How is climate change affecting waterborne diseases? New Nature Reviews Microbiology analysis explains

Researchers find bacteria, viruses and parasites respond differently to climate change, highlighting the need for pathogen-specific public health strategies

University of Colorado Anschutz

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Climate change is altering the spread of waterborne diseases around the world, according to a comprehensive review published today in Nature Reviews Microbiology. The publication is the most up-to-date and comprehensive analysis to date examining how climate change influences waterborne diseases.

The review warns that more frequent extreme weather events could undermine decades of progress in reducing waterborne diseases, which contribute to nearly 1.2 million deaths from infectious diarrhea each year.

Led by researchers from the Colorado School of Public Health at the University of Colorado Anschutz and the University of Washington School of Public Health, the review found that climate change does not affect all disease-causing microorganisms, known as pathogens, in the same way.

Instead, bacteria, viruses and parasites each respond differently to changing environmental conditions, showing why managing the public health response should be tailored to specific pathogens.

“We want people to know climate change changes the conditions that allow pathogens to spread,” said the review’s co-author Elizabeth Carlton, PhD, professor and chair of the Department of Environmental and Occupational Health at the Colorado School of Public Health. “It’s making it harder to control some of the world’s most deadly infectious diseases by creating more favorable conditions for transmission.”

Climate change affects transmission in multiple ways

The review explains that climate change alters the environmental conditions that determine whether pathogens survive, spread and infect new hosts. For example, while waterborne diseases are often associated with flooding and heavy rainfall that carry pathogens into drinking water supplies, the authors explain droughts can also increase disease risk by reducing access to safe water and changing how people use the water that is available.

The review also explains that rising temperatures generally promote bacterial growth, while some viruses, including norovirus, rotavirus and adenovirus, spread more easily under cooler, drier conditions - and may, in fact, decrease in a warmer world.

Public Health strategies that can reduce risk

The review outlines practical steps that can help communities adapt to the growing threat of climate-driven waterborne diseases.

• Invest in climate-resilient water, sanitation and hygiene (WASH) infrastructure. Safe drinking water, sanitation systems and hygiene practices remain among the most effective ways to prevent waterborne disease. Because floods, hurricanes and other extreme weather events can damage water and sanitation infrastructure, the authors emphasize the need for systems that can withstand climate-related stressors.
• Expand pathogen-specific disease surveillance. Early detection of outbreaks can help public health officials identify which pathogens are circulating and target interventions where they are needed most. Because bacteria, viruses and parasites respond differently to climate conditions, surveillance and response strategies should be tailored to specific pathogens rather than relying on a one-size-fits-all approach.
• Strengthen vaccination programs. Vaccines are already available for several major waterborne diseases, including cholera, rotavirus, polio, hepatitis A and typhoid. Increasing vaccine coverage can reduce disease burden but climate-related disasters can disrupt distribution by damaging infrastructure, limiting access to affected communities and interrupting vaccine cold chains.

These strategies are described in the paper as “no-regrets” investments because they not only reduce waterborne disease today but also help communities become more resilient to the health impacts of climate change.

“Climate change is changing the rules of how these diseases spread,” Carlton said. “The good news is we already have many of the tools needed to reduce risk. The challenge now is making sure they're designed and deployed for the climate conditions we're facing today and the ones we'll face in the future.”

The authors conclude that no single strategy will protect against every waterborne disease. Instead, they say climate adaptation efforts should account for how individual pathogens respond to changing environmental conditions, allowing public health officials to better anticipate and prevent future outbreaks.

About the University of Colorado Anschutz
The University of Colorado Anschutz is a world-class academic medical campus leading transformative advances in science, medicine, education and patient care. The campus includes the University of Colorado’s health professional schools, more than 60 centers and institutes, and two nationally ranked independent hospitals - UCHealth University of Colorado Hospital and Children's Hospital Colorado - which see nearly three million adult and pediatric patient visits each year. Innovative, interconnected and highly collaborative, CU Anschutz delivers life-changing treatments, exceptional patient care and top-tier professional training. The campus conducts world-renowned research supported by $890 million in funding, including $762 million in sponsored awards and $128 million in philanthropic gifts for research.

