Golf and Health 2016-2020. Golf and Health 2016-2020 | Contents 2 Golf and Health 2016-2020 | Introduction 3

Contents. The health benefits of

Introduction playing golf are significant. The health benefits of golf...... 3 It is a sport that can be played from the age Padraig Harrington Scientific Papers of four to 104. It can be played in the fresh air in the great outdoors, in many different forms The Scoping Review...... 5 and even indoors too. It allows golfers to enjoy The Spectator Study...... 7 a form of exercise, as well as boosting their The International Consensus Statement...... 9 mental wellbeing in a social environment. Even following your favourites by walking at Strength and Balance Study ...... 11 golf events is good for you. Other papers and research ...... 12 These facts alone have long been three million deaths worldwide – has known by golfers themselves. However, led to the World Health Organization Case Studies it is important to educate those (WHO) calling for action by sports. beyond the sport about its many 1. The Open ...... 15 health benefits, including non-golfers, Since 2016, The R&A and its public health professionals and partners, including the World Golf governments. Foundation (WGF), the United States 2. Wales Golf and the Stroke Association...... 17 Golf Association (USGA) and the As two-time Champion Golfer of the European Tour, have sought to: raise 3. Golf for the Disabled...... 18 Year, Padraig Harrington, said, “People awareness of the health benefits who play golf do realise the benefit of golf to encourage interest in 4. Monique Kalkman ...... 19 of it. But the wider public doesn’t participation by people of all ages understand it – the health benefits and abilities; improve the sport’s 5. Policy makers ...... 20 of playing golf for your physical image; and increase advocacy for golf and mental health. I have seen how by government agencies and public 6. National Federations ...... 21 impactful golf can be on peoples’ health bodies. wellbeing; now it is time to get the “People who play golf do 7. Social Prescription ...... 22 message out there.” The Golf & Health Project, supported by The R&A and the other WGF realise the benefit of it. But 8. Golf and Health Week...... 23 Put simply, golf has underplayed its partners, was formed to achieve these the wider public doesn’t health benefits. Against a background aims by producing and publishing high understand it – the health 9. The Home of Golf ...... 24 of busy modern lives, competing quality science that evidences golf’s interests and more sport and leisure physical and mental health benefits benefits of playing golf for 10. Golf Memories ...... 25 pursuits than ever, golf has perhaps to target existing golfers, non-golfers, your physical and mental not effectively positioned itself as a golf bodies and policy makers in health. I have seen how health-enhancing activity that can be government and health. enjoyed by people of all ages, abilities impactful golf can be on The Future and backgrounds. Dr Roger Hawkes, a sport and exercise peoples’ wellbeing; now it physician and former Chief Medical is time to get the message The future of golf and health...... 26 Nevertheless, an opportunity exists Officer of the European Tour and for golf. An epidemic of physical Ryder Cup Europe, is the Founder and out there.” inactivity-related disease in most of Executive Director of the Project. PADRAIG HARRINGTON the world’s populations – physical Two-time Champion Golfer inactivity is responsible for more than

Join us on a round to discover the Golf is a sport that can be many health benefits of golf... played from the age of four to 104 Golf and Health 2016-2020 | Introduction 4 Golf and Health 2016-2020 | Scientific papers 5

(L to R) Dr Andrew Murray, Fiona Bull, Steve Brine, “The scientific research Annika Sorenstam, Martin Slumbers and Craig Tracey Knowledge is power. at the First International Congress on Golf and Health clearly shows that there are significant physical and mental health benefits to It was Francis Bacon, one of the leading figures in natural philosophy, be gained from playing golf. We believe that golf who coined this now-famous phrase in 1597. For golf to accurately can provide a fantastic highlight its physical and mental health benefits (and any illness opportunity for people of all or injury), it was important to research and review the existing ages and abilities to have fun, get fit and socialise scientific evidence. with family and friends – something that is important The Scoping Review. to today’s society.”

MARTIN SLUMBERS Chief Executive of The R&A Summary of findings

On average, golfers live five years longer than The R&A has played a key role in Martin Slumbers, Chief Executive The future of golf and health is also the Project by part-funding research of The R&A, said, “The scientific assessed as the sport seeks to build non-golfers undertaken by Dr Andrew Murray of research clearly shows that there are on the foundations set in recent years • Published in the Scandinavian Journal of Medicine and Science in Sports, the University of Edinburgh, who is significant physical and mental health and continues to attract more golfers a landmark study found a 40% reduction in mortality rates among the lead research scientist. Dr Murray benefits to be gained from playing onto courses and into facilities around 300,000 members of the Swedish Golf Federation, corresponding to completed his PhD at the University golf. We believe that golf can provide the world. an increase in life expectancy of about five years (this applied for both of Edinburgh in 2020, where he was a fantastic opportunity for people genders, all ages and all socio-economic groups) supervised by world leaders in exercise of all ages and abilities to have fun, By understanding the health benefits A scoping review to identify key medicine. The leading sports medic get fit and socialise with family and of golf, we can be healthier and concepts and gaps in research was is now Chief Medical Officer for the friends – something that is important happier as golfers and encourage published in October 2016 by the Golf helps combat disease European Tour, advises the Scottish to today’s society. others to take up the sport. The BJSM, the world-leading sports • Golf, as a physical activity, can help prevent and treat 40 major chronic Government and has a role supporting golf industry and facilities can also medicine journal, and proved crucial diseases, including diabetes, heart attacks, stroke, breast and colon WHO projects. “We need to position golf as a leisure maximise the benefits by sharing the to understanding and raising pursuit that can be accessed and information to their audiences, while awareness of golf’s health benefits. cancer, depression and dementia. Other studies highlighted that risk The R&A has also directly supported enjoyed by everyone and encourage policy and decision makers can take It was one of the most read and used factors for heart disease and stroke, such as cholesterol and blood other activity, including being advocacy for the sport as a moderate key actions. scientific research papers of the year, pressure, are reduced in populations who play golf the sole funder of a Strength and intensity physical activity by generating interest in the health As Brooke Henderson, a Major Balance Study, sponsoring the First government agencies, public health benefits of golf on a global scale. Golf is a moderate intensity physical activity International Congress on Golf and bodies and health professionals.” Champion and a Golf and Health Health and increasing communication ambassador, notes, “I think it’s really Conducted at the University of • Highlighted by most sources, including the renowned international of various activities to promote the This report brings together what important for people to realise how Edinburgh, researchers reviewed publication of physical activity quantification, ‘The Compendium of benefits of golf for health. we know about the health benefits good golf is for you – not only your 5,000 studies into golf and wellbeing Physical Activities’, and recommended by policy makers worldwide of golf. It details these benefits by health physically, but also mentally and analysed in detail over 300 of including the WHO, the United States Department of Health and Human Robust research, data and key findings summarising the scientific research, and socially, being able to make the most relevant. The main findings Services and UK Chief Medical Officers have been regularly published in the the public exposure and increased friends out on the course and to from the Review highlighted that world-leading international journal, interest among national federations, connect with people. The sport offers golfers enjoy longer lives, particularly • Moderate intensity activities are those that get you moving fast or the British Journal of Sports Medicine policy makers and other organisations. so many health benefits.” as the sport can help prevent chronic strenuously enough to burn off three to six times as much energy per (BJSM), to support the principle that A number of case studies highlight diseases, improve mental health and minute as you do when you are sitting quietly, so the acceptance of this If you are a golfer, are thinking of golf can lead to greater health and the impact of collective endeavours, boost social wellbeing. for golf was significant wellness benefits for participants and spanning various countries and at taking up the sport or are keen to spectators attending events. leading professional events, with encourage others onto the fairways, • Balance and muscle endurance in older people are improved by playing associated media coverage. then read on… golf, while golf is also likely to improve cardiovascular, respiratory and metabolic health

1 Golf, as a physical activity, can help prevent Golfers live 5 years longer. and treat over 40 major chronic diseases. Golf and Health 2016-2020 | Scientific papers 6 Golf and Health 2016-2020 | Scientific papers 7

