This paper analyzes the success factors of health tourism based on natural attractions in selected European spa and health destinations. The natural resources included in the offers, such as water, salt, and air, play a central role in this context, as their evidence-based effects have a high relevance for the health and wellbeing of tourists. Due to its specific geographical location and considering the threat of climate change, however, this offer is facing increasing challenges which make adaptation strategies necessary. In addition to a conceptional introduction to the topic, this paper contains a descriptive analysis of tourism statistics and the results from self-administered questionnaires with six selected representatives from alpine health destinations (DE, FR, IT, AT, CH, SI). The results show varying forms of health tourism based on natural attractions, which are also reflected in online marketing, with potential for optimization. The web research and the responses to the questionnaire revealed that evidence-based studies hardly play a role in promoting health touristic offers. Furthermore, climate change effects on natural attractions are considered extremely small and tend to prompt the development of new offers. Health destinations are advised to generate a clearer focus on the risks of climate change regarding natural resources.
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