what is travel research

100+ Tourism Research Topics: Trends and Future Directions

Tourism research stands at the crossroads of exploration and understanding, dissecting the intricacies of an industry that transcends geographical boundaries. In this blog, we delve into the realm of tourism research topics, examining their importance, trends, popular areas of study, challenges faced by researchers, and the future directions that the field is poised to take.

Key Trends in Tourism Research

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Sustainable Tourism

Sustainable tourism has become a cornerstone of research in recent years, reflecting the global shift towards eco-conscious travel. Researchers are delving into the intricate balance between satisfying the wanderlust of tourists and preserving the environment.

Initiatives such as wildlife conservation, eco-friendly accommodations, and community engagement are key focus areas.

Technology in Tourism

The pervasive influence of technology on tourism cannot be overstated. From online booking platforms to virtual reality experiences, researchers are exploring the impact of technology on travel behavior.

Emerging areas of study include the use of artificial intelligence in personalized travel recommendations and the implications of augmented reality for enhancing tourist attractions.

What is the Importance of Tourism Research for Students?

Tourism research holds significant importance for students pursuing studies in various disciplines, including tourism management, hospitality, business, sociology, and environmental studies. Here are some key reasons why tourism research is valuable for students:

Academic Enrichment

Increases Understanding: By conducting study on the tourist business, students may increase their comprehension of the intricate relationships between the economic, social, cultural, and environmental facets of the sector.
Application of Theoretical information: This increases the practical relevance of their education by giving them the chance to apply the theoretical information they have learned in the classroom to real-world situations.

Skill Development

Research Skills: Gathering, analyzing, and interpreting data are just a few of the vital research skills that come from conducting tourist research. These abilities are adaptable and useful in a range of work environments.
Communication abilities: Through research papers, presentations, and conversations, students learn how to effectively express their results, which improves both their writing and spoken communication abilities.

Industry Insights

Current Trends and Issues: Research allows students to stay abreast of current trends, challenges, and emerging issues in the tourism industry. This awareness is crucial for adapting to the dynamic nature of the field.
In-Depth Knowledge: By delving into specific tourism research topics, students gain in-depth knowledge of particular sectors within the industry, positioning themselves as experts in specialized areas.

Career Opportunities

Competitive Advantage: Having experience in tourism research can provide students with a competitive advantage in the job market. Employers value candidates who can bring a research-driven perspective to decision-making.
Diverse Career Paths: Whether in academia, policy-making, destination management, or market analysis, a background in tourism research opens doors to a variety of career paths within the broader field of tourism and hospitality.

Contributions to Sustainable Practices

Environmental and Social Responsibility: Tourism research often focuses on sustainable practices. Students, through their research, can contribute ideas and solutions for promoting responsible tourism, minimizing negative impacts on the environment and local communities.

Global Perspective

Cultural Awareness: Researching diverse tourism topics exposes students to various cultures, traditions, and perspectives. This global perspective is crucial in an industry where interactions with people from different backgrounds are common.

Problem-Solving Skills

Analytical Thinking: Research involves analyzing complex issues and developing solutions. This cultivates students’ analytical thinking and problem-solving skills, valuable attributes in any professional setting.

Personal Growth

Confidence Building: Successfully conducting research and presenting findings builds students’ confidence in their abilities. It empowers them to tackle challenges and approach tasks with a systematic mindset.

In summary, tourism research is a multifaceted learning experience that goes beyond textbooks, providing students with the skills, knowledge, and perspectives needed for a successful and impactful career in the tourism industry or related fields.

Challenges and Opportunities in Tourism Research

Data collection and analysis.

While technology has streamlined data collection, challenges persist in ensuring data accuracy and relevance. Researchers are exploring advanced methodologies, such as big data analytics and machine learning, to overcome these hurdles and derive meaningful insights.

Globalization and Tourism

The globalization of the tourism industry poses both challenges and opportunities. Researchers are scrutinizing the impact of global trends on local economies, cultural identities, and the environment. Striking a balance between global and local interests is a complex task that requires careful consideration.

Future Directions in Tourism Research

Emerging tourism destinations.

The landscape of tourist destinations is ever-evolving. Researchers are turning their attention to emerging destinations, investigating the factors that contribute to their rise and the implications for the broader tourism industry.

This includes understanding the appeal of off-the-beaten-path locations and the potential challenges associated with their sudden popularity.

Post-Pandemic Tourism

The COVID-19 pandemic has reshaped the tourism industry in unprecedented ways. Researchers are exploring the long-term effects of the pandemic on travel behavior, destination preferences, and the overall structure of the tourism sector.

Strategies for recovery and resilience are also under the microscope as the industry adapts to the new normal.

Resources for Tourism Research Topics

Academic Journals and Publications: Leading academic journals in tourism research, such as the “Journal of Sustainable Tourism” and the “Annals of Tourism Research,” provide a wealth of knowledge for researchers. These publications cover a wide array of topics, from sustainable practices to cultural tourism.
Conferences and Events: Attending conferences and events, such as the “International Conference on Tourism Research” and the “World Tourism Forum,” offers researchers the opportunity to engage with peers, present their work, and stay abreast of the latest developments in the field.
Online Databases and Research Platforms: Online databases, including Google Scholar, ResearchGate, and Tourism Management Database , provide access to a vast repository of research articles, theses, and reports. These platforms facilitate collaboration and information exchange among researchers.

In conclusion, the landscape of tourism research topics is vast and dynamic, reflecting the multifaceted nature of the tourism industry. As researchers continue to explore sustainable practices, emerging trends, and the post-pandemic landscape, the importance of their work cannot be overstated.

By navigating the challenges and embracing the opportunities presented, tourism researchers contribute to a more informed and resilient industry, ensuring that the joy of travel remains accessible for generations to come.

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The Journal of Travel Research ( JTR ) is the premier, peer-reviewed research journal focusing on the business of travel and tourism development, management, marketing, economics and behavior. JTR provides researchers, educators, and professionals with up-to-date, high quality research on behavioral trends and management theory for one of the most influential and dynamic industries. Founded in 1961, JTR is the oldest of the world’s top-ranked scholarly journals focused exclusively on travel and tourism, reflecting the worldwide importance of tourism, both economically and socially.

Published by SAGE, an international leader in social science and business publishing, JTR publishes the most current and influential scholarship on travel and tourism.

The Journal of Travel Research publishes state-of-the-art research on the most important trends and issues in travel and tourism. JTR offers an international and multidisciplinary perspective on the best development and management practices by publishing research which enhances knowledge of important travel and tourism phenomena. JTR thereby contributes to the development of theory which enables improvements in tourism development policy and strategy; managerial practice; economic, social and environmental outcomes; and education and training programs.

All manuscripts submitted to the Journal of Travel Research are double-blind, peer-reviewed by leading tourism scholars. The JTR editorial review board includes top tourism scholars identified on the basis of their current research and scholarly contributions. This journal is a member of the Committee on Publication Ethics (COPE).

The mission of the Journal of Travel Research is to be the premier, peer-reviewed research journal focused on the business of travel and tourism development, management, marketing, economics and behavior. Given the multifaceted, multidisciplinary and multi-stakeholder character of the tourism economy, this focus implies a concern for both the public and private sector spheres of interest as well as economic, socio-cultural, political, environmental, legal, technological, and demographic issues. Specific goals are to be international in scope with geographic diversity, to be multidisciplinary with diversity in research topics and methodologies, and to be germane to the needs of the travel and tourism industry and its stakeholders.

All manuscripts published in the Journal of Travel Research are double-blind, peer-reviewed by accomplished scholars in the topical area. The standard for publication in the Journal of Travel Research is that a paper must make a substantive contribution, either theoretically or methodologically, to the travel and tourism research literature. Additionally, a paper should specify its contribution to pragmatic tourism management concerns and practice.

Published manuscripts must be on research of the highest standards, on topics of major significance and widespread interest, and relevant to the progress of this important global sector.

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Engineering Around Travel

Mastering Travel Research Online in the Digital Age

Posted June 27, 2022 in Engineering Around Travel - Last updated November 9, 2023

Travel research online is the key to unlocking amazing adventures in the digital age. It’s hard to find trustworthy travel info because there’s so much out there. We made this guide so you can confidently and easily research travel online. With our experience, we have visited many places, found simple solutions, and had unforgettable trips. Now, we want to share our insights and tips with you.

Also, check out our high-level overview of travel planning and creating an itinerary here . Also, note that Travel-Wise is built from the ground up to aid with travel planning, research , and community , and we truly hope it’ll inspire your next adventure. Travel-Wise now includes country travel guides that will help give you relevant links and information for good sources of information on a destination to help with your planning. Here is an example of preparing to travel to the United States.

Featured Photo 67852857 © Stanislav Moroz | Dreamstime.com

Government and official tourism agencies

I suggest checking official government agencies that publish information for inbound travelers for trustworthy information. The information is always the most up-to-date (with limitations to world events). You’ll find stale and old information online, but government websites are the most reliable. That is why my first stop is the official websites when I look for information on safety concerns, visas for travel, laws, and regulations.

Best used for

The current procedure, regulation, and costs of acquiring a visa and entering clearance.
Some countries have current and up-to-date travel advisories around safety topics for travelers. This information, if available, is trustworthy.

Books are the most detailed source of information. They are full of diverse data and are often more than you need. The problem with books is that they can go stale within a few years. Of course, nations, nature, and people don’t change that fast, but details here and there go close.

Also, the book’s author may not align with your travel persona. This is important. They may not speak to or cover activities, topics, or points of interest that say to you. As a result, you may buy a book and end up feeling it didn’t cover some of the essential pieces you were looking for. Still, books used to be one of my staples.

We own a lot of Lonely Planet travel guides, Mountaineering, and scuba diving books to aid in our travels. Because it is challenging to publish a book, getting a book out enriches information. Books remain an excellent source of information with reliable ratings and recommendations.

A starting point for consideration is if a recent (within the last 15 years) book covers the area comprehensively.

Travel agents

Travel Agents are professionals in the field who help you plan your travel. It is their job, and they often will have experienced everything they recommend to you. They can tell you about most of the activities in great detail. Because travel is centered on businesses, people, and agencies, travel agents specialize in specific areas of travel. Therefore, they know a lot about a particular place or style of travel. This experience is of great value for your travel planning. You may be interested in working with them to buy one of their packages and have all the planning done for you. The packages usually cost little or compete with your book rates due to affiliate deals with travel agencies.

The problem with travel agents comes back to your travel persona. They may not be a good match for your interests and, because of that, might prescribe you a trip they love. It might work better for you, though. Every travel agent is different, and some may be flexible in dealing with this. Being a good travel agent is a skill, and finding a good travel agent who works for you can be challenging.

