Golf and Health2016-2020.

Golf and Health 2016-2020 | Contents

Contents.
Introduction
The health benefits of golf....................................................................................... 3

Scientific Papers
The Scoping Review................................................................................................... 5
The Spectator Study................................................................................................. 7
The International Consensus Statement............................................................... 9Strength and Balance Study .................................................................................. 11
Other papers and research .....................................................................................12

Case Studies
1. The Open ...............................................................................................................15
2. Wales Golf and the Stroke Association.............................................................17
3. Golf for the Disabled............................................................................................18
4. Monique Kalkman ................................................................................................19
5. Policy makers ....................................................................................................... 20
6. National Federations ...........................................................................................21
7. Social Prescription ............................................................................................... 22
8. Golf and Health Week......................................................................................... 23
9. The Home of Golf ................................................................................................ 24
10. Golf Memories .................................................................................................... 25

The Future
The future of golf and health................................................................................. 26

Join us on a round to discover the
many health benefits of golf...

2

Golf and Health 2016-2020 | Introduction

3

The health benefits ofplaying golf are significant.
It is a sport that can be played from the ageof four to 104. It can be played in the fresh air
in the great outdoors, in many different forms
and even indoors too. It allows golfers to enjoy
a form of exercise, as well as boosting theirmental wellbeing in a social environment.
Even following your favourites by walking at
golf events is good for you.
These facts alone have long been
known by golfers themselves. However,
it is important to educate thosebeyond the sport about its many
health benefits, including non-golfers,
public health professionals andgovernments.
As two-time Champion Golfer of theYear, Padraig Harrington, said, “People
who play golf do realise the benefitof it. But the wider public doesn’t
understand it – the health benefitsof playing golf for your physicaland mental health. I have seen how
impactful golf can be on peoples’
wellbeing; now it is time to get themessage out there.”
Put simply, golf has underplayed its
health benefits. Against a backgroundof busy modern lives, competinginterests and more sport and leisurepursuits than ever, golf has perhaps
not effectively positioned itself as ahealth-enhancing activity that can beenjoyed by people of all ages, abilities
and backgrounds.
Nevertheless, an opportunity exists
for golf. An epidemic of physicalinactivity-related disease in most of
the world’s populations – physicalinactivity is responsible for more than

Padraig Harrington

three million deaths worldwide – has
led to the World Health Organization(WHO) calling for action by sports.
Since 2016, The R&A and its
partners, including the World Golf
Foundation (WGF), the United States
Golf Association (USGA) and theEuropean Tour, have sought to: raiseawareness of the health benefitsof golf to encourage interest in
participation by people of all ages
and abilities; improve the sport’s
image; and increase advocacy for golfby government agencies and publichealth bodies.
The Golf & Health Project, supportedby The R&A and the other WGF
partners, was formed to achieve theseaims by producing and publishing highquality science that evidences golf’s
physical and mental health benefits
to target existing golfers, non-golfers,
golf bodies and policy makers ingovernment and health.
Dr Roger Hawkes, a sport and exercise
physician and former Chief Medical
Officer of the European Tour andRyder Cup Europe, is the Founder andExecutive Director of the Project.

Golf is a sport that can beplayed from the age of four to“People who play golf do
realise the benefit of it. But
the wider public doesn’t
understand it – the healthbenefits of playing golf foryour physical and mental
health. I have seen how
impactful golf can be on
peoples’ wellbeing; now it
is time to get the message
out there.”
PADRAIG HARRINGTON

Two-time Champion Golfer

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Golf and Health 2016-2020 | Introduction

4(L to R) Dr Andrew Murray, Fiona Bull, Steve Brine,
Annika Sorenstam, Martin Slumbers and Craig Tracey
at the First International Congress on Golf and Health“The scientific research
clearly shows that there
are significant physical andmental health benefits to
be gained from playing
golf. We believe that golf
can provide a fantastic
opportunity for people of allages and abilities to havefun, get fit and socialise
with family and friends –something that is important
to today’s society.”

Golf and Health 2016-2020 | Scientific papers

5

Knowledge is power.
It was Francis Bacon, one of the leading figures in natural philosophy,
who coined this now-famous phrase in 1597. For golf to accurately
highlight its physical and mental health benefits (and any illness
or injury), it was important to research and review the existingscientific evidence.

The Scoping Review.

MARTIN SLUMBERS

Summary of findings

Chief Executive of The R&A

The R&A has played a key role in
the Project by part-funding researchundertaken by Dr Andrew Murray of
the University of Edinburgh, who is
the lead research scientist. Dr Murraycompleted his PhD at the Universityof Edinburgh in 2020, where he wassupervised by world leaders in exercise
medicine. The leading sports medic
is now Chief Medical Officer for theEuropean Tour, advises the Scottish
Government and has a role supporting
WHO projects.
The R&A has also directly supported
other activity, including being
the sole funder of a Strength andBalance Study, sponsoring the FirstInternational Congress on Golf and
Health and increasing communicationof various activities to promote thebenefits of golf for health.
Robust research, data and key findings
have been regularly published in theworld-leading international journal,
the British Journal of Sports Medicine(BJSM), to support the principle that
golf can lead to greater health andwellness benefits for participants andspectators attending events.

Golfers live

5

Martin Slumbers, Chief Executiveof The R&A, said, “The scientificresearch clearly shows that there are
significant physical and mental healthbenefits to be gained from playing
golf. We believe that golf can provide
a fantastic opportunity for peopleof all ages and abilities to have fun,get fit and socialise with family andfriends – something that is important
to today’s society.
“We need to position golf as a leisurepursuit that can be accessed andenjoyed by everyone and encourage
advocacy for the sport as a moderateintensity physical activity by
government agencies, public healthbodies and health professionals.”This report brings together what
we know about the health benefitsof golf. It details these benefits bysummarising the scientific research,
the public exposure and increased
interest among national federations,policy makers and other organisations.
A number of case studies highlightthe impact of collective endeavours,
spanning various countries and at
leading professional events, withassociated media coverage.

By understanding the health benefitsof golf, we can be healthier andhappier as golfers and encourageothers to take up the sport. The
golf industry and facilities can also
maximise the benefits by sharing theinformation to their audiences, while
policy and decision makers can takekey actions.
As Brooke Henderson, a Major
Champion and a Golf and Healthambassador, notes, “I think it’s really
important for people to realise how
good golf is for you – not only yourhealth physically, but also mentallyand socially, being able to makefriends out on the course and toconnect with people. The sport offers
so many health benefits.”
If you are a golfer, are thinking of
taking up the sport or are keen toencourage others onto the fairways,
then read on…

1

years longer.

On average, golfers live five years longer than
non-golfers

The future of golf and health is also
assessed as the sport seeks to buildon the foundations set in recent years
and continues to attract more golfers
onto courses and into facilities aroundthe world.

•

A scoping review to identify key
concepts and gaps in research was
published in October 2016 by the
BJSM, the world-leading sports
medicine journal, and proved crucial
to understanding and raisingawareness of golf’s health benefits.
It was one of the most read and usedscientific research papers of the year,
generating interest in the healthbenefits of golf on a global scale.
Conducted at the University of
Edinburgh, researchers reviewed
5,000 studies into golf and wellbeing
and analysed in detail over 300 of
the most relevant. The main findings
from the Review highlighted that
golfers enjoy longer lives, particularly
as the sport can help prevent chronic
diseases, improve mental health andboost social wellbeing.

Published in the Scandinavian Journal of Medicine and Science in Sports,
a landmark study found a 40% reduction in mortality rates among
300,000 members of the Swedish Golf Federation, corresponding toan increase in life expectancy of about five years (this applied for bothgenders, all ages and all socio-economic groups)

Golf helps combat disease•Golf, as a physical activity, can help prevent and treat 40 major chronic
diseases, including diabetes, heart attacks, stroke, breast and coloncancer, depression and dementia. Other studies highlighted that risk
factors for heart disease and stroke, such as cholesterol and bloodpressure, are reduced in populations who play golf

Golf is a moderate intensity physical activity•

Highlighted by most sources, including the renowned international
publication of physical activity quantification, ‘The Compendium of
Physical Activities’, and recommended by policy makers worldwide
including the WHO, the United States Department of Health and Human
Services and UK Chief Medical Officers•

Moderate intensity activities are those that get you moving fast or
strenuously enough to burn off three to six times as much energy per
minute as you do when you are sitting quietly, so the acceptance of thisfor golf was significant•

Balance and muscle endurance in older people are improved by playing
golf, while golf is also likely to improve cardiovascular, respiratory andmetabolic healthGolf, as a physical activity, can help preventand treat over 40 major chronic diseases.