Golf boosts social interaction “Research has shown that golfers live up to five years The Spectator Study. • Golf can help reduce the risk of anxiety, depression and dementia, improving an individual’s wellness, self-esteem and self-worth longer than people who don’t play golf. What is • A lack of social interaction can be addressed by golf participation. Summary of findings more important than being Social isolation has been shown to be the biggest health risk factor in a population of older people over a five-year period healthy? I think we should • The research, published in July 2017, found that almost 83% of spectators take time for golf. Together at the 2016 Paul Lawrie Match Play at Archerfield Links in East Lothian Walking is better than cart use with the researchers and met and exceeded the recommended daily step count, with the 339 fans in the study averaging 11,589 steps per day (people are generally doctors, we’re trying to tell • Walking and carrying clubs, or using a pull-cart, have much greater recommended to walk 10,000 steps a day) benefits than riding a golf cart policy makers, ‘hey, pay attention to golf. It should • Spectators walk between 5-6 miles on average and burn more than 1,000 calories per day be part of your programmes; Benefits substantially outweigh the risks Following the publication of The golf should be top of your list Scoping Review, other areas were • Golf also allows spectators to spend time in green space and socialise • There are risks to golf participation, including injury and illness, but the with friends and family which are proven to have mental health and rate per incidence is low and can be reduced by a seven-minute warm up as it is benefitting health.’” identified to further highlight golf’s health benefits, including from a psychological benefits ANNIKA SORENSTAM spectator point of view. • Sun exposure in golf is high but this can be alleviated with appropriate sun The study, published in the BJSM and BMJ Open Sport & Exercise Ten-time Major Champion and Golf • cream protection. Exposure to fresh air and sun also helps boost Vitamin Medicine, was the first to use pedometer data to assess golf spectators’ D levels and Health ambassador Attending live sporting events is a favourite pastime for fans all over the physical activity and it found men took about 1,800 more steps each day world and is by no means reserved than women to golf. Events provide fans with • Spectators also rated exercise and physical activity as important reasons an opportunity to get up close to Impact of the Scoping Review for attending golf events and 60% said they would like to be more active the players, sharing the trials and Highlighted the opportunity for increasing tribulations of their sporting icons. participation in golf However, as most sporting events Crowds enjoying The Open confine spectators to a seat, golf • More scientific knowledge, collaboration and networks to support has long been regarded as unique in participation in golf for health benefits “The Review demonstrates being the only mainstream sport that a wide variety of health provides fans with health benefits – benefits. Golf helps you live Robust science for policy makers just like the players on show – through attending a professional or amateur The Review opened up channels of communication to the WHO and longer and be healthier and • event. Although intuitive, proof was policy makers thanks to scientific evidence happier. required. • The Review was welcomed with an Early Day Motion in the UK Parliament “Anyone can play of all ages As part of the PhD study of Dr Andrew by the Minister for Public Health and abilities and there are Murray and the Golf & Health Project, research on the health benefits popular shorter formats, such Wider awareness of attending golf events achieved as GolfSixes, to make the valuable results and confirmed that sport more accessible. We • A communications campaign to raise awareness of golf’s health attending an event as a spectator is benefits achieved coverage around the world, while the Review was shared have to get away from the very beneficial for your health. by The R&A with over 150 affiliates spanning more than 140 countries idea golf is only a rich man’s sport – 75% of the courses • It was presented at golf industry meetings and public engagements and translated into Spanish, German, Cantonese, Mandarin and Arabic across the world are available A scientific follow-up paper in the event, demonstrating that golf events for the public to play on, not BMJ Open Sport & Exercise Medicine can not only offer enjoyment and only members.” found that 40% of the spectators entertainment but also leave a legacy increased their physical activity during of improved health for attendees. DR ANDREW MURRAY the three months after attending an Lead Researcher for the Scoping Review

On a regular 18-hole course, most players 2 3 will walk between four and five miles...... burning up to 2,000 calories. Golf and Health 2016-2020 | Scientific papers 8 Golf and Health 2016-2020 | Scientific papers 9

Impact of the Spectator Study The International Consensus Statement. Robust science for policy makers • The International Society for Physical Activity and Health (ISPAH) / WHO / International Olympic Committee all Summary of findings welcomed alignment to global policy • Playing golf is associated with better strength and balance, a sharper • The Scottish Government and UK policy makers indicated that the findings contributed to decision-making mind, a lower risk of heart disease and a longer life, with more people regarding support of events encouraged to take up the sport

• The study was highlighted at public health and sports academic conferences e.g. Planetary Health / International • To get the most benefit from the sport, golfers should play for at least Sports Science and Sports Medicine Conference 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 Wider awareness for events The 2018 International Consensus • While an estimated 60 million people play golf at least twice a year, golfers • Targeted information and infographics were provided to golf bodies who organise events, with meetings held with Statement on Golf and Health to are primarily middle-aged and older, affluent, male, white and living in e.g. The R&A, the European Tour and the Asian Tour guide action by people, policy makers North America, Europe and Australia and the golf industry was published in • An increase in health information has been provided on big screens, information towers and other spectator signage • Compared with other sports, the risk of injury in golf is moderate. As golf September 2018 in the BJSM. at a diverse range of events such as The Open, AIG Women’s Open, The Ryder Cup, The Solheim Cup, and events in is an outdoor activity, golfers may have a higher risk of skin cancer than Spain, Indonesia and China The Statement helps players, people who take up indoor sports or sports with less time outside and potential players, the golf industry, should use sunscreen when necessary • The study offered the opportunity for commercial third parties to contribute to the health narrative at future events. facilities and decision makers benefit For example, spectators attending the 2018 Andalucía Valderrama Masters (third round) in Spain were invited to join from a better understanding of how to the Walk & Win event, a ground-breaking European Tour initiative supported by QuirónSalud with the purpose of The Melanoma Fund is among organisations realise potential health benefits and promoting healthy lifestyle habits amongst golf fans. Spectators could have a card stamped when they passed by highlighting the importance of sun protection for minimise health risks related to golf. the 5th hole and again on the 13th, before handing it in at the QuirónSalud tent, after having walked a total of over golfers, including via its Slip! Slap! Swing! campaign three-and-a-half miles To assess the physical and mental health benefits of golf and propose • Cost and perceptions of the sport may put some people off the idea ways to make the sport more of playing golf. The sport is also perceived as difficult to learn and accessible to a wider population, Dr unwelcoming to women, yet a number of women and girls’ initiatives are Spectators enjoy the 2019 “Walking is one of the best assisting in this area Solheim Cup at Gleneagles Andrew Murray and more than 25 things you can do for your other experts in public health, health health, adding years to • Leaders in golf should make a greater effort to make the sport more policy and industry reviewed data inclusive and welcoming of people from all walks of life and ethnic life and increasing health from 342 previously published studies backgrounds and happiness. These on the sport. pilot findings show golf Three key infographics were developed to help spread the messaging for The Statement informed scientific golfers, the golf industry and policy makers: spectators can experience knowledge and action plans for (1) physical activity to benefit golfers and potential golfers, (2) golf • Playing golf can make you healthier and happier facilities and the golf industry, (3) their health while watching policy and decision makers external • Actions for policy / decision makers a top-quality sport at close to golf. • What can the golf industry / facilities do to maximise quarters. This could have the health benefits of golf? huge implications on event attendance and encouraging Click here for infographics and digital resources more people to attend a

Women in Golf Charter. professional event or begin 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 the playing the sport.” need for a fundamental shift in culture. There is a clear ethical need for change and the potential 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 May 2018, The R&A launched a Women in Golf Charter with the aim to increase women and In signing this Charter, we commit to making tangible efforts to develop a welcoming and inspiring environment for women. We will do more to attract women into golf, to remain, and to have rewarding careers.

