Health and Wellness Tourism: Spas and Hot Springs
376
Health and Wellness Tourism: Spas and Hot Springs
376Hardcover
-
PICK UP IN STORECheck Availability at Nearby Stores
Available within 2 business hours
Related collections and offers
Overview
Product Details
| ISBN-13: | 9781845411121 |
|---|---|
| Publisher: | Channel View Publications |
| Publication date: | 07/27/2009 |
| Series: | Aspects of Tourism , #40 |
| Pages: | 376 |
| Product dimensions: | 7.00(w) x 9.70(h) x 1.00(d) |
About the Author
Malcolm Cooper is Vice President (Research) at Ritsumeikan Asia Pacific Universityin Japan and lectures in tourism law and tourism development and planning. His research interests include tourism development and planning, sustainable development and management of environmental resources.
Read an Excerpt
Health and Wellness Tourism
Spas and Hot Springs
By Patricia Erfurt-Cooper, Malcolm Cooper
Multilingual Matters
Copyright © 2009 Patricia Erfurt-Cooper and Malcolm CooperAll rights reserved.
ISBN: 978-1-84541-112-1
CHAPTER 1
Introduction: Development of the Health and Wellness Spa Industry
PATRICIA ERFURT-COOPER and MALCOLM COOPER
Spas have been a way of relieving stress and physical ailments for thousands of years and ... sanus per aquam (health through water) originated around the practice of bathing in hot springs and thermal waters LaForest, 2004: 1
Introduction
The wellness concept originally based on the use of natural hot and mineral springs (thermalism, balneology) forms the foundation for the discussion of the development and growth of Health and Wellness Spa Tourism in this book. Wellness facilities and programmes became a worldwide tourist attraction during the last decade of the 20th century and this trend shows no sign of abating, with excellent prospects for continued growth in the future. However, both the term and concept of wellness have a complex history (EUPHA, 2005), and dating the exact onset of the trend towards wellness is not easy because opinions are divided, with several sources suggesting that spa and wellness holidays have been around for hundreds if not thousands of years (Foster & Keller, 2008; LaForest, 2004; Smith & Kelly, 2006).
The latter discussion does not refer to spa towns with thermal springs in particular but to all spa centres that existed in the past even without the added attraction of natural hot springs. In the Middle East tradition Pharaoh Cleopatra is said to have established one of the world's first spa resorts on the shores of the Dead Sea in about 25 BC (Svart, 2006), and the Romans of course left behind a long list of bathing facilities (bathhouses, thermae) that they built between 54 BC and 450 AD while they were occupying large parts of what has become Europe, the Middle East and North Africa. To heat their bathing facilities and their houses the Romans took advantage of natural geothermal resources wherever these were available locally.
The origin of the term spa that describes such facilities is usually linked to the town of Spa in Belgium, where from the 14th century AD local hot mineral springs have been frequented for their therapeutic benefits and which has subsequently developed into a health resort. The word spa has now become a household name and the common designation for health resorts around the world (Altman, 2000), whether based on natural hot springs or not.
In Japan, where the main attraction is the traditional Onsen (hot spring bathing facilities), the wellness tradition revolves around the use of hot springs by people who enjoy sharing a bath in the evening after work (a form of corporate stress relief) or as families and other groups of users. Onsen-type spas in Japan are, however, used differently from the spas of European tradition, where the emphasis is more on health treatment than the act of bathing; however, this is fast becoming popular in Japan too as the implicit health benefits of Japanese mineral springs are used more explicitly to attract customers. Nevertheless, given the approximately 26,000 natural geothermal springs in Japan and the Japanese preference for authentic hot water bathing as a social custom, European-style wellness centres that incorporate bathing with 'beauty therapy' are unlikely to be serious competition to the traditional Onsen in the immediate future (Hotta & Ishiguro, 1986).
In other parts of the world a blending of these two somewhat polar types (wellness treatment facilities vs. simple bathing) may be found, whose exact shape will be dependent on the status of the natural resource available and its cultural use that prevails in any particular location. This book provides case studies of the main forms of health and wellness spa tourism based on hot and mineral springs as well as a comprehensive discussion of their geological and historical antecedents, their nature, social and cultural usage, their technology and economics, and their management and marketing. While there are many coffee-table style books on spas and the health and wellness industry, to date there have been very few discussions of this form of tourism in the academic literature. This book is designed to redress this lack of attention and provide a framework for the expanded analysis and discussion of health and wellness spa tourism befitting its growing importance.
