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March 19, 2020
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Winning the lottery may not improve health

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Winning the lottery may not lead to more healthy habits or better overall health, according to a study published in JAMA Network Open.

“There is broad agreement that systematic differences in lifestyle and behavioral factors contribute to the income-health gradient,” Robert Östling, PhD, of the department of economics at the Stockholm School of Economics in Sweden, and colleagues wrote. “Research has consistently found that individuals with higher incomes are less likely to engage in health-impairing behaviors, such as smoking, and more likely to engage in health-promoting behaviors, such as maintaining a healthy diet or exercising regularly.”

To determine if an increase in unearned wealth from winning the lottery influenced peoples’ health — including habits like smoking, drinking, physical activity and diet — Östling and colleagues conducted a quasiexperimental study of participants from three different lotteries in Sweden.

A total of 3,344 participants who were aged 18 to 70 years when they played the lottery were surveyed between 5 and 22 years after the lottery event. The lottery outcomes ranged in value from $0 among nonwinners to $1.6 million. The analysis included 3,362 total observations because some individuals participated in more than one lottery or won the same lottery more than once.

Reference: Östling R, et al. JAMA Netw Open. 2020;doi:10.1001/jamanetworkopen.2019.19713.

Before winning the lottery, the health of participants was modestly worse than the health of the general population based on reports of general health (69% vs. 68%), smoking daily (11% vs. 10%), being physically active for at least 5 hours per week (26% vs. 34%) and never drinking alcohol (11% vs. 14%).

There were no statistically significant associations between the amount of money won and the evaluated health factors, according to Östling and colleagues. They determined that the associations with SD units per $100,000 included the following: smoking (0.006, 95% CI, 0.038 to 0.026), alcohol consumption (0.003, 95% CI, 0.027 to 0.033), physical activity (0.001, 95% CI, 0.029 to 0.032), diet quality (0.007, 95% CI, 0.040 to 0.026), subjective health (0.013, 95% CI, 0.017 to 0.043) and total health (0.003, 95% CI, 0.033 to 0.027).

The researchers recognized there is a common belief that winners squander their prizes. If this were the case, then their findings of no significant change to health would reflect that their winnings did not leave a lasting impact on lifestyle. However, the researchers further explained that there is little actual evidence supporting this, and some studies show that winners do not spend all their winnings in a short period of time.

“Hence, the evidence suggests that the large-prize winners in our sample had better financial circumstances for many years after the lottery, but this greater financial security was not accompanied by any detectable changes in long-term health behaviors or evaluations of overall health,” Östling and colleagues wrote. – by Erin Michael

Disclosures: All authors reported receiving grants from Swedish Research Council, the Hedelius Wallander Foundation and the Riksbankens Jubileumsfond during the conduct of the study.