Still, if you find a travel agent specializing in the place or type of travel you are interested in, you can count on good information. Nothing beats raw experience, and being able to ask your questions to someone directly can help prepare you much better than a book or other sources. If a package works for you, your planning gets automated as well! However, remember that these packages are struck through deals and are often more flexible than if you booked yourself.

Pre-packaged deals or custom-made to help with travel planning.
Knowledgeable travel expert that would be helpful to ask many important questions with.
Professional and recent travel knowledge based on the agent’s expertise.

Leveraging social media for travel inspiration

Social media influences the travel industry, shaping consumers’ choices and preferences. The social aspect of travel creates a significant opportunity for brands to reach more people with engaging content. As new social platforms become more popular, brands need to interact with travelers on these platforms.

Social media as a source of inspiration

Social media is becoming a more in-demand source of travel inspiration, according to the 2023 Traveler Value Index . It shows that 35% of consumers use social media for travel ideas, which is more than travel agents (29%), media publications (26%), and entertainment (25%). Social media substantially influences younger generations, as half of the people under 40 use it for inspiration.

Generational impact

For consumers under 40, social media is almost as important as family (52%) for travel inspiration. Gen Z values social media even more, as 53% use it as their primary source. Brands must have a solid social media presence to reach younger travelers effectively.

Regional influence

The Impact of social media on inspiration varies by region. In South Africa, 59% of consumers seek inspiration from social media, and in Mexico, the figure is 54%. These regional variations underscore the global significance of social media’s role in travel inspiration.

Crafting effective social media campaigns

Creating innovative and engaging campaigns is the key to connecting with travelers on social media. Successful campaigns enable brands to reach a wider audience, stand out, and leave a lasting impression. Bite-sized content can significantly impact, as shown by examples like Destination Canada’s TikTok campaign and Abu Dhabi’s immersive experience.

Harnessing social media marketing for travel inspiration

Using social media solutions for travel marketing offers a direct channel to a targeted audience across brands like Expedia , Vrbo , and Hotels.com . These solutions encompass social integration packages, Instagram stories, co-branded videos, and custom promotions across multiple platforms. With the ever-increasing popularity of social media, ensuring a strong social strategy is imperative for success in inspiring and influencing travelers.

Folks who recently visited

You’ll always hear of your co-workers, friends, and families traveling; sometimes, they’ve already gone to where you’ve been. Asking them for their suggestions of what to visit and a copy of their itinerary is an excellent way to give you a tremendous start in your travel plans! People love sharing; having someone trusted to ask detailed questions will help more than other sources.

Getting in touch with these trusted individuals could be challenging to schedule. I’ve often found that someone had much to suggest, but I couldn’t connect to jot all their info down. It is too much to ask most people to type it up for you, and if they have not already made a formal travel itinerary for sharing with you, the information is locked in their minds. Also, taking notes live from someone is a bit hit or miss for me. I feel like I always forget about something important someone told me about. Also, your travel persona may not match yours, leaving gaps in what you want to experience from your itinerary.

The trusted source of information from their experience with surprisingly strong detail and tips will be helpful. In addition, since they know you, they can custom-tailor the information for you and tell you what you want to hear.
When you have tough questions and need answers from someone who has been there.

Travel blogs

Travel blogs are popping up around the internet and target specific niches. Similar to what I mentioned, travel agents focus on specialization. Travel blogs are very similar. They focus on luring a specific traveler and use precise keywords to show up on search engines. Travel blogs provide genuine information identical to books. You can contact the travel bloggers live and ask questions of them. Travel bloggers offer trip packages with affiliate deals that have similar costs to self-booking.

The problem with travel blogs is that they are like books. They could go stale. However, I see some dedicated bloggers making sure they update their information. However, quality over time can differ between bloggers. The blog websites are more flexible than books as any update to the data can be live within minutes versus republishing and buying a new book. You can also hand-choose what areas interest you most in what to read.

Travel bloggers sometimes speak to your travel persona directly, leaving you with some holes to fill in on other websites. However, travel blogs are still excellent sources and relatively quick and free to search on your favorite search engine. In addition, they can be excellent sources of community and information and help validate the information from other sources.

Travel Bloggers often have pre-packed deals, too. If they match your travel persona, this can help with your planning.
They have a wealth of detailed information about their travel niche that can be as detailed as the books.

Why travel news and alerts matter

In the dynamic world of travel, staying well-informed

A proactive approach to ensure your exciting and secure adventures begins with keeping up with travel news and alerts. As you traverse the globe, staying updated on the latest developments empowers you to make informed decisions. Some of the travel news websites are given below.

Travel Weekly : Travel Weekly, owned by the prominent travel media conglomerate Northstar Travel Group, delivers up-to-the-minute breaking news, destination insights, hotel updates, cruise schedules, travel trends, and valuable content catering to the business-to-business sector of the tourism industry.
PhocusWire : PhocusWire is a website focusing on technology, distribution, and the digital economy for travel, tourism, and hospitality. It belongs to Phocuswright, a global authority in travel research and analysis.
BBC Tourism is a part of BBC News, a trusted source of global news. It features tourism news, travel guides, videos, photos, quizzes, and blogs from worldwide destinations. It helps you discover new locations and cultures with BBC’s quality journalism.

Safety measures for travelers

To stay secure while moving, travelers should remain vigilant and take proactive steps. Research the local customs and laws of your destination, register with your embassy if necessary, and stay connected with news sources and official government travel advisories. Utilize travel research online resources to access up-to-date information and practical tips to enhance your safety during your journey.

Create a tailored adventure

In modern travel, the power to curate your journey lies at your fingertips. “Customize Your Travel Preferences” isn’t just a phrase; it’s an invitation to embark on a personalized travel experience that caters to your unique desires. This process involves more than selecting destinations–crafting a travel plan that resonates with your soul.

What are travel preferences?

Travel preferences encompass the myriad choices that make a journey uniquely yours. The places you like to go, how you get there, where you stay, and what you create your adventure. Understanding and fine-tuning these preferences allows you to transform a mere trip into an unforgettable voyage. This article will help you understand your travel persona if you don’t already know it.

Crafting your travel plan

Writing a travel plan isn’t just about listing places to visit; it’s about creating a roadmap that aligns with your aspirations. Consider your desired experiences – travel excitement, cultural involvement, or leisure. Then, interweave these aspirations into a seamless itinerary. With Travel-Wise, every trip detail is tailored to your preferences and dreams. Plan your trip with our trip planner , and make it unforgettable.

Broadening horizons through travel

Traveling isn’t just about changing locations; it’s about shifting perspectives. It’s an opportunity to immerse yourself in diverse cultures, savor new cuisines, and engage with different ways of life. Trying new things can make you grow and appreciate different experiences.

Choosing the right destination

Selecting a destination can be exhilarating yet challenging. The allure of historical sites, pristine beaches, bustling cities, and tranquil retreats beckons from every corner of the globe. It’s essential to align your chosen destination with your interests. Your journey depends on what you like – history, nature, or cities. It’s easy to plan your trip when we have country guides to help you guide about everything about the country.

Exploring your travel options

Travel manifests in many forms – solo adventures, romantic getaways, family escapades, and group expeditions. The best form of travel is the one that resonates with you, capturing the essence of your desired experience. Whether it’s a backpacking adventure, a luxurious cruise, a road trip, or a train journey, your choice defines the flavor of your expedition.

Embrace the world of travel research online to unlock a treasure trove of information, insights, and options. Travel-Wise is a useful tool for creating your adventure. Customize your travel preferences and let the world unfold harmoniously with your desires.

Discover new horizons with Travel-Wise

Embarking on discovery journeys becomes effortless with innovative tools offered by Travel-Wise, your all-in-one travel companion. Travel-wise, it serves as your guide, enhancing every step of your adventure as you explore the world. Let’s explore how this tool transforms your travel experience and enhances your explorations.

Seamless travel planning

Travel-Wise simplifies travel planning by providing a comprehensive platform where you can design your journey . Our tool simplifies trip planning , saves time, and helps you make the most of your adventure.

Personalized recommendations

Tailoring your travels to your preferences is at the core of Travel-Wise. The tool leverages advanced algorithms to offer personalized recommendations that align with your interests. Our platform recommends activities and destinations that match your interests, whether you love nature, history, or food.

Interactive mapping

Navigate unfamiliar terrain with confidence using our interactive maps. Discover points of interest, local gems, and recommended routes, all accessible at your fingertips. The mapping feature guides you and adds an element of adventure to your journey.

Community engagement

Join a community of explorers on Travel-Wise to gain insights and share experiences. Engaging with like-minded individuals enriches your travels and opens up new horizons for discovery.

Local insights

Experience your destination like a local with insider tips and recommendations. Travel-Wise shows you unique and real experiences using the knowledge of locals and experienced travelers.

As you embrace the world of travel research online, Travel-Wise stands as your trusted ally, enhancing your journeys with its features. Create unforgettable memories of community and travel planning.

Did you know Travel-Wise is a free trip-planning tool to help you make your next trip plans a breeze?

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Medical, Health and Wellness Tourism Research—A Review of the Literature (1970–2020) and Research Agenda

1 Institute for Big Data Research in Tourism, School of Tourism Sciences, Beijing International Studies University, Chaoyang District, Beijing 100024, China; nc.ude.usib@anilgnohz (L.Z.); moc.361@5220niloabgned (B.D.); moc.361@gnay__uyil (L.Y.)

Baolin Deng

Alastair m. morrison.

2 Greenwich Business School, Old Royal Naval College, University of Greenwich, London SE10 9SL, UK; [email protected]

J. Andres Coca-Stefaniak

Associated data.

Data are reported in the article.

Medical, health and wellness tourism and travel represent a dynamic and rapidly growing multi-disciplinary economic activity and field of knowledge. This research responds to earlier calls to integrate research on travel medicine and tourism. It critically reviews the literature published on these topics over a 50-year period (1970 to 2020) using CiteSpace software. Some 802 articles were gathered and analyzed from major databases including the Web of Science and Scopus. Markets (demand and behavior), destinations (development and promotion), and development environments (policies and impacts) emerged as the main three research themes in medical-health-wellness tourism. Medical-health-wellness tourism will integrate with other care sectors and become more embedded in policy-making related to sustainable development, especially with regards to quality of life initiatives. A future research agenda for medical-health-tourism is discussed.

