the country. 

Social travel also takes you out of your comfort zone. You may find yourself eating new foods, trying new things, and meeting different types of people. It could also help you discover new ways of traveling!

What are the different types of social tourism?

Since social tourism in itself is a relatively broad term, there are many different types of social tourism. Based on the definitions provided above, social tourism can include everything from travel itineraries full of cultural programming to backpackers finding local hosts and new friends who are happy to show them around on Couchsurfing.

Is social travel the same as group travel?

Social travel is different from group travel in a few ways. To start, social travel is most commonly done by solo travelers. This is usually the best way to interact with locals. Not only are people more willing to approach you when you’re alone, but you’re also more likely to seek out interactions with locals when you are by yourself. 

Group travel generally entails planning a trip together, meeting at either your departure point or at the first destination on your itinerary. This can be a group of your own friends or family or as part of a prearranged group by tour operators like Contiki or G Adventures. The group dynamics of group travel are generally quite different than when you social travel with other people.

How do you get involved in social tourism?

One of the best ways to get involved in social tourism is to simply interact with locals and travelers. While you generally had to wait until you reached a destination for this process to start, today, the advent of the internet and social media has made this much easier!

What are the best social travel apps for facilitating social tourism?

There are a ton of new apps flooding the market aimed at social travel. However, I’ve found that you really need just a handful of apps. All of these apps are found on both Android and iOS.

1. Couchsurfing

Couchsurfing is a combination between an app and a social network where travelers and local hosts can connect. You can use the app and website to find people in specific destinations. Much like Booking.com or Airbnb, you are then able to look at the potential host’s reviews and send them an accommodation request. There’s no money exchanged for accommodation but Couchsurfers will usually offer something in return like a couple of beers, dinner, or a gift from their home country. 

Besides being able to find hosts, there are also opportunities to find meetups all over the world. This is the perfect way to meet both locals and travelers at the same time. You not only get to learn about some of the hidden gems in a destination but you may also meet some new travel buddies!

2. Facebook

Facebook is one of the best apps for social travel. Facebook groups are a great way to connect with people living or traveling in a particular destination. I’m part of several different digital nomad and “extreme” travel groups where people who are looking to meet other travelers offline will post their travel plans with upcoming destinations. It’s really easy to organize a time or place to meet. I have made contact with many people this way before I’ve arrived at my destination. On short trips, I have even found myself with a full social schedule of great activities that only locals would know!

One of the best things about using Facebook to meet other people is you can use their Facebook profiles as a form of a vetting system. One quick look can usually give you an idea of their interests, how they interact with other people, and so on. You can use this information to decide whether you want to meet them. 

When Airbnb started, it was a great example of social tourism. Locals could make extra money by renting out rooms in their houses to travelers. Meanwhile, travelers could get a special insight into the everyday life of locals rather than staying in hotels or hostels. Although Airbnb has kind of moved to the polar opposite of its initial premise, the app still provides opportunities for social networking. 

When you’re searching for an Airbnb, try to find options where you are simply renting a room rather than an apartment. Although it’s nice to have your own space, you tend to miss out on the cultural interaction you would have otherwise. I would also steer clear of any Airbnb hosts that just send you a code to get in. This leaves very little room for interaction.

4. Tinder/Bumble

While you may find yourself groaning inwardly at the sight of these two popular dating apps, they are great for social travel. In my experience, many people are excited about meeting someone from a different culture. They’re also willing to show you around a bit. Plus, it’s kind of exciting to go on a date in a new country! As always, be careful and use the same common sense that you would at home and make sure someone always knows where you are. 

5. Let’s Roam app 

We may be a bit biased on this one, but we also think our very own Let’s Roam app is perfect for social travel. Full of great scavenger hunts for destinations all over the world, fun virtual games, and much more, the app can provide a slew of things to do with your new friends!

What are the best destinations for social travel?

If you want or are interested in traveling to destinations where you have a ton of opportunities for social interactions, check out the list below! This has been compiled based on my own and other travelers’ experiences. This list is in no way exhaustive. While we wish we could list all of the great social travel destinations, this article would end up going in forever!

While it may seem like an eclectic list, there’s one thing that every place has in common. They’re welcoming toward foreigners and they are curious to know more about you. This plays a huge role in the interactions you will have with locals. They are also popular tourist destinations with a developed travel industry so you’re bound to meet other travelers to chat with. 

The one thing you should always keep in mind while traveling is that the locals don’t owe you anything. As harsh as it sounds, never expect anyone to do anything for you. Locals aren’t tour guides. They have busy lives just like you do. Always appreciate what they’re doing for you but never demand it. I have watched this happen many times around the world. It doesn’t put travelers in a good light. Sadly, fellow tourists may not be shown the same generosity and hospitality in the future. 

India is one of the most bewildering countries on the planet. It’s crowded and chaotic. Sometimes it’s a wonder that anything works. At the same time, it’s vibrant and warm. Parents will hand you their babies for photos. Old men will offer you chai. And if you stare at someone’s food long enough, they are highly likely to offer you a taste. After you’ve talked to them for a while, there is also a high chance they will invite you to their house for “home food.” 

Most travelers will fly into Delhi. From here, you can take a plane, train, or bus to onward destinations like Rishikesh, Mumbai, Goa, and Varanasi. Everywhere you go, there’s a high chance you’ll have a great experience interacting with locals. If you’re lucky, you may even be invited to an Indian wedding!

North American snowbirds have been using Mexico as a winter base for decades. Besides the warm weather, one of the many reasons people love Mexico is because of the friendly people. This makes it a great destination for social travel. Overall, Mexicans are very nice and have a great sense of humor. Although many people speak English fairly well, a little bit of Spanish can go a long way, and people are usually more than willing to help you. 

