Golf has never been short of critics! To some it is a pleasant walk interrupted by occasional swings. For others it’s all about competition. To others it is elitist! Some see it is an environmental extravagance, consuming land and water while transporting enthusiasts around the globe in search of famous fairways.
Yet golf remains one of the world’s most popular recreational activities, played by many tens of millions of people across a remarkably broad range of ages, from young children to the very elderly.
A counterpoint to the criticism might be seen in the possible health benefits of golf: is golf actually good for us? At a fundamental level, does it improve our health, wellbeing and perhaps even extends our lives?
This is not merely an idle curiosity. Modern societies spend enormous effort encouraging people to exercise more, spend time outdoors, remain socially connected and maintain mental engagement throughout life. Golf, uniquely perhaps, combines all of these things in a single activity. A round of golf may involve several hours of walking, it may involve hills, strategic thinking, social interaction and exposure to green spaces. It requires some modest athletic ability and needs balance and coordination. If public health experts were asked to design an activity from first principles, they might come up with something rather similar.
There is a lot of published data all generally pointing in the same direction. But the strongest evidence comes from an extraordinary study conducted in Sweden by researchers at the Karolinska Institute. Published in 2009 under the memorable title Golf: A Game of Life and Death, the study examined more than 300,000 registered golfers and compared their mortality rates with those of the wider Swedish population.
The results attracted considerable attention. Golfers were found to have a mortality rate approximately 40 per cent lower than the general population after adjustments for age, sex and socioeconomic factors. The researchers estimated that this difference corresponded to an increase in life expectancy of around five years. Five years!
Five years is not a trivial effect. In public health terms it is a remarkably large number. Actually it humongous! It places golf in the company of some of the most significant lifestyle factors associated with healthy ageing.
The finding became even more intriguing when the researchers looked at handicaps. Players with lower handicaps tended to have lower mortality rates than those with higher handicaps. It would be tempting to conclude that better golf leads directly to a longer life, but such a conclusion would be premature. Better golfers may simply play more often, walk more courses and maintain higher levels of fitness. They may also have fewer underlying health problems in the first place.
As every student of statistics knows, correlation does not necessarily imply causation. There are confounding factors. Perhaps most important among these factors is that (1) golf is generally played by wealthier people who may have healthier lifestyles and (2) healthier people may be able to play golf longer. While not perfect the Karolinska study was large enough to be able, at least to some extent, to control for such confounding factors. Importantly, the mortality reduction observed was seen in both genders, in all age groups, and in all socioeconomic categories.
The study raises an obvious question. What aspects of golf might contribute to the health benefits of golf?
The first candidate is physical activity. A typical round of eighteen holes may involve walking between four and eight miles depending on the course. Many golfers comfortably exceed twelve thousand steps during a round. Hills and inclines are common. Unlike a visit to the gym, which may last an hour, golf often occupies four or five hours. The intensity is moderate rather than extreme, but the duration is considerable.
There is an important lesson here. Health advice often focuses on vigorous exercise because it delivers measurable cardiovascular benefits. Yet many vigorous activities suffer from one major weakness: people stop doing them. The most effective exercise programme is not necessarily the most intense one. It is the one that can be sustained year after year and decade after decade.
Golf appears to pass that test rather well.
Visit any golf club and you will find players in their sixties, seventies and eighties still on the fairways, hitting shots, negotiating bunkers and discussing putts. Few sports remain accessible for so long. Golf, in clear contrast to most other sports, is participatory as a lifelong companion.
The physical benefits are not confined to walking. The golf swing requires balance, coordination, flexibility and rotational movement. None of these attracts the attention given to aerobic fitness, yet all become increasingly important with age. You might view them as potent “anti-frailty” activities! Loss of balance and mobility are among the principal reasons older adults lose independence. Activities that preserve these abilities may contribute significantly to what geriatricians call “healthspan”: the period of life spent in good health.
Then there is the mental dimension. Every shot in golf is a small problem in applied physics. The player must judge distance, slope, wind, lie, risk and reward before selecting a club and executing a movement that lasts little more than a second or two. Over four hours the brain performs hundreds of such calculations. The game is physically active but also intellectually demanding.
That combination may matter. Increasing evidence suggests that maintaining cognitive engagement throughout life is associated with better outcomes in later years. Golf is not merely exercise; it is exercise combined with decision-making, concentration and continuous problem solving.
The social dimension may be equally important. Human beings are social animals, and loneliness is increasingly recognised as a significant health risk. Golf is unusual among sports in that conversation occupies almost as much time as competition. Four hours spent walking with friends, partners or acquaintances provides opportunities for connection that many modern activities do not. Countless friendships, business relationships and family traditions have been built around a golf course.
Indeed, one could argue that golf’s greatest health benefit may not lie in the swing at all. It may lie in the fact that people look forward to playing. Activities that are enjoyable tend to become habits. Habits repeated over decades shape lives.
Of course, no honest assessment would ignore the downsides.
Golf is not injury-free. Lower back problems are common, particularly among enthusiastic amateurs who may swing with more enthusiasm than technique. Elbows, wrists, shoulders and knees can all suffer. Professional golfers, who hit thousands of balls each week, experience many of the repetitive strain injuries familiar in elite sport. Amateurs are not immune!
Nor are all forms of golf equally beneficial. Walking a course provides considerably more exercise than travelling between shots in a motorised buggy. The health benefits of carrying a bag differ from those using a trolley and are much greater than sitting behind the wheel of a buggy. But even buggy golf is better than no golf!
The Karolinska study does not prove that golf adds five years to every player’s life. Science rarely offers such certainty. Wealth, healthcare, lifestyle and countless other factors complicate the picture. Nevertheless, the findings are difficult to dismiss. Across hundreds of thousands of individuals, golfers appeared to live longer than expected.
Perhaps the explanation is ultimately simple.
- Golf encourages people to walk
- It encourages them to think.
- It encourages them to spend time outdoors.
- It encourages them to meet friends.
- It encourages them to keep doing all these things long after many other forms of exercise have been abandoned.
Frankly, if a pharmaceutical company announced a treatment that increased physical activity, improved balance, stimulated cognition, promoted social interaction and was associated with a five-year increase in life expectancy, it would be marketed very quickly! There stock market price would be skyrocketing!
Golf, it seems, has been offering something rather similar all along. But then golfers have known this all along and didn’t need any Academic studies to show them! 🤷🏻♂️
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