North America
As of 2014, the US is the largest wellness tourism market, with $180.7 billion in annual, combined international and domestic expenditures. The US is the top destination for inbound international wellness tourism, with 7.1 million international, inbound trips. Europe and high-income Asian countries are primary sources of wellness tourists traveling to the US.
Domestic tourism accounts for the majority (94 percent) of wellness trips in North America. Americans and Canadians receive—and take—few vacation days compared to workers in other countries making domestic, weekend trips the most popular wellness travel option.
Europe
Europe is the second largest wellness tourism market, with $158.4 billion in annual, combined international and domestic expenditures; the region ranks highest in number of wellness trips with 216.2 million, compared to North America's 171.7 in 2013. Europeans have long believed in health benefits derived from mineral baths, saunas, thalassotherapy, and other natural and water-based treatments. Thermal resorts and hotels in Turkey and Hungary cater to wellness tourists, many of whom are subsidized by host countries such as Norway and Denmark seeking to mitigate costs of medical procedures for patients with chronic conditions requiring expensive surgeries.
Asia-Pacific
The Asia-Pacific region ranks as the third largest with $6.4 billion in annual, combined international and domestic expenditures. Wellness traditions date back thousands of years in this region, and some of those wellness practices (e.g., Ayurveda, traditional Chinese medicine (TCM), yoga, Thai massage) incorporate preventive, curative, and therapeutic aspects that lie in the cross-over area between wellness and medical tourism.
Latin America-Caribbean
Latin America-Caribbean is the fourth largest region for wellness tourism in terms of number of trips and expenditures. Domestic tourism accounts for about 71 percent of wellness tourism trips, and 54 percent of wellness tourism expenditures.
Middle East and Africa
The Middle East and Africa are currently the smallest regions for wellness tourism, where international tourists account for the majority of wellness trips and wellness expenditures. The Middle East has a long tradition of bathing associated with Turkish baths, and some older facilities are being modernized to serve spa-bound tourists. Tourism in general is on the rise in the region, and governments and private developers have been investing heavily in facilities and amenities, especially those oriented to the wealthy traveler.
In Africa, wellness tourism is concentrated in a few regions and is dominated by international tourists. South Africa reports significant domestic wellness tourism. Tunisia and Morocco have a well-developed resort spa sector primarily serving leisure vacationers from Europe.