Golf and Health 2016-2020 | Scientific papers

6

Golf boosts social interaction•

There are risks to golf participation, including injury and illness, but therate per incidence is low and can be reduced by a seven-minute warm up“Research has shown that
golfers live up to five years
longer than people who
don’t play golf. What ismore important than being
healthy? I think we shouldtake time for golf. Together
with the researchers anddoctors, we’re trying to tellpolicy makers, ‘hey, pay
attention to golf. It shouldbe part of your programmes;
golf should be top of your list
as it is benefitting health.’”•Sun exposure in golf is high but this can be alleviated with appropriate sun
cream protection. Exposure to fresh air and sun also helps boost VitaminD levels

Ten-time Major Champion and Golfand Health ambassador•

Golf can help reduce the risk of anxiety, depression and dementia,
improving an individual’s wellness, self-esteem and self-worth•

A lack of social interaction can be addressed by golf participation.
Social isolation has been shown to be the biggest health risk factor in a
population of older people over a five-year period

Walking is better than cart use•

Walking and carrying clubs, or using a pull-cart, have much greater
benefits than riding a golf cart

Benefits substantially outweigh the risks

ANNIKA SORENSTAM

Impact of the Scoping Review
Highlighted the opportunity for increasing
participation in golf•
“The Review demonstrates
a wide variety of healthbenefits. Golf helps you live
longer and be healthier andhappier.
“Anyone can play of all ages
and abilities and there are
popular shorter formats, such
as GolfSixes, to make thesport more accessible. We
have to get away from theidea golf is only a rich man’s
sport – 75% of the courses
across the world are available
for the public to play on, notonly members.”

More scientific knowledge, collaboration and networks to support
participation in golf for health benefits

Robust science for policy makers•

The Review opened up channels of communication to the WHO andpolicy makers thanks to scientific evidence•

The Review was welcomed with an Early Day Motion in the UK Parliamentby the Minister for Public Health

Wider awareness•A communications campaign to raise awareness of golf’s healthbenefits achieved coverage around the world, while the Review was sharedby The R&A with over 150 affiliates spanning more than 140 countries•

It was presented at golf industry meetings and public engagements andtranslated into Spanish, German, Cantonese, Mandarin and Arabic

Golf and Health 2016-2020 | Scientific papers

The Spectator Study.
Summary of findings

Following the publication of The
Scoping Review, other areas wereidentified to further highlight golf’s
health benefits, including from aspectator point of view.
Attending live sporting events is afavourite pastime for fans all over theworld and is by no means reserved
to golf. Events provide fans with
an opportunity to get up close to
the players, sharing the trials andtribulations of their sporting icons.
However, as most sporting events
confine spectators to a seat, golf
has long been regarded as unique inbeing the only mainstream sport thatprovides fans with health benefits –just like the players on show – throughattending a professional or amateur
event. Although intuitive, proof was
required.

•

The research, published in July 2017, found that almost 83% of spectators
at the 2016 Paul Lawrie Match Play at Archerfield Links in East Lothian
met and exceeded the recommended daily step count, with the 339
fans in the study averaging 11,589 steps per day (people are generally
recommended to walk 10,000 steps a day)•Spectators walk between 5-6 miles on average and burn more than
1,000 calories per day•

Golf also allows spectators to spend time in green space and socialise
with friends and family which are proven to have mental health andpsychological benefits•

The study, published in the BJSM and BMJ Open Sport & Exercise
Medicine, was the first to use pedometer data to assess golf spectators’
physical activity and it found men took about 1,800 more steps each day
than women•Spectators also rated exercise and physical activity as important reasonsfor attending golf events and 60% said they would like to be more active

Crowds enjoying The OpenAs part of the PhD study of Dr Andrew
Murray and the Golf & Health Project,research on the health benefitsof attending golf events achieved
valuable results and confirmed that
attending an event as a spectator isvery beneficial for your health.

A scientific follow-up paper in the
BMJ Open Sport & Exercise Medicine
found that 40% of the spectators
increased their physical activity during
the three months after attending an

DR ANDREW MURRAY

Lead Researcher for the
Scoping Review

On a regular 18-hole course, most players
will walk between four and five miles...

72...burning up to

2,000

event, demonstrating that golf events
can not only offer enjoyment andentertainment but also leave a legacyof improved health for attendees.

3

calories.

Golf and Health 2016-2020 | Scientific papers

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Golf and Health 2016-2020 | Scientific papers

Impact of the Spectator Study

9

The International Consensus Statement.

Robust science for policy makers•

The International Society for Physical Activity and Health (ISPAH) / WHO / International Olympic Committee all
welcomed alignment to global policy•

The Scottish Government and UK policy makers indicated that the findings contributed to decision-making
regarding support of events•

The study was highlighted at public health and sports academic conferences e.g. Planetary Health / InternationalSports Science and Sports Medicine Conference

Wider awareness for events•

Targeted information and infographics were provided to golf bodies who organise events, with meetings held withe.g. The R&A, the European Tour and the Asian Tour•An increase in health information has been provided on big screens, information towers and other spectator signage
at a diverse range of events such as The Open, AIG Women’s Open, The Ryder Cup, The Solheim Cup, and events in
Spain, Indonesia and China•

The study offered the opportunity for commercial third parties to contribute to the health narrative at future events.
For example, spectators attending the 2018 Andalucía Valderrama Masters (third round) in Spain were invited to join
the Walk & Win event, a ground-breaking European Tour initiative supported by QuirónSalud with the purpose ofpromoting healthy lifestyle habits amongst golf fans. Spectators could have a card stamped when they passed by
the 5th hole and again on the 13th, before handing it in at the QuirónSalud tent, after having walked a total of overthree-and-a-half miles

Spectators enjoy the 2019
Solheim Cup at Gleneagles“Walking is one of the bestthings you can do for yourhealth, adding years tolife and increasing healthand happiness. Thesepilot findings show golf
spectators can experience
physical activity to benefit
their health while watchinga top-quality sport at closequarters. This could havehuge implications on event
attendance and encouraging
more people to attend a
professional event or begin
playing the sport.”
DR ANDREW MURRAY

Lead Researcher for theSpectator Study

13,000steps (depending where your ball goes!)can be walked during an 18-hole round...

Summary of findings

The 2018 International Consensus
Statement on Golf and Health toguide action by people, policy makers
and the golf industry was published in
September 2018 in the BJSM.

•

Playing golf is associated with better strength and balance, a sharper
mind, a lower risk of heart disease and a longer life, with more people
encouraged to take up the sport•

To get the most benefit from the sport, golfers should play for at least
150 minutes a week and avoid riding in a golf cart. Players should also do
warm-up and strengthening exercises to lower their risk of injury•

While an estimated 60 million people play golf at least twice a year, golfers
are primarily middle-aged and older, affluent, male, white and living inNorth America, Europe and Australia•

Compared with other sports, the risk of injury in golf is moderate. As golf
is an outdoor activity, golfers may have a higher risk of skin cancer thanpeople who take up indoor sports or sports with less time outside andshould use sunscreen when necessary

The Statement helps players,potential players, the golf industry,
facilities and decision makers benefit
from a better understanding of how torealise potential health benefits andminimise health risks related to golf.
To assess the physical and mental
health benefits of golf and propose
ways to make the sport moreaccessible to a wider population, Dr
Andrew Murray and more than 25
other experts in public health, healthpolicy and industry reviewed datafrom 342 previously published studies
on the sport.
The Statement informed scientificknowledge and action plans for (1)golfers and potential golfers, (2) golf
facilities and the golf industry, (3)policy and decision makers external
to golf.

The Melanoma Fund is among organisations
highlighting the importance of sun protection for
golfers, including via its Slip! Slap! Swing! campaign•

Cost and perceptions of the sport may put some people off the ideaof playing golf. The sport is also perceived as difficult to learn andunwelcoming to women, yet a number of women and girls’ initiatives are
assisting in this area•

Leaders in golf should make a greater effort to make the sport more
inclusive and welcoming of people from all walks of life and ethnic
backgrounds

Three key infographics were developed to help spread the messaging for
golfers, the golf industry and policy makers:•

Playing golf can make you healthier and happier•

Actions for policy / decision makers•

What can the golf industry / facilities do to maximise
the health benefits of golf?

Click here for infographics and digital resources

Women in Golf Charter.
A commitment to a more inclusive culture within golf
We call on everyone involved in golf to play their part in developing a culture that values
women’s involvement in every aspect of the sport, from participating to pursuing a career.
Our aim is to increase the number of women and girls playing and working in golf.
To achieve this goal and to enable women to flourish throughout golf, we recognise theneed for a fundamental shift in culture. There is a clear ethical need for change and thepotential economic benefits of growing the sport through more women and girls playing
are substantial.
The R&A commits to playing a leading role in this process and to working with affiliates,
partners and the wider golf industry towards achieving this goal.
In signing this Charter, we commit to making tangible efforts to develop a welcoming andinspiring environment for women. We will do more to attract women into golf, to remain,
and to have rewarding careers.