The first thing you need to do is get out of the major tourist areas of Cancun, Playa del Carmen, and Puerto Vallarta. Instead, head to some of the smaller colonial cities like Merida, San Cristobal, or Guanajuato. These places are all very safe and are major vacation destinations for Mexicans. Once you’re there, you can either join a tourist experience led by locals or you can simply hang out at a cafe or cantina. Nine times out of ten, someone will come to say hello. Another great option is to join a language exchange event. These will usually pull in a younger crowd and can be a great way to meet new friends!

3. Saudi Arabia

Up until very recently, Saudi Arabia was in the public eye for all the wrong reasons. The treatment of women, human rights violations, etc. were major issues the country faced. However, all this began to change in the past decade. The country has made tremendous strides toward having a more open society which has included opening for tourism.

Today, you’ll find a country of warm, welcoming locals who will greet you with a cheerful “welcome to Saudi Arabia” everywhere you turn. Young women will ask you to take pictures with you while young men try to practice their English. You will likely be asked to join people for an early breakfast, mid-afternoon coffee, late-night shisha, and everything in between. It’s a heartwarming experience. It gives you a completely different perspective of the country than what you’ve probably seen on TV. 

Are you ready to roam?

We hope this guide to social tourism has inspired you to download some apps, pack your bags, and head out into the great unknown! As always, we would love to hear your feedback, so please let us know if you have any questions or if you have any examples of how social travel has had an impact on you!

If you’d like to read more about different types of travel or about any of the destinations listed above, make sure to head over to the Let’s Roam Explorer blog . Here, you’ll find travel guides and plenty of travel inspiration for your next adventure. Think of it as your very own travel agency!

Frequently Asked Questions

Social travel is travel that focuses on the interaction you have with locals and with fellow travelers. It’s a great way to learn more about the place you’re visiting. Learn more at the Let’s Roam Explorer blog !

Social travel can impact people in different ways. For locals, it can be an opportunity to meet people from around the world as well as serve as an important source of income.

While both social tourism and heritage tourism help you more about the history and culture of a place, heritage tourism does it through historical sites while social tourism emphasizes social interactions.

Social travel can be anything from meeting a local you connected with for a coffee to hanging out with people from around the world at a hostel. Check out the Let’s Roam Explorer blog for more info!

If you want to learn more about different types of social travel , the best apps to use while traveling, and the best places to visit as a social tourist, make sure to head over to the Let’s Roam blog !

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The Sociological Sphere of Tourism as a Social Phenomenon

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BIRESWAR PRADHAN

The main aim of this paper is how tourists in Tourism system affect social relationship, i.e., relationship man to man, of one group to another group, or of one group to the whole society during their temporary stay other than their normal place of residence or at work. Modern Tourism has institutional both tourist as well as commercialized services that are used in the pursuit of Tourism, because Tourism often combines with other complex motivations, expectations and behaviour. Sociology of Tourism combines both theoretical and empirical attempts to understand how Tourists and Tourism often carry over attitudes, expectations and behaviour from the destinations other than their norms at usual place of residence.

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The object of study is a necessary epistemological demarcation for the development of a social theory of tourism under a socio-historical approach. Contextualizing the profile of a contemporary tourist is the problem of knowledge. I conceptualize tourism as a social phenomenon that takes place with the travel of tourists to places, an expression of the modern capitalist industrial era that involves the offer of economic services of hospitality, whose rationality impacts spatial, environmental, sociocultural, moral and (geo)politics dimensions. ethnicities, peoples, countries, regions and host communities. This meaning is adequate to encompass its essence and the dimension of the totality in which it is inserted. The main objective is a historical and theoretical foundation of the Sociology of Tourism, contributing to an epistemology of Tourismology. In the results I try to emphasize that society and tourism interact and change dialectically. The 21st century, a complex context of the hyperdevelopment of the scientific, technological, organizational and informational revolution, engenders, in the late capitalism of the superposition of modernity and post-modernity, the hybrid tourist, the one who manipulates his identity, whether as a conventional tourist in mass tourism. Fordist, or as a new traveler with a greater degree of autonomy and cultural capital in Toyotist flexible tourism. I conclude on the importance and actuality of this new meaning of the hybrid tourist concept, and the development of a social theory as educational foundations for the qualification of new tourism professionals. I conclude by converging phenomenological and dialectical principles for new investigations in this field as a methodological thesis.

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The unprecedented development of all areas of human concern, in particular the growth of tourism as a central and global phenomenon has drawn the researchers’ attention to tourism and the investigative potential of the language used in tourism. This paper discusses the ways in which the English language relates to tourism and sociology, laying particular emphasis on the role language plays in revealing much about how tourism operates, how perceptions, identities are formed and, henceforth, how tourism as a system depends on the use of language. The article is grounded in the seminal works of Dann, G.M. (1996, 1996a, 2012; Mesthrie, R. Swann, J, et al., 2000; Cohen, D. 1984; Dann, G.M. and Cohen, E., 1996, 2001; Thurlow and Jaworsky, 2003; Fox, 2008) and their views on the sociological aspects of the language of tourism.

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What is social impact travel?

By: Channing Fisher

Kiva employees, fellows, interns and lenders all have a global awareness that leads them to care about people all over the world. For some, this awareness comes from their travels. For others, they travel because of this awareness.

According to a United Nations report , the global travel industry makes $7 trillion each year and represents 9% of global GDP. However, only 5% of that stays in local communities.

Social impact travel is a growing trend in the travel industry that aims to support local economies and make a positive impact in host communities. This new trend centers on discovering local cultures and respecting the cultural, economic, and ecological environment. People are increasingly seeking immersive local cultural experiences that are respectful, ethical and sustainable. This trend has taken many different forms, depending on the preferences of the traveler. Here are a few examples:

• Locally-Sourced Travel emphasizes supporting local businesses to benefit the local economy rather than large multinational corporations. Travelers can opt for family-owned restaurants rather than chains, stay in AirBnB's or locally-owned hotels, and patronize local travel guides rather than international agencies.
• Eco Travel aims for low- or zero-impact traveling. Depending on the destination, some travelers stay in eco-lodges, which are accommodations created to have the least impact on the natural environment as possible. Often they aim to educate guests on the surrounding natural environment.
• ​​​​​​​ Conservation Travel is often found in areas with rich wildlife. Conservation travelers will patronize tour companies that are involved in conservation work in order to protect the local flora and fauna.
• Volunteer Travel combines travel with volunteering for organizations in local communities. Examples include working with kids for childcare or tutoring, contributing to construction projects, working for conservation efforts and assisting healthcare programs, among others. Despite the good intentions of volunteer travelers, the amount of true impact by short-term volunteers is debatable. To read more about the discussion around volunteer travel, click here .