1. Introduction

In 1841, Thomas Cook organized a tour of 570 people to travel from Leicester to Loughborough’s hot springs [ 1 ]. This was the first historically documented tour arranged by a travel agent. However, far earlier, people in Ancient Greece used to travel considerable distances for medical treatment [ 2 ]. Thus, the pursuit of health and medical care has been an essential reason for travel for centuries.

Today, people continue to travel in the pursuit of relaxation, for health reasons, as well as fitness and well-being [ 3 ]. As a response to this growing demand, countries, medical providers, and hospitality and tourism organizations are adapting to offer a broader set of medical, health, and wellness tourism experiences.

The concept of medical-health-wellness tourism has emerged relatively recently as a scholarly field of enquiry in tourism [ 4 , 5 , 6 ]. Although it has been pointed out that travel medicine has existed for 25 years [ 7 ], much of the research related to this has traditionally focused on medical aspects with inadequate consideration given to travel or tourism. Medical-health-wellness tourism can be classified into two primary categories according to a tourist’s choice - obligatory or elective. Obligatory travel occurs when required treatments are unavailable or illegal in the place of origin of the traveler and, as a result of this, it becomes necessary to travel elsewhere to access these services. Elective travel is usually scheduled when the time and costs are most suitable, and the treatments may even be available in the travelers’ home regions [ 8 ]. Other studies have classified these forms of travel and tourism into specific types based on the purpose of the treatment, such as dental tourism [ 9 ], stem cell tourism [ 10 ], spa tourism [ 11 ], springs tourism [ 12 ], IVF treatment [ 13 ], hip and knee replacements, ophthalmologic procedures, cosmetic surgery [ 5 ], cardiac care, and organ transplants [ 14 ].

A consensus is yet to be established on the definitions and contents of medical-health-wellness tourism, and how they interact, including their potential overlaps. Medical travel and tourism, health tourism, wellness tourism, and other similar terms (e.g., birth tourism, cosmetic surgery tourism, dental tourism) tend to be investigated separately in tourism research [ 15 , 16 , 17 , 18 , 19 , 20 ]. Notwithstanding the apparently disconnected nature of published research in this field, medical-health-wellness tourism has become much more popular for a variety of economic, cultural, lifestyle and leisure reasons [ 11 , 21 , 22 ]. Given their rapid development, it seems appropriate to conduct a comprehensive review of the definitions, history, typologies, driving factors, and future directions for these forms of tourism.

This study firstly reviews existing scholarly research through a meta-analysis of medical-health-wellness publications in the context of tourism ( Section 2 ). Then, the method used to analyze the data collected from ISI Web of Science is outlined in Section 3 , followed by a discussion of the research findings ( Section 4 ). Finally, in Section 5 , the conclusions, future research directions, and limitations of the study are presented.

2. Scholarly Reviews and Meta-Analyses of Medical, Health and Wellness Tourism

Previous reviews of the literature and meta-analyses have contributed to clarifying the overall understanding of medical-health-wellness tourism. Existing literature reviews tend to be very broad, spanning health-oriented tourism, medical tourism, sport and fitness tourism, adventure tourism, well-being (Yang sheng in Chinese) tourism, cosmetic surgery tourism, spa tourism, and more.

Medical tourism is an expanding global phenomenon [ 15 , 23 , 24 ]. Driven by high healthcare costs, long patient waiting lists, or a lack of access to new therapies in some countries, many medical tourists (mainly from the United States, Canada, and Western Europe) often seek access to care in Asia, Central and Southern Europe, and Latin America [ 25 , 26 , 27 ]. There are potential biosecurity and nosocomial risks associated with international medical tourism [ 28 ]. One research study collected 133 electronic copies of Australian television programs (66 items) and newspapers (65) about medical care overseas from 2005 to 2011 [ 29 ]. By analyzing these stories, the researchers discovered that Australian media coverage of medical tourism was focused geographically mainly on Asia, featuring cosmetic surgery procedures and therapies generally not available in Australia. However, people tend to engage with medical tourism for a broad range of reasons. In some cases, it is better service quality or lower treatment costs that prevail. In other cases, treatments may not be available locally, or there are long patient waiting lists for non-emergency medical care. Some 100 selected articles were reviewed and categorized into different types of medical tourism depending on the medical treatments they involved, such as dentistry, cosmetic surgery, or fertility work [ 25 ]. An analysis was done on 252 articles on medical tourism posted on the websites of the Korean Tourism Organization and the Korean International Medical Association [ 30 ]. This work enhanced the understanding of medical tourism in Korea as well as identifying the key developmental characteristics. Another research study detailed patient experiences in medical travel, including decision making, motivations, risks, and first-hand accounts [ 31 ]. A literature review was conducted on international travel for cosmetic surgery tourism [ 5 ] and it concluded that the medical travel literature suffered from a lack of focus on the non-surgery-related morbidity of these tourists.

Another set of authors defined health tourism as a branch of tourism in general in which people aim to receive specific treatments or seek an enhancement to their mental, physical, or spiritual well-being [ 32 ]. This systematic literature review assessed the value of destinations’ natural resources and related activities for health tourism. It was argued that most of the research on health tourism has focused on travel from developed to developing countries, and that there is a need to study travel between developed nations [ 33 ].

Wellness tourism is a key area of relevant research as well [ 34 ]. One research study reviewed trends in wellness tourism research and concluded that tourism marketing had so far failed to tap into the deeper meaning of wellness as a concept [ 35 ]. The emergence of health and wellness tourism was explored with their associated social, political, and economic influences [ 13 ]. A review was conducted of the development of wellness tourism using the concept of holistic wellness tourism where it was found that the positive impacts of this type of tourism on social and economic well-being were key to its rising levels of popularity [ 36 ].

All in all, although earlier literature reviews provide invaluable insights into medical-health-wellness tourism, there is a lack of studies that approach this concept in a holistic way. This research seeks to redress this balance by delivering a holistic review of the literature with the following objectives in mind: (1) investigating international journal articles across the typologies of tourism outlined above; (2) identifying influential scholars that have significantly contributed to this field; and (3) summarizing key trends in markets, industry development and promotion, as well as policy-making and impacts. In order to achieve this, a systematic review was conducted to analyze research articles in medical-health-wellness tourism published over a 50-year period from 1970 to 2020.

3.1. Data Collection

A two-step approach was adopted for the development of a database of publications for analysis with CiteSpace. The first step involved a search for relevant, high-quality refereed articles in medical-health-wellness tourism. Several academic journal databases, within tourism and hospitality but also including other disciplines too, were searched for relevant articles in medical-health-wellness tourism using a set of selected keywords. The ISI Web of Science and Scopus were chosen for this purpose as a result of their international recognition and comprehensiveness. Articles included in the list of references of selected articles were also considered valid as part of this search, in line with methodological suggestions for systematic literature searches [ 37 ]. Cited articles were also collected from prominent journals, including the Southern Medical Journal, Journal of Travel Medicine, BMC Public Health, Annals of Tourism Research, Tourism Management, Journal of Travel Research, and Journal of Vacation Marketing. Non-tourism related journals were selected as well including Amfiteatru Economic, Asia Pacific Viewpoint, Public Personal Management, and Revista de Historia Industrial. Adding these references not only delivered a higher number of relevant articles to the database, but it also increased its representativeness.

The second step involved using appropriate, valid and representative search keywords. A total of 986 articles were gathered using the following keywords: medical tourism, health tourism, wellness tourism, and spa tourism. After careful sorting of these publications, using their abstracts and keywords, the number of articles in the database was narrowed down to 802. Of these, 615 were obtained using the keywords medical tourism or wellness tourism, 157 were located by searching for health tourism, and 30 were discovered using spa tourism as the search term. Using the above keywords and restricting the search to 50 years (1970–2020), the first article was found to be published in 1974. As a result, the ensuing analysis of the literature comprises the period from 1974 to 2020.

3.2. Data Analysis

The research tool used for this study was CiteSpace, which is a bibliometric analysis software developed by Professor Chaomei Chen of Drexel University based on the Java framework [ 38 ]. This software assists researchers in the analysis of research trends in a specific field of knowledge and presents scientific knowledge structures through visualization. It has been applied to numerous research fields by scholars from many countries. The data processing for this research used the software V.5.7.R2 (64-bit) version.

The data were classified and analyzed to achieve three specific goals. The first and primary goal of this review work was to analyze the content of the chosen articles, including year of publication, authors, journal impact factors, and the institutional affiliations of scholars in this field. The data were then sorted into categories. The order of authorship was not recorded. For multiple-authored articles, each author was given the same level of credit as sole authors. Second, one of the aims of this research was to discover associations in authorships, regions, and affiliations using statistical analysis. Third, the 802 articles were classified into dominant thematic categories applying the approach proposed by Miles and Huberman [ 39 ]. Three flows of analytical activities were targeted here: data reduction, data display, and verification of data. In the data reduction activity, the word count technique was adopted. Through content analysis, each article’s title and full-text body were recorded for word counting. The most frequently appearing words were extracted to represent the main topics of the collected articles. The dominant thematic categories to be explored further based on the content analysis and word count were: (1) tourism market: tourist demand and behavior; (2) tourism destinations: development and promotion; and (3) tourism development contexts: policies and impacts.

Finally, in order to refine the set of topic sub-categories, abstracts, first paragraphs, and conclusions were read to make the most appropriate assignments. This approach contributed to the more advanced stages of development of the classification of sub-categories and, consequently, the verification of findings.

This section presents the results of the data analysis carried out in this study and provides further insights on the methodology adopted.

4.1. Overview of Articles Published

The 802 articles selected were all published in English and in international peer-reviewed academic journals. Figure 1 displays the timeline distribution of the research on medical-health-wellness tourism and shows a steady growth in publications in this field between 1974 and 2020. This growth in scholarly activity is particularly significant from 2010 onwards. In fact, 74.9% of the articles were published between 2013 and 2020.

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Number of articles by publication year.

4.2. Source Journals

Initially, the first stage of this literature search involved identifying academic journals publishing research articles on medical-health-wellness tourism. It was found that 38 articles had been published on this topic in Tourism Management, and 24 articles in Social Science & Medicine. Table 1 shows the top ten tourism journals for publications in this field, with Tourism Management in first place.

Tourism journals publishing articles on medical-health-wellness tourism.

Non-tourism journals in fields such as business, economics, and health, also contributed a significant number of publications in this field, as shown in Table 2 .

Non-tourism journals publishing articles on medical-health-wellness tourism.

4.3. Author Productivity and Authorship Analysis

The second aim was to identify the most prolific scholars in medical-health-wellness tourism research. This was achieved using co-occurrence network analysis of the authors of relevant research articles ( Figure 2 ). Each node in the co-occurrence map shown in Figure 2 represents a given scholar. The larger the node, the more articles the authors published on the topic, with the connections between nodes representing cooperation between authors.