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Journal

Nature Reviews Microbiology

Article Title

Waterborne diseases and climate change

 

Climate change has a disproportionate impact on food security in Small Island Developing States

CMCC Foundation - Euro-Mediterranean Center on Climate Change

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Key findings:

• Climate change impacts are disproportionately severe in SIDS compared to global averages, despite their minimal contribution to greenhouse gas emissions
• SIDS tend to be highly dependent on food imports, making them vulnerable to climate and international shocks, affecting food production and supply chains
• In 2024, SIDS lost the equivalent of 1.27% of GDP due to reduced labour capacity, higher than the global figure of 0.99%, and experienced an increase in heat-related mortality costs by 432% since the early 2000s, the steepest increase of any group
• In 2023, an additional 2.7 million people (4.9% of the total population in 26 countries considered) were estimated to have experienced moderate or severe food insecurity due to a higher frequency of heatwaves and droughts
• People with low levels of income have a significantly higher risk of suffering from food insecurity relative to those with medium-incomes
• Countries that are relatively more dependent on food imports are at a higher risk of food insecurity
• Climate shocks, which damage infrastructure and disrupt import trade, have a higher impact on more food-import-dependent countries

Small Island Developing States (SIDS) are among the most exposed to climate impacts – whether these be sea level rise, droughts, floods, or extreme events – yet contribute less than 1% to global emissions. A contrast that has seen them become both frontline victims and powerful advocates for stronger climate action.

The new 2025 Small Island Developing States report of the Lancet Countdown on health and climate change sheds light on the status of SIDS and the progress towards achieving the goals of the Paris Agreement by looking at the numbers behind specific indicators that track the relationship between health and climate change in SIDS.

One of these indicators, led by CMCC researcher Shouro Dasgupta and Professor Elizabeth Robinson of the Grantham Research Institute, LSE, tracks the impact of higher frequency of heatwaves and droughts on access to food and quantifies the number of people in SIDS who have become food insecure due to climate change. 

“We combined FAO data with heatwave-day and drought-month anomalies compared to the 1981–2010 baseline,” says Shouro. “The use of this empirical methodology allowed us to examine whether the relationship between climate change and food insecurity has evolved over time.”

The headline finding is that in 2023 an additional 2.7 million people (4.9% of their combined population) across 26 SIDS,  which include some of the world’s smallest and most vulnerable countries from the Atlantic, Indian Ocean, and South China Sea, the Caribbean, and the Pacific for a combined total population of around 70 million people, experienced moderate or severe food insecurity due to the higher frequency of heatwaves and droughts. 

According to the report, a higher number of heatwave days was associated with 5.74% higher moderate or severe food insecurity in 2023; while increasing frequency of droughts was associated with 3.53% higher food insecurity.

The report strengthens the evidence-base for some of the most vulnerable countries and should be situated alongside the idea that the 1.5°C target is legally binding, that fossil-fuel production may constitute an internationally wrongful act, and that a duty to make reparations can arise where causation is established.

 

Climate Insight for Global Impact

The CMCC Foundation – Euro-Mediterranean Centre on Climate Change (CMCC) is an international, independent research centre that provides state-of-the-art climate science for adaptation and mitigation strategies. By combining climate modelling with economic and impact analysis, CMCC delivers the knowledge, data and analyses that policymakers, businesses and communities need to make science-based decisions on climate change – from the global to the local scale.

 

Political representatives more polarized on climate change than their constituents

Whether people consider climate change to be mainly the result of human action depends a lot on their political orientation

University of Konstanz

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It is no surprise that there are political disagreements on climate protective measures. Parties differ in their assessment of which measures they consider to be effective, fair or economically acceptable. However, the question of whether climate change is mainly human-caused is not a matter of political preference, but a well-documented scientific fact. An international study involving researchers from the Cluster of Excellence "The Politics of Inequality" at the University of Konstanz now shows: Agreement with this fact does not just depend strongly on one's political orientation. In addition to this, the ideological divide among elected representatives is significantly wider than in the general population. On the political fringes, in particular, politicians' views diverge from those of their constituents.