DR ANDREW MURRAY The Charter: • Is a statement of intent from the golf industry to unite and to focus on gender balance girls’ participation and membership in golf, encourage more families to enjoy golf as a leisure • Commits us all to supporting measures to increase the number of women, girls and families playing golf • Calls for positive action to encourage women to pursue careers in all areas of the sport Lead Researcher for the • Recognises the need for change that creates an inclusive environment within golf activity and encourage more opportunities for women to work and volunteer in the golf industry We commit to activate this Charter by: • Developing and implementing an internal strategy for enhancing gender balance at every level Spectator Study • Establishing senior management responsibility and accountability for gender balance 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 play golf and work in golf.

steps (depending where your ball goes!) ...that’s well over the 10,000 4 13,000 can be walked during an 18-hole round... recommended daily average. Golf and Health 2016-2020 | Scientific papers 10 Golf and Health 2016-2020 | Scientific papers 11

Impact of the Consensus Statement “Physical activity of any Strength and Balance Study. type comes with a range of physical, social and mental Robust science for policy makers An international research study benefits. For some, golf can Summary of findings The uptake, use and impact of the Statement has been considerable and a backed by The R&A has found new valuable tool to show that the golf industry is taking positive action. be a great way to stay active evidence to suggest golf can provide and there’s growing evidence significant health benefits to older • Participants in the golf training programme improved their muscular Professor Fiona Bull, WHO Programme Manager, Non-Communicable Disease strength, power, endurance, balance, flexibility and walking performance about ways the sport can participants in the form of improved Prevention, said, “Golf is a popular sport for men and women and it’s great muscle strength and balance. to see golf’s global leadership recognising health priorities and identifying help those living with long • Golfers under the age of 80 had better strength and balance than ways golf can be more accessible to more people. I took up golf in my 30’s but term conditions such as Muscle strength and balance exercises sedentary non-golfers of similar ages thought it was a very technical, expensive and elitist sport. form an important part of the WHO’s Parkinson’s and dementia. Golfers had better dynamic balance and static balance than non-golfers recommended guidelines to tackle • “Thankfully, a six-week ‘come and try course’ showed me how easy it was to And for those who haven’t physical inactivity in older people • Strength of limb muscles and balance were better in golfers than non-golfers enjoy golf as a beginner and how active playing nine holes can be! I’m looking discovered their favourite about which little was previously e.g. indicative through gripping and swinging a club, walking, squatting forward to seeing how golf can attract many more girls and women to enjoy sport yet, it’s never too late known for golf. the sport and be more active and healthy.” • The golf training programme was feasible and effective; novice golfers were to get inspired, connect with The Strength and Balance Study, able to play nine holes of golf by the 10th week and completed 282 of 300 people and improve your carried out with two sample groups Wider awareness (94%) total training sessions wellbeing.” over two years by Professor Maria Stokes OBE at the University of • A communications campaign generated 40 million reach in press and • The physical demands recorded during a golf round were equivalent Southampton and Dr George Salem at online, with social media coverage reaching over 1.6 million accounts STEVE BRINE or greater than the demands for other common activities e.g. gym work Former UK Parliamentary Under the University of Southern California or yoga • Discussions were held with over 30 policy makers and alignment agreed Secretary of State for Public Health (USC), has indicated that older golfers with the WHO Global Action Plan for Physical Activity and Primary Care have and develop strength and • Participants benefited from green space, social interaction and walking balance benefits. over hilly terrain

Underlining the sport’s capability • The programme was safe; there were no golf-related injuries or “Golf is the first sport to improve the physical health of adverse events First International Congress on Golf to make a meaningful participants, the evidence suggests and Health, October 2018 golf can improve quality of life through investment in looking at Ahead of the study being peer “Moreover, as golf is an exercise muscle strengthening, improved reviewed to validate findings and activity that includes strengthening, its risks and benefits of Building on the Consensus Statement, The R&A sponsored the First balance, aerobic exercise (equivalent future presentations made to the power, balance, endurance and participation. Players, International Congress on Golf and Health in London to increase interest to gym-based work or yoga) and academic world, Professor Maria cognitive challenges, it satisfies management and policy and participation in the sport by helping players, potential players, the golf social interaction. Stokes said, “The findings indicate the recommended physical activity industry and policy makers understand what actions can lead to better makers can now feel that golf is associated with health guidelines of the World Health health through golf. Golf and Health ambassador Annika Sorenstam The Southampton group involved benefits related to better muscle Organization, the American College of confident, not only that supported the activity in London. 152 individuals aged 65-79 and over strength and balance. Sports Medicine and UK guidelines.” there are significant 80 and set out to demonstrate the Evidence linking golf and health was presented at the 7th Congress of the physical and psychosocial benefits “This suggests golf may meet associated benefits from International Society for Physical Activity and Health (ISPAH), the biennial associated with playing recreational World Health Organization “These findings should playing golf, but the golf club scientific meeting. The ISPAH event included a breakfast meeting on the golf regularly by comparing physical recommendations for older people, encourage policy makers environment can provide Health Benefits of Golf, together with public health practitioners and policy measures between older golfers and which would potentially qualify golf and healthcare professionals makers. Golf industry leaders also hosted a satellite event in the Palace of sedentary non-golfers. a health enhancing and for social prescription and exercise to consider recommending Westminster, supported by the All-Party Parliamentary Group for Golf. referral schemes among policy makers commercial opportunity.” A study at the USC was undertaken to help manage health conditions.” playing golf to older people A further Golf and Health Scientific to see if non-golfers developed these as part of encouraging them DR ROGER HAWKES Meeting was held at High Elms Golf benefits while undertaking a 10-week Dr George Salem added, “Our Executive Director, to adopt a more active Course, Bromley, a club promoting instructional golf training programme. findings suggest that golf should be Golf & Health Project healthy lifestyles. Offering a forum to considered when prescribing exercise lifestyle, as well as tackling support and grow ideas, researchers The USC group involved 15 individuals for older adults because it appears physical inactivity to reduce aged 63 (+/- 5 years) at a municipal from Asia, Australia, Europe and the to be safe, feasible and an adherent healthcare costs.” USA discussed their respective projects course in the greater Los Angeles form of exercise for a better, healthier and the future direction of research on area, which also examined the quality of life. MARTIN SLUMBERS feasibility, safety and adherence of the golf and health. Chief Executive of The R&A programme for senior non-golfers.

In a 9-hole round, most players 5 will walk two to three miles...... and take over 5,000 steps. Golf and Health 2016-2020 | Scientific papers 12 Golf and Health 2016-2020 | Scientific papers 13

