The term spa is commonly thought to be derived from the name of the town of Spa in Belgium, where a natural hot springs has been a site of healing since before Roman times. Evidence of human visitation to hot and cold springs can be traced to prehistoric times, and many people worldwide have believed in the healing power of certain springs and of bathing and purification in general. Most spas were established at sites that had been used for centuries for health and well-being, often built around natural hot springs or near lakes. The ancient Greeks and Romans were well known for their medicinal bathing and the vast complexes they built to accommodate this pastime.
Spas and sanitariums in the United States blossomed in the 1800s along with a resurgence in values associated with the Greco-Roman period: a focus on physical exercise, hygiene, disease prevention, and overall well-being. European and British colonialists brought to the New World an interest in the medicinal use of bathing and hot and cold springs. In addition, many learned about local hot and cold springs from Native Americans. Colonial doctors began recommending water cures in the 18th century, establishing famous spas such as Saratoga Springs in New York, as well as in Pennsylvania and Virginia. Entrepreneurs built hotels where visitors could lodge, eat, and visit the hot springs, thus giving rise to the U.S. health resort industry. Industrialization gave rise to a prosperous middle class in the United States that could also afford to use upper-class spas and sanitariums, mostly to treat ailments under a physician’s recommendation.
In the United States, the spa industry grew and prospered in the late 20th century, with a 24 percent growth rate between June 2007 and June 2008 and $10.9 billion of revenue according to the International Spa Association (ISPA) (Figure 1).
One in four Americans has been to a spa, with 138 million spa visits estimated in 2007 (Figure 2). In a 2002 American Massage Therapy Association survey, 28 percent of Americans who said they had received a massage in the previous five years said the reasons were relaxation or stress reduction (23%), other health reasons (53%), and pampering themselves (15%). Twenty-seven percent preferred to receive a massage at a spa compared with 19 percent in the therapist’s office.
Corporate Wellness Culture
Founded in 1991, ISPA is the first professional organization to represent the industry. It represents 3,200 health and wellness facilities and providers in 83 countries. Members include resorts, hotels, medical spas, mineral springs, and cruise ships, as well as service providers such as physicians, massage therapists, and product suppliers. Its mission is to forward the industry’s mission to promote the spa experience, demonstrating that the spa is not a luxury but a lifestyle. The organization offers directories, a job bank, promotions, and outreach programs to promote wellness to communities through education, research, and scholarship. ISPA has also conducted ethnographic consumer trends research into spa use, exploring why the spa experience is becoming a sought-after lifestyle focused on wellness and connection to self.
Figure 1 U.S. Spa Industry Revenue from 2003 to 2007 (in billions)
Figure 2 Number of Spa Visits in the United States from 2003 to 2007 (in millions)
Worksite wellness programs advanced in the 1990s focused on employee wellness. In particular, corporations often funded retreats for their top-level employees at spas with the intent to enhance company performance. This helped to fuel the burgeoning spa industry, which caters increasingly to corporate culture and high-income clients. Recent news reports suggest that executives from firms receiving bailout money from U.S. taxpayers spent hundreds of thousands of dollars on expensive spa retreat weekends, angering the public.
The spa industry employs a range of workers, including massage therapists, nutritionists, physicians, wellness educators, cosmetologists, and cleaning staff. Most employees in the spa industry are part-time or contract employees, numbering 160,500 in comparison to 143,200 full-time employees.
Massage therapists have always been part of the spa industry, but were employed in greater numbers in day spas and beauty salons as the industry boomed during the early 20th century and again in the 1990s. Although most massage therapists, according to the American Massage Therapy Association (AMTA) practice privately, 22 percent of AMTA members say they are employed in a spa or salon, compared to 43 percent who travel to client locations, 33 percent who have a home office, 16 percent who have an office with other massage therapists, 30 percent who are in private practice with their own office, and 19 percent who work in a medical setting.
Most massage students tend to train in regions where there is a large potential market for massage services. Increasing numbers of students, however, are likely to become employees in the burgeoning spa industry rather than practicing for themselves. Changing licensing laws and increasing educational standards are more likely to affect the provision of massage in the enormous day spa industry. Hotel spas and large corporate day spas typically pay between 20–30 percent commissions to massage therapists.
Another reason for the burgeoning spa industry has been a ready supply of cheap labor, allowing spa business to make a hefty profit. For many workers in day spas and salons, $10–$12/hour is the industry maximum, although some contract massage workers make more. Being non–English speaking means lower wages, sometimes $50 a day, well below minimum wage, and up to 20 percent of spa-worker income can be based on commissions. At times, spa owners may change the percentage of the treatment price they pay employees or change or stop paying the hourly rate altogether. In some spas, there is no hourly rate and employees are not paid at all for no-shows. Plaintiffs in a lawsuit against two nail salons on the Upper West Side of New York City were awarded $250,000 for overtime violations and wrongful terminations; these salon workers were routinely putting in 10-hour days, often without a break, six days a week.
A spa environment offering services to customers on a day-use basis is usually built in a stand-alone facility, without lodging or restaurants. Most day spas offer massage services, and cosmetology services such as facials, waxing, body treatments, manicures, pedicures, and sometimes hairstyling.
A medical spa operates under the supervision of a licensed health care professional and integrates complementary and alternative therapies with typical spa services. In addition, many medical spas offer the latest dermatological skin treatments that can be practiced by technicians under the supervision of a licensed medical professional, such as microdermabrasion, a tool that exfoliates the top layer of skin from the face, medical chemical peels, and Restylane and Botox injections.
Mineral Springs Spas
A mineral springs spa is a spa that is built around a natural mineral hot or cold spring that offers hydrotherapy treatments. They can be day spas or may also include a hotel or resort spa environment with lodging, restaurants, and a full range of spa services. Some of the most famous include the Spring Resort and Spa in Desert Hot Springs, CA; Colorado’s Hot Sulphur Springs Resort and Spa; the Ojo Caliente Mineral Springs Resort and Day Spa in Northern New Mexico; and the Hot Springs Resort in North Carolina.
Hotel/resort spas are hotels or resorts that offer spa services or a spa environment within the facility; this may include fitness and wellness services, as well as special meals. Examples of the best known spas in the country include Canyon Ranch (Tucson, Arizona), The Spa at the Mandarin Oriental (New York), Mii Amo (Sedona, Arizona) and Lake Austin Spa Resort (Austin, Texas).