The Charter:•

Is a statement of intent from the golf industry to unite and to focus on gender balance•Commits us all to supporting measures to increase the number of women, girls andfamilies playing golf•

Calls for positive action to encourage women to pursue careers in all areas of the sport•

Recognises the need for change that creates an inclusive environment within golf

We commit to activate this Charter by:•

Developing and implementing an internal strategy for enhancing gender balanceat every level•

Establishing senior management responsibility and accountability for genderbalance and inclusion•

Strongly advocating more women and girls playing and working in golf•

Working with key stakeholders to develop and embed a more inclusive culture•

Promoting the Charter and our goal of encouraging more women and girls to playgolf and work in golf.

In May 2018, The R&A launched a Women in Golf Charter with the aim to increase women andgirls’ participation and membership in golf, encourage more families to enjoy golf as a leisureactivity and encourage more opportunities for women to work and volunteer in the golf industry...that’s well over the 10,000
recommended daily average.

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Golf and Health 2016-2020 | Scientific papers

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Impact of the Consensus Statement
Robust science for policy makers
The uptake, use and impact of the Statement has been considerable and avaluable tool to show that the golf industry is taking positive action.
Professor Fiona Bull, WHO Programme Manager, Non-Communicable Disease
Prevention, said, “Golf is a popular sport for men and women and it’s great
to see golf’s global leadership recognising health priorities and identifying
ways golf can be more accessible to more people. I took up golf in my 30’s but
thought it was a very technical, expensive and elitist sport.
“Thankfully, a six-week ‘come and try course’ showed me how easy it was toenjoy golf as a beginner and how active playing nine holes can be! I’m looking
forward to seeing how golf can attract many more girls and women to enjoy
the sport and be more active and healthy.”

Wider awareness••A communications campaign generated 40 million reach in press andonline, with social media coverage reaching over 1.6 million accounts
Discussions were held with over 30 policy makers and alignment agreed
with the WHO Global Action Plan for Physical Activity“Golf is the first sport
to make a meaningful
investment in looking at
its risks and benefits ofparticipation. Players,
management and policy
makers can now feel
confident, not only that
there are significant
associated benefits fromplaying golf, but the golf club
environment can provide
a health enhancing andcommercial opportunity.”“Physical activity of any
type comes with a range ofphysical, social and mental
benefits. For some, golf can
be a great way to stay active
and there’s growing evidence
about ways the sport canhelp those living with longterm conditions such as
Parkinson’s and dementia.
And for those who haven’t
discovered their favourite
sport yet, it’s never too late
to get inspired, connect withpeople and improve yourwellbeing.”
STEVE BRINE

Former UK Parliamentary Under
Secretary of State for Public Healthand Primary CareFirst International Congress on Golfand Health, October 2018
Building on the Consensus Statement, The R&A sponsored the FirstInternational Congress on Golf and Health in London to increase interest
and participation in the sport by helping players, potential players, the golfindustry and policy makers understand what actions can lead to better
health through golf. Golf and Health ambassador Annika Sorenstam
supported the activity in London.
Evidence linking golf and health was presented at the 7th Congress of theInternational Society for Physical Activity and Health (ISPAH), the biennial
scientific meeting. The ISPAH event included a breakfast meeting on the
Health Benefits of Golf, together with public health practitioners and policy
makers. Golf industry leaders also hosted a satellite event in the Palace ofWestminster, supported by the All-Party Parliamentary Group for Golf.

DR ROGER HAWKES

Executive Director,
Golf & Health Project

In a 9-hole round, most players
will walk two to three miles...

A further Golf and Health Scientific
Meeting was held at High Elms Golf
Course, Bromley, a club promoting
healthy lifestyles. Offering a forum tosupport and grow ideas, researchers
from Asia, Australia, Europe and the
USA discussed their respective projects
and the future direction of research ongolf and health.

Golf and Health 2016-2020 | Scientific papers

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Strength and Balance Study.
An international research study
backed by The R&A has found new
evidence to suggest golf can provide
significant health benefits to older
participants in the form of improved
muscle strength and balance.
Muscle strength and balance exercises
form an important part of the WHO’s
recommended guidelines to tackle
physical inactivity in older people
about which little was previously
known for golf.
The Strength and Balance Study,
carried out with two sample groups
over two years by Professor Maria
Stokes OBE at the University ofSouthampton and Dr George Salem at
the University of Southern California(USC), has indicated that older golfers
have and develop strength andbalance benefits.
Underlining the sport’s capability
to improve the physical health ofparticipants, the evidence suggests
golf can improve quality of life throughmuscle strengthening, improved
balance, aerobic exercise (equivalent
to gym-based work or yoga) andsocial interaction.
The Southampton group involved
152 individuals aged 65-79 and over
80 and set out to demonstrate thephysical and psychosocial benefits
associated with playing recreationalgolf regularly by comparing physicalmeasures between older golfers andsedentary non-golfers.
A study at the USC was undertaken
to see if non-golfers developed thesebenefits while undertaking a 10-week
instructional golf training programme.
The USC group involved 15 individuals
aged 63 (+/- 5 years) at a municipal
course in the greater Los Angeles
area, which also examined thefeasibility, safety and adherence of the
programme for senior non-golfers.

5...and take over

Summary of findings•

Participants in the golf training programme improved their muscularstrength, power, endurance, balance, flexibility and walking performance•

Golfers under the age of 80 had better strength and balance thansedentary non-golfers of similar ages•

Golfers had better dynamic balance and static balance than non-golfers•

Strength of limb muscles and balance were better in golfers than non-golfers
e.g. indicative through gripping and swinging a club, walking, squatting•

The golf training programme was feasible and effective; novice golfers wereable to play nine holes of golf by the 10th week and completed 282 of 300(94%) total training sessions•

The physical demands recorded during a golf round were equivalentor greater than the demands for other common activities e.g. gym workor yoga•

Participants benefited from green space, social interaction and walking
over hilly terrain•

The programme was safe; there were no golf-related injuries oradverse events

Ahead of the study being peer
reviewed to validate findings andfuture presentations made to theacademic world, Professor Maria
Stokes said, “The findings indicatethat golf is associated with healthbenefits related to better muscle
strength and balance.
“This suggests golf may meet
World Health Organization
recommendations for older people,
which would potentially qualify golf
for social prescription and exercise
referral schemes among policy makers
to help manage health conditions.”
Dr George Salem added, “Ourfindings suggest that golf should beconsidered when prescribing exercise
for older adults because it appears
to be safe, feasible and an adherent
form of exercise for a better, healthierquality of life.

5,000“Moreover, as golf is an exercise
activity that includes strengthening,
power, balance, endurance andcognitive challenges, it satisfies
the recommended physical activity
guidelines of the World HealthOrganization, the American College ofSports Medicine and UK guidelines.”“These findings should
encourage policy makers
and healthcare professionals
to consider recommending
playing golf to older people
as part of encouraging themto adopt a more active
lifestyle, as well as tackling
physical inactivity to reduce
healthcare costs.”
MARTIN SLUMBERS

Chief Executive of The R&A

steps.

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Golf and Health 2016-2020 | Scientific papers

Mental health and wellbeing

Other papers and research.
Research has taken place, and continues to do so, to identify and support projects across various areas of golf and health,with a view to further informing policy makers, golfers and the wider public.

Dementia and memory loss
With mental health a growing area of focus across the world, conditions
such as Alzheimer’s Disease, other forms of dementia and memory loss
have been seen to benefit from golf. A number of sites in Australia,
England, Japan, Scotland and the USA have all identified that the golfclub environment is therapeutic, provides social interaction, boosts mental
health and even encourages people back into golf e.g. at driving ranges,
simulators, pitch & putt, par-3 courses.

With COVID-19 impacting society worldwide in 2020, playing golf andspending time in green spaces was highlighted as a possible solution to
overcoming mental health problems.
Leading environmental psychologist Professor Jenny Roe from the Universityof Virginia highlighted that golf course environments possess many of
the natural features – including water, biodiversity, spatial variety andlight patterns – that help reduce stress and induce calm. In a feature from
Syngenta Growing Golf, broadcast on World Environment Day on 5 June
2020, Roe suggested prospective players are attracted to golf because it is
outdoors and offers relaxation and stress relief.
Golf clubs and courses could reposition themselves as valuable green spacedestinations to encourage more golfers and boost their health.

While evidence in this area is anecdotal and more tangible scientificresearch is required, notable examples can be highlighted.

Furthermore, a project carried out in 2020 found that golf can have a positive
impact on children’s behaviour and wellbeing.