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Author article productivity.

Among the 2381 authors identified, 1820 (76.4%) contributed to only one article, whereas the remaining 561 (23.6%) authored two or more articles. The three most prolific authors were Jeremy Snyder, Valorie Crooks, and Rory Johnston.

4.4. Author Regions and Affiliations

Another objective was to illustrate the relationships and networks of authors publishing research on medical-health-wellness tourism. An analysis of countries this research originated from was carried out using the CiteSpace software. Figure 3 shows that scholars publishing in this field were distributed across 61 countries. The largest group of authors originated from the USA ( n =197). The second and third largest groups corresponded to Canada ( n = 88) and the UK ( n = 84), respectively, followed by Australia ( n = 70) and South Korea ( n = 65). As shown in Figure 3 , authors from the USA and Canada have made the most significant contributions to medical-health-wellness tourism based on the number of journal articles published.

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Country of origin of authors in medical-health-wellness tourism.

As shown in Figure 4 , a significant number of scholars publishing in this field ( n = 47) were affiliated to Simon Fraser University in Canada. This university was followed by Sejong University in South Korea ( n = 13), and the London School of Hygiene & Tropical Medicine ( n = 13) in the UK. The top universities in terms of author frequency were based in Canada, USA, Australia, UK, South Korea, and Hong Kong.

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Institutions of authors.

4.5. Thematic Analysis of Research

The fourth research objective was to elicit the prevailing research themes using the 802 articles gathered. First, an analysis of keyword frequency was performed to identify the main research interests. High frequency keywords reflect the research ‘hotspots’ in the field. Using CiteSpace’s keyword visualization analysis function, the keyword co-occurrence knowledge map of medical-health-wellness tourism research was drawn to grasp the research ‘hotspots’ ( Figure 5 ).

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Frequencies of research keywords.

Then, content analysis performed on the articles gathered for this study identified three main themes, namely: markets (tourist demand and behavior), destinations (development and promotion), and development environments (policies and impacts). An uneven distribution of research themes is highlighted in Figure 6 and Figure 7 .

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Timeline of research keyword appearance.

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Themes of research articles.

4.6. Markets: Demand and Behavior

Previous studies have shown that the growth of medical-health-wellness tourism in developing countries is largely linked to lower costs, shorter patient waiting lists, and better quality of care [ 40 ]. Similarly, it is suggested that the inequalities and failures in domestic health care systems often lead to people seeking treatment to travel abroad to obtain it [ 41 ]. In general terms, higher costs, long patient waiting lists, the relative affordability of international air travel, favorable exchange rates, and the availability of well-qualified doctors and medical staff in developing countries, all contribute to this situation [ 42 ].

As the demand for these forms of tourism has risen over time, processes and factors influencing decision-making have attracted growing levels of scholarly enquiry. For example, a political responsibility model was used to develop a decision-making process for individual medical tourists [ 43 ]. A sequential decision-making process has been proposed, including considerations of the required treatments, location of treatment, and quality and safety issues attendant to seeking care [ 44 ]. Accordingly, it has been found that health information and the current regulatory environment tend to affect the availability of medical care.

Multiple factors may simultaneously influence decisions related to the destination for care, including culture [ 45 ], social norms [ 46 ], religious factors [ 47 ], and the institutional environment [ 48 ]. It is suggested that socioeconomic conditions shape medical travelers’ decision-making and spending behavior relative to treatment, accommodation, and transport choices as well as the length of stay [ 49 ]. Perceived value is a key predictor of tourist intentions. More specifically, perceived medical quality, service quality, and enjoyment significantly influence the intention to travel abroad for medical-health-wellness purposes [ 50 ]. Further, perceived quality, satisfaction, and trust in the staff and clinics have significant associations affecting intentions to revisit clinics and the destination country [ 51 ]. An empirical study was conducted and found that physical convenience in willingness to stay and time and effort savings in perceived price were key factors affecting the decision-making related to medical hotels [ 52 ]. In addition, the level of perceived advantages, price perceptions, and willingness to stay were found to differ significantly between first-time patients and those with two or more previous visits. In addition, it was found that community communication was a major factor influencing decision-making. For instance, it is argued that virtual community membership has a strong influence on tourist behaviors and the way information is transmitted [ 53 ].

Compared to other tourists, the mental activity and behavior of medical-health-wellness travelers are quite different. Medical tourists are less likely to question their need for surgery and tend to be much readier to accept it [ 54 ]. The emotion and anxiety conditions of medical tourists differ from others’ experiences of travel and tourism, as well as their giving and receiving of transnational health care [ 55 ]. It has been found that language barriers and parenting responsibilities can be significant challenges, while hospital staff and their own families are often major sources of support for medical tourists [ 56 ]. Furthermore, there are significant differences among visitors from different countries in terms of choices, discomfort, preferred product items, and attitudes towards medical tourism [ 57 , 58 ].

4.7. Destinations: Development and Promotion

In response to the demands of medical-health-wellness tourism, destination development and promotion are attracting growing levels of scholarly interest. Scholars from different countries have discussed the market status of Turkey [ 12 , 59 ], the Caribbean [ 60 ] and Barbados [ 61 ], India [ 62 , 63 ], Canada [ 64 ], and Albania [ 65 ]. Table 3 outlines the most frequently researched country destinations in this respect.

Medical-health-wellness destination frequency in keywords.

The advantages and disadvantages of Turkey were examined and indicated needs for improvements [ 59 ]. In another research study, three years (2005, 2007, and 2011) of actual and projected operational cost data were evaluated for three countries: USA, India, and Thailand [ 66 ]. This study discussed some of the inefficiencies in the U.S. healthcare system, drew attention to informing uninsured or underinsured medical tourists of the benefits and risks, and determined the managerial and cost implications of various surgical procedures in the global healthcare system.

As regards medical-health-wellness tourism destination development, scholars have explored research from various perspectives. Conceptual frameworks have been developed to include tourism destinations and services in the context of medical and health tourism [ 59 , 67 ]. Advice has been provided from the perspective of public and private hospital doctors [ 68 ]. The principles of designing hospital hotels have been proposed, including proper planning, low prices of tourism services, medical education, creating websites on medical tourism, and health tourism policy councils [ 69 ]. Above all, scholars have posited that meeting or exceeding tourist expectations and requirements should remain the top priorities as regards the effective development of medical tourism destinations [ 69 , 70 ].

Once a medical-health-wellness tourism destination is developed successfully, marketing and promotion are essential to attract tourists. As part of this process, informing potential patients about procedural options, treatment facilities, tourism opportunities, and travel arrangements are the keys to success [ 71 ]. Most tourists rely on the Internet to gather information about destinations, often using mobile devices or personal computers [ 72 ], with websites and social media playing a key role in this respect, and specifically with regards to information about destinations’ medical facilities, staff expertise, services, treatments, equipment, and successful cases [ 73 ]. For example, apps for medical travel are available to attract tourists and promote medical tourism in Taiwan [ 74 ].

Numerous businesses promote medical-health-wellness travel, including medical travel companies, health insurance companies, travel agencies, medical clinics, and hospitals [ 75 ]. Among them, medical travel facilitators play a significant role as engagement moderators between prospective patients in one country and medical facilities elsewhere around the world [ 76 ]. The services offered on medical tourism facilitator websites vary considerably from one country to another [ 77 ]. Although medical travel facilitators operate on a variety of different scales and market their services differently, they all emphasize the consumer experience through advertising quality assurance and logistical support [ 78 ].

Scholarly research has also considered the factors that need to be taken into consideration in medical-health-wellness tourism promotion. This research has suggested that destinations should identify the specifics in their health tourism resources, attractions, and products, seek collaboration with others, and build a common regional brand [ 79 ]. Regional differences should be considered in the process of marketing as medical-health-wellness tourism is a global industry [ 77 ]. International advertisers need to understand the important, contemporary, and cultural characteristics of target customers before promotion [ 80 ]. Similarly, destinations need to portray safe and advanced treatment facilities to dispel potential patient worries and suspicions. Messages related solely to low cost may detract from and even undermine messages about quality [ 71 ]. However, while benefits are highly emphasized online, websites may fail to report any procedural, postoperative, or legal concerns and risks associated with medical tourism [ 81 ].

4.8. Development Environments: Policies and Impacts

The rise of medical-health-wellness tourism emphasizes the privatization of healthcare, an increasing dependence on technology, and the accelerating globalization of healthcare and tourism [ 82 ]. There are challenges and opportunities in the development of these tourism forms. For instance, it has been suggested that medical tourism distorts national health care systems, and raises critical national economic, ethical, and social questions [ 83 ]. Along with the development of medical-health-wellness tourism, social-cultural contradictions [ 84 ] and economic inequities are widening in terms of access, cost, and quality of healthcare [ 85 ]. It is argued that this tourism leads destinations to emphasize tertiary care for foreigners at the expense of basic healthcare for their citizens [ 86 ]. Moreover, in some instances, this phenomenon can exacerbate the medical brain drain from the public sector to the private sector [ 43 , 87 , 88 ], leading to rising private health care and health insurance costs [ 88 ].

While medical-health-wellness tourism is a potential source of revenue, it also brings a certain level of risk to destinations and tourists [ 89 ]. The spread of this type of tourism has been posited as a contributing factor to the spread of infectious diseases and public health crises [ 90 , 91 ]. Medical tourists are at risk of hospital-associated and procedure-related infections as well as diseases endemic to the countries where the service is provided [ 92 ]. Similarly, the safety of some treatments offered has also been the subject of growing levels of scrutiny. Contemporary scholarship examining clinical outcomes in medical travel for cosmetic surgery has identified cases in which patients traveled abroad for medical procedures and subsequently returned home with infections and other surgical complications [ 93 ]. Stem cell tourism has been criticized on the grounds of consumer fraud, blatant lack of scientific justification, and patient safety [ 94 , 95 ]. During the process of medical tourism, inadequate communication, and information asymmetry in cross-cultural communication may bring medical risks [ 96 ].

Medical-health-wellness tourism has emerged as a global healthcare phenomenon. Policy guidance is vital for the development of this sector in the future [ 97 ]. There are policy implications for the planning and development of medical-health-wellness tourism destinations [ 98 ]. Generally, it has been found that the medical-health-wellness tourism sector tends to perform better in countries with a clear policy framework for this activity [ 99 ]. Similarly, scholars have argued the need for a clearer policy framework regulating tourism agencies and the information and services they provide [ 100 ]. The upsurge of these tourism forms presents new opportunities and challenges for policy makers in the health sector. It has been argued that existing policy processes are mainly based on entrenched ideological positions and more attention should be paid to robust evidence of impact [ 101 ]. The UK developed policies focused on ’patient choice’ that allow people who are able and willing to choose to travel further for healthcare [ 102 ]. However, more robust policy making is still required to strengthen national health services and facilitate medical-health-wellness tourism sector development in destinations [ 103 , 104 ].