Other papers and research. Mental health and wellbeing

With COVID-19 impacting society worldwide in 2020, playing golf and Research has taken place, and continues to do so, to identify and support projects across various areas of golf and health, spending time in green spaces was highlighted as a possible solution to with a view to further informing policy makers, golfers and the wider public. overcoming mental health problems. Dementia and memory loss Leading environmental psychologist Professor Jenny Roe from the University of Virginia highlighted that golf course environments possess many of the natural features – including water, biodiversity, spatial variety and With mental health a growing area of focus across the world, conditions light patterns – that help reduce stress and induce calm. In a feature from such as Alzheimer’s Disease, other forms of dementia and memory loss Syngenta Growing Golf, broadcast on World Environment Day on 5 June have been seen to benefit from golf. A number of sites in Australia, 2020, Roe suggested prospective players are attracted to golf because it is “Contact with nature slows England, Japan, Scotland and the USA have all identified that the golf outdoors and offers relaxation and stress relief. down our stress response club environment is therapeutic, provides social interaction, boosts mental and induces calm. There health and even encourages people back into golf e.g. at driving ranges, Golf clubs and courses could reposition themselves as valuable green space simulators, pitch & putt, par-3 courses. destinations to encourage more golfers and boost their health. is evidence to show this is happening in our biological While evidence in this area is anecdotal and more tangible scientific Furthermore, a project carried out in 2020 found that golf can have a positive system. It is promoting stress research is required, notable examples can be highlighted. impact on children’s behaviour and wellbeing. resilience, it is improving Golf Memories Scotland works with a number of facilities across the Carnoustie Golf Links and Abertay University ran the ‘Golf Collaboration our mood, it is decreasing country, enjoying success at Carnoustie (as featured on the Golf Channel) Project’, which set out to test the effects of golf on young people via the club’s our risk of depression and inspiring a programme at TPC Sawgrass in the USA. ‘Carnoustie Craws Programme for Young Golfers’. and increasing our social Golf In Society helps people living with Parkinson’s disease. It has provided Over a six-week period, children who took part were assessed on their golf wellbeing, particularly on opportunities for groups and individuals with dementia and Parkinson’s to participate skills, physical activity and personal wellbeing. Testing included physical a golf course where you at a number of golf clubs in the UK and is being reviewed by a research group from measurements such as jump performance, back and grip strength, reaction Sheffield Hallam University. time and balance, as well as on their own sense of self-esteem and resilience. are interacting with other Participants reported an increase in wellbeing across all categories, while members of that community. A scoping review has also been commissioned on dementia and golf with a view to three out of four physical tests also showed improved results. proposing a study to provide a level of evidence which will influence policy makers. So, there are a host of The Golf Foundation’s ‘Skills for Life’ research project in 2017-18 achieved mental and social wellbeing similar success. Designed to develop the mental toughness and resilience benefits.” The COVID-19 pandemic of the participants involved, PGA teaching professionals delivered the programme to groups of young people, aged between 11 and 16 years. PROFESSOR JENNY ROE University of Virginia The COVID-19 pandemic considerably impacted on golf relation to physical activity. The R&A also launched a Average mental toughness increased in the participants by 20% during at all levels and a variety of guidelines were put in place COVID-19 Support Fund, a £7 million funding package, the programme. across the golf industry during lockdown. to help golf deal with the impact of the pandemic. The fund was largely aimed at national federations and other Yet the health benefits of golf helped the sport quickly bodies in Great Britain and Ireland, as well as major Green space activity, including playing golf, can boost health resume in many countries, given golf can provide health overseas affiliates. enhancing physical activity and safe social interaction in a low risk environment. Health professionals were also involved in re-establishing golf on the European Tour post-lockdown, together with Relationships developed as a result of the Golf & Health support for their ‘Golf for Good’ initiative which aimed Project, with the WHO, The R&A, public health bodies, to highlight the sport’s health benefits and support universities and governments contributed to golf being communities and true heroes. one of the first sports to return, particularly for the safe reintroduction of recreational golf in the UK. Golf’s reputation was enhanced during the pandemic, with a significant number of clubs welcoming large Golf organisations worked hard to provide golfers, golf numbers of new members post-lockdown and increased clubs and greenkeepers with guidance and information footfall. For example, in Norway, almost 300,000 to assist them with the safe resumption of golf during rounds were booked in May 2020, over double for the the pandemic. It was important for everyone to carefully corresponding month in 2019. follow government measures countries put in place in

6 7 If you play golf for at least 150 minutes per week...... you are meeting WHO global exercise guidelines. Golf and Health 2016-2020 | Scientific papers 14 Golf and Health 2016-2020 | Case studies 15

Joint replacement Mortality Case Studies New research in 2019 reported positive news on joint A 2020 US study into mortality among the over 65s in the replacement among golfers, highlighting that they 1990s reported that playing golf may help older adults live should have no reservations about returning to golf and longer. Researchers found during the decade-long study The Impact of Golf and Health. may return quicker than was initially thought. that golfers had a death rate of 15.1% compared to 24.6% among non-golfers. The complete findings were presented An academic evaluation of golf and community. The evaluation also BJSM, in the autumn of 2020, joining Notably, it reported that two in five golfers play more at the American Stroke Association International Stroke health was published in the BJSM in highlighted the collaborative only football and rugby in publishing golf after undergoing joint replacements and almost 90% Conference in Los Angeles. In summary: January 2020, entitled: “Maximising approach of the WGF, The R&A, a comprehensive report of its health continue to play at least the same amount of golf after and evaluating the uptake, use and various universities and other golf benefits and dis-benefits. the operation. • Researchers at the Zeenat Qureshi Stroke Institute in impact of golf and health studies”. bodies. Minnesota studied data about a group of nearly 5,900 Assessing scientific evidence across Impact Study overview To further examine the impact of The findings came from a survey carried out by Europe’s adults, with an average age of 72, from 1989 to 1999. golf and health studies, it outlined in golf and health, 10 case studies are largest online golfing community, HowDidiDo, under the Everyone studied was over the age of 65 and underwent summary terms their effectiveness Another collective overview of the highlighted. auspices of consultant orthopaedic shoulder surgeon extensive medical examinations every six months across the general public/golfers, work across golf and health was Peter Hughes. Almost 3,500 joint replacement recipients policy makers and the scientific published in a special e-edition of the responded to a questionnaire regarding post-operation • Of all the people examined, 384 played golf at least golf habits and this was collated alongside data from once a month. About 15% of them died during the nearly seven million rounds of golf. decade. However, of the more than 5,500 adults who weren’t golfers, about 25% of them died before the 1 The Open. From the raw data, analysts were able to determine year 2000 how age affected handicap and frequency of play in the As scientific research has shown, golf can provide health- general population – playing intensity gradually rises to “Due to its social nature and controlled pace, people Promoting health age 55 then declines from 70 – and to compare that with often maintain motivation and the ability to continue enhancing physical activity for players and can have physical benefits at The Open the information supplied specifically by respondents. It playing the sport even in older age,” said Dr Adnan and wellbeing benefits for spectators at major amateur and showed that those who had undergone joint replacement Qureshi, the study’s lead author and neurology professor professional events. operations could maintain – or even increase – the at the University of Missouri. “Regular exercise, exposure frequency of their golf, with many even reporting a more to a less polluted environment and social interactions Player welfare, spectator awareness, Spectator Guide satisfying experience as a result. provided by golf are all positive for health.” commercial opportunities with health • A ‘Red Route’ – approximately View more information partners and influencing opinion Key findings included: 6km in length – was detailed in with local and national governments the pocket guide for spectators to • 63% of golfers being able to play iron shots again provide areas of focus. Injury encourage them to walk around within three months of their operation Therefore, at some of the biggest the course when viewing play. golf tournaments worldwide in recent • 76% of golfers returning to club competitions within Player Gym The European Tour Performance Institute (ETPI) has times, opportunities have been taken six months published a number of articles in the last 10 years on elite to promote health messages – with • An exclusive, dedicated player golf with a focus on common injury areas such as the • 22% used a golf cart in the early stages of their The Open among them. gym was first introduced for The “While we know one of the wrist and hip. In 2018, a systematic review was published Open at Royal Birkdale in 2017 return, which dropped to a little more than 11% once The Open is a major global sporting best things you can do for in the BJSM. and the purpose-built facility is full recovery had been made event and has enabled the promotion complemented by the Health and your health is playing golf, However, studies of injury in elite and recreational of key health messages to hundreds Hughes, who presented the findings at the Fortius Performance unit provided by the golfers have lacked consistency in methods and of thousands of fans attending the actually coming to The Open International Sports Injury Conference in London, said, ETPI. Players and their teams can definitions employed. Championship at Carnoustie in 2018 or any golf tournament and “The joint replacement process is successful and most use the space and facilities provided and at Royal Portrush in 2019. walking the course, seeing players can expect to play on for more than 10 further In a sport-wide statement from the International to focus on preparation, recovery years with deterioration no different from other ageing Olympic Committee in 2020, there was a call for sport- Information Towers and Screens and physical conditioning. what the players can do at golfers. Physios, osteopaths, sports specific consensus statements. On invitation by the • Four information towers on site close quarters, gives you a International Golf Federation, a group of international therapists, performance nutritionists “Worldwide, I would estimate there are probably three – two in the Spectator Village healthy dose of exercise and experts in sport and exercise medicine, golf research and and strength & conditioning staff million golfers playing for an extra 10 years because of and two on the course – and LED fresh air.” sports injury and illness epidemiology were selected to provide valuable input to a large their new joint. If they spend just £1,000 per year on their screens throughout the venues prepare a golf-specific consensus statement. number of players. Dr Andrew golf – on membership or green fees, food and beverage, were used to display positive DR ROGER HAWKES Murray was based for the week in hardware and so on – then that’s an extra £3 billion kept health messaging. Executive Director, If this advice is followed, it is hoped to increase the players’ facility at Royal Portrush in the game every year that would otherwise be lost.” Golf & Health Project knowledge on injuries in golf and then tackle the even in 2019 to complement The R&A

more important issue of prevention. medical team.