Golf Memories Scotland works with a number of facilities across thecountry, enjoying success at Carnoustie (as featured on the Golf Channel)
and inspiring a programme at TPC Sawgrass in the USA.

Carnoustie Golf Links and Abertay University ran the ‘Golf Collaboration
Project’, which set out to test the effects of golf on young people via the club’s‘Carnoustie Craws Programme for Young Golfers’.

Golf In Society helps people living with Parkinson’s disease. It has provided
opportunities for groups and individuals with dementia and Parkinson’s to participate
at a number of golf clubs in the UK and is being reviewed by a research group from
Sheffield Hallam University.
A scoping review has also been commissioned on dementia and golf with a view toproposing a study to provide a level of evidence which will influence policy makers.

The COVID-19 pandemic
The COVID-19 pandemic considerably impacted on golf
at all levels and a variety of guidelines were put in placeacross the golf industry during lockdown.
Yet the health benefits of golf helped the sport quickly
resume in many countries, given golf can provide healthenhancing physical activity and safe social interaction ina low risk environment.
Relationships developed as a result of the Golf & Health
Project, with the WHO, The R&A, public health bodies,
universities and governments contributed to golf being
one of the first sports to return, particularly for the safe
reintroduction of recreational golf in the UK.
Golf organisations worked hard to provide golfers, golf
clubs and greenkeepers with guidance and information
to assist them with the safe resumption of golf during
the pandemic. It was important for everyone to carefully
follow government measures countries put in place in

6

If you play golf for at least13

relation to physical activity. The R&A also launched a
COVID-19 Support Fund, a £7 million funding package,to help golf deal with the impact of the pandemic. The
fund was largely aimed at national federations and otherbodies in Great Britain and Ireland, as well as major
overseas affiliates.

Over a six-week period, children who took part were assessed on their golf
skills, physical activity and personal wellbeing. Testing included physicalmeasurements such as jump performance, back and grip strength, reaction
time and balance, as well as on their own sense of self-esteem and resilience.
Participants reported an increase in wellbeing across all categories, while
three out of four physical tests also showed improved results.
The Golf Foundation’s ‘Skills for Life’ research project in 2017-18 achieved
similar success. Designed to develop the mental toughness and resilienceof the participants involved, PGA teaching professionals delivered theprogramme to groups of young people, aged between 11 and 16 years.
Average mental toughness increased in the participants by 20% during
the programme.

“Contact with nature slows
down our stress response
and induces calm. Thereis evidence to show this ishappening in our biologicalsystem. It is promoting stressresilience, it is improving
our mood, it is decreasing
our risk of depression
and increasing our social
wellbeing, particularly ona golf course where you
are interacting with othermembers of that community.
So, there are a host ofmental and social wellbeing
benefits.”
PROFESSOR JENNY ROE

University of Virginia

Green space activity, including
playing golf, can boost health

Health professionals were also involved in re-establishinggolf on the European Tour post-lockdown, together withsupport for their ‘Golf for Good’ initiative which aimed
to highlight the sport’s health benefits and support
communities and true heroes.
Golf’s reputation was enhanced during the pandemic,
with a significant number of clubs welcoming large
numbers of new members post-lockdown and increased
footfall. For example, in Norway, almost 300,000
rounds were booked in May 2020, over double for thecorresponding month in 2019.

150

7

minutes per week...

...you are meeting WHO global exercise guidelines.

Golf and Health 2016-2020 | Scientific papers

14

Joint replacement
New research in 2019 reported positive news on joint
replacement among golfers, highlighting that theyshould have no reservations about returning to golf andmay return quicker than was initially thought.
Notably, it reported that two in five golfers play more
golf after undergoing joint replacements and almost 90%
continue to play at least the same amount of golf after
the operation.
The findings came from a survey carried out by Europe’s
largest online golfing community, HowDidiDo, under the
auspices of consultant orthopaedic shoulder surgeon
Peter Hughes. Almost 3,500 joint replacement recipients
responded to a questionnaire regarding post-operation
golf habits and this was collated alongside data fromnearly seven million rounds of golf.
From the raw data, analysts were able to determine
how age affected handicap and frequency of play in thegeneral population – playing intensity gradually rises toage 55 then declines from 70 – and to compare that with
the information supplied specifically by respondents. It
showed that those who had undergone joint replacement
operations could maintain – or even increase – thefrequency of their golf, with many even reporting a moresatisfying experience as a result.
Key findings included:•

63% of golfers being able to play iron shots again
within three months of their operation•

76% of golfers returning to club competitions within
six months•

22% used a golf cart in the early stages of theirreturn, which dropped to a little more than 11% once
full recovery had been madeHughes, who presented the findings at the FortiusInternational Sports Injury Conference in London, said,“The joint replacement process is successful and most
players can expect to play on for more than 10 further
years with deterioration no different from other ageing
golfers.
“Worldwide, I would estimate there are probably three
million golfers playing for an extra 10 years because of
their new joint. If they spend just £1,000 per year on theirgolf – on membership or green fees, food and beverage,
hardware and so on – then that’s an extra £3 billion kept
in the game every year that would otherwise be lost.”

Golf has been shown to help
strength and balance in older people.

Mortality
A 2020 US study into mortality among the over 65s in the
1990s reported that playing golf may help older adults live
longer. Researchers found during the decade-long study
that golfers had a death rate of 15.1% compared to 24.6%
among non-golfers. The complete findings were presented
at the American Stroke Association International Stroke
Conference in Los Angeles. In summary:••

Researchers at the Zeenat Qureshi Stroke Institute in
Minnesota studied data about a group of nearly 5,900
adults, with an average age of 72, from 1989 to 1999.
Everyone studied was over the age of 65 and underwent
extensive medical examinations every six months
Of all the people examined, 384 played golf at least
once a month. About 15% of them died during thedecade. However, of the more than 5,500 adults who
weren’t golfers, about 25% of them died before theyear 2000“Due to its social nature and controlled pace, people
often maintain motivation and the ability to continue
playing the sport even in older age,” said Dr Adnan
Qureshi, the study’s lead author and neurology professor
at the University of Missouri. “Regular exercise, exposure
to a less polluted environment and social interactions
provided by golf are all positive for health.”
View more information

InjuryThe European Tour Performance Institute (ETPI) has
published a number of articles in the last 10 years on elite
golf with a focus on common injury areas such as thewrist and hip. In 2018, a systematic review was publishedin the BJSM.
However, studies of injury in elite and recreational
golfers have lacked consistency in methods anddefinitions employed.
In a sport-wide statement from the International
Olympic Committee in 2020, there was a call for sportspecific consensus statements. On invitation by theInternational Golf Federation, a group of international
experts in sport and exercise medicine, golf research andsports injury and illness epidemiology were selected toprepare a golf-specific consensus statement.
If this advice is followed, it is hoped to increaseknowledge on injuries in golf and then tackle the evenmore important issue of prevention.

8

Golf and Health 2016-2020 | Case studies

15

Case Studies
The Impact of Golf and Health.
An academic evaluation of golf andhealth was published in the BJSM in
January 2020, entitled: “Maximisingand evaluating the uptake, use andimpact of golf and health studies”.
Assessing scientific evidence acrossgolf and health studies, it outlined insummary terms their effectivenessacross the general public/golfers,
policy makers and the scientific1

community. The evaluation also
highlighted the collaborative
approach of the WGF, The R&A,
various universities and other golf
bodies.
Impact Study overview
Another collective overview of thework across golf and health was
published in a special e-edition of thePlayer welfare, spectator awareness,
commercial opportunities with healthpartners and influencing opinion
with local and national governments
provide areas of focus.
Therefore, at some of the biggest
golf tournaments worldwide in recent
times, opportunities have been taken
to promote health messages – withThe Open among them.
The Open is a major global sporting
event and has enabled the promotionof key health messages to hundredsof thousands of fans attending theChampionship at Carnoustie in 2018
and at Royal Portrush in 2019.

Information Towers and Screens
Four information towers on site
– two in the Spectator Village
and two on the course – and LED
screens throughout the venues
were used to display positive
health messaging.

6

To further examine the impact ofgolf and health, 10 case studies arehighlighted.

The Open.

As scientific research has shown, golf can provide healthenhancing physical activity for players and can have physicaland wellbeing benefits for spectators at major amateur andprofessional events.

•

BJSM, in the autumn of 2020, joining
only football and rugby in publishinga comprehensive report of its healthbenefits and dis-benefits.

Promoting healthbenefits at The OpenSpectator Guide•

A ‘Red Route’ – approximately
6km in length – was detailed in
the pocket guide for spectators toencourage them to walk aroundthe course when viewing play.