These are just a few types of social impact travel, but you don’t have to book your trip through a specific social impact company to participate. Social impact travel just means having an awareness of the impact made by one’s travel and consciously looking for ways to benefit the community while protecting the local culture and environment.

Stay tuned for our next post about easy ways to have a positive social impact on your next trip or vacation!

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AMC, BlackBerry shares surge along with GameStop. Here's why meme stocks are back.

By Aimee Picchi

Edited By Alain Sherter

Updated on: May 14, 2024 / 4:18 PM EDT / CBS News

It's like 2021 all over again — at least, in one bullishness-on-steroids corner of the stock market. 

Several "meme stocks," or companies whose shares are buoyed by social media buzz rather than traditional business fundamentals like growth and profits, surged on Tuesday. It's the second consecutive day that such stocks have popped in the stock market, following GameStop's 72% surge on Monday. 

Other favorites with  WallStreetBets , the Reddit forum that spurred the meme-stock craze three years ago, jumped in pre-market trading on Tuesday. Among them are movie-theater operator AMC Entertainment, whose shares soared 31%, and BlackBerry, with a 12% gain. GameStop shares spiked 60%.

The resurgence of the meme stock phenomenon comes as trader Keith Gill, also known as "Roaring Kitty," resurfaced on X (formerly Twitter) after a three-year hiatus, posting a sketch Sunday night of a man leaning forward in a chair. Gill became the face of meme stock traders after he bought GameStop shares for $53,000 in 2019 and reportedly turned it into a multi-million stake due to the hype around the stock. 

Once again, traders are posting about meme stocks on WallStreetBets, urging others to buy stakes in GameStop and additional meme favorites with the term YOLO, or "you only live once." Others posted screenshots of their gains from AMC, BlackBerry and additional stocks.

Other stocks that are getting a lift in the meme stock resurgence include:

• SunPower Corp., a photovoltaic solar energy company, whose shares jumped 60% Tuesday
• Plug Power, a company that makes hydrogen fuel cell systems, with a 19% gain
• Virgin Galactic, Richard Branson's spaceflight company, up 22%

In the case of SunPower and Plug Power, the companies may also have drawn interest from traders due to President Joe Biden's announcement of new tariffs on Chinese EVs, solar cells and other products.

"Extremely speculative"

The appeal is simple: the opportunity to make a quick buck in a short period of time, with the bonus of sticking it to the professional traders on Wall Street who have shunned meme stocks. 

"[W]e expect day traders will pile in not because they think the memes have any real value, but because they hope others will get FOMO (the Fear of Missing Out), jack the price up and then they can sell off and make a quick profit," noted Nigel Green, the CEO of the financial advisory firm deVere Group, in an email. 

But there are very real risks, Green added. 

"Of course, big, big money can be made by some," he said. "But let's very clear: This is extremely speculative, and valuations can be expected to be incredibly wild — in both directions."

The dynamic was on full display Tuesday, with shares of AMC, BlackBerry, GameStop and other stocks that rocketed up in early trade already losing much of those gains by the afternoon. 

Among the immediate casualties aren't retail investors, but rather hedge funds and other traders who had bet that GameStop's stock would decline. Such a strategy, called short selling, involves a trade that will make money if a stock declines — investors lose money if the shares rise.

On Monday, hedge funds with short positions in GameStop lost more than $1 billion, analytics firm S3 Partners told CBS MoneyWatch. 

"Shorting [GameStop shares] again may soon rank as the worst risk-reward of any hedge fund trade over the past decade: best case, make a dollar; worst case, lose five," Andrew Beer, co-founder and managing member of Dynamic Beta investments, said in an email. 

Some meme stocks have a high share of short interest, Ihor Dusaniwsky, managing director of predictive analytics at S3 Partners, wrote in a blog post. For instance, about 65 million shares of GameStock are currently shorted, or about 24% of its available stock, he noted. 

Such companies have tended to attract meme stock investors because of the potential to engineer a so-called "short squeeze." That can occur when a shorted stock gains in price, forcing short sellers to cover their positions by buying the stock, which in turns sends the share price higher. 

The surge in GameStop's shares will "squeeze [short sellers] out of their positions with their buy-to-covers pushing [GameStop's] stock price even higher than the momentum and day traders could do on their own," Dusaniwsky wrote.

The renewed focus on meme stocks comes amid a broader melt-up in financial markets powered by strong corporate profits and robust economic growth. The S&P 500 is up 26% over the last 12 months, while the Dow Jones Industrial Average and tech-heavy Nasdaq have risen 18% and 33%, respectively.

• AMC Theatres

Aimee Picchi is the associate managing editor for CBS MoneyWatch, where she covers business and personal finance. She previously worked at Bloomberg News and has written for national news outlets including USA Today and Consumer Reports.

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The Nature Conservancy Applauds Kittatinny Ridge Sentinel Landscape Designation

Pennsylvania

May 15, 2024 | Schuylkill County, Pennsylvania

Media Contacts

Kathleen McFadden Media Relations Manager The Nature Conservancy Phone: 610-368-7108 Email: [email protected]

The Nature Conservancy (TNC) in Pennsylvania celebrates today’s designation of the Kittatinny Ridge as one of five new Sentinel Landscapes nationwide.

The Sentinel Landscape Partnership —formed in 2013 by the Department of Defense, the Department of Agriculture, and the Department of the Interior—is an effort among those agencies in cooperation with each other and with tribal, state, and local governments, non-governmental agencies, and private landowners to identify landscape-scale areas in the United States where conservation, working lands, and national defense interests converge.

