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��ñ���� and one in six people feel lonely on a regular basis, a troubling reality that has prompted some public health officials to declare an “.”

A new global study presents a novel remedy. It found that nature-based social prescribing—clinicians literally prescribing things like gardening, hiking or birdwatching—can significantly reduce loneliness. Spending time in nature with others works even better, particularly for the loneliest among us, the study found.��

The findings appear in the October issue of the journal .

“There has been a lot of passion about nature-based prescriptions, but not a lot of evidence,” said corresponding author Jill Litt, professor of environmental health at ��ñ���� and principal investigator for the , which studied a social prescribing model called Friends in Nature in 1,200 adults in six cities across Europe, Latin America and Australia. “We now have randomized controlled trials showing this works and the impacts last.”��

What is loneliness?

As Litt explains, loneliness is not about being physically isolated. Rather, it is a “subjective disconnect between one’s expectations of their social relationships and one’s reality.”

“I’ve heard people describe it like a knot in their stomach, like something is just not right,” said Litt. “You could be in a room full of people and still feel lonely.”��

that chronic loneliness can increase risk of cardiovascular disease, dementia, stroke, depression and anxiety. It can also burden the healthcare system financially, as people suffering from loneliness tend to (sometimes in search of human connection) and are more likely to visit the emergency department with vague complaints on Friday afternoons — a phenomenon known as “Friday afternoon syndrome.”��

Professor Jill Litt at Horesbarn Garden in Denver. Credit: Louissé Studio

Participants in the Friends in Nature program enjoy a bird watching outing. Credit: Irene Cervera��Buisán/The RECETAS Project.

Due to stigma, people are often reluctant to admit or don’t recognize they are lonely and assume the physical symptoms they feel are due to something else.

“Once clinicians really start to drill down to the root causes, they discover that loneliness is a big factor and the solutions may lie outside the traditional medical system,” said Litt, who is also a researcher with the Barcelona Institute for Global Health.

Nature as medicine

RECETAS (Re-imagining Environments for Connection and Engagement) was launched in 2021 with a $5.6 million grant from the European Union. It has since conducted randomized controlled trials in Barcelona, Spain; Prague, Czech Republic; and Helsinki, Finland; and quasi-experimental studies in Marseille, France; Cuenca, Ecuador; and Melbourne, Australia.

Thus far, all the studies have yielded promising results. The newest, published this month, center around the site in Barcelona, where loneliness rates have doubled in recent years as multi-generational living has become less common and families have spread apart.

The study included 320 lonely older adults from 12 low-income neighborhoods.��

Half were placed in a group of 8–10, which spent two hours weekly for nine weeks together doing things like gardening, birdwatching or nature-based art programs along with two trained facilitators. The group activities were chosen from a menu co-created by the local community. The other half were provided the same menu of free, easily accessible nature-based activities that they could do on their own.

Both strategies worked. Participants on average showed an 11% reduction in loneliness scores at three months; 12% at six months; and 17% at one year. For those who started with lower emotional wellbeing, the group intervention worked significantly better.

“Not only did it work, but the effects were sustained,” said Litt, noting that many participants still meet today for outdoor activities.

Why nature works

Litt said that nature, with its vivid sounds, smells and sights, can act as an “additional facilitator,” augmenting therapeutic benefits and creating a safe space to support the formation of social bonds. Some participants told her, “nature doesn’t judge you” and “it’s hard to be angry in nature.”

"In the outings we have done I have learned to contemplate everything more, to be with the sounds, to focus," reported one 63-year-old female participant. "I have met people. I have shared. It has been wonderful."

But how could being in nature alone alleviate loneliness?

In addition to the documented benefits of relieving stress and mental fatigue and promoting motivation, it can also create new memories.

“Being out in nature forms this kind of reservoir of calm that we can return to later in life during stressful times,” said Louise Chawla, an environmental psychologist and professor emerita at ��ñ����. “It’s not just restorative when you are in a place but also when you go back to it in memory.”

Chawla recently co-authored another paper with Litt, calling for more attention to in fostering social connections.

She notes that with a shortage of mental health workers, the model of an individual sitting down with one therapist in an office is no longer realistic or affordable for many.

“We need to think in broader terms about how we can create group healing activities in places like parks and community gardens,” Chawla said.

Public health agencies in Spain have already begun to recognize the Friends in Nature model as a best-practice for addressing the loneliness epidemic.

Litt is now working to bring similar trials to the U.S. in hopes that someday, insurance might cover things like a membership in a community garden or birdwatching club.

“We have nature in our cities and investment in our green infrastructure,” she said. “Now we need a mechanism to bridge these resources with our health systems to offer person-centered care that leverages the power of nature for healing and wellbeing.”