Player Gym•

An exclusive, dedicated player
gym was first introduced for The
Open at Royal Birkdale in 2017
and the purpose-built facility iscomplemented by the Health andPerformance unit provided by the
ETPI. Players and their teams canuse the space and facilities provided
to focus on preparation, recovery
and physical conditioning.
Physios, osteopaths, sports
therapists, performance nutritionists
and strength & conditioning staff
provide valuable input to a large
number of players. Dr Andrew
Murray was based for the week inthe players’ facility at Royal Portrush
in 2019 to complement The R&A
medical team.

“While we know one of thebest things you can do foryour health is playing golf,
actually coming to The Openor any golf tournament andwalking the course, seeing
what the players can do atclose quarters, gives you ahealthy dose of exercise andfresh air.”
DR ROGER HAWKES

Executive Director,
Golf & Health Project

km is the distance spectators walk, following the entire
Red Route at The Open (over the recommended daily steps).

Golf and Health 2016-2020 | Case studies

16

The Player Clubhouse at The
148th Open at Royal Portrush

Health promotion atother professional events
The 2018 Ricoh Women’s British
Open at Royal Lytham & St Annes
and the 2019 AIG Women’s British
Open at Woburn, now named
the AIG Women’s Open, used
information boards, LED screensand video on social media topromote health messages.

Player Clubhouse

Media

•

•

•

A bespoke clubhouse wasintroduced at Royal Portrush in2019 that brought together all
player services under one roof –services that enable the players
to perform to their maximum
potential (e.g. a players’ lounge,
locker rooms, creche, gym,
performance unit and more).
The nutritional offering in 2019
was also carefully considered
for all players, with a wide rangeof catering on offer to enable
their bodies to fuel and repair
and to protect against illness.
Protein, carbohydrate and fruit &vegetable options were all of goodquality, produced in consultation
with leading chefs and Professor
Graeme Close, a global expert inperformance nutrition. A coffee
bar and smoothie station were also
provided, along with healthy snack
availability, including protein bars.

The Open has also offered theopportunity to gain wide media
exposure for golf and healthmessaging, including with SkySports, the Golf Channel, golf
magazines and on The Open and
The R&A’s digital platforms.

The 2018 Ryder Cup at Le Golf
National in France highlighted
health benefits to 250,000 fansthrough on-course signage andthe official programme. On theeve of the match, a Medical
Forum was also held at the Louis
Vuitton Foundation which brought
together 250 experts to discuss
golf’s physical and mental healthbenefits.

Sports Ministers••

With health and wellbeing a vitalarea for governments, The Openand the AIG Women’s Open haveprovided the chance to engage
with ministers and other leading
policy makers on site to promote
key points and help drive change.
Aileen Campbell, former Minister
for Public Health and Sport at the
Scottish Government, said, “I knowthat golf can be beneficial for both
our physical and mental healthand work has sought to back thisup with sound evidence. The work
has been a great way of identifying
the benefits and researching themfurther so we, in the Home of Golf,
can promote our sport aroundthe world.”

Spectators at the 2014 Ryder Cup at Gleneagles
collectively walked four times around the world.

The 2019 Aberdeen Standard
Investments Scottish Open at
The Renaissance Club was oneof the most inclusive healthsupporting golf events staged in
Scotland, including the stagingof the EDGA Scottish Open for
Disabled Golfers, information
boards with messaging fromleading players and Scotland’s
Chief Medical Officer andspectator maps and giant seats at
the furthest points on the course
supporting active spectating.

Golf and Health 2016-2020 | Case studies

17

2 Wales Golf and the Stroke Association.
The power of golf and its life-changing properties continues to be effectively
highlighted in a partnership with Wales Golf and the Stroke Association, helping
people physically and contributing to improved mental health and wellbeing.
In doing so, it has helped save money
for the health service (as detailed instatistics from Sport Wales below).
New2Golf/Back2Golf is an initiative
Wales Golf set up at local golf
facilities for all ages and abilities
as part of the national federation’s‘Everyone’s Game, Anywhere’ strategy.
The Stroke Association is a UK-widecharity helping stroke survivors andtheir carers, with approximately 7,000
strokes happening in Wales every year.
Parc Golf Club set up a pilot scheme
in 2017, with participants putting,chipping, hitting balls at the range andsocialising. Such was their love for theactivity, 63% of the participants still
meet and play regularly three years on.
2018 saw a national roll-out, withgolf the first sport to attract funding
direct from Health in Wales. During
this 12-week programme, more than
10 clubs took part, with over 86 stroke
survivors participating, consisting ofboth new and lapsed golfers. 76%
participated regularly and, following
the scheme, 71% of the regularparticipants took part in golf activity(either at a home club or elsewhere).
A further 9% became club members.
On further analysis, all participants
reported improvements in confidence
and a boost to fitness leading to
improvements in wellbeing andmental health.
Peggy Cumbers, part of the initial
pilot in 2017, tells her own story, “Golfhelped me get my life back after astroke. I was in hospital for sevenweeks and the clot was on the rightside of my brain, so it was my left sidethat was affected. I really couldn’t
even imagine walking again.

“I was worried I wasn’t going to be able
to hit a ball without falling over. Afterthe session I went home as pleased
as punch that I had been able to doit and had been out meeting andchatting to people. Back2Golf has
been fantastic for my recovery. I’mback active again and it has made me
more confident overall.”Peggy’s story was used by Sport Wales
to illustrate research evidencing a£295m per annum saving for healthbudgets by being active and playing
sport (in 2016-17).
The figure came from researchcommissioned by Sport Wales andundertaken by the Sport Industry
Research Centre at Sheffield Hallam
University, which calculated that adults
who participated in sport and exercise
at moderate intensity lowered their riskof major illnesses by up to 30%.
Joe Vickery, PGA Professional at Parc
Golf Club, added, “I would encourageother golf professionals and clubs
to be inclusive with coaching andmembership options, as it is so
rewarding and great for recruitment
and retention.”
In 2019, a further nine groups took
part throughout Wales, with 44 regularparticipants of which 78% continued
into regular golf activity. Even during
lockdown due to the COVID-19
pandemic in 2020, Wales Golf
developed online sessions for stroke
survivors to keep them active at homeand connected, again boosting their
physical and mental health.
View more information

Golf can help improve cholesterol, bodycomposition, and your metabolism.

Peggy Cumbers“I was worried I wasn’t
going to be able to hit aball without falling over.
After the session I went
home as pleased as punchthat I had been able to
do it and had been out
meeting and chatting topeople. Back2Golf has been
fantastic for my recovery.
I’m back active again and it
has made me more confident
overall.”
PEGGY CUMBERS

Participant in the pilot
Back2Golf initiative10

Golf and Health 2016-2020 | Case studies

18

3 Golf for the Disabled.

Golf and Health 2016-2020 | Case studies

19

4 Courageous Kalkman Inspiring Disabled Golfers.

The growing focus on health is likely to have contributed to increasing inclusivity
and diversity within the sport, including women and girls’ golf and shorter formats
like nine-hole golf, par-3 golf and GolfSixes. Disability is another such area.

Golf has been proven to be a great sport for the physical and mental health of people
with disability, a fact that should be of interest to potential players, national federations
and governments.

Golf is a sport for everyone. Regardlessof age, gender, physical condition or
physical challenge, it’s a great way tobuild friendships and to exercise, whileproviding an opportunity for personal
challenge and growth.

The story of Monique Kalkman isillustrative. Cancer as a teenager left
Kalkman facing huge life challenges. A
lover of tennis and hockey as a child,
she had to revise her sporting dreams.
Due to the cancer (and paralysis fromher waist down), she adjusted to life asa wheelchair user.

Information on the benefits of golf for
health has been used to support thedevelopment of golf for the disabled in
36 countries, to tackle some negative
perceptions about golf and to help
make golf a more inclusive sport.
Highly-rated disabled
golfer Brendan Lawlor

EDGA (formerly known as theEuropean Disabled Golf Association)affiliated to The R&A in 2018 and is
the leading organisation in this area,
regularly promoting golf for playerswith disability at every level andactively involved in various campaigns,
such as ‘PLAY GOLF’. The campaign
showcases eight EDGA players fromthree continents with a range of
disabilities who live life to the full
through playing golf. The campaign
is supported by a dedicated training
programme which engages withhospitals, rehabilitation centres, golf
clubs and other sporting venues.
Golf for the disabled has also
developed in other ways. For example,
the World Ranking for Golfers with
Disability (WR4GD) was launched at
the start of 2019 to promote inclusivity
within the sport and is administered intandem with the World Amateur Golf
Ranking® for both men and women.
The R&A and the USGA assumed
responsibility for calculation of the
rankings, taking over from EDGA,
who created the comprehensive andindependent Ranking for Golfers with
Disability in 2014.
There has been a sizeable increasein the number of players included in
all three ranking categories (Gross,
Nett and Stableford Ranking)since its introduction. In 2019, theWR4GD included 854 players from 32
countries who competed in 43 ranking
tournaments played in 18 countries. In
comparison, there were 594 players whocompeted in 23 ranking events in 2018.
Golf for the disabled has also beenhighlighted at leading professional
events, working with national
governments to promote inclusivity
in golf and sport more widely.