The Wellness Concept: An Important Resource for Tourism in the 21st Century
The wellness concept is a term subject to different interpretations (Cohen & Bodecker, 2008; Foster & Keller, 2008; Smith & Kelly, 2006), but almost invariably has its origins in a natural and holistic approach to health that includes the use of water and the minerals within it (derived from sources at different temperatures) to provide cures for various human ailments. While the European tradition can be traced back in historically attested sources to the Greek and Roman cultures (Hall, 2003), it is likely to be far older (see Chapter 3; Foster & Keller, 2008). In the Americas, and especially in the Asia Pacific region (Lund, 2005; Schafer, 1956), the use of thermal and mineral springs has a very long tradition attached to it, dating back thousands of years to the Native North and South Americans, the Indus Valley, China and Japan, and the Polynesian peoples in the Asia Pacific area and New Zealand (see Chapter 4). More recently, the revived wellness concept of the 19th to 21st centuries is aimed at the prevention of illness not just through the mineral content and use of thermal waters, but also through informed health promotion, education and encouragement of a holistic approach to nutrition, and achieving mental and spiritual balance (see Chapter 2). For many people a very personal decision involving a change in lifestyle and a desire to achieve balanced well-being that includes physical, mental and spiritual health has been made, and this very often includes attendance at spa and wellness facilities (Cohen & Bodecker, 2008; IUTO, 1973).
Impact of information
The recent growth of the health and wellness movement has also brought an increased availability of 'coffee-table' marketing information and other published literature relating to the hot and mineral springs spa experience in the form of books, magazines and DVDs (see Chapter 8). Use of the immediacy and visual nature of the internet has also triggered a heightened awareness of the long-term benefits of taking care of personal health. This increased information supply has also included non-scientific versions for laypeople of discussions on the results of clinical trials and studies of the effects of thermalism (balneology and hydrotherapy at thermal spas) on problems such as rheumatism, osteoarthritis and psoriasis (Chapters 2 and 3). Given the range of general information now available, almost every spa visitor or tourist has different expectations of the likely experience and/or outcome that they are seeking and/or will tolerate (Adams, 2003). The health and wellness spa industry has recognised this complexity and is endeavouring to cater for it. In fact different types of spas are directly linked to these customer expectations through media advertising and marketing (see Chapter 8; Cohen & Bodecker, 2008). Some of the more common threads are:
• taking time out in a peaceful and calming environment;
• relaxing and unwinding in comfort and quality;
• enjoying the benefits for personal health and well-being from 'taking the
• waters'; feeling safe and well cared for;
• experiencing professionally trained and qualified staff; and
• receiving value for money.
Definitions of Health and Wellness Tourism
In order to establish some guidelines on how to define and classify health and wellness tourism based on the use of hot and mineral springs and spa and wellness centres, a segmented approach has been adopted for this book. Figure 1.1 outlines the conceptual model we use to relate health and wellness spas to hot springs spas. This model also suggests important definitional segmentations within our subject matter and these too are followed in this book. The following individual segments are discussed independently:
• health;
• wellness;
• tourism;
• health tourism;
• medical tourism;
• wellness tourism;
• hot and mineral springs; and
• mineral composition and geological background of the springs.
Health, according to the Merriam-Webster Dictionary (n.d. (a)), is defined as
(1) The condition of an organism or one of its parts in which it performs its vital functions normally or properly.
(2) The state of being sound in body or mind.
(3) Freedom from physical disease and pain.
There are many definitions along similar lines, but all these indicate the same condition of optimal well-being combined with vigour, vitality, strength, fitness and stamina. The most cited definition of health is that by the World Health Organization (WHO), which can be found on the first page of that organisation's constitution (WHO, 2006). The original constitution came into force on 7 April 1948, with the following definition of health in its preamble:
Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
This definition has not been changed or updated significantly in over 5 decades and in recent years there have been critics calling for its reconsideration. One of the most vocal has been Saracci (1997), who advocated a change of terminology in the original definition to:
Health is a condition of well being free of disease or infirmity and a basic and universal human right.
His concern is that the original definition of 'a state of complete physical, mental and social well-being' in fact corresponds much more closely to happiness than to health and therefore poses conceptual problems when used as a basis for the study of wellness as a motivator for travel to destinations comprising hot or mineral springs. Because it also manifestly downgrades important mediating variables such as politics, economics and poverty, to mention but a very few, Awofeso (2005) argues 'that the WHO definition of health is utopian, inflexible, and unrealistic'. Following Awofeso we argue in this book that it is important to recognise that health is as much an ideal as an actual state of existence, and that this opens up the possibility of seeking a desired future state of health through conscious action to modify health patterns in the present. This wider definition of the nature of health allows consideration to be extended to states of health (in this case wellness), and it is this concept that underlies the health and wellness spa industry's claim to be of importance to the individual and group health of tourists.
Wellness is defined as:
(1) an approach to health care that emphasises preventing illness and prolonging life, as opposed to emphasising the treatment of diseases;
(2) the condition of good physical and mental health, especially when maintained by proper diet, exercise and habits (American Heritage Dictionary of the English Language (n.d.));
(3) a healthy state of well-being free from disease (American Heritage Stedman's Medical Dictionary (n.d.)); and
(4) the quality or state of being in good health especially as an actively sought goal, for example lifestyles that promote wellness (MerriamWebster Medical Dictionary (n.d. (b)).
