Article Critique: “Golf: A Game of Life and Death – Reduced Mortality in Swedish Golf Players”

The article “Golf: A Game of Life and Death – Reduced Mortality in Swedish Golf Players” by Farahmand, Broman, de Faire, Vagero, and Ahlbom (2009) aimed to determine whether specific health benefits can be achieved via participation in golf as a form of leisure-time physical activity. The authors stated that the purpose of their research was to analyze and compare mortality rates among golf players in Sweden in comparison with the general population. Since people engage in a variety of different physical exercises and sports partly to achieve health benefits, Farahmand et al. (2009) sought to find out whether a regular low-intensity leisure-time physical activity, such as golf, carries health benefits and risks for golf players. In Sweden, one golf session lasts four to five hours and involves walking five to six kilometers since golf carts are not used frequently in Sweden (Farahmand et al., 2009). Although there were studies that examined benefits and risks of such sports like running, skating, skiing, and athletics, there have not been a study to determine benefits and risks of golf participation. Therefore, the authors attempted to fill this gap in existing knowledge.

Farahmand et al. (2009) did not state explicit research questions or hypotheses. Nevertheless, the analysis of the article content allows identifying the unstated research questions of the study. The first question can be formulated in the following way, “Do Swedish people who play golf regularly have lower mortality rates than people in Sweden who are not golf players?” The second question can be stated as follows, ”Does regular involvement in such physical activity as golf account for lower mortality rates among golf players in comparison with mortality rates of people who do not play golf?” The third question is the following: “Can golf be recommended as a sports activity that can help to reduce the risk of mortality?” The unstated hypothesis may be expressed in two ways. First, it may state, “Regular golf activity helps to reduce mortality rate among golf players in comparison with the general population.” The second possible hypothesis is, “Regular golf activity does not contribute to reducing mortality rate among golf players in comparison with the general population” – depending on whether Farahmand et al. (2009) intended to prove or disprove the association between engaging in regular golf activity and mortality.

The study by Farahmand et al. (2009) investigated the association (or the absence of the association) between the two variables. As the analysis of the article demonstrates, an independent variable was a confirmed fact of a person’s engagement in a regular low-intensity leisure-time physical activity in the form of golf. In other words, the independent variable is having membership in the Swedish Golf Federation. The authors assumed that the fact of being registered in this Federation for at least five years implied that its members played golf on a regular basis. A dependent variable is a mortality rate among golf players. Therefore, the study attempted to determine whether playing golf regularly can be considered a factor that contributes to possible differences in mortality among golf players and people who do not play golf.

The authors used the following procedure/method to gather the information for the purpose of the study. First, they obtained access to the computerized registry of all members of the Swedish Golf Federation. The information in the registry about incoming and outgoing members (including deceased ones) is regularly updated. Second, the information in the Federation’s registry was compared with the information in the Registry of the Total Population to ensure that deceased members were removed from both registries and achieve meaningful and current information on mortality. The Registry of the Total Population is an official registry maintained by the Swedish government. It contains a complete coverage of all Swedish citizens registered as residing in the country. Third, since the socioeconomic status of golf players may differ from socioeconomic status of the general population, the information in the Federation’s registry was matched with the information in the Swedish Census in order to adjust mortality for the socioeconomic status. Fourth, the information in the official Mortality Registry was used to check and confirm data contained in the Swedish Golf Federation and the Total Population registries. Fifth, the authors utilized the Swedish Work and Mortality Data Base to analyze death rates by socioeconomic status. Finally, Farahmand et al. (2009) calculated standardized mortality ratios to compare death rates in the golf cohort with death rates among the general population (standardized mortality ratio values were calculated with 95% confidence interval).

The sample cohort of study participants was selected by taking the total number of registered members of the Swedish Golf Federation and keeping in a sample group only those Federation members who had completed personal registration, were born after a certain date, were Swedish residents, were identified in the Census to determine their socioeconomic status, had updated membership registration and had at least five years of membership in a golf club. The aforementioned measures left a sample group consisting of nearly half of all the golf players registered in Sweden. Furthermore, a sample group was broken down by such categories as socioeconomic status, sex, educational level, and age. A socioeconomic status included such categories as blue-collar members of the Federation, lower-middle white-collar golf players, and entrepreneurs-members of the Federation. In fact, age of a sample group included such categories as 20-39, 40-49, 50-59, 60-69, 70-79, and over 80-years-old. The educational level was broken down into three categories such as low (< 9 years), medium (9-12 years), and high (> 12 years). Therefore, a sample group can be viewed as representative of all the Swedish golf players of all ages, educational levels, and socioeconomic statuses.

The way that study was conducted adheres to requirements for conducting scientific research. For example, non-experimental study design can be used for measuring relationships between variables via studying data and records. Therefore, a procedure for selecting a sample of participants, data collection, and data analysis seems rigorous and fit the purpose of the conducted quantitative study. Farahmand et al. (2009) describe in detail study design, participants, and data analysis. Data analysis procedure seems adequate for the quantitative research. Generated data is well described and presented in accompanying tables. Farahmand et al. (2009) presented detailed interpretations of the study findings and demonstrated persuasively a relationship between independent and dependent variables. Possible implications of the research findings are stated. However, limitations of the study and areas of future research are not identified.

Conclusions from the study can be considered relevant to professional practice in a health care field. For example, professionals can make use of study findings in several ways. First of all, they can recommend playing golf as a physical activity that has the potential to benefit health, reduce mortality, and increase a life expectancy of about five years (Farahmand et al., 2009). This recommendation applies to all age groups of both sexes across all educational levels and socioeconomic statuses. Second, as a low-intensity leisure-time physical activity, golf has the potential to reduce risk of cardiovascular diseases and has a positive psychological effect. Hence, golf can be recommended as a physical activity associated with decreased risk of illness and premature death due to cardiovascular conditions. Third, golf can be included in the list of sports that can be suggested for reducing the risk of cardiovascular illnesses and associated mortality.