After analyzing statements by 714 elected representatives and more than 18,000 residents of eight different countries, researchers concluded: "Politicians have significantly more polarized views on climate change. In concrete terms, this means that the difference between the positions of left- and right-wing representatives is almost three times greater than the difference between the views of left- and right-wing voters", explains Johannes Kotz, first author of the study and an academic staff member in the Department of Psychology at the University of Konstanz.

"Our results not only show that left- and right-wing representatives have different climate policy positions," adds Wolfgang Gaissmaier, professor of social psychology and a member of the Cluster of Excellence "The Politics of Inequality" at the University of Konstanz. "The differences begin with their assessments of the scientific basis. If even foundational facts are interpreted differently along political lines, this makes it more difficult to have a shared basis for political decisions."

For this reason, the findings also raise the question of political representation. Elected representatives should know the interests and preferences of their constituents – and translate these into political decisions. However, if the positions on the political fringes are more extreme than those of their constituents, this causes a gap in representation. "Views on climate change are not just abstract opinions that do not have political consequences. They are directly linked to whether or not one supports concrete measures", Johannes Kotz says. This is why it is particularly relevant that right-wing representatives are more sceptical of human-caused climate change than right-wing voters are. This additional gap can make it more difficult to implement climate policy.

 

Key facts

 

• Original publication: Kotz, J., Giese, H., Breunig, C. et al. Ideological polarization on anthropogenic climate change is stronger among politicians than among citizens across eight countries. Commun. Sustain. 1, 111 (2026).
  DOI: https://doi.org/10.1038/s44458-026-00113-y
• Researchers from the University of Konstanz:
  • Johannes Kotz is an academic staff member in the Department of Psychology and the first author of the study.
  • Wolfgang Gaissmaier is a professor of social psychology and a member of the Cluster of Excellence: "The Politics of Inequality".
  • Christian Breunig is a professor of political science and a member of the Cluster of Excellence "The Politics of Inequality".
  • Maj-Britt Sterba is a postdoctoral researcher at the Cluster of Excellence "The Politics of Inequality".
• Other researchers and partner institutions:
  • Helge Giese, Charité - Universitätsmedizin Berlin, Berlin, Germany
  • Nathalie Brack, Université libre de Bruxelles (ULB), Brussels, Belgium
  • Patrick Dumont & Marija Taflaga, Australian National University, Canberra, Australia
  • Patrick Dumont & Javier Olivera, Luxembourg Institute of Socio-Economic Research (LISER), Belval Esch-sur-Alzette, Luxembourg
  • Javier Olivera, Pontificia Universidad Catolica del Peru (PUCP), Lima, Peru
  • Lior Sheffer, Tel Aviv University, Tel Aviv, Israel
  • Annika Werner, University of Southampton, Southampton, UK
  • Anam Kuraishi, University of Sussex, Brighton, UK
• Methodology: The study analyzed statements from 714 elected representatives and 18,281 residents of eight countries (Australia, Belgium, Germany, Israel, Luxembourg, the Netherlands, Norway and the Czech Republic). The members of the public surveyed were representative for their respective countries in terms of age, gender and level of education. The surveys took place in the context of the international research project "How Politicians Evaluate Public Opinion".
• The Cluster of Excellence "The Politics of Inequality" at the University of Konstanz investigates the political causes and consequences of inequality from an interdisciplinary perspective. The research is dedicated to some of the most pressing issues of our time: access to and distribution of (economic) resources, the global rise of populists, climate change and unfairly distributed educational opportunities.

 

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Journal

Communications Sustainability

DOI

10.1038/s44458-026-00113-y 

 

COVID-19 booster strategies provide lasting immunity

Murdoch Childrens Research Institute

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Smaller doses of COVID-19 booster vaccines can provide long-lasting immunity, helping to reduce costs and improve access to vaccination, according to new research. And the findings could also inform vaccine dosing and options during future pandemics.

An international research program led by Murdoch Children’s Research Institute (MCRI) and involving more than 2,000 participants across Australia, Indonesia and Mongolia has provided new evidence that will help shape future COVID-19 booster strategies. 