Designated Sentinel Landscapes are anchored by at least one high-value military installation or range; encompass natural areas and agricultural and/or forestry lands; and are the appropriate size and scale needed to address the ecological restoration and other objectives defined for each landscape by the participating agencies, organizations, and landowners.

The newly designated Kittatinny Ridge Sentinel Landscape includes Fort Indiantown Gap, the busiest Army National Guard training center, the Army’s second busiest heliport, and one of only three specialized Army National Guard aviation facilities in the country.

The Sentinel Landscape program helps connect private landowners with voluntary state and federal assistance programs that provide tax reductions, agricultural loans, disaster relief, educational opportunities, technical aid, and funding for conservation easements. By focusing multiple agencies' resources on a Sentinel Landscape, the agencies and their partners can use taxpayer dollars more efficiently and achieve greater conservation outcomes.

“This is a significant conservation victory for one of Pennsylvania’s greatest natural treasures,” said Lori Brennan, Executive Director of TNC in Pennsylvania and Delaware. “The Sentinel Landscape designation will help advance large-scale voluntary and coordinated land protection and management efforts along the Kittatinny Ridge as well as help preserve habitat in one of the most important wildlife corridors in the northeastern United States. We are proud to have worked alongside the Governor’s office and our fellow Kittatinny coalition members to achieve this important milestone.”

"The collaborative efforts of the federal and state agencies, local governments, NGOs, and private landowners within designated Sentinel Landscapes are vital to preserving not only our natural resources and working lands, but the ability of our military forces to test and train at key installations like Fort Indiantown Gap so that they are fully ready to defend the nation when called upon,” said retired Brigadier General Bob Barnes, TNC's national liaison with the Department of Defense.

Quote : Lori Brennan

The Sentinel Landscape designation will help advance large-scale voluntary and coordinated land protection and management efforts along the Kittatinny Ridge.

Lori Brennan

The Kittatinny Ridge is a key subrange within the Central Appalachians. Identified as the most resilient landscape in Pennsylvania, this forested corridor provides an incredibly biodiverse superhighway that allows wildlife to move safely within and between climate-resilient areas in response to rising temperatures, increased floods, or drought. The continued health of the Kittatinny Ridge is considered critical to the future of hundreds of animal and bird species.

Since 2017, TNC has managed the Hamer Woodlands at Cove Mountain Preserve in Marysville, Pennsylvania, located along the Susquehanna River. The 1,379-acre preserve offers outdoor recreation opportunities for the public while simultaneously protecting and restoring connected lands, healthy forests, and clean water.

For more information, please visit nature.org/Pennsylvania .

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• Published: 16 May 2024

Catastrophic costs incurred by tuberculosis affected households from Thailand’s first national tuberculosis patient cost survey

• Sitaporn Youngkong 1 , 2 ,
• Phalin Kamolwat 3 ,
• Phichet Wongrot 4 ,
• Montarat Thavorncharoensap 1 , 2 ,
• Usa Chaikledkaew 1 , 2 ,
• Sriprapa Nateniyom 3 ,
• Petchawan Pungrassami 3 ,
• Naiyana Praditsitthikorn 5 ,
• Surakameth Mahasirimongkol 6 ,
• Jiraphun Jittikoon 7 ,
• Nobuyuki Nishikiori 8 ,
• Ines Garcia Baena 8 &
• Takuya Yamanaka 10 , 8 , 9  

Scientific Reports volume  14 , Article number:  11205 ( 2024 ) Cite this article

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• Health care economics
• Tuberculosis

Tuberculosis (TB) causes an economic impact on the patients and their households. Although Thailand has expanded the national health benefit package for TB treatment, there was no data on out-of-pocket payments and income losses due to TB from patients and their household perspectives. This national TB patient cost survey was conducted to examine the TB-related economic burden, and assess the proportion of TB patients and their households facing catastrophic total costs because of TB disease. A cross-sectional TB patient cost survey was employed following WHO methods. Structured interviews with a paper-based questionnaire were conducted from October 2019 to July 2021. Both direct and indirect costs incurred from the patient and their household perspective were valued in 2021 and estimated throughout pre- and post-TB diagnosis episodes. We assessed the proportion of TB-affected households facing costs > 20% of household expenditure due to TB. We analyzed 1400 patients including 1382 TB (first-line treatment) and 18 drug-resistant TB patients (DR-TB). The mean total costs per TB episode for all study participants were 903 USD (95% confident interval; CI 771–1034 USD). Of these, total direct non-medical costs were the highest costs (mean, 402 USD, and 95%CI 334–470 USD) incurred per TB-affected household followed by total indirect costs (mean, 393 USD, and 95%CI 315–472 USD) and total direct medical costs (mean, 107 USD, and 95%CI 81–133 USD, respectively. The proportion of TB-affected households facing catastrophic costs was 29.5% (95%CI 25.1–34.0%) for TB (first-line), 61.1% (95%CI 29.6–88.1%) for DR-TB and 29.9% (95%CI 25.6–34.4%) overall. This first national survey highlighted the economic burden on TB-affected households. Travel, food/nutritional supplementation, and indirect costs contribute to a high proportion of catastrophic total costs. These suggest the need to enhance financial and social protection mechanisms to mitigate the financial burden of TB-affected households.

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Introduction.