Golf has been shown to help 8 km is the distance spectators walk, following the entire strength and balance in older people. 6 Red Route at The Open (over the recommended daily steps). Golf and Health 2016-2020 | Case studies 16 Golf and Health 2016-2020 | Case studies 17

The Player Clubhouse at The Health promotion at 148th Open at Royal Portrush 2 Wales Golf and the Stroke Association. other professional events

The 2018 Ricoh Women’s British The power of golf and its life-changing properties continues to be effectively Open at Royal Lytham & St Annes highlighted in a partnership with Wales Golf and the Stroke Association, helping and the 2019 AIG Women’s British people physically and contributing to improved mental health and wellbeing. Open at Woburn, now named the AIG Women’s Open, used In doing so, it has helped save money “I was worried I wasn’t going to be able information boards, LED screens for the health service (as detailed in to hit a ball without falling over. After and video on social media to statistics from Sport Wales below). the session I went home as pleased promote health messages. as punch that I had been able to do New2Golf/Back2Golf is an initiative it and had been out meeting and The 2018 Ryder Cup at Le Golf Wales Golf set up at local golf chatting to people. Back2Golf has National in France highlighted facilities for all ages and abilities been fantastic for my recovery. I’m health benefits to 250,000 fans as part of the national federation’s back active again and it has made me through on-course signage and ‘Everyone’s Game, Anywhere’ strategy. more confident overall.” the official programme. On the The Stroke Association is a UK-wide eve of the match, a Medical charity helping stroke survivors and Peggy’s story was used by Sport Wales Forum was also held at the Louis their carers, with approximately 7,000 to illustrate research evidencing a Vuitton Foundation which brought strokes happening in Wales every year. £295m per annum saving for health Player Clubhouse Media together 250 experts to discuss budgets by being active and playing golf’s physical and mental health Parc Golf Club set up a pilot scheme sport (in 2016-17). • A bespoke clubhouse was • The Open has also offered the benefits. in 2017, with participants putting, introduced at Royal Portrush in opportunity to gain wide media chipping, hitting balls at the range and The figure came from research 2019 that brought together all exposure for golf and health socialising. Such was their love for the commissioned by Sport Wales and player services under one roof – messaging, including with Sky activity, 63% of the participants still undertaken by the Sport Industry services that enable the players Sports, the Golf Channel, golf meet and play regularly three years on. Research Centre at Sheffield Hallam to perform to their maximum magazines and on The Open and University, which calculated that adults 2018 saw a national roll-out, with who participated in sport and exercise potential (e.g. a players’ lounge, The R&A’s digital platforms. golf the first sport to attract funding locker rooms, creche, gym, at moderate intensity lowered their risk Sports Ministers direct from Health in Wales. During of major illnesses by up to 30%. performance unit and more). Peggy Cumbers this 12-week programme, more than • The nutritional offering in 2019 • With health and wellbeing a vital 10 clubs took part, with over 86 stroke Joe Vickery, PGA Professional at Parc was also carefully considered area for governments, The Open survivors participating, consisting of Golf Club, added, “I would encourage “I was worried I wasn’t for all players, with a wide range and the AIG Women’s Open have both new and lapsed golfers. 76% other golf professionals and clubs of catering on offer to enable provided the chance to engage participated regularly and, following to be inclusive with coaching and going to be able to hit a their bodies to fuel and repair with ministers and other leading the scheme, 71% of the regular membership options, as it is so ball without falling over. policy makers on site to promote participants took part in golf activity and to protect against illness. rewarding and great for recruitment After the session I went Protein, carbohydrate and fruit & key points and help drive change. (either at a home club or elsewhere). and retention.” The 2019 Aberdeen Standard home as pleased as punch vegetable options were all of good A further 9% became club members. • Aileen Campbell, former Minister Investments Scottish Open at quality, produced in consultation On further analysis, all participants In 2019, a further nine groups took that I had been able to for Public Health and Sport at the The Renaissance Club was one with leading chefs and Professor reported improvements in confidence part throughout Wales, with 44 regular do it and had been out Scottish Government, said, “I know of the most inclusive health- Graeme Close, a global expert in and a boost to fitness leading to participants of which 78% continued that golf can be beneficial for both supporting golf events staged in meeting and chatting to performance nutrition. A coffee improvements in wellbeing and into regular golf activity. Even during our physical and mental health Scotland, including the staging people. Back2Golf has been bar and smoothie station were also mental health. lockdown due to the COVID-19 and work has sought to back this of the EDGA Scottish Open for provided, along with healthy snack pandemic in 2020, Wales Golf fantastic for my recovery. up with sound evidence. The work Disabled Golfers, information Peggy Cumbers, part of the initial availability, including protein bars. developed online sessions for stroke I’m back active again and it has been a great way of identifying boards with messaging from pilot in 2017, tells her own story, “Golf survivors to keep them active at home the benefits and researching them leading players and Scotland’s helped me get my life back after a and connected, again boosting their has made me more confident further so we, in the Home of Golf, Chief Medical Officer and stroke. I was in hospital for seven physical and mental health. overall.” can promote our sport around spectator maps and giant seats at weeks and the clot was on the right the world.” the furthest points on the course side of my brain, so it was my left side View more information PEGGY CUMBERS supporting active spectating. that was affected. I really couldn’t Participant in the pilot even imagine walking again. Back2Golf initiative

Spectators at the 2014 Ryder Cup at Gleneagles Golf can help improve cholesterol, body 10 collectively walked four times around the world. composition, and your metabolism. Golf and Health 2016-2020 | Case studies 18 Golf and Health 2016-2020 | Case studies 19

3 Golf for the Disabled. 4 Courageous Kalkman Inspiring Disabled Golfers.

The growing focus on health is likely to have contributed to increasing inclusivity Golf has been proven to be a great sport for the physical and mental health of people and diversity within the sport, including women and girls’ golf and shorter formats with disability, a fact that should be of interest to potential players, national federations like nine-hole golf, par-3 golf and GolfSixes. Disability is another such area. and governments.