The $17.6 million program, funded by the Coalition for Epidemic Preparedness Innovations (CEPI), evaluated different COVID-19 booster approaches through three randomised clinical trials, tracking participants for up to two years. 

The trials found fractional doses, where people receive half the standard vaccine amount given as boosters, produced strong immune responses that remained comparable to full-dose boosters.

MCRI Dr Nadia Mazarakis said fractional dosing could help extend vaccine supplies, widen coverage and improve equity in future vaccination programs, particularly in low-income countries. 

“This research provides valuable evidence showing that smaller vaccine doses can still provide strong, long-lasting immunity, which is encouraging for countries looking for practical and affordable ways to deliver booster programs,” she said. 

“Fractional dosing attracted global interest during the COVID-19 pandemic when vaccine supplies were limited. While circumstances have changed, the findings remain relevant because they show there may be opportunities to use vaccines more efficiently without compromising immune responses.

“Importantly, these vaccine strategies will reduce costs, extend supplies and support broader and more equitable access to booster programs, especially in resource constrained countries across Southeast Asia and Africa.” 

CEPI Clinical Development Science Lead Amol Chaudari said, “These pivotal insights - produced across different countries, with different vaccines and people who had received different first COVID vaccine doses - essentially show that public health officials can get ‘more bang for their buck’ with COVID vaccine boosters. If COVID cases were to ramp up again and there be strain on the vaccine supply, these findings could be key to expanding vaccination coverage quickly and preventing future infections and deaths. The findings could also prove helpful for future vaccines against other coronaviruses manufactured using similar technologies.”

Results from the Indonesian study, published in Nature Communications, followed more than 1,200 adults for up to two years after receiving either fractional or standard doses of Pfizer or AstraZeneca vaccines, or a standard CoronaVac vaccine.

The researchers found that while fractional doses produced slightly lower immune responses shortly after vaccination, those differences narrowed over time and remained comparable to full doses at 24 months.  

A companion study of 601 Mongolian adults, published in Frontiers in Immunology, discovered a fractional Pfizer booster produced long-lasting antibody responses similar to a full dose for two years. A further analysis of the same cohort reported that key cellular immune responses, which help protect against serious infections, also remained strong.

In Australia, researchers compared mRNA and protein-based booster vaccines as a fourth full dose. Published in the Journal of Infection, the study involving 496 healthy adults found mRNA vaccines generated higher antibody responses. Both vaccine types reduced infections and produced comparable immune responses over 12 months. The study recently received a further $2 million from the National Health and Medical Research Council (NHMRC) to follow the cohort for 30 months to examine the effects of repeated mRNA COVID-19 vaccination.

Additional research from the team published in Vaccine, found vaccination in the morning, rather than afternoon, improved responses to the mRNA vaccine, but not the protein-based vaccine. The findings suggest simple changes to vaccination timing may offer meaningful benefits.

MCRI Associate Professor Paul Licciardi said while the acute phase of the pandemic had passed, COVID-19 remained a significant cause of respiratory illness and death globally. 

“Understanding how long vaccine-induced immunity lasts remains important for future vaccination planning,” he said. “As countries move towards long-term management of COVID-19, we need evidence about which booster strategies provide durable immunity while making the best use of healthcare resources.

“This knowledge can also help future public health strategies to combat emerging pathogens like hantavirus, Ebola and mpox.”

Australia spends about 10 per cent of its gross domestic product (GDP) on healthcare, compared with 4.4 per cent in Mongolia and 2.7 per cent in Indonesia, highlighting the importance of identifying vaccination strategies that maximise the impact of available resources. 

MCRI Associate Professor Claire von Mollendorf said, “These trial results demonstrate that shaping effective public health policy requires monitoring long-term immune responses across diverse settings with variable infection rates and different primary vaccine schedules.”

