Physical environment and loneliness across cultures: A scoping review

In recent years, loneliness has increased along with epidemics and extreme weather events, leading to adverse effects on the physical and mental health of the global population. With a special focus on human-environment interactions, this study investigated the influence of physical environment on loneliness across various cultural backgrounds. Following the guidelines of Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), the study identified 344 peer-reviewed articles and retained 26 of them for analysis after title/abstract and full-text screenings. The primary selection criteria were: 1) studies in which the outcome of interest included loneliness; 2) consideration of people's interaction with the physical environment; 3) population-based studies (i.e., without a focus on certain professions or diseases); and 4) the inclusion of cultural factors or description of the cultural/demographic settings. The study found that environments perceived as safe and supportive with resources - foundational infrastructure in the Global South and high-quality amenities in the Global North, mobility, and nature engagement opportunities, were consistently associated with reduced loneliness in most cultural settings. However, the cultural meaning of places, environmental needs, and focused aspects of the environment vary across cultural contexts. The results indicate a need for further research to analyze the potential mediating role of subjective perception and nature engagement on the association between the physical environment and loneliness. For policymakers, the study highlights health disparities caused by loneliness, emphasizing the need for culturally specific, participatory spatial interventions that go beyond merely providing amenities and instead design places that foster a subjective sense of belonging and enable social engagement.