Contact with nature, nature prescriptions, and loneliness: Evidence from an international survey of adults in Australia, India, Singapore, the United Kingdom, and the United States.

Evidence to support nature contact and nature prescriptions to reduce loneliness is scant. A total of 2100 individuals took part in a survey conducted in Australia (n = 525, mean age = 34.1), India (n = 526, mean age = 29.5), Singapore (n = 523, mean age = 36.1), the UK (n = 526, mean age = 37.3), and the US (n = 525, mean age = 43.6) in 2022 (overall age range 18-89yrs). Multilevel logistic regressions adjusted for confounding indicated mean levels of overall loneliness tended to be higher in India (Odds Ratio [OR] 1.21, 95% Confidence Interval [95%CI] 0.90-1.62), Singapore (OR = 1.54, 95%CI = 1.15-2.07), the UK (OR = 1.26, 95%CI = 0.96-1.67) and the US (OR = 1.24, 95%CI = 0.94-1.64) compared with Australia. Notable differences were observed by loneliness type, for example, with lower odds of social loneliness (OR = 0.57, 95%CI = 0.41-0.79) and higher odds of emotional loneliness (OR = 1.57, 95%CI = 1.14-2.06) in India compared with Australia. Findings with regards to loneliness and nature contact varied between country. In general, social loneliness was lower in participants who visited natural surroundings regularly (OR = 0.81, 95%CI = 0.61-0.98) and spent two hours or more per week in nature (OR = 0.65, 95%CI = 0.49-0.81). Overall loneliness (OR = 1.98, 95%CI = 1.48-2.47) and emotional loneliness (OR = 2.84, 95%CI = 2.13-3.51) were substantially higher among those who felt having no-one to go with was a barrier to spending time in nature. Emotional loneliness was higher in those who had more time in nature (OR = 1.32, 95%CI = 0.94-1.75) or more frequent visits (OR = 1.24, 95%CI = 0.94-1.49), which may be indicative of selective processes by which some people who feel emotionally lonely seek meaningful sources of connection or solace in natural environments. In sum, these findings highlight potentially important contingencies in how people feel lonely in different countries, and the potential of contact with nature as a means to address this critical issue of modern times. Randomised trials of nature prescription interventions for loneliness co-designed with respect to contrasting cultural, economic, and climatic contexts are needed to ensure programs intended to reconnect people with nature are effective, equitable, and acceptable for everyone.