Publication: John D. Hart, Eddy Fadlyana, Nadia Mazarakis, Nina Dwi Putri, Emma Watts, Kerryn A. Moore, Eleanor F. G. Neal, Djatnika Setiabudi, Muhammad Gilang Dwi Putra, Cattram Nguyen, Aqila Sakina Zhafira, Pratama Wicaksana, Robert Sinto, Dwi Oktavia, Rini Fajarani, Agnes Rengga Indrati, Chrysanti Murad, Yovita Hartantri, Hendarsyah Suryadinata, Yulia Sofiatin, Kusnandi Rusmil, Hindra I. Satari, Sri Rezeki. Hadinegoro, Cissy B. Kartasasmita, Julitasari Sundoro, Paul V. Licciardi, Claire von Mollendorf and Edward K. Mulholland. ‘Immunogenicity of fractional and standard dose COVID-19 vaccine boosters among healthy adults in Indonesia: twenty four month follow-up from a randomised controlled trial,’ Nature Communications. DOI: 10.1038/s41467-025-63598-6

Publication: Tsetsegsaikhan Batmunkh, Eleanor FG Neal, Otgonjargal Amraa, Nadia Mazarakis, Bolor Altangerel, Naranbaatar Avaa, Lkhagvagaram Batbayar, Khishigjargal Batsukh, Kathryn Bright, Tsogjargal Burentogtokh, Lien Anh Ha Do, Gantuya Dorj, John D Hart, Otgonbold Jamiyandorj, Khulan Javkhlantugs, Sarantsetseg Jigjidsuren, Frances Justice, Shuo Li, Khaliunaa Mashbaatar, Kerryn A Moore, Narantuya Namjil, Cattram D Nguyen, Batbayar Ochirbat, Unursaikhan Surenjav, Helen Thomson, Bilegtsaikhan Tsolmon, Paul V Licciardi, Claire von Mollendorf and Kim Mulholland. ‘Fractional BNT162b2 boosters induce durable immune responses after non-mRNA priming in Mongolia: a randomised controlled trial,’ Frontiers in Immunology. DOI: 10.3389/fimmu.2026.1789248

Publication: Nadia Mazarakis, Zheng Quan Toh, Eleanor Neal, Cattram Nguyen, Kathryn Bright, Skky Luu, Leanne Quah, Yan Yung Ng, John Hart, Lien Anh Ha Do, Anna Rudel, Shashini Dassanayake, Rachel A. Higgins, Rachael Carissa, Darren Suryawijaya Ong, Frances Justice, Kerryn A. Moore, Emma Watts, Kanta Subbarao, Kim Mulholland, Claire von Mollendorf and Paul V. Licciardi. ‘Immunogenicity and efficacy over 12 months following a fourth dose of a bivalent mRNA or protein-based COVID-19 vaccine: A randomised controlled trial in Australia,’ Journal of Infection. DOI: 10.1016/j.jinf.2026.106727 

Available for interview:

Associate Professor Paul Licciardi, MCRI Group Leader, Vaccine Immunology

Associate Professor Claire von Mollendorf, MCRI Team Leader, New Vaccines

Dr Nadia Mazarakis, MCRI Postdoctoral Researcher, Vaccine Immunology

 

 

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Journal

Journal of Infection

DOI

10.1016/j.jinf.2026.106727 

Method of Research

Randomized controlled/clinical trial

Subject of Research

People

Article Title

Immunogenicity and efficacy over 12 months following a fourth dose of a bivalent mRNA or protein-based COVID-19 vaccine: A randomised controlled trial in Australia.

 

Public investment in liver transplants saves lives and is also beneficial in economic and social terms

Pompeu Fabra University (UPF), the National Transplant Organization (ONT) and Vall d’Hebron University Hospital have led the first study to assess the economic feasibility of the Spanish transplant system, in addition to its impact on patients’ health

Universitat Pompeu Fabra - Barcelona

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Public investment in liver transplants not only saves lives and substantially improves patients’ survival and quality of life, but also generates a positive long-term social and economic return. So demonstrates a pioneering study led by researchers from Pompeu Fabra University (UPF), the National Transplant Organization (ONT), and Vall d’Hebron University Hospital. More than four decades after the first liver transplant in Spain in 1984, this is the first study to perform a global assessment of the impact of these interventions, not only from the perspective of patients’ health, but also from the economic and social perspectives.