Golf is a sport for everyone. Regardless EDGA (formerly known as the The EDGA Scottish Open was the The story of Monique Kalkman is Sunrise Medical, in 1997, but in 2004 Now in her 50s, golf suits her age of age, gender, physical condition or European Disabled Golf Association) first of two tandem events on the illustrative. Cancer as a teenager left suffered some health problems and lifestyle, being out in the fresh physical challenge, it’s a great way to affiliated to The R&A in 2018 and is European Tour in 2019, with the 36- Kalkman facing huge life challenges. A including heart issues. After an air and using different muscles. “I build friendships and to exercise, while the leading organisation in this area, hole EDGA Dubai Finale featuring as lover of tennis and hockey as a child, operation and issues with neck have a different goal now,” she said. providing an opportunity for personal regularly promoting golf for players part of the season-ending DP World she had to revise her sporting dreams. dystonia, Monique decided she “Tennis, for me, was all about being challenge and growth. with disability at every level and Tour Championship, with George Due to the cancer (and paralysis from needed to find a new sport to help her competitive. Golf is more of a mix actively involved in various campaigns, Groves winning in Dubai. her waist down), she adjusted to life as physically. of competition with huge social Information on the benefits of golf for such as ‘PLAY GOLF’. The campaign a wheelchair user. and health benefits. All national health has been used to support the Previously, she had taken a buggy showcases eight EDGA players from “The very nature of a game federations should encourage and development of golf for the disabled in three continents with a range of Yet she remained strong, notably ride on a golf course while at a tennis help disabled golfers, as it is a great where the player is in control 36 countries, to tackle some negative disabilities who live life to the full through the support of family and camp and was “amazed by the beauty sport to help them physically and perceptions about golf and to help through playing golf. The campaign of their own ball, which is friends. In 1980, she was at home in of the nature” on a course, enjoying mentally.” make golf a more inclusive sport. is supported by a dedicated training still, makes golf an ideal Arnhem watching the Paralympics “the serenity and elegance of the on TV and was duly inspired. She sport”. Monique, who has developed her own programme which engages with sport for even the most hospitals, rehabilitation centres, golf discovered table tennis, and soon ‘Going for Golf’ Foundation, is well Highly-rated disabled profoundly disabled, so found a way to start winning in Monique found that using a specially- respected by members of EDGA. “Just golfer Brendan Lawlor clubs and other sporting venues. allowing golf to be the most style, blowing away the competition. designed paragolfer chair was ideal as Monique paved the way in tennis for her fitness and for her neck injury, Golf for the disabled has also inclusive sport of all.” She thrived to become a four-time for those with a disability, she is in developed in other ways. For example, Paralympic champion in wheelchair as she could play from a standing the vanguard of passionate people position. Her patience gradually the World Ranking for Golfers with TONY BENNETT tennis and table tennis and a member aiming to do the same in golf,” says helped develop her golf game. Disability (WR4GD) was launched at EDGA President of the International Tennis Federation Tony Bennett, EDGA President. “She the start of 2019 to promote inclusivity Hall of Fame. Watching the likes of two other is helping to break down barriers, to within the sport and is administered in The second edition of the Australian wheelchair golfers, Anthony Netto make competitive golf for those with tandem with the World Amateur Golf All Abilities Championship also After a decade of achievement, and Sebas Lorente, also helped, as did disabilities a more attractive and Ranking® for both men and women. took place alongside the Emirates Monique found the intense level her willingness to spend hours on the likely proposition despite numerous The R&A and the USGA assumed Australian Open in December 2019, of competition and practice too range, making Monique the highly- challenges.” responsibility for calculation of the with 12 of the world’s best golfers with demanding. She became European rated player she is today. rankings, taking over from EDGA, disability in the field, where Swede Product Manager for her sponsor, who created the comprehensive and Johan Kammerstad successfully Monique Kalkman in action independent Ranking for Golfers with defended his title. “Tennis, for me, was all using her paragolfer Disability in 2014. Tony Bennett, EDGA President, said, about being competitive. There has been a sizeable increase “EDGA listens intently to its members Golf is more of a mix of and players, to understand the in the number of players included in competition with huge social all three ranking categories (Gross, critical needs of golf for the disabled. Nett and Stableford Ranking) We continue to develop strategies and health benefits. All since its introduction. In 2019, the and practical tools that inform the national federations should WR4GD included 854 players from 32 industry, educate the coaches and encourage and help disabled players, and promote initiatives to countries who competed in 43 ranking golfers, as it is a great sport tournaments played in 18 countries. In practically get more individuals with comparison, there were 594 players who disability into the game. The very to help them physically and competed in 23 ranking events in 2018. nature of a game where the player is mentally.” in control of their own ball, which is Golf for the disabled has also been still, makes golf an ideal sport for MONIQUE KALKMAN highlighted at leading professional even the most profoundly disabled, Four-time Paralympic champion events, working with national so allowing golf to be the most governments to promote inclusivity inclusive sport of all.” in golf and sport more widely.

You don’t have to join a gym 11 ...playing golf can provide most of 12 to gain the benefits of exercise... these benefits, for all ages. Golf and Health 2016-2020 | Case studies 20 Golf and Health 2016-2020 | Case studies 21

5 Policy makers. 6 National Federations.

Golf plays an important role in maintaining a healthy, active population and delivers For the benefits of golf and health to be fully realised on a worldwide scale, the support of benefits to all ages and abilities – benefits that more and more policy makers are national federations remains vital to raising awareness. incorporating into their policies and agendas. Indeed, there are already many Encouraging golfers onto the Policy makers are vital in deciding As highlighted, the research has also infographics spelling out the promising examples in this regard, fairways to enjoy health benefits what national governments and helped shape policy regarding major relationships of golf with health; aided by The R&A sending information authorities invest their time and events, such as at The Open, to keep actions to support improved health (research, infographics and media resources in. the golf and health agenda in the through golf and physical activity material) to over 150 affiliates to public eye. Communication has also more generally; and opportunities encourage adoption of health For example, multiple motions in the helped inform walking and physical to align work to local, national and promoting actions. Meetings to UK Parliament have welcomed the activity policy. international policy. support engagement work with research and opportunities related to national federations have also taken golf and health, while the All-Party In the published article ‘Physical The WHO Programme Manager place, including with China, France,

Parliamentary Group for Golf was a activity investments that work — Get of Non-Communicable Disease Germany, Hong Kong, Indonesia, signatory to the 2018 International Scotland walking: a National Walking Prevention, Professor Fiona Bull, Portugal and Spain. Consensus Statement on Golf and Strategy for Scotland,’ authors describes golf’s efforts to contribute Health and the suggested actions for including the then Chief Medical to health improvements, “Golf is a For example, China has highlighted policy makers. Officer for Scotland, Dr Catherine popular sport for men and women that golf and health messaging can Calderwood, and the then Minister and it is great to see golf’s global help to increase participation, as

Steve Brine, former UK Parliamentary for Public Health and Sport and leadership recognising health priorities evidenced in the quote below from the

Under Secretary of State for Public current Communities Minister, Aileen and identifying ways golf can be more 2018 First International Congress on

Health and Primary Care, said, “Golf Campbell, state, “We work with The accessible to more people.” Golf and Health. is very important in terms of keeping World Golf Foundation, The R&A Wei Qingfeng Weber, Director – Communication was then sent to people active and it is also part of and the European Tour to encourage Policy makers are urged to continue “We have planned and Golf Development at China Golf all courses so they could inform the the loneliness agenda, part of good spectators to walk the course. Our to promote the benefits of regular implemented a lot of sub- Association, said, “Golf and health is 642,000 registered golfers across mental health. Increasingly, there golfers are encouraged to walk the physical activity, including golf, for the most important area for China Germany of the benefits of golf and projects as part of the is evidence that golf is very good course rather than riding carts.” people of all ages, genders, and for managing long-term conditions, income brackets, and publicise the Golf currently. We are seeing growth health, along with guidelines on how German golf and health helping people stay focused and stay Activities to support uptake and specific health enhancing aspects and aim for more than 500% increase courses can effectively organise a golf project to motivate non- and health tournament for golfers and active for longer. There are lots of use by policy makers have included of golf. in junior participation between golfers to start golfing for 2018–2022.” an open day for non-golfers. benefits to golf.” providing summary briefings; health reasons and golfers “Golf is very important in The German Golf Association (DGV) has The DGV also designed a supplement to play more.” terms of keeping people also been very active, working on the and added 160,000 copies to a large German daily newspaper to inform Golf is great to keep active active and it is also part DGV-Project ‘Golf and Health’ over the MARKUS LAWATSCH

of the loneliness agenda, last two years to motivate non-golfers non-golfers on golf and health. Further Marketing Director, DGV to start golfing for health reasons and communication work has included a part of good mental existing golfers to play more. golf and health website, a dedicated The Confederation of Professional health. Increasingly, there social media campaign and filmed Golf (formerly the Professional Golf is evidence that golf is very Using the scientific evidence fitness exercises. Associations of Europe) has also available, they produced a ‘toolbox’ facilitated the adoption of golf and good for managing long- for golf courses to encourage local Further projects are planned on golf health into the curriculums for all term conditions, helping non-golfers to the sport for health and nutrition, as well as a prevention prospective coaches in their area of people stay focused and stay reasons. The toolbox includes posters, guide so clubs can offer prevention influence. Overall, national federations courses, financially supported by active for longer. There are advertisements, flyers, online banners are now equipped with stronger and guidelines. “The special thing health insurance companies. science on golf and health and can lots of benefits to golf.” about the toolbox is that there are take concrete actions to improve Leading German golfer Max Kieffer four versions, as we have worked out health. STEVE BRINE is an ambassador for the work in four different target groups in golf Former UK Parliamentary Under Germany, with the German Olympic and health so that each course can Secretary of State for Public Health Sports Confederation also supportive use a toolbox tailored to its marketing and Primary Care of the projects too. position,” says Markus Lawatsch, Marketing Director at DGV.

