Wellness tourism is worth US$639bn, but what do these figures include?

 

Wellness tourism is taking off and with incredible growth that is over shadowing medical tourism. A rising global middle class, increasing consumer desire to adopt a wellness lifestyle, and a growing interest in experiential travel has stimulated the rapid growth of wellness tourism around the world.

The majority of the wellness tourism market however is in ‘secondary wellness tourism’ (e.g. visits to a hotel with spa attached), and much of the wellness travel is also domestic rather than international.

These are the conclusions IMTJ has drawn from the detailed ‘2018 Global Wellness Tourism Economy’ report, published this month by the Global Wellness Institute.

IMTJ health warning: dangers of ‘secondary traveller’ definitions

The report identifies two types of wellness travellers: ‘primary’ wellness travellers, who take a wellness trip and ‘secondary’ wellness travellers, who go on holiday and take part in wellness activities.

Secondary wellness tourism accounted for 89% of wellness tourism trips and 86% of wellness tourism expenditures in 2017. It also continues to grow at a faster rate than primary wellness tourism.  Secondary wellness tourism trips grew by 10% while primary trips grew by 8% annually from 2015 to 2017.

The definition of these two categories is important.  If destinations are promoting wellness travel, these messages will be key to the primary wellness traveller and will help them decide where to go.  It might be less influential for the secondary wellness traveller however. IMTJ asks to what extent is the choice of hotel or destination for a general holiday influenced by the presence of wellness activities?

There is also a danger that this report is using too broad a definition for secondary wellness travellers. Their numbers include, for example:

  • A business or leisure traveller who actively seeks out healthy accommodations, food and fitness options during a trip
  • A family that spends a day at a hot springs establishment as part of a holiday trip
  • A vacationer at a beach resort who wants to visit the spa
  • A cruise tourist who specifically selects a ship with extensive spa, beauty, and fitness amenities
  • An adventure tourist who visits an eco-spa after much of their day hiking or biking
  • A tour group traveller who decides on a Thai massage, reflexology treatment, or visits a hammam

On this basis, IMTJ argues, everyone could define themselves as a secondary wellness tourist, just because the destination they’re visiting happens to have wellness facilities. It is also uncertain, not explained in the report, about how numbers are sourced. Do hotels, for example, count the number of guests using their various wellness facilities, and over what period?

Use of such broad definitions serve to undermine the true picture of the size and value of a healthcare travel market. In the early days of medical travel an assumption was made by many industry enthusiasts that medical travellers would choose to combine medical treatment with a holiday. In reality, most people go for medical treatment only.

Figures for the global medical travel market could be further inflated if the industry followed a similar GWI definition for secondary wellness travellers. Secondary medical tourism, for example, could include both patients and their companions and the money spent by them on tourism. Taken to extremes, if someone travels to visit a patient in hospital, and buys flowers and a snack, are they a secondary domestic medical traveller?

For a realistic global wellness tourism picture, where travel is primarily for wellness treatment, IMTJ suggests that figures for domestic travel and secondary wellness should be removed.

Key findings in the 2018 Global Wellness Tourism Economy report

Global Market

Wellness tourism grew by 6.5 % between 2015 and 2017, from US$563.2 billion to US$639.4 billion. It is forecast to grow at an average annual rate of 7.5% through 2022, considerably faster than the 6.4% growth estimated for overall tourism. By 2022, the spend will hit US$919 billion, with 1.2 billion wellness trips taken annually.

GWI defines wellness tourism as travel associated with the pursuit of maintaining or enhancing one’s personal wellbeing. Travellers made 830 million wellness trips in 2017, which is 139 million more than in 2015.

Wellness tourism splits into:

  • Lodging (including destination spas, health resorts, retreats, hotels, resorts and camping): US$130.5 billion
  • Food and drink: US$115.5 billion
  • Shopping: US$98.3 billion
  • Activities and excursions (including spas, bathing, fitness, meditation, life coaching, museums, theatres and tours): US$99.7 billion

Wellness tourism is split between primary wellness travellers who take a wellness trip, and secondary wellness travellers who go on holiday and also take part in wellness activities.

Secondary wellness tourism accounted for 89% of wellness tourism trips and 86% of wellness tourism expenditures in 2017. Secondary wellness tourism continues to grow at a faster rate than primary wellness tourism; secondary wellness tourism trips grew by 10% annually, while primary trips grew by 8% annually from 2015 to 2017.

GWI estimates that international wellness travellers spend 53% more than the average tourist, and domestic wellness travellers spend 178% more than the average domestic tourist. 

Analysis by region

Europe is the destination for the largest number of wellness trips. North America leads in wellness tourism expenditures, because average spending per trip is higher. In the past five years, Asia has made the most gains in the number of wellness trips and wellness tourism expenditures, with demand stimulated by strong economies and an expanding middle class.

Wellness tourism expenditure by region for 2017:

  • Europe: US$210.8 billion
  • North America: US$241.7 billion
  • Latin America/Caribbean: US$34.8 billion
  • MENA: US$10.7 billion
  • Africa: US$4.8 billion
  • Asia Pacific: US$136.7 billion

Wellness tourism trips by region for 2017:

  • Europe: 291.8 million
  • North America: 204.1 million
  • Latin America/Caribbean: 59.1 million
  • MENA:11.0 million
  • Africa: 6.5 million
  • Asia Pacific: 257.6 million

Wellness tourism is heavily concentrated in several major countries across North America, Europe, and Asia-Pacific. The USA accounts for over one-third of global revenues. The top five countries (USA, Germany, China, France, Japan) represent 59% of the global market, and the top twenty countries represent 84%.

Since 2013, China has continued to move up in the rankings for wellness tourism expenditures (and is now in the top three). India has moved into the top ten, while Malaysia has entered the top twenty for the first time.

The number of countries actively marketing their wellness offerings at the national level has grown from 65 in 2013 to over 100 in 2018. In the USA, while only eight of the 50 states marketed the sector in 2013, now over one-third promote some form of wellness tourism on their official state tourism websites.

Destinations are now developing far more authentic, place-based wellness tourism products and brands. Pioneers include Kerala, India which branded itself the "Land of Ayurveda" over two decades ago, or Costa Rica’s new "Wellness Pura Vida" campaign.

The lucrative nature of wellness tourists means there are many opportunities for tourism businesses to infuse wellness into their offerings and capture spending. Airports and airlines are offering spa treatments, wellness classes and healthier food options. Healthy hotels are now mainstream with in-room fitness equipment, healthy snacks and partnerships with wellness brands.

The top 20 destinations BY VALUE:

Position

Country

Expenditure US$ billion

Number of trips

millions

1

USA

226.0

176.5

2

GERMANY

65.7

66.1

3

CHINA

31.7

70.2

4

FRANCE

30.7

32.4

5

JAPAN

22.5

40.5

6

AUSTRIA

16.5

16.8

7

INDIA

16.3

56.0

8

CANADA

15.7

27.5

9

UK

13.5

23.2

10

ITALY

13.4

13.1

11

MEXICO

12.8

18.7

12

SWITZERLAND

12.6

9.7

13

THAILAND

12.0

12.5

14

AUSTRALIA

10.5

10.0

15

SPAIN

9.9

18.8

16

SOUTH KOREA

7.2

19.6

17

INDONESIA

6.9

8.3

18

MALAYSIA

5.0

8.3

19

TURKEY

4.4

9.1

20

BRAZIL

4.1

10.5

Source: GWI, 2018 Global Wellness Tourism Economy report

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