You don’t have to join a gym
to gain the benefits of exercise...

The EDGA Scottish Open was thefirst of two tandem events on theEuropean Tour in 2019, with the 36hole EDGA Dubai Finale featuring aspart of the season-ending DP World
Tour Championship, with George
Groves winning in Dubai.

“The very nature of a gamewhere the player is in controlof their own ball, which isstill, makes golf an ideal
sport for even the mostprofoundly disabled, so
allowing golf to be the mostinclusive sport of all.”TONY BENNETTEDGA President

The second edition of the Australian
All Abilities Championship also
took place alongside the Emirates
Australian Open in December 2019,with 12 of the world’s best golfers withdisability in the field, where Swede
Johan Kammerstad successfully
defended his title.
Tony Bennett, EDGA President, said,“EDGA listens intently to its members
and players, to understand thecritical needs of golf for the disabled.
We continue to develop strategies
and practical tools that inform theindustry, educate the coaches andplayers, and promote initiatives topractically get more individuals withdisability into the game. The very
nature of a game where the player isin control of their own ball, which isstill, makes golf an ideal sport foreven the most profoundly disabled,so allowing golf to be the mostinclusive sport of all.”11

Yet she remained strong, notably
through the support of family andfriends. In 1980, she was at home in
Arnhem watching the Paralympics
on TV and was duly inspired. She
discovered table tennis, and soon
found a way to start winning instyle, blowing away the competition.
She thrived to become a four-timeParalympic champion in wheelchairtennis and table tennis and a memberof the International Tennis Federation
Hall of Fame.
After a decade of achievement,
Monique found the intense levelof competition and practice too
demanding. She became European
Product Manager for her sponsor,“Tennis, for me, was allabout being competitive.
Golf is more of a mix ofcompetition with huge socialand health benefits. Allnational federations should
encourage and help disabled
golfers, as it is a great sport
to help them physically andmentally.”

Sunrise Medical, in 1997, but in 2004
suffered some health problems
including heart issues. After anoperation and issues with neckdystonia, Monique decided sheneeded to find a new sport to help her
physically.
Previously, she had taken a buggy
ride on a golf course while at a tennis
camp and was “amazed by the beautyof the nature” on a course, enjoying“the serenity and elegance of the
sport”.
Monique found that using a speciallydesigned paragolfer chair was ideal
for her fitness and for her neck injury,
as she could play from a standing
position. Her patience gradually
helped develop her golf game.
Watching the likes of two otherwheelchair golfers, Anthony Nettoand Sebas Lorente, also helped, as did
her willingness to spend hours on therange, making Monique the highlyrated player she is today.

Now in her 50s, golf suits her age
and lifestyle, being out in the fresh
air and using different muscles. “Ihave a different goal now,” she said.
“Tennis, for me, was all about being
competitive. Golf is more of a mixof competition with huge socialand health benefits. All national
federations should encourage andhelp disabled golfers, as it is a great
sport to help them physically andmentally.”
Monique, who has developed her own‘Going for Golf’ Foundation, is wellrespected by members of EDGA. “Justas Monique paved the way in tennis
for those with a disability, she is in
the vanguard of passionate people
aiming to do the same in golf,” says
Tony Bennett, EDGA President. “Sheis helping to break down barriers, tomake competitive golf for those withdisabilities a more attractive andlikely proposition despite numerous
challenges.”

Monique Kalkman in action
using her paragolfer

MONIQUE KALKMAN

Four-time Paralympic champion...playing golf can provide most ofthese benefits, for all ages.

12Golf and Health 2016-2020 | Case studies

20

5 Policy makers.

For example, multiple motions in the
UK Parliament have welcomed theresearch and opportunities related togolf and health, while the All-Party
Parliamentary Group for Golf was asignatory to the 2018 International
Consensus Statement on Golf and
Health and the suggested actions forpolicy makers.
Steve Brine, former UK Parliamentary
Under Secretary of State for Public
Health and Primary Care, said, “Golfis very important in terms of keeping
people active and it is also part ofthe loneliness agenda, part of goodmental health. Increasingly, thereis evidence that golf is very goodfor managing long-term conditions,
helping people stay focused and stay
active for longer. There are lots ofbenefits to golf.”

21

6 National Federations.

Golf plays an important role in maintaining a healthy, active population and delivers
benefits to all ages and abilities – benefits that more and more policy makers areincorporating into their policies and agendas.
Policy makers are vital in deciding
what national governments andauthorities invest their time andresources in.

Golf and Health 2016-2020 | Case studies

For the benefits of golf and health to be fully realised on a worldwide scale, the support ofnational federations remains vital to raising awareness.

As highlighted, the research has also
helped shape policy regarding major
events, such as at The Open, to keep
the golf and health agenda in the
public eye. Communication has also
helped inform walking and physicalactivity policy.

infographics spelling out therelationships of golf with health;actions to support improved healththrough golf and physical activity
more generally; and opportunities
to align work to local, national andinternational policy.

In the published article ‘Physicalactivity investments that work — Get
Scotland walking: a National Walking
Strategy for Scotland,’ authors
including the then Chief Medical
Officer for Scotland, Dr Catherine
Calderwood, and the then Minister
for Public Health and Sport andcurrent Communities Minister, Aileen
Campbell, state, “We work with The
World Golf Foundation, The R&A
and the European Tour to encourage
spectators to walk the course. Our
golfers are encouraged to walk thecourse rather than riding carts.”

The WHO Programme Manager
of Non-Communicable Disease
Prevention, Professor Fiona Bull,
describes golf’s efforts to contributeto health improvements, “Golf is a
popular sport for men and womenand it is great to see golf’s global
leadership recognising health priorities
and identifying ways golf can be moreaccessible to more people.”

Activities to support uptake anduse by policy makers have included
providing summary briefings;

Golf is great to keep active

Policy makers are urged to continue
to promote the benefits of regularphysical activity, including golf, forpeople of all ages, genders, andincome brackets, and publicise thespecific health enhancing aspectsof golf.

“Golf is very important interms of keeping people
active and it is also partof the loneliness agenda,
part of good mental
health. Increasingly, thereis evidence that golf is very
good for managing longterm conditions, helping
people stay focused and stay
active for longer. There arelots of benefits to golf.”
STEVE BRINE

Former UK Parliamentary Under
Secretary of State for Public Healthand Primary Care

51% of the general population consider
themselves to be in good health...

Indeed, there are already many
promising examples in this regard,
aided by The R&A sending information(research, infographics and media
material) to over 150 affiliates toencourage adoption of healthpromoting actions. Meetings to
support engagement work withnational federations have also takenplace, including with China, France,
Germany, Hong Kong, Indonesia,
Portugal and Spain.

Encouraging golfers onto the
fairways to enjoy health benefits

For example, China has highlighted
that golf and health messaging canhelp to increase participation, as
evidenced in the quote below from the2018 First International Congress on
Golf and Health.
Wei Qingfeng Weber, Director –Golf Development at China Golf
Association, said, “Golf and health is
the most important area for China
Golf currently. We are seeing growth
and aim for more than 500% increasein junior participation between
2018–2022.”

Communication was then sent toall courses so they could inform the
642,000 registered golfers acrossGermany of the benefits of golf andhealth, along with guidelines on how
courses can effectively organise a golf
and health tournament for golfers andan open day for non-golfers.

The German Golf Association (DGV) has
also been very active, working on the
DGV-Project ‘Golf and Health’ over thelast two years to motivate non-golfers
to start golfing for health reasons andexisting golfers to play more.

The DGV also designed a supplement
and added 160,000 copies to a large
German daily newspaper to inform
non-golfers on golf and health. Further
communication work has included agolf and health website, a dedicatedsocial media campaign and filmed
fitness exercises.

Using the scientific evidence
available, they produced a ‘toolbox’for golf courses to encourage local
non-golfers to the sport for healthreasons. The toolbox includes posters,
advertisements, flyers, online banners
and guidelines. “The special thing
about the toolbox is that there are
four versions, as we have worked out
four different target groups in golf
and health so that each course canuse a toolbox tailored to its marketing
position,” says Markus Lawatsch,
Marketing Director at DGV.

Further projects are planned on golf
and nutrition, as well as a prevention
guide so clubs can offer prevention
courses, financially supported byhealth insurance companies.
Leading German golfer Max Kieffer
is an ambassador for the work inGermany, with the German Olympic
Sports Confederation also supportiveof the projects too.