More dictionary-sourced definitions are not hard to find, but they all contain similar variables and their purpose and meaning do not vary widely (Cohen, 2008; Foster & Keller, 2008). Essentially, wellness is an approach to health care and lifestyle choice that is based on active prevention of illness and active promotion of a state of well-being. It is this sense of action that attracts many clients and ultimately supports the unique form of tourism known as Health and Wellness Spa Tourism (Cohen, 2008; Hall, 2003). Adams (2003) refers to four main principles of wellness:
Wellness is multi-dimensional.
Wellness research and practice should be oriented towards identifying causes of wellness rather than causes of illness.
Wellness is about balance.
Wellness is relative, subjective or perceptual.
These will be elaborated below and in Chapter 2, but it is reasonably clear that wellness is as much a psychological as a physical state. Indeed, what little research there is in the tourism literature concerning wellness makes much of this distinction.
Tourism on the other hand has almost as many definitions as there are scholars and businesses that study or operate within it. It has been defined by the United Nations World Tourism Organization (UNWTO) as 'the activities of persons travelling to and staying in places outside their usual environment for not more than one consecutive year for leisure, business or other purposes' (TIAC, n.d.). Tourism is also defined as 'The entire world industry of travel, hotels, transportation and all other components, including promotion that serves the needs and wants of travellers' (Goeldner & Ritchie, 2003). Weaver and Lawton (2002) define tourism in their glossary as 'the sum of the phenomena and relationships arising from the interaction among tourists, business suppliers, host governments, origin governments, universities, community colleges and non-governmental organisations, in the process of attracting, transporting, hosting and managing these tourists and other visitors'.
One of the major motivations for the act of tourism is that of escape (Goeldner & Ritchie, 2003). Escape from an everyday personal or physical environment to one perceived to be likely to give to the traveller all the elements of 'life' he or she feels are missing from those everyday experiences. In addition, satisfaction of the desire for a healthy lifestyle, which as Hall (2003) notes is a significant intrinsic reward of much travel, has become a very important part of the range of new products available to tourists in recent years. This growing desire for the combination of escape with satisfaction of the need to maintain or recapture personal well-being has been recognised by the tourism industry through the promotion of health and wellness tourism.
Health tourism is defined by Ross (2001) and Tabacchi (2003) as 'any kind of travel to make yourself or a member of your family healthier'. Ross also refers to the concept of health tourism as 'as ancient as pre-history and as up-to-date as tomorrow', reinforcing the fact that we do not know exactly when health tourism first started because of the absence of written records. With reference to the healing benefits of hot springs Ross points out that in Europe post the Roman Empire these resources were used at least during the Middle Ages period (c. 900–1400 AD) and at that time were characterised by a firmly established belief in their curative powers (de la Barre et al., 2005). In recent years health tourism has undergone significant renewal and expansion, and is now incorporating medical tourism (Hall, 2003). Hall also gives spa and health tourism a positive prognosis for the future, suggesting that this particular type of tourism could well be reclaiming its position after a time of dormancy during the past century.
In France and Germany, and in many of the countries of the former Soviet bloc, health tourism is 'emphatically medicalised' with spa therapy or thermalisme, as the French call it, still going strong. This is, according to Weisz (2001), due to the fact that 'thermalism found a place in the health care structure of those countries from which it cannot easily be dislodged'. Weisz gives valuable insight into the French hot and mineral spring spa system, which is rather unique by global standards. In France most medical spa treatments are covered by the national health system, which was and is partly true of several other European countries, especially Germany and the countries of the former Soviet Union.
The growth of Medical Tourism has been so rapid that there is as yet little scholarly work on it (Eades, 2010). Given this problem, the following definition has been derived from Wikipedia:
Medical tourism (also called medical travel, health tourism or global health care) is a term initially coined by travel agencies and the mass media to describe the rapidly-growing practice of travelling across international borders to obtain health care. Such services typically include elective procedures as well as complex specialized surgeries such as joint replacement (knee/hip), cardiac surgery, dental surgery, and cosmetic surgeries. As a practical matter, providers and customers commonly use informal channels of communication-connection-contract, and in such cases this tends to mean less regulatory or legal oversight to assure quality and less formal recourse to reimbursement or redress, if needed. Leisure aspects typically associated with travel and tourism may be included on such medical travel trips. (http://en.wikipedia.org/wiki/Medical_tourism)
(Continues...)
Excerpted from Health and Wellness Tourism by Patricia Erfurt-Cooper, Malcolm Cooper. Copyright © 2009 Patricia Erfurt-Cooper and Malcolm Cooper. Excerpted by permission of Multilingual Matters.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.
Table of Contents
1 Introduction: The Development of the Health and Wellness Spa Industry2 The Health and Wellness Concept: A Global Overview
3 The Use of Natural Hot and Mineral Springs throughout History
4 The Cultural and Religious Use of Water
5 The Geological Background of Natural Hot and Mineral Springs
6 The Health and Wellness Spa Tourism Industry Environment
7 The Technology and Economics of Health and Wellness Spa Tourism
8 Aspects of Management and Marketing in Health and Wellness Spa Tourism
9 Case Studies from the Contemporary World
10 Conclusions: Retrospect, Challenges and the Future