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Unlock This CourseHealth is one of the most powerful forces shaping whether people travel, where they go and how many tourists a destination receives. A single disease outbreak can wipe out millions of visitors overnight. On the other hand, a destination with excellent healthcare, clean water and safe food can attract huge numbers of tourists who feel confident and safe.
Health factors work in two directions. They can push tourists away from a destination (if there is disease, poor sanitation, or health risks) or they can pull tourists towards a destination (if it offers world-class medical care, wellness retreats, or a healthy environment).
Key Definitions:
Some health-related factors actually increase tourism demand. These include destinations with excellent hospitals, clean environments, wellness resorts and spa retreats. Medical tourism is one of the fastest-growing sectors in global travel. Countries like Thailand, India and Hungary attract millions of visitors who travel specifically for healthcare treatments.
Disease outbreaks, pandemics, poor sanitation, unsafe food and water and lack of healthcare facilities all reduce tourist demand. When travellers fear for their health, they simply do not go. A single news headline about a disease outbreak can cause bookings to collapse within days, even if the actual risk is very small.
Nothing destroys tourism demand faster than a serious disease outbreak. When people fear they might get ill or worse they cancel their holidays, avoid certain countries and stay at home. Governments issue health advisories, airlines cancel flights and hotels stand empty. The effects can last for months or even years after the disease has been brought under control.
When a disease outbreak is reported, several things happen very quickly that reduce tourism demand:
The COVID-19 pandemic was the single biggest shock to global tourism in recorded history. In 2019, there were approximately 1.5 billion international tourist arrivals worldwide. By 2020, this had collapsed to just 381 million a fall of nearly 74%.
Key impacts included:
COVID-19 also changed how people travel. Demand for domestic tourism surged as international travel became difficult. "Staycations" became popular in the UK, with the Lake District, Cornwall and Scotland seeing record visitor numbers in 2021.
The Ebola outbreak in West Africa centred on Guinea, Sierra Leone and Liberia had a devastating effect on tourism across the entire African continent, even in countries thousands of miles from the outbreak.
This is a crucial point for your exam: health scares affect tourism far beyond the actual affected area. Many tourists cancelled safaris in Kenya, Tanzania and South Africa countries nowhere near the Ebola zone simply because they were on the same continent and feared the disease.
Not all health scares affect all tourists equally. The Zika virus outbreak of 2015–2016, centred on Brazil and other parts of Latin America, had a very specific impact on tourism demand. Zika is spread by mosquitoes and can cause serious birth defects in unborn babies.
The Zika outbreak did not stop all tourism to Brazil. However, it had a very strong impact on specific groups of tourists:
Pregnant women and those trying to conceive were strongly advised not to travel to Zika-affected areas. Many cancelled trips to Brazil, the Caribbean and Central America.
The Zika outbreak coincided with the 2016 Rio Olympics. Several high-profile athletes withdrew from the Games citing Zika fears. Some tourists also cancelled trips to attend the Olympics.
The Caribbean a hugely popular honeymoon destination saw a significant drop in bookings from couples who were planning to start a family, as Zika posed a risk to future pregnancies.
This case study shows that health factors can affect specific segments of the tourist market rather than all tourists equally. This is an important exam point.
Many countries require visitors to show proof of vaccination against certain diseases before they are allowed to enter. This acts as a barrier to tourism for some travellers, particularly those who cannot or will not get vaccinated, or those from countries where vaccines are not easily available.
Common vaccination requirements for travellers include:
Malaria is one of the most significant health barriers to tourism in sub-Saharan Africa. Although malaria is preventable with medication, many tourists are deterred by the cost of anti-malarial drugs, the potential side effects and the need to take medication for several weeks before and after travel. This reduces demand for some of Africa's most spectacular destinations, including parts of Kenya, Tanzania and Uganda.
The quality of healthcare available at a destination is a major factor in tourists' decisions. Travellers especially older tourists, those with existing medical conditions and families with young children want to know that if something goes wrong, they will receive good medical care.
Destinations with modern hospitals, well-trained doctors and good emergency services attract more tourists, especially from the older age groups. Countries like Spain, France and the USA benefit from their reputation for good healthcare. Cruise ships are required to carry medical staff and equipment, which reassures passengers.
Destinations with poor healthcare infrastructure limited hospitals, shortage of doctors, or lack of emergency services may deter tourists, particularly those who are older or have health conditions. Some remote adventure tourism destinations face this challenge, as they are far from medical facilities.
Medical tourism is one of the most fascinating and fast-growing areas of the travel industry. Instead of health being a reason not to travel, medical tourists travel because they want healthcare. They visit other countries to receive medical treatments that are cheaper, faster, or of higher quality than what is available at home.
The global medical tourism market was valued at approximately $19.7 billion in 2023 and is growing rapidly. Key reasons people become medical tourists include:
Thailand is one of the world's leading medical tourism destinations, attracting over 2.5 million medical tourists per year (pre-pandemic figures). Bangkok's Bumrungrad International Hospital alone treats over 500,000 international patients annually from more than 190 countries.
Why Thailand?
Other major medical tourism destinations include India (specialist cardiac and cancer treatment), Hungary (dental tourism from the UK and Germany), Mexico (popular with American patients) and South Korea (cosmetic surgery).
Wellness tourism is slightly different from medical tourism. Rather than seeking treatment for illness, wellness tourists travel to improve their health and wellbeing. This is one of the fastest-growing segments of the global tourism market.
Visiting thermal spas, hot springs and luxury wellness retreats. Iceland's Blue Lagoon, Hungary's thermal baths and Japan's onsen (hot spring) culture all attract wellness tourists in huge numbers.
Yoga retreats in destinations like Bali (Indonesia), Rishikesh (India) and Costa Rica attract tourists seeking mental and physical wellbeing. The global yoga tourism market is worth billions of pounds annually.
Specialist retreats offering detox programmes, healthy eating, fitness training and mental health support. These are popular in Southeast Asia, the Caribbean and increasingly in the UK and Europe.
A person's own health directly affects whether they can travel and what kind of holiday they choose. This is an important demand factor that is easy to overlook.
Severe Acute Respiratory Syndrome (SARS) was a respiratory disease that spread rapidly across Asia in 2002–2003, with major outbreaks in China, Hong Kong, Singapore and Canada. Although the total number of deaths worldwide was 774, the impact on tourism was enormous.
History shows that tourism can and does recover after health crises but the speed and completeness of recovery depends on several factors:
In the exam, you may be asked to explain how health factors affect tourism demand. Remember to give specific examples don't just say "disease outbreaks reduce tourism." Name the disease (COVID-19, SARS, Ebola, Zika) and give specific statistics where you can. Also remember that health factors can work both ways they can reduce demand (disease outbreaks) OR increase demand (medical tourism, wellness tourism). Examiners love to see that you understand this two-sided nature. Finally, always note that perception of risk is often more powerful than actual risk the Ebola effect on Kenyan tourism is a brilliant example of this.