5. Discussion and Conclusions

5.1. generation discussion.

This study is based on a literature review of 802 articles on medical-health-wellness tourism from 1970 to 2020. Jeremy Snyder was found to be the most prolific author in this field with 45 articles. It has been found that the literature on this topic can be summarized into three themes: markets (tourist demand and behavior), destinations (development and promotion), and development environments (policies and impacts). The scholarly research in this growing field has undergone a shift in emphasis from tourist demand and behavior to the promotion and development of destinations, and, more recently, to policies and impacts.

To attract more tourists, destinations should explore their potential for medical-health-wellness tourism. Accessibility, procedural options, treatment facilities, travel arrangements, safety guarantees, and government policies remain influential factors. In the development and promotion of this form of tourism, childhood vaccinations, oral health, legal frameworks, evaluation systems, entrance systems, and macro-policy continue to be areas of concern and where further research is required. Above all, meeting or exceeding tourist expectations and requirements is the most important consideration to promote medical-health-wellness tourism. Similarly, appropriate policy guidelines and frameworks are necessary to support this form of tourism. Importantly, medical-health-wellness tourism may result in negative impacts on the healthcare service provision for local residents in poorer countries, with tourists from richer countries benefiting to the detriment of local communities. However, if managed successfully, this form of tourism can also be a force for good in terms of fostering the economic development of countries delivering these services.

The results indicated that the research literature is spread across a range of different disciplines and there is not one single venue for publishing in this field. A better integration of the research and improved understanding of the overlaps among medical, health, and wellness tourism is required.

5.2. Future Research Trends

5.2.1. industrial perspective.

Medical-health-wellness tourism will, over time, integrate fully with other healthcare and wellness services. Similarly, medical challenges such as disease prevention and traditional medicine remain essential directions for the future of health tourism. This form of tourism will also integrate further with industries such as wellness culinary tourism, mindfulness tourism, active tourism (including adventure tourism), and even cosmetic surgery tourism, leading to a vast array of potential research avenues linked to health tourism destinations. These futures will greatly promote the physical and mental health of wellness tourists. This is another emerging direction for future medical-health-wellness tourism research.

5.2.2. Destination Development Perspectives

Medical-health-wellness tourism will become more significant forms of tourism and impact the development of different nations and areas. For example, this tourism will integrate with Chinese traditional culture. Traditional treatments and remedies will become more of an advantage and should be a topic for future medical-health-wellness tourism research, as well as in other countries with unique health cultures, treatments, and procedures.

Thailand, Malaysia, and other Southeast Asian countries are favored by tourists from developed countries due to lower costs. In the future, these areas need to focus more on tourism product design, health tourism marketing, community participation, and cross-cultural communication. Developed countries such as the USA, Japan, and South Korea, will use advanced technology and medical equipment to take the path to high-end, high value-added tourism development. This will lead to some new research opportunities.

5.2.3. Tourist Perspectives

Compared with other types of tourists, the needs of medical-health-wellness tourists will receive more attention. Based on previous research, the psychology and perceived value of these tourists are the focus of considerable research. In the future, more emphasis will be paid to people and especially to their psychological and physiological needs. Research on demand will become a more popular topic of this tourism research. Second, the current research on medical-health-wellness tourists is concentrated on the study of tourists in the USA and Canada. Future research should be more dispersed and diversified. Tourists from emerging countries such as Eastern Europe, Asia, the Middle East, and Africa will receive more attention.

5.3. Limitations

This study, inevitably, has a number of limitations, including the relatively modest amount of articles collected. Only articles written in English were considered. The sample number is rather small to represent the general research trends in medical-health-wellness tourism from 1970 to 2020. Therefore, it is desirable to increase the number of publications and expand the time and language coverage of the research articles to gain more insights.

Although the research scope of medical-health-wellness tourism is vast, it lacks in-depth exploration. Current research is fragmented, lacks continuity and comprehensiveness, and therefore cannot be considered systematic. Also, the legal aspects of the development of this tourism, environmental capacity of medical-health tourism, wellness tourism management, and mechanisms of profit distribution for medical-health-wellness tourism are less frequently mentioned in research articles. Innovation in this field and international cooperation, and talent cultivation are also not sufficiently addressed. The methods used in medical-health-wellness tourism research are often simple. Scholars still use traditional descriptive statistics and related analysis methods. The theoretical foundation of medical-health-wellness tourism is still relatively weak. We are in the primary stage of this tourism research and in the development of related tourism products. People all over the world are eager for healthy lives. Medical-health-wellness tourism is likely to play a more important future role in travel medicine and tourism research. Beyond what has been done already, follow-up research should be focused on interdisciplinarity and based on the integration of industries. More theoretical research is necessary to support the future growth of medical-health-wellness tourism.

Author Contributions

Formal analysis, L.Z.; Funding acquisition, L.Z.; Investigation, L.Z.; Supervision, B.D.; Data collection and analysis, B.D.; Writing-original draft, A.M.M. and J.A.C.-S.; Writing—original draft, A.M.M.; Writing—review & editing, A.M.M., J.A.C.-S. and L.Y.; Data collection and analysis. All authors have read and agreed to the published version of the manuscript.

National Natural Science Foundation of China, Grant no: 71673015); Ethnic research project of the National Committee of the people’s Republic of China. NO: 2020-GMD-089; Fundamental Research Funds for the Central Universities of Beijing Foreign Studies University, 2021JS001.

Institutional Review Board Statement

No human subjects were involved in this research and no institutional review was required.

Informed Consent Statement

Not applicable as there were no human subjects.

Data Availability Statement

Conflicts of interest.

The authors have no conflict of interest.

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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In the 1950s, the introduction of the jet engine dramatically reduced travel times, changing the way people traveled forever. Now AI is upending the industry in a similarly fundamental way. Industry players down to individual travelers are using advances in generative AI (gen AI) , machine learning , and deep learning to reimagine what it means to plan, book, and experience travel. “It’s quite clear,” says McKinsey partner Vik Krishnan , “that gen AI significantly eases the process of travel discovery.”

For travel companies, the task now is to rethink how they interact with customers, develop products and services, and manage operations in the age of AI. According to estimates by McKinsey Digital, companies that holistically address digital and analytics opportunities have the potential to see an earnings improvement of up to 25 percent .

McKinsey and Skift Research interviewed executives from 17 companies across five types of travel business. Here are three key findings on how travel companies can reckon with emerging technologies, drawn from the resulting report The promise of travel in the age of AI :

Segmentation. Companies can use AI to create hyperspecific customer segments to guide how they interact with and serve customers. Segmentation can be based on a single macro characteristic (such as business versus leisure), or it can be so specific as to relate to just one customer.
Surprise and delight. In the travel context, gen AI could take the form of digital assistants that interact with customers throughout their journeys, providing personalized trip itineraries and tailored recommendations and helping to resolve unexpected disruptions.
Equipping workers better. AI tools can free up frontline workers’ time, allowing them to focus more on personal customer interactions. These tools can also shorten the training time for new hires and quickly upskill the existing workforce.

AI is important, yes. But, according to Ella Alkalay Schreiber, general manager (GM) of fintech at Hopper, “The actual challenge is to understand the data, ask the right questions, read prediction versus actual, and do this in a timely manner. The actual challenge is the human thinking, the common sense .”

How is mass tourism changing travel?

More people are traveling than ever before. The most visited destinations are experiencing more concentrated flows of tourists ; 80 percent of travelers visit just 10 percent of the world’s tourist destinations. Mass tourism can encumber infrastructure, frustrate locals, and even harm the attractions that visitors came to see in the first place.

Tourism stakeholders can collectively look for better ways to handle visitor flows before they become overwhelming. Destinations should remain alert to early warning signs about high tourism concentration and work to maximize the benefits of tourism, while minimizing its negative impacts.

Destinations should remain alert to early warning signs about high tourism concentration and work to maximize the benefits of tourism, while minimizing its negative impacts.

For one thing, destinations should understand their carrying capacity of tourists—that means the specific number of visitors a destination can accommodate before harm is caused to its physical, economic, or sociocultural environment. Shutting down tourism once the carrying capacity is reached isn’t always possible—or advisable. Rather, destinations should focus on increasing carrying capacity to enable more growth.

Next, destinations should assess their readiness to handle mass tourism and choose funding sources and mechanisms that can address its impacts. Implementing permitting systems for individual attractions can help manage capacity and mitigate harm. Proceeds from tourism can be reinvested into local communities to ensure that residents are not solely responsible for repairing the wear and tear caused by visitors.

After risks and funding sources have been identified, destinations can prepare for growing tourist volumes in the following ways:

Build and equip a tourism-ready workforce to deliver positive tourism experiences.
Use data (gathered from governments, businesses, social media platforms, and other sources) to manage visitor flows.
Be deliberate about which tourist segments to attract (business travelers, sports fans, party groups, et cetera), and tailor offerings and communications accordingly.
Distribute visitor footfall across different areas, nudging tourists to visit less-trafficked locations, and during different times, promoting off-season travel.
Be prepared for sudden, unexpected fluctuations triggered by viral social media and cultural trends.
Preserve cultural and natural heritage. Engage locals, especially indigenous people, to find the balance between preservation and tourism.

How can the travel sector accelerate the net-zero transition?

Global warming is getting worse, and the travel sector contributes up to 11 percent of total carbon emissions. Many consumers are aware that travel is part of the problem, but they’re reticent to give up their trips: travel activity is expected to soar by 85 percent from 2016 to 2030. Instead, they’re increasing pressure on companies in the travel sector to achieve net zero . It’s a tall order: the range of decarbonization technologies in the market is limited, and what’s available is expensive.