Tuberculosis (TB) causes a significant economic impact on the patients and their households 1 , 2 . Although most high TB-burden countries have offered diagnosis and treatment free of charge, patients and their households still incur substantial cost including the direct medical cost (during pre-treatment phase), direct non-medical cost (i.e., transportation, accommodation, and food), as well as indirect costs from job loss and productivity loss. Therefore, TB-affected household are still facing the risk of catastrophic costs, defined as the total costs related to TB management exceeding 20% of annual household income or expenditures 3 , leading to poor treatment access, adherence, and worsening health outcome 1 , 2 , 4 . Hence, to achieve the End TB Strategy introduced by the Sustainable Development Goals (SDGs) 5 , one of the World Health Organization (WHO)’s strategies 6 was to eliminate the catastrophic costs among TB-affected households by 2020. According to the WHO’s global monitoring of the End TB indicators reports 7 , 8 , which covered the findings from the national TB patient cost survey data of the 27 countries, one in two patients (48%, 95%CI 36–67%) faces catastrophic costs. Recent modelling that produced estimates for countries that had not yet been able to complete survey 9 shows that estimated proportions of TB-affected households experiencing catastrophic total costs were 54.9% (47.0–63.2%) overall. According to the recent meta-analysis 10 , the pooled proportion of patients faced catastrophic costs (95% Confident Interval) from the existing 29 studies was 43% (34–51%) while the main predictors of the catastrophic costs included country, drug sensitivity, and Human immune-deficiency virus (HIV) co-infection.

Thailand, an upper-middle-income country, has high TB-burden with an incidence (new TB cases per year) of 105,000 (79,000–134,000) in 2020 8 . At present, almost all necessary diagnostic and TB treatments have been covered by public health insurance schemes. As of 2019, there was no data on economic burden due to TB from patients and their household perspectives. To achieve the goal of zero catastrophic costs due to TB as one of the three targets of the WHO End TB Strategy, the current situation must be investigated. This paper is the first study aiming to estimate the prevalence of catastrophic costs due to TB from the patient and their household perspective. Factors affecting catastrophic costs were also explored. The findings could provide important evidences to guide the development of policies/strategies to protect TB patients from risk of financial crisis, hence, improving the treatment outcomes leading to the achievement of end TB target.

Study design

The national cross-sectional survey design and methodology were in line with WHO recommendations in their handbook for TB patient cost surveys 11 . The cost components included direct medical costs (i.e., out-of-pocket spent on diagnostic tests, medication, outpatient and inpatient care, and doctor fees), direct non-medical costs (i.e., out-of-pocket spent on transportation, food, and accommodation), and indirect costs (i.e., productivity loss due to TB) based on hourly wage computed individually from reported.

Sample size and sampling method

We calculated the sample size based on an estimated proportion of households experiencing catastrophic costs (p) at 50%, a design effect (D.E.) of 2.0 and 4% precision level (e) with the following standard formula 12 .

where n is the total number of TB notifications registered in 2017 13 was as 67,971; and 15% adjustment of data incompleteness, the required sample size was 1400. A stratified multi-stage cluster sampling was used to sample TB patients for the interview to ensure balance in the economic status and healthcare services accessibility of each locality that can be nationally representation in this case. Firstly, the health facilities with TB clinics were stratified into 2 groups (i.e., low- and high-poverty area) according to the poverty level (i.e., the proportion of number of individuals with income below the per capita poverty thresholds to the total number of individuals of each province compared to the national poverty proportion of 7.87 14 ). Then, health facilities in each poverty level were further stratified into secondary and tertiary level, resulting in 4 stratums. The total of 40 clusters were, then, randomly selected from the 4 stratums. The number of clusters for each stratum were calculated using proportional to size approach. For each cluster, 35 patients were recruited. These resulted in 420 patients recruited from 12 clusters of tertiary hospitals in low-poverty incidence areas, 280 patients recruited from 8 clusters of tertiary hospitals in high-poverty incidence areas, 315 patients recruited from 9 clusters of secondary hospitals in low-poverty incidence area, and 385 patients recruited from 11 clusters of secondary hospitals in high-poverty incidence area). The patients were eligible if they (1) were registered for TB treatment enrolled in the National Tuberculosis Control Programs (NTPs) from October 2019 to July 2021 at sampled facility, and (2) were on treatment for a minimum of 14 days either in intensive or continuation phase. Eligible patients were selected randomly from database of each facility, and then were asked for their consent to face-to-face interview.

Data collection

Structured face-to-face interviews with a paper-based questionnaire were conducted by the 60 trained interviewers who were the employees of the 12 Regional office of Disease Prevention and Control covering the 40 clusters of this survey. One-day training on the interview approach with the survey questionnaire was provided to all interviewers prior to data collection. Questionnaires were adapted to Thai contexts and translated into Thai language (and were pre-tested to ensure the clarity and understandability) from a generic data collection tool provided by the WHO handbook for TB patient cost surveys 11 comprising four sections: (1) informed consent; (2) patient information (including patient and clinical characteristics, employment, household composition, healthcare utilization, time spent and income lost while seeking and receiving care); (3) costs (i.e., direct medical, direct non-medical, and indirect costs), and time loss before/during the current TB treatment; and (4) coping mechanisms during the treatment phase 15 .

Data analysis

To estimate direct costs per month, the cost per visit were multiplied by the number of visits per month. The number of visits including outpatient visits, facility-based directly observed therapy (DOT), follow-up, and drug pick-up, of each treatment phase was derived from the national TB control guidelines while direct cost per visit included direct medical cost and direct non-medical cost.

Indirect costs were estimated using a human capital approach. We selected this approach because the proportion of the patients with informal employment in the survey was much higher than other sectors, and this was the better way to present socioeconomic status of the patients based on the Thai context as the consensus from the Thai expert’s consultation. This approach included time lost due to traveling to health facilities and waiting time lost during healthcare consultations of both patients and their household members. The self-reported total time spent on those activities was multiplied by the estimated income per person per minute.

To estimate costs in the remainder of the patient’s current treatment phase (i.e., intensive or continuous phase), extrapolation of the patient's costs in that treatment phase to date was done according to WHO methods 11 . In the case that the costs were estimated for different treatment phases, the mean and median reported costs and number of hours from other patients who were sampled in that treatment phase were used.

Total cost was, then, calculated as the summation of direct medical cost, direct non-medical costs, and indirect costs and was reported for the following treatment stages: pre-diagnosis (from the onset of symptoms to the first visit to a health facility), and post-diagnosis (from first visit to end of treatment).

