Research suggesting health benefits of golf could also suggest benefits of being rich

“Round of golf once a month can reduce risk of early death.”

The Times, 13 February 2020

While playing golf almost certainly has a positive effect on someone’s health, compared with inactivity, reports that it reduces the risk of premature death are based on recent research which has severe limitations. 

American researchers analysed data from the US Cardiovascular Health Study, which looks at risk factors for heart disease and strokes in adults aged 65 and above. 

They found that that, during the follow up period, the death rate was lower among participants who played golf compared to other participants, but that the rate of “cardiovascular events” like heart attacks and strokes was not different. 

(It’s unclear how frequently participants had to play golf to be counted in this group. The press release says golfers played at least once a month, while the research says playing “for at least one month per year” qualified. We’ve asked the researchers for clarification.)

The researchers controlled for other factors including age, race, gender, hypertension and diabetes.

What this means is that they tried to isolate the effect of playing golf from other factors that might impact the death rate. For example, we know that men have a lower life expectancy than women, and that men are significantly more likely to play golf so the researchers tried to account for that.

However there are two factors that weren’t controlled for that could also make a big difference to these results, and that excluding them means these findings are limited.

Firstly, the research does not control for economic status. Golf.com’s 2016 survey of American golfers found that 70% had a household income of $100,000 or more. The median American household income in 2016 was $58,000 meaning golfers are much richer than Americans on average. 

The World Health Organisation says: “Higher income and social status are linked to better health.” So by not controlling for income the research could simply be affirming something we already know—that being rich is good if you want to live longer. 

Secondly, the research does not control for other exercise.

It could be the case that people who play golf monthly are also more likely to do some other form of exercise compared to people who don’t play golf. 

And so without controlling for other forms of exercise, it’s impossible to say whether golf is the reason for lower death rates.  

The research press release published by the American Stroke Association (a division of the American Heart Association) did say “while researchers were unable to determine if golfing had a direct impact on lowering the risk of heart attack or stroke, they are currently performing additional analyses to identify what other health conditions may benefit from regularly playing golf.”

However it is also misleading in saying that “regularly golfing – at least once per month – was found to lower the risk of death among older adults” when no causal link was examined or proven. 

We asked the researchers why economic status and other exercise were not controlled for and will update this piece if they respond.