51% of the general population consider 13 14 themselves to be in good health...... but this rises to 72% of golfers. Golf and Health 2016-2020 | Case studies 22 Golf and Health 2016-2020 | Case studies 23

7 Social Prescription. 8 Golf and Health Week.

Given the burden and challenges for the National Health Service (NHS) in the UK, shifting the Building on the work of various health initiatives, the first-ever Golf and Health Week was held balance from medicine to ‘prescribing’ social activities to improve the health of millions has been in April 2019. It saw various golfing bodies working collaboratively to highlight the sport’s health a growing focus for the UK Government in recent times. benefits and reach an audience of over 20 million on social media.

Among pilot UK schemes that offer Steven Ward, ukactive CEO, said, “Golf participants were given two sessions Co-ordinated by The R&A, it was The collaborative campaign ran across “I think health and fitness is a massive social support and health-enhancing is a fantastic way to encourage people a week for six weeks. Each involved primarily focused on Great Britain digital and social media channels part of golf nowadays,” said Syme. activities, GPs have been encouraged to be more active, particularly among a 30-minute group discussion about and Ireland with the support of the using the hashtag #GolfHealthWeek “Generally, I use the gym for injury to prescribe golf for their patients parts of the population who may not lifestyle changes, followed by 45 European Tour, the Ladies European and included content focused on prevention and keeping fit.” On his after studies showed it boosted be too engaged with other activities. minutes of golf coaching. Tour, The Professional Golfers’ highlighting the physical and mental top fitness tip for amateur golfers, levels of fitness, muscle strength and Association and the Golf Foundation, health benefits of playing golf and Ferguson added: “Just try and keep “The research shows that there are happiness. “The research shows that as well as national federations projects being delivered by golf bodies yourself lean and in shape, going clear mental, physical and emotional including England Golf, Scottish and clubs to encourage golfers, non- through the motions of different there are clear mental, In 2018, a scheme, backed by fitness benefits for ‘golf on referral’ – Golf, Wales Golf, the Golfing Union golfers and lapsed golfers into taking exercises without adding a lot of body ukactive, and funded by England we should look to roll out more of physical and emotional of Ireland and the Irish Ladies’ Golf part in the sport. It created significant weight on to keep yourself flexible and Golf and leisure operator Mytime these programmes across the country benefits for ‘golf on referral’ Union. media and TV coverage, including on loose.” Active, offered clear insight into the as part of wider efforts to get the – we should look to roll out Sky Sports. benefits of ‘golf on referral’. nation moving.” It also reached the likes of Australia, The week also highlighted individual more of these programmes Canada and the United Arab Emirates European Challenge Tour golfers stories such as from Stewart Harris, Pilot schemes in south London, in At the start of their programme, across the country as part (Abu Dhabi) and engaged a number of Connor Syme and Ewen Ferguson, an ambassador for Wales Golf, who Bromley and Orpington, found that participants’ average activity levels of wider efforts to get the leading professionals including Justin both former Walker Cup players, credits the sport for help saving his life patients referred for golf saw levels of were the equivalent of about one Rose, Padraig Harrington and Gary helped support the fitness theme after enduring physical and mental vigorous exercise triple, with significant hour’s running a week. Six weeks’ later, nation moving.” Player and broadcasters such as Iona through filming at the Institute of problems following a bomb blast in boosts in life satisfaction, happiness those levels were equivalent to more Stephen and Eilidh Barbour. Sport & Exercise at the University of Afghanistan while on tour as a soldier. and self-esteem. Researchers said ‘golf than three hours’ running. STEVEN WARD ukactive CEO Dundee. The story of Rachel Ingram, from Hull on referral’ could be particularly good A number of health-related themes in England, was also profiled, having Grip strength, a strong indicator of at encouraging middle aged men to were promoted during each day of the The Scottish duo went through seen her health (anxiety, depression vitality in older people, also increased Richard Flint, Participation & Club take up exercise – those who are often campaign, including: their paces at the University’s gym, and an eating disorder) and lifestyle significantly over the course of the Support Director at England Golf, unlikely to respond to standard health highlighting the importance of fitness turned around by playing and enjoying study – suggesting improvements in added, “We’re thrilled to see this • Fitness – professionals and initiatives. for their games, as well as taking part the sport. muscle strength and reduced risk of scheme developing from our earlier amateurs in fun challenges. falls or disability. In pilot schemes, research into the impact of playing golf on health and wellbeing, which we • Mental health (including carried out with the support of Mytime dementia) Stewart Harris, Ambassador for Wales Golf Active and ukactive. Golf offers emotional benefits • Disability golf “It’s been exciting to see the results • Golf for everyone – featuring of the pilot schemes and to gain even various health projects (e.g. more evidence that golf is good for Parkinson’s, loneliness, stroke and health. We hope that ‘golf on referral’ other programmes that can benefit can be made more widely available.” health)

• Club level – focus at golf clubs (e.g. fitness, food, drink, gym classes)

The week was chosen immediately after the Masters Tournament to capitalise on the early season interest in golf, further boosted by Tiger Woods’ victory.

15 Golfers are at moderate risk of injuries, SPF Golf and Health Week reached an few are serious, and risk to sun can be minimised. 50 audience of over 20 million on social media. Golf and Health 2016-2020 | Case studies 24 Golf and Health 2016-2020 | Case studies 25

9 The Home of Golf Leading the Way. 10 Improving Life Through Golf Memories.

Golf has been played in St Andrews for more than 600 years, globally Going down memory lane recognised as the home of the sport. History and tradition may dominate, in golf is helping improve but golf continues to evolve. people’s mental and physical health – including at renowned Today, more than 230,000 rounds are Germany – to emphasise the physical Open venues. played annually over seven public and mental health benefits of playing Health areas the Links Trust courses managed by the St Andrews golf and the importance of multi- are focusing on Francesco Molinari’s notable feat in Links Trust, with the Trust also functional facilities, with the COVID-19 2018 in becoming the first Italian to • Plans being developed for gym overseeing a number of additional pandemic putting increased focus on win a major championship is among facility to complement existing facilities, including a golf academy, three practices and priorities. the many golfing highlights recalled by golf performance suite clubhouses, three cafes and five shops. a local 15-strong group at Carnoustie, Laurie Watson, Head of • Focus on entry level nine-hole who meet every month in the new The largest public golfing complex Communications at St Andrews Links Balgove course to encourage Links House. With an average age in Europe has also enhanced its Trust, said: “We know there are a new golfers of 78, they browse the history books, commitment to health, building on huge range of wider benefits through looking at photos of past Open • Increased number of women the recommendations made in the playing golf, as research has proven. champions over the famous links and girls’ golfers International Consensus Statement The Trust are committed to health- such as Molinari, Ben Hogan, Gary on Golf and Health in 2018. Using the enhancing activity across our facilities • Provision of toilets on course Player and Tom Watson, as well as expertise of Dr Andrew Murray, the for golfers and potential golfers and Members of the Carnoustie sharing stories of their own golfing Memories Group at The 147th Open Trust is working in a number of areas are grateful to the support of Dr • Promoting walking, as nature achievements. to boost health through golf. Murray to achieve our goals.” intended, rather than cart use They also strike a ball in the simulator Lorraine Young is a key driving force • Warm up areas at Academy “The Consensus provided information Murray added: “It’s great to see that bays, play ‘The Nestie’ short six-hole for the golf group in Carnoustie, and practice areas to golfers themselves; to facilities and the Home of Golf never stands still par-3 course or try the public putting which is also supported by the Golf the golf industry; and to policy makers and combines the finest traditions • Wide range of healthy food and green, all this is in competition for Links team. “Being afforded the on how to improve health through with embracing the concrete actions beverage options their own ‘Claret Jug’ monthly award. opportunity to spend meaningful golf,” notes Murray. “St Andrews Links that can lead to improved health time with our members, in a setting • Retail offering including Trust and many other leading facilities through golf. It’s not simply about the The Carnoustie Golf Memories Group, within which they freely start to tell “For each individual member sunscreen and caps to minimise throughout the UK, and globally, are Old Course, it’s about their range of launched in 2015, is among a number their compendium of stories, is a health risks from skin cancer there is a story to be told and embracing the Consensus and working facilities for all. of groups that have sprung up at golf real honour,” says Lorraine. “For each creating the environment to meet its recommendations.” facilities across Scotland, including individual member there is a story to “The simplest actions done well make • Staff training in health and at Noah’s Ark in Perth and in Troon. be told and creating the environment within which they can begin Murray has spoken at Links Trust the biggest difference, maximising safety The British Golf Museum, which is within which they can begin to tell and to tell and relive, at least part staff forums and partner gatherings – golf’s health benefits and encouraging • Promoting sustainability e.g. part of The R&A family, and Alzheimer relive, at least part of their story, is including with Rolex and Allianz who people through the door to get into of their story, is magical.” restricting the use of chemicals Scotland also came together to run a magical.” have now further supported work in golf – and keep playing golf.” monthly social group at the Home of LORRAINE YOUNG