All cost data were calculated in 2021 value and then converted to USD using the average UN operational rates of exchange during the data collection period (October 2019 to July 2021) of 1 USD = 31.07 THB 16 .

Descriptive statistics were used to describe the participated patients’ characteristics (i.e., genders, age, education level, insurance status, and household size), clinical characteristics (i.e., treatment phase, treatment category, HIV status, type of TB, diagnostic delay, modality of TB treatment, and hospitalization), household economic status (i.e., incomes, expenditures, and impoverishment), costs incurred in TB-affected households, coping strategies, social consequences, social support and perceived financial impact. The proportion of TB-affected household facing catastrophic costs, TB-related total costs (direct and indirect) exceeding 20% of the annual household expenditure as per definition by WHO 11 and global monitoring 8 was estimated. Annualized self-reported household expenditure was used as the primary method for determining household ability to pay. In addition, we evaluated pre-disease household poverty levels by comparing daily income (calculated from self-reported household monthly income) against the international poverty threshold of 1.90 USD purchasing power parity 11 adjusted dollars (converted to PPP by using the PPP conversion factor of 12.34 for Thailand in 2020 17 ).

Pearson's chi-square test was applied to compare between patients with first line treatment and patient with drug resistance. Univariate logistic regression analysis was conducted to identify variables associated with facing catastrophic costs due to TB. The variables explored in the univariate analysis included age, sex, employment status, household expenditure quintile, household size, education level, insurance status, HIV status, drug resistance status, TB history, hospitalization during TB episode, mode of TB treatment. Multivariate backward stepwise logistic regression was performed to identify factors affecting catastrophic cost. Adjusted odds ratios (OR) and 95%CI was reported.

Ethical issues

Prior to the primary data collection of this study, ethical clearance was approved by the Institute for the Development of Human Research Protections (IHRP) (COA No.IHRP2019081 and IHRP No.073-2562), and the Ethical Committee for human research at the Faculty of Dentistry and Faculty of Pharmacy, Mahidol University, Bangkok, Thailand (COA.No.MU-DT/PY-IRB 2018/068.0711 for the initial approval and COA.No.MU-DT/PY-IRB 2020/029.0206 for changes in the sample size). All respondents received a written and oral explanation of the study, and each of them signed an informed consent form before participating in the interview. All methods were performed in accordance with the relevant guidelines and regulations.

Patients characteristics

One thousand and four hundred patients (1382 first-line treatment TB and 18 drug-resistant TB, DR-TB patients) in total participated in the costing survey. Table 1 shows the demographic and clinical data for those participants included in the analysis. Most patients were male (68.9%), aged older than 45 years (69.3%) including one quarter over 65 years, had attended pre/primary school education (60.1%), and had public health insurance (98.0%). The median of their household size was three members (range 1–17). The patients who participated in this survey were in any of the two treatment phases with similar proportions (46.1% were in the intensive phase and 53.9% were in the continuation phase). Most patients were new TB (94.4%) without HIV infection (88.2%). Around 31.7% of the patients in the intensive phase experienced a long diagnostic delayed (> 4 weeks). For modality of TB treatment, most patients (75.4%) self-administered their medications, 18.0% of them had home-based directly observed therapy (DOT), and few of them (6.6%) received facility-based DOT. Only 6.6% were hospitalized during their current TB episode, and almost half of them (47.6%) previously hospitalized in their current treatment phase.

Socio-economic characteristics and the changes in income among TB-affected households

The average monthly income of survey participants and that of their households before the onset of TB symptoms was 355 USD (95%CI 321–388 USD), and 1152 USD (95%CI 708–1597 USD), respectively (Table 2 ). Almost half of TB patients (48.3%) were the primary income earner. The average monthly household expenditure was 640 USD (95%CI 459–822 USD). While at the interview, the average monthly income of the patient and household decreased to 220 USD (95%CI 193–246 USD), and 643 USD (95%CI 572–714 USD), respectively.

Before the onset of TB symptoms, 2.2% of the participant households faced impoverishment (their incomes were below the poverty line—poverty headcount ratio at USD 1.90 per day at 2011 PPP), and it was increased from 2.2 to 11.1% due to TB (Table 2 ). The differences in the percentage of impoverishment of TB-affected households before and during TB episodes among the different household income quintile groups are demonstrated in Supplementary (Fig. S1 ). Our findings show that TB has affected the patients and their households in terms of income loss. The proportion of TB-affected households living below the poverty line was substantially higher among those in lower quintiles.

Costs of TB-affected households

The mean total costs per TB episode for all study participants (n = 1400) were 903 USD per patient (95%CI 771–1034 USD), and median total costs per episode were 412 USD per patient (IQR 184–879 USD) (Table 3 ). Of these, total direct non-medical costs were the highest costs (mean, 402 USD, and 95%CI 334–470 USD) incurred per TB-affected households followed by total indirect costs (mean, 393 USD, and 95%CI 315–472 USD) and total direct medical costs (mean, 107 USD, and 95%CI 81–133 USD, respectively. The mean total costs per episode among TB first-line treatment patients (n = 1382) and DR-TB patients (n = 18) were 848 USD (95%CI 725–971 USD) and 4987 USD (95%CI 2884–7090 USD), respectively (Fig. S2 in the Supplementary).

For the pre-TB diagnosis episode, the mean direct costs (37 USD with 95%CI 33–42 USD) were the highest costs incurred by the patients. The mean total costs incurred during pre-TB diagnosis episode were less than those incurred during post-TB diagnosis episode. Whereas the post-TB diagnosis episode, the mean direct non-medical costs (384 USD with 95%CI 98–191 USD) and the mean indirect costs (381 USD with 95%CI 303–458 USD) were the two highest costs incurred by the patients and their households. This reflects travel, food, and time costs (or productivity lost) by the patients and their caregivers during the TB treatment due to the many facility visits and hour lost (Table 4 ). In terms of number of facility visits, patients involved in facility-based DOT made 125.8 visits (ranged 114.6–137.0 visits) mainly during their treatment, followed by medical follow-up 9.4 visits (ranged 8.5–10.2 visits). Of these visits, DR-TB patients had significantly higher total number of visits than those of TB patients. Hours lost by DR-TB patients (743.4 h with ranged 350.3–1136.4 h) were also significantly much higher than the lost by TB patients (142.0 h with ranged 122.7–161.3 h). Although hours lost by caregivers were not statistically significant different between TB and DR-TB patients, total lost time of DR-TB caregivers were around four times of those of TB caregivers (372.9 h vs. 85.9 h, respectively).

