Mapping loneliness prevention and alleviation interventions: a comparative survey of Basel, Bern, Zurich, and Dublin.

Introduction: Loneliness affects 38% of Swiss residents, higher than the global average. Considering that loneliness is associated with increased morbidity and mortality akin to smoking, drinking and obesity, the state of loneliness represents a serious health risk. To date no study has been undertaken to assess the landscape of loneliness prevention and alleviation interventions (LPAIs) in a high-income country like Switzerland and to compare this to other contexts. Results: NGOs delivered 84% of Swiss and 89% of Dublin LPAIs; direct state provision was ≤5%. Yet 60-75% of providers received some public funding, and 82% (CH) versus 93% (IE) were free to users. Older adults dominated addressees, while middle-aged adults, adolescents and chronically ill people were underserved. Support services and social-activity formats dominated, while evidence-based psychological interventions were scarce (<15%). LPAIs placed less focus on the Social Relationship Expectation variable Generativity, with Dublin LPAIs covering more Social Relationship Expectation domains and offering greater virtual access (78%) than Swiss counterparts (≤35%). Discussion: The landscape is rich yet fragmented. Heavy reliance on NGO delivery and ad-hoc funding jeopardises sustainability and equity. Under-representation of active, generative and tech-enabled formats signals possible low-cost missed opportunities for areas where loneliness is rising fastest. State leadership, strategic funding and digital innovation could close these gaps. Conclusion: High-income cities host many LPAIs, but without coordinated public-health strategies they fall short of preventive potential. Governments should mainstream, subsidise and modernise interventions to meet the multidimensional challenge of urban loneliness.