The study reveals that liver transplant patients currently contribute at least 100 million euros per year to the Spanish economy. This figure exceeds the annual investment in liver transplants, which stands at around 75 million euros. If the costs of post-surgical treatment -lifelong immunosuppressive therapy to prevent the rejection of the transplanted organ- are also taken into account, this investment would total 90 million euros per year. The research is based on official and historical data from the Spanish Registry of Liver Transplantation (RETH), the ONT, and the Spanish Society of Liver Transplantation (SETH), which include transplants conducted between 1984 and 2024.

The system has been profitable since the start of the 21st century

When liver transplants began in the mid-1980s, only a few dozen were carried out each year, while currently the figure stands at about 1,200. Precisely when this figure began to stabilize, in the early 2010s, the costs of the operation and patient treatment and the economic return to society cancelled each other out, and today the balance is clearly positive. This is possible thanks to the economic contributions of patients of working age (active population), although it must not be forgotten that transplanted children will end up doing the same in the longer term and that older people, given the foreseen increase in life expectancy and quality, will be able to make increasing contributions to society beyond the labour market.

Longer life expectancy for patients, especially children

The research also reveals an increase in transplant patients’ life expectancy and quality. While in the 1980s, patients gained an average of 10 years of life, today this figure ranges between 16 and 20 among adults and between 21 and 29 in the case of children, due to significant advances in paediatric surgery. Currently, the Spanish liver transplant system is an international benchmark and the state organ donation rate is one of the highest in the world (52.6 per million inhabitants).

The results of the study have been published in an article in Health Economics Review. At UPF, the principal investigator is Gemma Piella, co-director of the SIMBYOsys group of the BCN MedTech Unit of the Department of Engineering, who led the study together with Gloria de la Rosa (National Transplant Organization), and Concepción Gómez Gavara (linked to Vall d’Hebron University Hospital while the study was being conducted and now, to Hospital Clínic de Barcelona). Other co-authors are Edson Plasencia (article lead author, with the UPF SIMBYOsys group), Gloria Merino Pinto (Centre for Research in Economics and Health -CRES- of the UPF Department of Economics and Business), Roger Sabater Mezquita (CRES-UPF and the Department of Econometrics, Statistics and Applied Economics at the University of Barcelona), Itxarone Bilbao (Vall d’Hebron University Hospital and Department of Surgery at the UAB), and Gerardo Blanco-Fernández (SETH and University Hospital of Badajoz).

Roger Sabater (UPF and UB) and Edson Plasencia (UPF) highlight: “Thanks to gradual technological advances, more and more contemporary surviving recipients of working age have accumulated, whose income exceeds the costs of new transplants and immunosuppressive treatments in each of the last fifteen years, and with an increasingly larger margin. This trend will continue into the future if innovative technology is able to further improve survival and reduce the likelihood of re-transplantation”.

Gloria de la Rosa, an assistant physician at the ONT, adds that this study shows the value of keeping robust national records sustained over time: “The Spanish Registry of Liver Transplantation, together with the data from the ONT concerning donations, waiting lists and transplant activity, allow analysing four decades of the evolution of liver transplantation in Spain from the clinical, organizational and social standpoints. This data is essential to evaluate results, guide planning, and continue improving a model based on the quality, equity and solidarity of donors and their families”.

Regarding future challenges, Gemma Piella (UPF) explains that the number of donors is still below the number of patients awaiting transplants. This has led her to develop a new smart system, LiverColor, which will reduce the margin of error of current methods used to identify which donated livers are suitable for transplantation and prevent valid organs from going to waste. Piella highlights “the potential of biomedical technology to further improve the efficiency of the system”.

Dr. Concepción Gómez Gavara adds: “Innovation in the field of transplantation has traditionally been a particularly complex challenge, as any new technology must demonstrate with the utmost rigor that it can improve current outcomes without compromising patient safety or graft survival. With this vision, we launched a line of work that combines clinical and surgical expertise with technological knowledge and engineering, leading to the development of LiverColor, a more precise, objective, and personalized transplantation model.” Currently, at Hospital Clínic Barcelona, Gómez Gavara continues to drive the development and evolution of the technology, exploring new applications and innovation opportunities to further improve the transplantation process.