13

“We have planned andimplemented a lot of subprojects as part of theGerman golf and healthproject to motivate nongolfers to start golfing for
health reasons and golfers
to play more.”
MARKUS LAWATSCH

Marketing Director, DGV
The Confederation of Professional
Golf (formerly the Professional Golf
Associations of Europe) has also
facilitated the adoption of golf andhealth into the curriculums for allprospective coaches in their area ofinfluence. Overall, national federations
are now equipped with stronger
science on golf and health and cantake concrete actions to improvehealth.

14...but this rises to 72% of golfers.

Golf and Health 2016-2020 | Case studies

22

Golf and Health 2016-2020 | Case studies

7 Social Prescription.

23

8 Golf and Health Week.

Given the burden and challenges for the National Health Service (NHS) in the UK, shifting thebalance from medicine to ‘prescribing’ social activities to improve the health of millions has beena growing focus for the UK Government in recent times.

Building on the work of various health initiatives, the first-ever Golf and Health Week was heldin April 2019. It saw various golfing bodies working collaboratively to highlight the sport’s healthbenefits and reach an audience of over 20 million on social media.

Among pilot UK schemes that offer
social support and health-enhancing
activities, GPs have been encouraged
to prescribe golf for their patients
after studies showed it boosted
levels of fitness, muscle strength andhappiness.

Co-ordinated by The R&A, it was
primarily focused on Great Britain
and Ireland with the support of theEuropean Tour, the Ladies European
Tour, The Professional Golfers’
Association and the Golf Foundation,
as well as national federations
including England Golf, Scottish
Golf, Wales Golf, the Golfing Unionof Ireland and the Irish Ladies’ Golf
Union.

In 2018, a scheme, backed by fitness
body ukactive, and funded by England
Golf and leisure operator Mytime
Active, offered clear insight into thebenefits of ‘golf on referral’.
Pilot schemes in south London, in
Bromley and Orpington, found thatpatients referred for golf saw levels ofvigorous exercise triple, with significant
boosts in life satisfaction, happinessand self-esteem. Researchers said ‘golf
on referral’ could be particularly goodat encouraging middle aged men to
take up exercise – those who are often
unlikely to respond to standard healthinitiatives.

Steven Ward, ukactive CEO, said, “Golfis a fantastic way to encourage people
to be more active, particularly amongparts of the population who may not
be too engaged with other activities.

participants were given two sessions
a week for six weeks. Each involved
a 30-minute group discussion about
lifestyle changes, followed by 45
minutes of golf coaching.

“The research shows that there areclear mental, physical and emotional
benefits for ‘golf on referral’ –we should look to roll out more ofthese programmes across the country
as part of wider efforts to get thenation moving.”“The research shows that
there are clear mental,
physical and emotional
benefits for ‘golf on referral’– we should look to roll out
more of these programmes
across the country as partof wider efforts to get thenation moving.”

At the start of their programme,
participants’ average activity levels
were the equivalent of about one
hour’s running a week. Six weeks’ later,
those levels were equivalent to morethan three hours’ running.
Grip strength, a strong indicator ofvitality in older people, also increased
significantly over the course of thestudy – suggesting improvements inmuscle strength and reduced risk offalls or disability. In pilot schemes,

Golf offers emotional benefits

STEVEN WARD

ukactive CEO

Richard Flint, Participation & Club
Support Director at England Golf,
added, “We’re thrilled to see thisscheme developing from our earlier
research into the impact of playing
golf on health and wellbeing, which we
carried out with the support of Mytime
Active and ukactive.
“It’s been exciting to see the resultsof the pilot schemes and to gain evenmore evidence that golf is good for
health. We hope that ‘golf on referral’
can be made more widely available.”

It also reached the likes of Australia,
Canada and the United Arab Emirates(Abu Dhabi) and engaged a number ofleading professionals including Justin
Rose, Padraig Harrington and Gary
Player and broadcasters such as Iona
Stephen and Eilidh Barbour.
A number of health-related themes
were promoted during each day of thecampaign, including:•Fitness – professionals andamateurs•

Mental health (including
dementia)•

Disability golf•

Golf for everyone – featuring
various health projects (e.g.
Parkinson’s, loneliness, stroke andother programmes that can benefit
health)•Club level – focus at golf clubs (e.g.
fitness, food, drink, gym classes)

The collaborative campaign ran acrossdigital and social media channels
using the hashtag #GolfHealthWeek
and included content focused onhighlighting the physical and mental
health benefits of playing golf andprojects being delivered by golf bodies
and clubs to encourage golfers, nongolfers and lapsed golfers into taking
part in the sport. It created significant
media and TV coverage, including on
Sky Sports.
European Challenge Tour golfers
Connor Syme and Ewen Ferguson,
both former Walker Cup players,
helped support the fitness theme
through filming at the Institute ofSport & Exercise at the University of
Dundee.
The Scottish duo went throughtheir paces at the University’s gym,
highlighting the importance of fitness
for their games, as well as taking partin fun challenges.
Stewart Harris, Ambassador for Wales Golf

The week was chosen immediately
after the Masters Tournament tocapitalise on the early season interestin golf, further boosted by Tiger
Woods’ victory.

Golfers are at moderate risk of injuries,
few are serious, and risk to sun can be minimised.

SPF

50

15

Golf and Health Week reached an
audience of over 20 million on social media.

“I think health and fitness is a massive
part of golf nowadays,” said Syme.
“Generally, I use the gym for injury
prevention and keeping fit.” On his
top fitness tip for amateur golfers,
Ferguson added: “Just try and keep
yourself lean and in shape, going
through the motions of different
exercises without adding a lot ofweight on to keep yourself flexible andloose.”
The week also highlighted individual
stories such as from Stewart Harris,
an ambassador for Wales Golf, who
credits the sport for help saving his life
after enduring physical and mental
problems following a bomb blast in
Afghanistan while on tour as a soldier.
The story of Rachel Ingram, from Hullin England, was also profiled, having
seen her health (anxiety, depression
and an eating disorder) and lifestyleturned around by playing and enjoying
the sport.

Golf and Health 2016-2020 | Case studies

24

9 The Home of Golf Leading the Way.

The largest public golfing complex
in Europe has also enhanced its
commitment to health, building on
the recommendations made in theInternational Consensus Statement
on Golf and Health in 2018. Using theexpertise of Dr Andrew Murray, theTrust is working in a number of areas
to boost health through golf.
“The Consensus provided information
to golfers themselves; to facilities andthe golf industry; and to policy makers
on how to improve health throughgolf,” notes Murray. “St Andrews Links
Trust and many other leading facilities
throughout the UK, and globally, areembracing the Consensus and working
to meet its recommendations.”
Murray has spoken at Links Trust
staff forums and partner gatherings –including with Rolex and Allianz who
have now further supported work inGermany – to emphasise the physicaland mental health benefits of playing
golf and the importance of multifunctional facilities, with the COVID-19
pandemic putting increased focus onpractices and priorities.
Laurie Watson, Head ofCommunications at St Andrews Links
Trust, said: “We know there are ahuge range of wider benefits throughplaying golf, as research has proven.
The Trust are committed to healthenhancing activity across our facilities
for golfers and potential golfers andare grateful to the support of Dr
Murray to achieve our goals.”
Murray added: “It’s great to see thatthe Home of Golf never stands stilland combines the finest traditions
with embracing the concrete actions
that can lead to improved healththrough golf. It’s not simply about the
Old Course, it’s about their range offacilities for all.
“The simplest actions done well makethe biggest difference, maximising
golf’s health benefits and encouraging
people through the door to get into
golf – and keep playing golf.”
The Home of Golf, St Andrews

Going down memory lanein golf is helping improve
people’s mental and physicalhealth – including at renowned
Open venues.

Health areas the Links Trustare focusing on•

Plans being developed for gym
facility to complement existing
golf performance suite•

Focus on entry level nine-hole
Balgove course to encourage
new golfers•

Increased number of womenand girls’ golfers•

Provision of toilets on course•

Promoting walking, as natureintended, rather than cart use•

Warm up areas at Academy
and practice areas•

Wide range of healthy food andbeverage options•

Retail offering including
sunscreen and caps to minimise
health risks from skin cancer•

Staff training in health andsafety•Promoting sustainability e.g.
restricting the use of chemicals“We know there are a huge
range of wider benefits
through playing golf, as
research has proven.
The Trust are committed
to health-enhancing
activity across our facilities
for golfers and potential
golfers...”LAURIE WATSON

Head of Communications,
St Andrews Links Trust

80

25

10 Improving Life Through Golf Memories.

Golf has been played in St Andrews for more than 600 years, globally
recognised as the home of the sport. History and tradition may dominate,
but golf continues to evolve.
Today, more than 230,000 rounds areplayed annually over seven publiccourses managed by the St Andrews
Links Trust, with the Trust also
overseeing a number of additional
facilities, including a golf academy, threeclubhouses, three cafes and five shops.