But decarbonization doesn’t have to be a loss-leading proposition. Here are four steps travel companies can take toward decarbonization that can potentially create value:

Identify and sequence decarbonization initiatives. Awareness of decarbonization levers is one thing; implementation is quite another. One useful tool to help develop an implementation plan is the marginal abatement cost curve pathway framework, which provides a cost-benefit analysis of individual decarbonization levers and phasing plans.
Partner to accelerate decarbonization of business travel. Many organizations will reduce their business travel, which accounts for 30 percent of all travel spend. This represents an opportunity for travel companies to partner with corporate clients on decarbonization. Travel companies can support their partners in achieving their decarbonization goals by nudging corporate users to make more sustainable choices, while making reservations and providing data to help partners track their emissions.
Close the ‘say–do’ gap among leisure travelers. One McKinsey survey indicates that 40 percent of travelers globally say they are willing to pay at least 2 percent more for carbon-neutral flights. But Skift’s latest consumer survey reveals that only 14 percent of travelers said they actually paid more for sustainable travel options. Travel companies can help close this gap by making sustainable options more visible during booking and using behavioral science to encourage travelers to make sustainable purchases.
Build new sustainable travel options for the future. The travel sector can proactively pioneer sustainable new products and services. Green business building will require companies to create special initiatives, led by teams empowered to experiment without the pressure of being immediately profitable.

What’s the future of air travel?

Air travel is becoming more seasonal, as leisure travel’s increasing share of the market creates more pronounced summer peaks. Airlines have responded by shifting their schedules to operate more routes at greater frequency during peak periods. But airlines have run into turbulence when adjusting to the new reality. Meeting summer demand means buying more aircraft and hiring more crew; come winter, these resources go unutilized, which lowers productivity . But when airlines don’t run more flights in the summer, they leave a lot of money on the table.

How can airlines respond to seasonality? Here are three approaches :

Mitigate winter weakness by employing conventional pricing and revenue management techniques, as well as creative pricing approaches (including, for example, monitoring and quickly seizing on sudden travel demand spikes, such as those created by a period of unexpectedly sunny weather).
Adapt to seasonality by moving crew training sessions to off-peak periods, encouraging employee holiday taking during trough months, and offering workers seasonal contracts. Airlines can also explore outsourcing of crew, aircraft, maintenance, and even insurance.
Leverage summer strengths, ensuring that commercial contracts reflect summer’s higher margins.

How is the luxury travel space evolving?

Quickly. Luxury travelers are not who you might expect: many are under the age of 60 and not necessarily from Europe or the United States. Perhaps even more surprisingly, they are not all millionaires: 35 percent of luxury-travel spending is by travelers with net worths between $100,000 and $1 million. Members of this group are known as aspirational luxury travelers, and they have their own set of preferences. They might be willing to spend big on one aspect of their trip—a special meal or a single flight upgrade—but not on every travel component. They prefer visibly branded luxury and pay close attention to loyalty program points and benefits .

The luxury-hospitality space is projected to grow faster than any other segment, at 6 percent per year through 2025. And competition for luxury hotels is intensifying too: customers now have the option of renting luxurious villas with staff, or booking nonluxury hotels with luxury accoutrements such as rainfall showerheads and mattress toppers.

Another critical evolution is that the modern consumer, in the luxury space and elsewhere, values experiences over tangible things (exhibit).

Luxury properties may see more return from investing in a culture of excellence—powered by staff who anticipate customer needs, exceed expectations, create cherished memories, and make it all feel seamless—than in marble floors and gold-plated bath fixtures. Here are a few ways luxury properties can foster a culture of excellence :

Leaders should assume the role of chief culture officer. GMs of luxury properties should lead by example to help nurture a healthy and happy staff culture and listen and respond to staff concerns.
Hire for personalities, not resumes. “You can teach someone how to set a table,” said one GM we interviewed, “but you can’t teach a positive disposition.”
Celebrate and reward employees. Best-in-class service is about treating customers with generosity and care. Leaders in the service sector can model this behavior by treating employees similarly.
Create a truly distinctive customer experience . McKinsey research has shown that the top factor influencing customer loyalty in the lodging sector is “an experience worth paying more for”—not the product. Train staff to focus on tiny details as well as major needs to deliver true personalization.

What’s the latest in travel loyalty programs?

Loyalty programs are big business . They’ve evolved past being simply ways to boost sales or strengthen customer relationships; now, for many travel companies, they are profit centers in their own right. One major development was that travel companies realized they could sell loyalty points in bulk to corporate partners, who in turn offered the points to their customers as rewards. In 2019, United’s MileagePlus loyalty program sold $3.8 billion worth of miles to third parties, which accounted for 12 percent of the airline’s total revenue for that year. In 2022, American Airlines’ loyalty program brought in $3.1 billion in revenue, and Marriott’s brought in $2.7 billion.

But as this transition has happened, travel players have shifted focus away from the original purpose of these programs. Travel companies are seeing these loyalty programs primarily as revenue generators, rather than ways to improve customer experiences . As a result, loyalty program members have become increasingly disloyal. Recent loyalty surveys conducted by McKinsey revealed a steep decline in the likelihood that a customer would recommend airline, hotel, and cruise line loyalty programs to a friend. The same surveys also found that airline loyalty programs are driving fewer customer behavior changes than they used to.

So how can travel brands win customers’ loyalty back? Here are three steps to consider:

Put experience at the core of loyalty programs. According to our 2023 McKinsey Travel Loyalty Survey , American respondents said they feel more loyal to Amazon than to the top six travel players combined, despite the absence of any traditional loyalty program. One of the reasons for Amazon’s success may be the frictionless experience it provides customers. Companies should strive to design loyalty programs around experiential benefits that make travelers feel special and seamlessly integrate customer experiences between desktop, mobile, and physical locations.
Use data to offer personalization to members. Travel brands have had access to customer data for a long time. But many have yet to deploy it for maximum value. Companies can use personalization to tailor both experiences and offers for loyalty members; our research has shown that 78 percent of consumers are more likely to make a repeat purchase when offered a personalized experience.
Rethink partnerships. Traditionally, travel companies have partnered with banks to offer cobranded credit cards. But many credit card brands now offer their own, self-branded travel rewards ecosystems. These types of partnerships may have diminishing returns in the future. When rethinking partnerships, travel brands should seek to build richer connections with customers, while boosting engagement. Uber’s partnership with Marriott, for example, gives users the option to link the brands’ loyalty programs, tapping into two large customer bases and providing more convenient travel experiences.

In a changing travel ecosystem, travel brands will need to ask themselves some hard questions if they want to earn back their customers’ loyalty.

Learn more about McKinsey’s Travel, Logistics, and Infrastructure Practice . And check out travel-related job opportunities if you’re interested in working at McKinsey.

Articles referenced include:

“ Updating perceptions about today’s luxury traveler ,” May 29, 2024, Caroline Tufft , Margaux Constantin , Matteo Pacca , and Ryan Mann
“ The way we travel now ,” May 29, 2024, Caroline Tufft , Margaux Constantin , Matteo Pacca , and Ryan Mann
“ Destination readiness: Preparing for the tourist flows of tomorrow ,” May 29, 2024, Caroline Tufft , Margaux Constantin , Matteo Pacca , and Ryan Mann
“ How the world’s best hotels deliver exceptional customer experience ,” March 18, 2024, Ryan Mann , Ellen Scully, Matthew Straus, and Jillian Tellez Holub
“ How airlines can handle busier summers—and comparatively quiet winters ,” January 8, 2024, Jaap Bouwer, Ludwig Hausmann , Nina Lind , Christophe Verstreken, and Stavros Xanthopoulos
“ Travel invented loyalty as we know it. Now it’s time for reinvention. ,” November 15, 2023, Lidiya Chapple, Clay Cowan, Ellen Scully, and Jillian Tellez Holub
“ What AI means for travel—now and in the future ,” November 2, 2023, Alex Cosmas and Vik Krishnan
“ The promise of travel in the age of AI ,” September 27, 2023, Susann Almasi, Alex Cosmas , Sam Cowan, and Ben Ellencweig
“ The future of tourism: Bridging the labor gap enhancing customer experience ,” August 1, 2023, Urs Binggeli, Zi Chen, Steffen Köpke, and Jackey Yu
“ Hotels in the 2030s: Perspectives from Accor’s C-suite ,” July 27, 2023, Aurélia Bettati
“ Tourism in the metaverse: Can travel go virtual? ,” May 4, 2023, Margaux Constantin , Giuseppe Genovese, Kashiff Munawar, and Rebecca Stone
“ Three innovations to solve hotel staffing shortages ,” April 3, 2023, Ryan Mann , Esteban Ramirez, and Matthew Straus
“ Accelerating the transition to net-zero travel ,” September 20, 2022, Danielle Bozarth , Olivier Cheret, Vik Krishnan , Mackenzie Murphy, and Jules Seeley
“ The six secrets of profitable airlines ,” June 28, 2022, Jaap Bouwer, Alex Dichter , Vik Krishnan , and Steve Saxon
“ How to ‘ACE’ hospitality recruitment ,” June 23, 2022, Margaux Constantin , Steffen Köpke, and Joost Krämer
“ Opportunities for industry leaders as new travelers take to the skies ,” April 5, 2022, Mishal Ahmad, Frederik Franz, Tomas Nauclér, and Daniel Riefer
“ Rebooting customer experience to bring back the magic of travel ,” September 21, 2021, Vik Krishnan , Kevin Neher, Maurice Obeid , Ellen Scully, and Jules Seeley

Want to know more about the future of travel?

The promise of travel in the age of AI

Travel Disruptors: Bringing fintech to travel booking

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Research and development in travel

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“What is research but a blind date with knowledge?” — Will Harvey, American software developer and entrepreneur

At its core, research and development (R&D) is the generation of new knowledge. The term encompasses activities by which companies, governments or other institutions develop new products and services or refine exiting ones.

The quotes above illustrate the duality of the process: It can deliver great results, generate new knowledge – but the path to get there is not always clear at the start of the journey. Nevertheless, many businesses make increasing investments in research & development. And it’s not hard to see why: In today’s fast-paced environment, new knowledge is essential for companies to remain competitive and make profit. Despite being capital-intensive, R&D can drive innovation, help improve marketplace position, and increase long-term customer satisfaction.

Surveying 2,500 companies that invested the largest sums in R&D worldwide in 2020, the EU Industrial R&D Investment Scoreboard found that despite the Covid-19 pandemic, global investment in research and development continued to increase significantly in 2020 for the eleventh consecutive year. According to UNESCO, global spending on R&D has reached a record high of almost USD 1.7 trillion in 2021.

When it comes to investment by industry, according to the EU’s Scoreboard, four major sectors account for 77.4% of global R&D: Information and Communications Technologies (ICT) producers (22.9%), Health industries (20.8%), ICT services (18.6%) and Automotive (15.2%). Despite travel being close to the bottom when it comes to overall industry R&D spending, there are many forward-thinking players that invest significantly in moving the industry forward. For instance, the Lufthansa Innovation Hub (LIH) is the digitalization spearhead of the Lufthansa Group and connects the world’s largest aviation group with relevant players in the global travel and mobility tech ecosystem. And in 2022, Marriott International launched the Marriott Design Lab to accelerate the development and deployment of new technologies and products.