Catastrophic total costs

Figure  1 illustrates the percentage of TB-affected households facing catastrophic total costs. At the 20% threshold, the percentage of catastrophic total costs was 29.5% (95%CI 25.1–34.0%) for TB and 61.1% (95%CI 29.6–88.1%) for DR-TB patients; this reflects 29.9% of TB-affected households facing catastrophic costs for overall TB participants of this study.

Percentage of TB-affected households facing catastrophic costs. CI confidence interval, TB tuberculosis. *Error bars represent 95% confidence interval.

Coping mechanisms and social consequences

The patients reported the use of loan as the main coping strategy (19.1%) to face costs incurred with very little social support; 2.2% and 1.0% of survey participants reported receipt of social assistance and vouchers from NTP (Table 5 ). Getting TB infection causes social consequences, i.e., their working days loss (41.9%), job loss (34.6%), and social exclusion (27.8%). Overall, those proportions of social consequences were significantly higher among DR-TB patients. The proportion of patients who became unemployed more than doubled when comparing the employment status before TB episode to the status during TB episode (at the time of interview) (16.0–42.0%) (Fig.  2 ). While the proportion of employment in the informal and formal sector decreased from 69.0% and 11.0% to 46.0% and 8.5%, respectively, when comparing the same time periods. More than half of the patients (52.0%) did not perceive any change in the financial impact, while 38.2% of them perceived they were poorer and 8.5% felt they were much poorer than in the past.

Changes in employment status before and during TB episode.

Factors affecting catastrophic costs

Figure  3 presents the selected final model with adjusted odd ratio (OR) of the risk factors that had a significant association with the probability of facing catastrophic costs due to TB. Households with lower expenditure quintiles (for the first 3 quintiles) had a significantly higher incidence of facing catastrophic costs compared to those in the highest expenditure quintile (the lowest expenditure quintile: OR 54.6, 95%CI 29.0–103.0; the second lowest expenditure quintile: OR 8.1, 95%CI 4.6–14.0, and the third expenditure quintile: OR 3.6, 95%CI 1.8–7.0). The other significant factors associated with the catastrophic costs include experiencing hospitalization (OR 9.4, 95%CI 6.0–15.0, compared to not hospitalizing), being DR-TB patient (OR 5.3, 95%CI 1.4–20.0, compared to those with first-line treatment), patients who do not have health insurance (OR 5.0, 95%CI 1.3–19, compared to those with health insurance), patients with extrapulmonary TB (OR 3.0, 95%CI 1.1–8.4, compared to those with pulmonary TB), and patients who received the facility-based directly observed therapy as their treatment support (OR 1.7, 95%CI 1.1–2.6, compared to those with self-administration).

Risk factors for TB-affected households facing costs > 20% of household expenditure due to TB. *Error bars represent 95% confidence interval.

Our findings illustrated that 29.9% of TB-affected households face catastrophic total costs, a lower proportion compared to the global pooled average of 48% (95%CI 36–61%) with 27 countries with published survey data 8 and also lower than the global pooled average of 135 low- and middle-income countries with meta-regression estimates 54.9% (47.0–63.2%) overall 9 .

The largest cost driver to the economic burden supported by TB-affected households were travel, food, and nutritional supplementation, in the form of direct non-medical costs (44.5% of total costs), and patient (and their caregivers) productivity loss, in the form of indirect costs (43.6% of total costs).

On the other hand, overall out-of-pocket expenses associated with direct medical costs accounted for only 12% of total costs. Thus, our findings also confirm that most of the direct medical costs have been covered by the Thai public health insurance 18 . Although, almost all direct medical costs during the treatment phase were covered by public health insurance, this study showed that most direct medical costs incurred before TB diagnosis episode were disbursed by patients (pre-diagnosis out-of-pocket expenses represent 2.1% of total episode costs). The patient might seek care by going to the private sector, such as drug store. This could increase out-of-pocket expenses. Thus, increasing proactive access to early TB diagnosis can help early detection of people with TB and bring them to be covered under the public health insurance schemes. Although this has been already included in the Thailand operational plan to end TB for 2017–2021 19 , this finding encourages the Ministry of Public Health to continue this strategy for the next plan to end TB. Moreover, refining benefit packages in all public health insurance schemes to include standard TB care, including diagnosis, treatment and social support is recommended. This can ensure that all presumptive TB cases have access to standard TB treatment.

Although the Thai UHC provides free TB treatment and other medical services, this does not cover traveling and productivity loss incurred from the facility-visits due to TB treatment. Enhancing patient-centered care in the Thai TB treatment guidelines or strengthen all primary health care services may reduce the time required for those facility visits and then decrease the direct non-medical costs and income losses of the patients. Moreover, this has led to another issue of social protection policies that required attention from national policymakers. Social protection policies beyond free medical services, e.g., financial incentives for cost of living, should be strengthened by the national and local government. Only 2.2% (95%CI 1.4–3.3) of survey respondents (Table 5 ) were accessing social assistance and 1% (95%CI 0.2–2.5) accessed vouchers. For TB patients who are in formal employment, the government should strengthen the policy by securing their jobs. Nevertheless, this issue is not solely the responsibility of government organizations in the health sector, but it also requires cooperation among the health and non-health sectors. Cooperation between The Ministry of Public Health and the Ministry of Labour, the Ministry of Social Development and Human Security, or non-government agencies is required to support TB patients in developing social support mechanism, such as enabling patients to take sick leave or be compensated in case of dismissal, especially for the patients with lower expenditure quintiles. This can mitigate the economic burden and reduce the proportion of households that experience catastrophic costs in Thailand.