Golf and Health 2016-2020 | Case studies% of golfers are happier with their social life
compared to 60% of the general population...

Francesco Molinari’s notable feat in2018 in becoming the first Italian to
win a major championship is among
the many golfing highlights recalled bya local 15-strong group at Carnoustie,
who meet every month in the new
Links House. With an average ageof 78, they browse the history books,
looking at photos of past Open
champions over the famous links
such as Molinari, Ben Hogan, Gary
Player and Tom Watson, as well as
sharing stories of their own golfing
achievements.
They also strike a ball in the simulatorbays, play ‘The Nestie’ short six-holepar-3 course or try the public putting
green, all this is in competition for
their own ‘Claret Jug’ monthly award.
The Carnoustie Golf Memories Group,
launched in 2015, is among a numberof groups that have sprung up at golf
facilities across Scotland, including
at Noah’s Ark in Perth and in Troon.
The British Golf Museum, which ispart of The R&A family, and Alzheimer
Scotland also came together to run amonthly social group at the Home of
Golf in St Andrews.
The groups are part of the overall Golf
Memories Project, which in turn is partof the wider Sports Heritage Scotland
network helping those living withdementia and memory loss.
Scotland currently leads the worldin reminiscence therapy. Football,cricket, curling, rugby and shinty areamong the sports also involved, acollaborative effort of reminiscencegroups to stir memories, fulfil lives andalso encourage participants back into
the sports they love.

Members of the Carnoustie
Memories Group at The 147th Open

Lorraine Young is a key driving force
for the golf group in Carnoustie,
which is also supported by the Golf
Links team. “Being afforded theopportunity to spend meaningfultime with our members, in a setting
within which they freely start to telltheir compendium of stories, is areal honour,” says Lorraine. “For eachindividual member there is a story to
be told and creating the environment
within which they can begin to tell andrelive, at least part of their story, ismagical.”A former Chief Social Work Officer
for Angus and a Rotarian, Lorraine
chose to commit her free timeto creating and supporting thedevelopment of Golf Memories.
The group is ably supported by acommitted and dedicated team oflocal volunteers, such as David Taylor,
Trevor Williamson and Margaret Muir.
“Creating a sense of being valued
and a belonging is central to our corevalues,” continues Lorraine. “Families
tell us that, as a result of our meetings,
they get their loved one back.”

16

17...and less likely to be at ‘risk of loneliness’.

“For each individual member
there is a story to be told andcreating the environment
within which they can begin
to tell and relive, at least partof their story, is magical.”LORRAINE YOUNG

Carnoustie Golf Memories GroupIn 2019, the world-famous TPC
Sawgrass course in Florida saw thelaunch of the Pete Dye Chapter Golf
Memories group, inspired by thepioneering work being achieved at
Carnoustie Golf Links.
Please visit The R&A website or the
Golf & Health Project website forfurther case studies.

Golf and Health 2016-2020 | The Future26

Golf and Health 2016-2020 | The Future

27

The Future of Golf and Health.
What has been achieved?
The sustained work in this area since2016 has highlighted golf’s healthbenefits to a global audience andunderlined the role that the sport
plays in health and social wellbeing.

Activities have been undertaken
to raise awareness of thesebenefits with:

By maximising the uptake, use andimpact of scientific research, it has
been consistently highlighted that golf
is a health-enhancing physical activity
and a range of actions can be taken to
promote better health through golf.

•

In summary, golf’s health benefits
have shown that:•

Golfers live longer and arehealthier and happier•Golf can help strength andbalance and improve qualityof life•••

Golf can be played by people of
all ages and abilities, including
with disability
Golf provides social interaction,a significant protective factor formental health and wellbeing
Golf can help reduce healthcosts and can add value tohealth systems through socialprescription•

Global government ministers/
heads of state
National federations and bodies
such as the All-Party ParliamentaryGroup for Golf (UK)•Global golf tournaments•

PGA professionals•

Attendees of over 30 keynote
talks on golf and health at events,
including the First International
Congress on Golf and Health andPlanetary Health•Attendees of medical meetings in
Chicago, Edinburgh, London, Los
Angeles, Paris and Vancouver, andat various golf clubs

Over 300 media articles have also
been generated from the original
research to help promote the healthbenefits of golf, as well as coverage
on NBC, CNN, BBC, Sky News / Sports
and Chinese State TV, and in a varietyof global newspapers and magazines.

Golfers of all ages canbenefit from the sport

What you can do...
Golfer – please play more often,
encourage others to play, walkthe course if you are able and tell
everyone you know about thehealth benefits of golf
Golf facility – spread the word
on golf’s health benefits, promote
inclusivity, promote safety andsustainability, stock sunscreen andhealthy food and drink
Golf industry – work to promote
the health benefits of the sport,
engage with policy makers, aim toencourage entry level play, consider
making facilities multi-functionaland encourage participation by allof society
Golf federation – promote thehealth benefits of golf withyour clubs and golfers and look
to integrate this into policy,
perhaps working closely with yourgovernment
Policy maker – work with national
federations to promote golf and,
where relevant, include golf as amoderate intensity physical activity
in policy documents, guidance andrecommendations
Scientist – please tell The R&A
about your research“Golf is now connectedto the World HealthOrganization and has
developed a relationship with
policy makers in the UK andabroad who may now see
golf in an improved light.”
DR ROGER HAWKES

Executive Director,
Golf & Health ProjectOver 300 media articles generated from the original
research to help promote the health benefits of golf.

What can be achieved in the future?
Golf has welcomed the completionof the first PhD in golf and health byresearcher Dr Andrew Murray, with theevidence available to all as a lastingscientific summary. The work has also
provided a focus for other research
not directly funded or commissioned,
further enhancing public awarenessof golf and health. It is now importantfor golf to maintain the momentum
and continue the messaging to keygroups, such as policy makers, about
the sport’s health benefits.
Yet, policy and practice, as a result ofresearch, can take many years before
being fully evident. Further time andevaluation are needed to determine
the impact of a better understandingof golf and health and increased
interest and participation in physicalactivity, especially through golf.

“When your doctor perhaps
encourages you to exercise
more, not everyone thinks
about golf. But it can actually
have huge benefits, to getstronger or lose weight.”

To fill gaps in knowledge and build on
the current research, work continues
across various areas of golf and healthamong researchers. Studies include:
1. Parkinson’s – an academic study
at Harvard University in the USA withresults awaited
2. Golf on prescription – Two ‘golf onreferral’ schemes have been identified
and monitored in the UK and are
already showing promising results
3. The Australian Golf and Wellbeing
study – an international collaborative
project between researchers at the
University of South Australia, La Trobe
University in Melbourne, the Universityof Oxford and the Golf & Health
Project. The aim is to link regulargolf participation with measuresof health and provide high quality
research evidence

4. Diabetes and golf – a study inDenmark with results awaited
5. Autism – further study to provide
evidence on golf’s benefits for people
with autism
6. Joint replacement – further study
to provide more evidence on how tosafely get back playing, or starting
golf for the first time, following
joint replacement. A proposal for aprospective study is being discussedwith the prestigious Hospital forSpecial Surgery in New York City
Identifying health related topics,
sharing good practice andencouraging the use of golf club
environments in health initiatives
remain vital in continuing to build on
the work already achieved.
Golf’s health benefits can help break
down the traditional barriers to attract
more golfers.

Main: A father supports his son; Phone Inset:
Media coverage during Golf and Health Week

SO YEON RYU
Golf and Health ambassador andtwo-time Major Champion

For more information, please visit:
The R&A: https://www.randa.org/en/theranda/initiatives/golfandhealth
The Golf & Health Project: https://www.golfandhealth.org/
The World Golf Foundation: http://www.worldgolffoundation.org/
The World Health Organization: https://www.who.int/
References
The Scoping Review: https://bjsm.bmj.com/content/51/1/12
The Spectator Study: https://bmjopensem.bmj.com/content/3/1/e000244
Spectator Study follow-up: https://bmjopensem.bmj.com/content/5/1/e000503
The International Consensus Statement: https://bjsm.bmj.com/content/52/22/1426
Infographics and digital resources: International Consensus on Golf and Health:
https://bjsm.bmj.com/content/52/22/1421
Impact Study: https://bjsm.bmj.com/content/early/2019/12/18/bjsports-2019-100994

18

And finally, while we have no statistics
about the 19th, it should also be enjoyed!

The R&A, St Andrews, Fife, Scotland KY16 9JD
Tel: +44 (0)1334 460 000 Fax: +44 (0)1334 460 001
info@randa.org www.RandA.org www.TheOpen.org