Sabre has always been at the forefront of research and development in travel, first and foremost through Sabre Labs, the world’s first travel-focused innovation lab. Founded in 1996, Sabre Labs explores novel uses of big data, machine learning, AI and other emerging technologies to shape the future of travel. The group mission is to create and maintain a robust innovation pipeline of disruptive ideas, generate business value, and position Sabre as technology leader. Collaborating closely with the teams in product development and technology operations, Sabre Labs focuses on projects that involve data and analytics (including applications of machine learning and artificial intelligence techniques), operations research and software engineering (across the entire software development lifecycle from ideation, to prototyping and co-creating proofs of concepts with Sabre customers).

Many Sabre products and solutions available today originated from Labs, including TripCase and Sabre APIs or, more recently, Sabre Travel AI TM , which combines the software and technology expertise of Sabre with the artificial intelligence and machine learning capabilities of Google Cloud. In addition to these product-focused inventions, Sabre Labs has also been instrumental in modernizing product development and engineering practices as well as facilitating the company’s ongoing tech transformation, including the move to the cloud.

[1] https://iri.jrc.ec.europa.eu/scoreboard/2021-eu-industrial-rd-investment-scoreboard
[2] uis.unesco.org/apps/visualisations/research-and-development-spending/
[3] https://lh-innovationhub.de/ [1] https://skift.com/2022/01/07/marriott-gives-a-peek-into-its-new-rd-lab-for-post-pandemic-travel/

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Data Descriptor
Open access
Published: 23 September 2021

A database of travel-related behaviors and attitudes before, during, and after COVID-19 in the United States

Rishabh Singh Chauhan ORCID: orcid.org/0000-0001-7188-557X 1 ,
Matthew Wigginton Bhagat-Conway ORCID: orcid.org/0000-0002-1210-2982 2 ,
Denise Capasso da Silva ORCID: orcid.org/0000-0003-1414-8439 3 ,
Deborah Salon ORCID: orcid.org/0000-0002-2240-8408 2 ,
Ali Shamshiripour 1 ,
Ehsan Rahimi ORCID: orcid.org/0000-0002-8649-7542 1 ,
Sara Khoeini 3 ,
Abolfazl (Kouros) Mohammadian ORCID: orcid.org/0000-0003-3595-3664 1 ,
Sybil Derrible ORCID: orcid.org/0000-0002-2939-6016 1 &
Ram Pendyala 3

Scientific Data volume 8 , Article number: 245 ( 2021 ) Cite this article

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Research data

The COVID-19 pandemic has impacted billions of people around the world. To capture some of these impacts in the United States, we are conducting a nationwide longitudinal survey collecting information about activity and travel-related behaviors and attitudes before, during, and after the COVID-19 pandemic. The survey questions cover a wide range of topics including commuting, daily travel, air travel, working from home, online learning, shopping, and risk perception, along with attitudinal, socioeconomic, and demographic information. The survey is deployed over multiple waves to the same respondents to monitor how behaviors and attitudes evolve over time. Version 1.0 of the survey contains 8,723 responses that are publicly available. This article details the methodology adopted for the collection, cleaning, and processing of the data. In addition, the data are weighted to be representative of national and regional demographics. This survey dataset can aid researchers, policymakers, businesses, and government agencies in understanding both the extent of behavioral shifts and the likelihood that changes in behaviors will persist after COVID-19.

Machine-accessible metadata file describing the reported data: https://doi.org/10.6084/m9.figshare.15141945

Effect of COVID-19 response policies on walking behavior in US cities

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A travel time matrix data set for the Helsinki region 2023 that is sensitive to time, mode and interpersonal differences, and uses open data and novel open-source software

Background & summary.

The COVID-19 pandemic has spread across the world, infecting tens of millions and killing over one million people 1 . By March 2021, the United States (U.S.) had recorded the highest number of confirmed COVID-19 cases and COVID-19 related deaths in the world 1 . Since social distancing is one of the most effective measures in containing the spread of the infection 2 , several U.S. states issued various restrictions including stay at home orders. Moreover, numerous restaurants and bars closed for dine-in services, various recreation facilities were shut down, many offices and schools switched from meeting in-person to meeting online, and travel restrictions were imposed. These measures had a profound impact on how people in the U.S. went about their daily lives.

To understand the current and future impacts of the pandemic, we conducted a nationwide online survey. The goal of the survey is to capture attitudes and shifts in travel-related choices of people across the nation both during the pandemic and once COVID-19 is no longer a threat. The data are shared publicly in order to help government agencies and businesses prepare for the future. We are conducting additional survey waves with the same respondents to monitor how people’s choices evolve over the course of the pandemic and beyond.

An early version of the survey took place from April to June 2020, when the stay at home orders were in place in most parts of the country 3 , 4 ; this portion of the data collection is referenced as Wave 1 A . A slightly-modified larger-scale survey, Wave 1B ,was deployed between late June and October 2020. Subsequent survey waves are being conducted as the situation evolves. The collected data are released as they become available and necessary procedures for cleaning, documenting, and weighting the data are completed. This procedures for data processing are detailed in this paper. The present article focuses on data from the first wave of the survey.

In the months following the beginning of the spread of COVID-19, several efforts have been made to collect data related to COVID-19. In fact, many datasets have been compiled, specifically on COVID-19 testing 5 , medical imaging of COVID-19 cases 6 , the timeline of government interventions 7 , policy announcements 8 , implementation and relaxation of public health and social measures 9 , epidemiological data 10 , mobility-related data 11 , and out-of-home activity information 12 , to name a few. Researchers also turned to social media platforms, like Twitter and Instagram, to gather COVID-19-related data 13 , 14 , 15 , 16 . Furthermore, several surveys have been conducted to measure the impacts of the pandemic 17 , 18 , 19 , some of which are now released for public use 20 , 21 .

Our survey data are different from most others in several ways. First, it is comprehensive insofar as it includes data about a wide range of topics including commuting, daily travel, air travel, working from home, online learning, shopping, attitudes, risk perception, and socioeconomic and demographic details. Second, it captures detailed information about behaviors before and during the COVID-19 pandemic, as well as the choices that people expect to make when the COVID-19 virus is no longer a threat. Third, it was collected from respondents across the U.S., covering diverse socio-economic backgrounds, professions, education levels, and ages. Fourth, the survey is a true longitudinal panel survey, collecting data in multiple waves from the same individuals at regular intervals. Finally, the data are made publicly available to promote data-driven analysis and research.

The next section describes the data collection methodology, the questions included in the survey, the survey deployment process, and the participant recruitment strategy. Next, the data records section describes the data file types and metadata. Subsequently, the technical validation section explains the procedure for the survey data cleaning and weighting. Lastly, the final section provides additional notes for data users.

Ethical compliance

Our study protocol was approved by both Arizona State University (ASU) and University of Illinois at Chicago (UIC) Institutional Review Board offices. Participants were informed that their participation is voluntary, and that their responses are shared anonymously. An online informed consent was obtained from everyone who responded to the survey.

Survey questions

The data were collected through an extensive online survey with over 120 questions. The survey questions can be broadly divided into three categories: (1) retrospective questions focusing on the period before COVID-19, (2) questions about the period during COVID-19, and (3) prospective questions on respondent expectations for a future period in which COVID-19 is no longer a threat. The questions cover a wide variety of subjects including commuting habits, discretionary travel choices, work-related questions, study-related questions, shopping, dining, and so on – all before, during, and expected after the pandemic.

The survey questions can be classified into eight categories based on question subject type, namely: demographics, work, study, shopping and dining, transportation, and general attitudes. Table 1 describes each of these categories.

Survey recruitment

From April to mid-June 2020, initial Wave 1A responses were collected from a convenience sample via mailing lists, social media outreach, and mainstream media articles. A total of 1,110 responses were collected during this phase.

From late June onward, Wave 1B, the modified version of the survey, was deployed through survey invitations sent to a random email list purchased from a data marketing company. The list contained 350,000 email addresses belonging to people in 24 metropolitan areas across the U.S., as well as the state of Ohio (see Fig. 1 ). We purchased 100,000 additional email addresses of people randomly selected from across the country, including rural areas and excluding the areas covered by the first 350,000 emails. A total of 1,116 responses were received from the email list. Unfortunately, major email service providers quickly began marking our survey invitations as spam, while some smaller providers did not. While we took several steps to mitigate this issue, including changing the wording of the emails, changing the source of the emails (a uic.edu, asu.edu, or covidfuture.org email address), we were ultimately not able to fully solve this problem and saw a lower response rate from individuals with addresses from major email providers.

Distribution of survey respondents by the state of residence for survey dataset version 1.0. Alaska and Hawai’i are in the same weighting division as California, Oregon, and Washington.

Survey invitation emails were also sent to an additional list of approximately 39,000 email addresses from the Phoenix metropolitan area purchased for a previous survey effort 22 . This list yielded 782 responses. The survey invitation emails were sent using Amazon Web Services (AWS) and through the Qualtrics platform. Every 20 th respondent who was invited through the purchased email addresses received a $10 incentive as a gift card. Respondents also had the option to donate their survey incentive to a charity. Invitees received two reminders as part of efforts to maximize response rates.

An additional 5,250 responses to the Wave 1B survey were collected through a Qualtrics Online Panel. Qualtrics recruits these respondents from a variety of panels maintained by other firms and uses quota sampling to recruit respondents that are demographically representative of the nation. The Qualtrics quotas were set to collect information from 20 U.S. metropolitan areas, mostly consistent with the metropolitan areas sampled from the purchased email list, as well as the states of Ohio, Utah, North Carolina, upstate New York, and rural areas. In order to obtain samples that would represent the population in each of the selected geographies, quotas were imposed in the Qualtrics online panel subsample to guarantee representation based on income, age, race and ethnicity, and education. We requested all respondents to provide their email addresses in order to recontact them for subsequent survey waves. Since the Qualtrics respondents are professional survey takers, we designated most questions as mandatory, and we included attention check questions, which are shown to improve response quality 23 .

The distribution of responses by geography, as well as the targeted metropolitan areas, are shown in Fig. 1 . Figure 2 shows the distribution of responses by recruitment method, available in the “org” variable in the dataset. The geographical targets were chosen based on geographic and metropolitan area size diversity, as well as the state of the virus spread in May 2020.

Distribution of Record by Source (from the survey dataset version 1.0).