Golf in St Andrews. A former Chief Social Work Officer Carnoustie Golf Memories Group The Home of Golf, St Andrews “We know there are a huge for Angus and a Rotarian, Lorraine The groups are part of the overall Golf chose to commit her free time range of wider benefits In 2019, the world-famous TPC Memories Project, which in turn is part to creating and supporting the through playing golf, as Sawgrass course in Florida saw the of the wider Sports Heritage Scotland development of Golf Memories. research has proven. launch of the Pete Dye Chapter Golf network helping those living with The group is ably supported by a Memories group, inspired by the The Trust are committed dementia and memory loss. committed and dedicated team of pioneering work being achieved at local volunteers, such as David Taylor, to health-enhancing Scotland currently leads the world Carnoustie Golf Links. Trevor Williamson and Margaret Muir. activity across our facilities in reminiscence therapy. Football, “Creating a sense of being valued for golfers and potential cricket, curling, rugby and shinty are Please visit The R&A website or the and a belonging is central to our core among the sports also involved, a Golf & Health Project website for golfers...” values,” continues Lorraine. “Families collaborative effort of reminiscence further case studies. tell us that, as a result of our meetings, LAURIE WATSON groups to stir memories, fulfil lives and they get their loved one back.” Head of Communications, also encourage participants back into St Andrews Links Trust the sports they love.

% of golfers are happier with their social life 16 17 80 compared to 60% of the general population...... and less likely to be at ‘risk of loneliness’. Golf and Health 2016-2020 | The Future 26 Golf and Health 2016-2020 | The Future 27

The Future of Golf and Health.

What has been achieved? What can be achieved in the future? What you can do... The sustained work in this area since Activities have been undertaken Golf has welcomed the completion To fill gaps in knowledge and build on 4. Diabetes and golf – a study in Golfer – please play more often, 2016 has highlighted golf’s health to raise awareness of these of the first PhD in golf and health by the current research, work continues Denmark with results awaited encourage others to play, walk benefits to a global audience and benefits with: researcher Dr Andrew Murray, with the across various areas of golf and health the course if you are able and tell underlined the role that the sport evidence available to all as a lasting among researchers. Studies include: 5. Autism – further study to provide • Global government ministers/ everyone you know about the plays in health and social wellbeing. scientific summary. The work has also evidence on golf’s benefits for people heads of state health benefits of golf provided a focus for other research 1. Parkinson’s – an academic study with autism By maximising the uptake, use and • National federations and bodies not directly funded or commissioned, at Harvard University in the USA with impact of scientific research, it has Golf facility – spread the word 6. Joint replacement – further study such as the All-Party Parliamentary further enhancing public awareness results awaited been consistently highlighted that golf on golf’s health benefits, promote to provide more evidence on how to Group for Golf (UK) of golf and health. It is now important is a health-enhancing physical activity inclusivity, promote safety and 2. Golf on prescription – Two ‘golf on safely get back playing, or starting for golf to maintain the momentum and a range of actions can be taken to sustainability, stock sunscreen and referral’ schemes have been identified golf for the first time, following • Global golf tournaments and continue the messaging to key promote better health through golf. healthy food and drink and monitored in the UK and are joint replacement. A proposal for a groups, such as policy makers, about • PGA professionals already showing promising results prospective study is being discussed Golf industry – work to promote the sport’s health benefits. In summary, golf’s health benefits with the prestigious Hospital for have shown that: • Attendees of over 30 keynote the health benefits of the sport, 3. The Australian Golf and Wellbeing Yet, policy and practice, as a result of Special Surgery in New York City talks on golf and health at events, engage with policy makers, aim to study – an international collaborative research, can take many years before • Golfers live longer and are including the First International encourage entry level play, consider project between researchers at the Identifying health related topics, being fully evident. Further time and healthier and happier Congress on Golf and Health and making facilities multi-functional University of South Australia, La Trobe sharing good practice and evaluation are needed to determine Planetary Health and encourage participation by all University in Melbourne, the University encouraging the use of golf club • Golf can help strength and the impact of a better understanding of society of Oxford and the Golf & Health environments in health initiatives balance and improve quality of golf and health and increased • Attendees of medical meetings in Project. The aim is to link regular remain vital in continuing to build on of life Golf federation – promote the interest and participation in physical Chicago, Edinburgh, London, Los golf participation with measures the work already achieved. Angeles, Paris and Vancouver, and health benefits of golf with activity, especially through golf. • Golf can be played by people of of health and provide high quality at various golf clubs your clubs and golfers and look Golf’s health benefits can help break all ages and abilities, including research evidence to integrate this into policy, down the traditional barriers to attract with disability “When your doctor perhaps Over 300 media articles have also perhaps working closely with your more golfers. been generated from the original government encourages you to exercise • Golf provides social interaction, research to help promote the health more, not everyone thinks a significant protective factor for benefits of golf, as well as coverage Policy maker – work with national Main: A father supports his son; Phone Inset: mental health and wellbeing about golf. But it can actually on NBC, CNN, BBC, Sky News / Sports federations to promote golf and, Media coverage during Golf and Health Week where relevant, include golf as a have huge benefits, to get • Golf can help reduce health and Chinese State TV, and in a variety moderate intensity physical activity stronger or lose weight.” costs and can add value to of global newspapers and magazines. in policy documents, guidance and health systems through social SO YEON RYU recommendations prescription Golf and Health ambassador and Scientist – please tell The R&A two-time Major Champion about your research Golfers of all ages can benefit from the sport

“Golf is now connected to the World Health For more information, please visit: The R&A: https://www.randa.org/en/theranda/initiatives/golfandhealth Organization and has The Golf & Health Project: https://www.golfandhealth.org/ developed a relationship with The World Golf Foundation: http://www.worldgolffoundation.org/ The World Health Organization: https://www.who.int/ policy makers in the UK and abroad who may now see References The Scoping Review: https://bjsm.bmj.com/content/51/1/12 golf in an improved light.” The Spectator Study: https://bmjopensem.bmj.com/content/3/1/e000244 Spectator Study follow-up: https://bmjopensem.bmj.com/content/5/1/e000503 DR ROGER HAWKES The International Consensus Statement: https://bjsm.bmj.com/content/52/22/1426 Executive Director, Infographics and digital resources: International Consensus on Golf and Health: https://bjsm.bmj.com/content/52/22/1421 Golf & Health Project Impact Study: https://bjsm.bmj.com/content/early/2019/12/18/bjsports-2019-100994

Over 300 media articles generated from the original 18 And finally, while we have no statistics research to help promote the health benefits of golf. 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 [email protected] www.RandA.org www.TheOpen.org