Reference article:

Plasencia Sánchez, E., Gómez Gavara, C., Merino Pinto, G. et al. The Spanish transplantation model as a benchmark: clinical, societal, and economic impact of liver transplants in Spain (1984–2024). Health Econ Rev (2026). https://doi.org/10.1186/s13561-026-00801-4

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Journal

Health Economics Review

DOI

10.1186/s13561-026-00801-4 

Method of Research

Data/statistical analysis

Subject of Research

People

Article Title

The Spanish transplantation model as a benchmark: clinical, societal, and economic impact of liver transplants in Spain (1984–2024)

 

Study: Golf generates nearly €630 million in societal benefits in Finland

PUBLIC VS TRUMP GOLF COURSES

University of Eastern Finland

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A new study published in Frontiers in Sports and Active Living shows that Finnish golf players spend approximately €330 million on golf annually, and that this generates an estimated benefit to society almost twice as high.

The study analysed the societal significance of golf in Finland in 2021. It examined two dimensions: the flow of money spent by golf players into different sectors of the economy, and the broader societal impacts of the physical activity and well-being promoted by golf, including their effects on healthcare costs.

SROI, or Social Return on Investment, is a method used to assess the social return of investments, that is, their societal impacts, value and benefits in relation to their costs. The SROI ratio estimates the return on an investment relative to the amount invested. In this study, the SROI of golf illustrates the sport’s impacts on public health and the national economy. The SROI ratio was 1.9, rising to as much as 2.4 when economic multiplier effects were taken into account.

The main data for the study were collected through an online survey in May 2021, completed by 1,052 members of the Finnish Golf Union. The study also drew on existing research literature, financial statements from ten golf courses and other national economic statistics.

The first author of the study was Julia Kettinen, a visiting researcher at the University of Eastern Finland and a postdoctoral researcher at ETH Zürich. The research team included researchers from Finland, Switzerland and the United Kingdom.

 

Golf players’ spending flows widely into the national economy

Golf players spent a total of approximately €330 million per year on their sport. The largest single category of expenditure comprised shareholder, club membership and green fees, together with other costs related to playing, amounting to approximately €150 million. The second-largest expenditure category was the purchase of golf equipment in Finland, at approximately €59 million, followed by domestic golf tourism, at €50 million. This spending supported the national economy through wages (€57 million), local suppliers and subcontractors (€50 million), and domestic tourism services (€50 million), among other channels.

 

Golf promotes physical activity and generates €80 million in savings for society

Golf players were considerably more physically active than Finns on average: of the survey respondents, 89% engaged in physical activity for at least four hours per week throughout the year and 59% engaged in vigorous physical activity for more than two hours per week. Owing to these higher levels of physical activity, golf participation was estimated to generate annual societal savings and additional revenues of approximately €80.9 million. The largest individual benefit categories were increased tax revenues (€46.0 million), reduced costs of institutional care for older people (€11.0 million) and lower disability pension costs (€8.1 million).

 

SROI ratio of 1.9 – golf creates positive externalities

The SROI analysis consisted of three components: the enjoyment and well-being experienced by players (€330 million), economic flows in Finland (€220 million), and societal savings and added revenues (€80 million). Total benefits were estimated at approximately €630 million, resulting in an SROI ratio of 1.9. When the economic multiplier effects of sports and recreation services are taken into account, the economic impact rises to approximately €370 million, total benefits to approximately €770 million and the SROI ratio to 2.4. The result is in line with other SROI studies in the sport and physical activity sector, in which SROI ratios have ranged from 1.92 to 3.28.

The findings suggest that golf players do not personally receive all the societal value generated by their participation in the sport: they spend €330 million to gain personal benefits, while at the same time generating approximately €300 million in additional benefits for wider society.

“The results show that golf is more than just a leisure activity – it can be a significant societal investment. The sport brings economic activity to Finland and keeps golf players more physically active than Finns on average. It is a particularly valuable form of physical activity for middle-aged and older adults, among whom physical activity has the greatest potential to reduce healthcare costs,” says Julia Kettinen.

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Journal

Frontiers in Sports and Active Living

DOI

10.3389/fspor.2026.1832817 

Article Title

The social significance of golf in Finland in the year 2021 based on SROI analysis