Figure 1 shows the distribution of survey respondents across the U.S. (50 states and the District of Columbia). Following our recruitment strategy, a greater number of responses come from larger and more urban states. Arizona is overrepresented due to the oversample of Arizona respondents in the email-based deployment. The respondents from the initial Wave 1A sample are also more likely to hail from Arizona as the Arizona State University survey team’s network is heavily Arizona-based. When the data are weighted, any geographic discrepancies at the census division level are controlled and overrepresentation of Arizona is controlled/corrected separately.

Additional survey waves

To monitor how people’s attitudes and behaviors evolve, survey respondents are contacted again with at least two shorter follow-up surveys, approximately four months apart in spring and fall 2021.

Data Records

The survey dataset 24 can be accessed from the ASU Dataverse at: https://doi.org/10.48349/ASU/QO7BTC . The dataset is available in CSV (comma-separated value) format. Since the data will be updated periodically, the data are versioned—in this article, results from the survey dataset version 1.0 are reported. The dataverse also contains the database codebook containing the metadata and explaining the variables. The codebook contains a changelog for each new version.

The respondents to Waves 1A and 1B received similar but not identical surveys. We have merged the responses to these two versions of the survey into the final dataset wherever possible. For some variables, the questions were identical, whereas for other variables, harmonization of similar responses was required. In the dataset, variables ending in ‘_harm’ are harmonized between the two datasets, variables ending in ‘_w1a’ are available only for Wave 1A respondents, variables ending in ‘_w1b’ are available only for respondents from our Qualtrics Online Panel, purchased email lists, and anyone who found the survey via the COVIDFuture web site or email lists after June 19, 2020 (start date of Wave 1B). Variables with no suffix were asked the same way between the two surveys, and no harmonization was necessary. We also provide a file containing only Wave 1B responses and variables, which simplifies analysis of the Wave 1B data.

Technical Validation

Data cleaning.

To monitor respondents’ attention to survey questions in the Qualtrics online panel, attention check questions were included. Respondents were allowed to miss one attention check and be given an opportunity to answer that section again. If they missed an attention check twice, or both attention checks once, their survey was terminated.

We additionally undertook several quality checks to help ensure that the collected data were valid. We removed any respondents who reported that they shop for groceries both in-store and online every day, or expect to after the pandemic, as these are likely to be invalid responses. We also removed respondents who reported strongly agreeing or strongly disagreeing with all COVID-related attitudes, as some of these were worded positively and some negatively. Several additional quality checks were undertaken in the Qualtrics Online Panel as part of Qualtrics’ data cleaning process, including a check for people finishing the survey too quickly.

Respondents that did not report a state of residence, reported living outside the 50 states and the District of Columbia, or did not provide answers to all of the control variables used in the data weighting process described in the next section were removed from the data. Due to this restriction, 558 records with missing control variable information, 59 records with missing home location, and one response from Puerto Rico were not included in the final dataset encompassing responses received through October 14, 2020. Further steps in data preparation will include imputation of missing data, which will allow for some of these omitted records to be recovered in the next version of the dataset. Among the respondents who were not included in the dataset due to missing control variable information, there are 34 respondents who declared their gender as Other; these respondents could not be included because the Census offers no control marginals to weight these records. Further data weighting procedures will attempt to incorporate non-binary gendered individuals on the dataset. Due to the data cleaning and filtering process applied to responses obtained through October 14, 2020, a total of 618 records were not included in the published dataset.

Data weighting

Because the raw data are not fully representative of the U.S. population, weights were calculated using the following control variables: age, education, gender, Hispanic status, household income, presence of children, and number of household vehicles. The weighting procedure accounts for the true population characteristics at the person level. Household-level variables (i.e., income, presence of children, and number of vehicles) were controlled at the person level as well. For example, the marginal distribution used for presence of children refers to the share of adults aged 18 years and older living in household with children, instead of the share of households that have children as it is usually represented. Those marginal distributions were computed using data from the Integrated Public Use Microdata Sample and the American Community Survey (ACS) 2018 1-year data 25 using the sample 18 and older in each of the weighting region boundaries. A noteworthy consequence of this approach is that adjusted household weights are necessary to evaluate household-level characteristics since individuals from larger households are more likely to be represented in the survey (given there are more individuals in these households), and thus have a higher probability of being selected. Weights for household-level analysis can be computed by dividing the person-level weight (provided in the data) by the number of adults in the household.

The national sample was divided into nine regions based on the reported home state (Table 2 ). Each region’s sample was then weighted to match the distributions observed in ACS 2018 1-year estimates 25 , meaning that the survey is demographically representative at the level of each region as well as the entire U.S. The unweighted and weighted survey results are shown in Table 3 ; the weighted results closely replicate population distributions, with inevitable minor deviations on variables that were not controlled in the weighting process.

Weights were calculated using iterative proportional fitting (IPF) procedures embedded within the synthetic population generator PopGen2.0 26 , 27 , 28 . Univariate marginal control distributions were derived from the Integrated Public Use Microdata Sample, American Community Survey (ACS) 2018 1-year data 25 .

Usage Notes

Since the survey will be followed by at least two follow-up survey waves, the database will be updated periodically after the data for each wave is collected, cleaned, and weighted. Each version of the data will be uploaded to the ASU Dataverse and assigned a new DOI number, and all previous versions will remain available to promote reproducibility.

The weights were developed to produce a sample that is representative of the U.S. population, as well as representative of nine divisions within the U.S.: eight census regions (with East and West South Central combined due to small samples in these regions), and a separate category for Arizona due to its large number of respondents. The weights are not guaranteed to produce a representative sample for other (smaller) geographies. When evaluating subsamples at a finer geography (e.g., state or metropolitan area), data users should compare marginal distributions of key demographic variables with the census, and re-weight the data if needed to be representative of the area being analyzed.

Some questions differ between Waves 1A and 1B. Therefore, we have weighted the dataset twice: once including all respondents (Waves 1A and 1B), and once excluding respondents to the Wave 1A sample. Data users should use the Wave 1B weights whenever using variables that are not present in the convenience sample. Since Wave 1A data deviates significantly in terms of population representativeness 4 , there are no weights for questions asked only of Wave 1A respondents. In the file with only Wave 1B responses, only Wave 1B weights are presented.

This unique dataset provides insights on attitudes and behaviors not just before and during pandemic, but also on what might be expected after the pandemic. Possible use cases include modeling of during-pandemic and longer-term changes in mode use, air travel, transit ridership, work from home, and traffic congestion (especially for peak period traffic planning). Published uses of this dataset are documented in Capasso da Silva et al . 29 , Chauhan et al . 30 , Mirtich et al . 31 , and Salon et al . 32 .

Code availability

No codes were developed for this research.

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Acknowledgements

This research was supported in part by the National Science Foundation (NSF) RAPID program under grants no. 2030156 and 2029962 and by the Center for Teaching Old Models New Tricks (TOMNET), a University Transportation Center sponsored by the U.S. Department of Transportation through grant no. 69A3551747116, as well as by the Knowledge Exchange for Resilience at Arizona State University. This COVID-19 Working Group effort was also supported by the NSF-funded Social Science Extreme Events Research (SSEER) network and the CONVERGE facility at the Natural Hazards Center at the University of Colorado Boulder (NSF Award #1841338) and the NSF CAREER award under grant no. 155173. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the funders.

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Contributions

R.P., A.M., S.D., D.S. and S.K. planned the project. D.S., M.C., D.C.S., R.C., E.R. and A.M. prepared the survey questions. M.C., D.C.S. and D.S. designed the survey flow logic. R.C., D.C.S., M.C., D.S. and S.D. deployed the survey. M.C. and D.C.S. performed data cleaning and survey data analysis. D.C.S. weighted the dataset. M.C. and D.S. worked on sending out the incentives to the selected respondents. R.C. prepared the first draft. All the authors made significant contributions to manuscript editing and approving the final version of the manuscript.

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Correspondence to Rishabh Singh Chauhan .

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Chauhan, R.S., Bhagat-Conway, M.W., Capasso da Silva, D. et al. A database of travel-related behaviors and attitudes before, during, and after COVID-19 in the United States. Sci Data 8 , 245 (2021). https://doi.org/10.1038/s41597-021-01020-8

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Travelers sometimes pick up more than just memories when they go abroad. Unfortunately, they may also experience health issues brought about by pathogens. Data collected by a novel travel app developed by UZH researchers in cooperation with the World Health Organization (WHO) now shows that this happens remarkably often.

The app is not only useful for travelers but may also help track outbreaks and the spread of infectious diseases such as dengue or novel influenza viruses. The findings are published in the journal BMJ Open .

"Travelers are an excellent reflection of what's happening around the globe," says study leader Patricia Schlagenhauf from the Epidemiology, Biostatistics and Prevention Institute at UZH. "They also often play a part in introducing pathogens to different regions of the world." By way of example, she cites the recent case of mpox in Sweden, which was imported by a traveler returning from Africa.

Tracking the spread of infections

The Illness Tracking in Travelers (ITIT) app lets people who are on the move report daily symptoms by filling in a short, user-friendly questionnaire. This information is then linked to location data as well as climate and air quality information.

The research team has now analyzed data collected through the app between April 2022 and July 2023. The analysis covered 470 trips recorded by 609 people across all continents. Travelers fell ill surprisingly often during their travels, with health issues occurring on more than one-third of trips.

Novel app tracks travel-related illnesses

Gastrointestinal symptoms top the list

The most common health issues were gastrointestinal symptoms , which were reported in 19% of trips and most frequently in travelers to Asia. In contrast, these symptoms occurred less often in people traveling to Africa.

Significantly more women than men reported symptoms of diarrhea. It is possible that women are more susceptible to diarrhea, or that they were more conscientious when recording symptom information in the app.

By contrast, respiratory diseases (17%) such as colds were most common among travelers in Europe. "Don't forget that you should carry a first-aid kit even when you're traveling to supposedly low-risk countries like France or Greece," says Schlagenhauf.

She recommends that travelers pack medication to treat diarrhea, nausea, headache and fever, since these are the health issues that people are most restricted by on their travels, according to the study.

Healthy and safe travels

The research team would now like to invite even more people to use the app. Larger sets of data would enable the researchers to run automated analyses using artificial intelligence , which could, for example, be used to detect outbreaks of dengue or mpox at an early stage.

"This real-time bottom-up approach is much faster than top-down reporting systems," says Schlagenhauf. Even in well-organized government bodies such as the Swiss Federal Office of Public Health, it often takes months for case numbers to be available.

"Mobile technologies offer a revolutionary solution to how we track travel-related illnesses. This will ultimately make our travels safer and healthier."

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