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.@en

Objective: “Nature prescriptions” are increasingly being adopted by health sectors as an adjunct to standard care to attend to health and social needs. We investigated levels of need and interest in nature prescriptions in adults with cardiovascular diseases, psychological distress and concomitants (e.g. physical inactivity, sedentary behaviour, obesity, loneliness, burn-out). Methods: A nationally-representative survey of 3,319 adults across all states and territories of Australia was completed in February 2021 (response 84.0%). Participants were classified across 15 target groups using validated health indicators and surveyed on (1) time and frequency of visits to green and blue spaces (nature spaces), (2) interest in a nature prescription, and (3) potential confounders (e.g. age, income). Analyses were done using weighted logistic regressions. Results: The sample was 50.5% female, 52.0% were aged ≥45 years, 15.2% were living alone and 19.3% were born overseas in non-English-speaking countries. Two-thirds of the sample spent 2 hours or more a week in nature, but these levels were generally lower in target groups (e.g. 57.7% in adults with type 2 diabetes). Most participants (81.9%) were interested in a nature prescription, even among those spending fewer than 2 hours a week in nature (76.4%). For example, 2 hours a week or more in nature was lowest among sedentary adults (36.9%) yet interest in nature prescriptions in this group was still high (74.0%). Lower levels of nature contact in target groups was not explained by differences in access to or preference for local nature spaces. Conclusions: High levels of interest in nature prescriptions amid low levels of nature contact in many target health groups provides impetus for developing randomised trials of interventions that enable people to spend more time in nature. These findings can inform intervention co-design processes with a wide range of community stakeholders, end-users in target health groups, and the health professionals who support them.

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Cities are constantly evolving and so are the living conditions within and between them. Rapid urbanization and the ever-growing need for housing have turned large areas of many cities into concrete landscapes that lack greenery. Green infrastructure can support human health, provide socio-economic and environmental benefits, and bring color to an otherwise grey urban landscape. Sometimes, benefits come with downsides in relation to its impact on air quality and human health, requiring suitable data and guidelines to implement effective greening strategies. Air pollution and human health, as well as green infrastructure and human health, are often studied together. Linking green infrastructure with air quality and human health together is a unique aspect of this article. A holistic understanding of these links is key to enabling policymakers and urban planners to make informed decisions. By critically evaluating the link between green infrastructure and human health via air pollution mitigation, we also discuss if our existing understanding of such interventions is sufficient to inform their uptake in practice.

Natural science and epidemiology approach the topic of green infrastructure and human health very differently. The pathways linking health benefits to pollution reduction by urban vegetation remain unclear and the mode of green infrastructure deployment is critical to avoid unintended consequences. Strategic deployment of green infrastructure may reduce downwind pollution exposure. However, the development of bespoke design guidelines is vital to promote and optimize greening benefits, and measuring green infrastructure's socio-economic and health benefits are key for their uptake. Greening cities to mitigate pollution effects is on the rise and these need to be matched by scientific evidence and appropriate guidelines. We conclude that urban vegetation can facilitate broad health benefits, but there is little empirical evidence linking these benefits to air pollution reduction by urban vegetation, and appreciable efforts are needed to establish the underlying policies, design and engineering guidelines governing its deployment.@en