Despite the free TB treatment policy under the UHC in Thailand, the percentage of TB-affected households living below the international poverty line 11 among the TB-affected households increased during TB treatment compared to the pre-TB episode (from 2.2 to 11%). The disease does not affect only to the poor households (percentage living below international poverty line rose from 11 and 0% to 22% and 15% in the 1st and 2nd household income quintiles, respectively) but it also impacts on the richer households (percentage living below international poverty line increased from 0 to 4.7% in the 5th household income quintile). This requires policy actions beyond the strictly medical and into social protection especially for those who are poorer. In addition to the free medical services during TB treatment, income replacement during TB treatment and the post-TB socioeconomic recovery strategies (e.g., maintain their formal employment, looking for a new job, and re-employment) are also key to protect the patients and their households against financial hardship due to TB.

It is also noteworthy that the mean monthly individual incomes reported by TB (first-line treatment) patients is significantly higher than that reported by patients with DR-TB. In fact, the mean total costs incurred by DR-TB cases were almost 6 times of the costs incurred by TB (first-line treatment) patients, even though Thailand has started shorter DR-TB regimen 20 . This highlights the serious socioeconomic impact of DR-TB on their households.

To our knowledge, this is the first national TB patient cost survey in Thailand using the standardized methodology for cross-sectional survey in TB-affected countries developed by WHO 11 . Our findings do not only deliver the significant indicator of catastrophic costs status due to TB in Thailand to achieve the end TB strategies, but we also provide insights that there were gaps in TB policy implementation that needed to improve.

This study has limitations that have led to some concerns. First, we started the survey in 2019 and data collection was ongoing as COVID-19 pandemic hit. This brought an obstacle to the interview process and many of the related health facilities did not allow the interviewers to go to the field. This may cause recall biases due to the delay of the interview appointment. Moreover, the number of health facility visits and income losses may have been interrupted by the pandemic. These might cause under-reported number of the facility visits and the income losses might be resulted from the pandemic. Second, there were missing income data reported from the patients, especially the ones working in informal sector, even though the interviewers tried to ask them to estimate. This might affect the indirect cost estimation. For those missing ones, the estimations of their individual incomes were based on ascribing a proportion of the household annual income to the individual of the reported one. Third, we did not specifically sample for DR-TB, and randomly selected DR-TB in the random clusters; therefore, our findings due to DR-TB cases may not represent the DR-TB patients in Thailand. Although the costs calculation for DR-TB patients were referred to the national standard practice guideline of the DR-TB, its sample size was small and we did not design our data collection of the DR-TB patients for this survey. However, our findings can highlight the higher economic burden of DR-TB than those incurred by TB patients. Thus, we strongly suggest the further study focusing only on DR-TB patients to examine economic burden and catastrophic total costs incurred in DR-TB patients that can be representative of this specific groups of TB patients in Thailand.

This study is the first national TB patient cost survey in Thailand. Our findings highlight the economic burden on TB patients and their households and of their falling into deeper poverty and greater unemployment. Travel costs, food/nutritional supplementation, and productivity costs drive total TB episode costs in Thailand and a significant proportion of TB-affected households incur in costs > 20% of household expenditure (i.e. catastrophic total costs). Such evidence suggests financial and social protection mechanisms to mitigate the economic burden of the TB-affected households.

Data availability

The datasets used and/or analysed during the current study available from the corresponding author on reasonable request and with permission of the Health System Research Institute.

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Acknowledgements

We gratefully acknowledge the contribution of our study participants; the research team from both Faculty of Pharmacy, Mahidol University, and the Division of Tuberculosis, Department of Disease Control, Ministry of Public Health, Thailand. This research was funded by the Health system Research Institute (HSRI). The findings, interpretations and conclusions expressed in this article do not necessarily reflect the views of the aforementioned funding agencies. Also, we would like to thank Dr.Viroj Tangcharoensathien and his team at the International Health Policy Program, Thailand, for their support in data validation and verification in Thailand context.

This research was funded by the Health system research Institute (HSRI) under Grant HSRI 64-019.

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Mahidol University Health Technology Assessment (MUHTA) Graduate Program, Mahidol University, Bangkok, Thailand

Sitaporn Youngkong, Montarat Thavorncharoensap & Usa Chaikledkaew

Social and Administrative Pharmacy Division, Department of Pharmacy, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand

Division of Tuberculosis, Department of Disease Control, Ministry of Public Health, Bangkok, Thailand

Phalin Kamolwat, Sriprapa Nateniyom & Petchawan Pungrassami

Faculty of Nursing, Mahidol University, Nakhon Pathom, Thailand

Phichet Wongrot

Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand

Naiyana Praditsitthikorn

Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand

Surakameth Mahasirimongkol

Department of Biochemistry, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand

Jiraphun Jittikoon

World Health Organization Global Tuberculosis Programme, Geneva, Switzerland

Nobuyuki Nishikiori, Ines Garcia Baena & Takuya Yamanaka

Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK

Takuya Yamanaka

School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan

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All authors conceived and designed the work. S.Y., P.K., P.W., M.T. and U.C. supervised and monitored the survey. S.Y., P.W. and T.Y. did the analysis. S.Y. wrote the first draft of the manuscript with input from other authors. All authors interpreted the data, provided critical revision for important intellectual content and approved the final version to be published.

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Correspondence to Sitaporn Youngkong .

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Youngkong, S., Kamolwat, P., Wongrot, P. et al. Catastrophic costs incurred by tuberculosis affected households from Thailand’s first national tuberculosis patient cost survey. Sci Rep 14 , 11205 (2024). https://doi.org/10.1038/s41598-024-56594-1

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Received : 04 January 2024

Accepted : 08 March 2024

Published : 16 May 2024

DOI : https://doi.org/10.1038/s41598-024-56594-1

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