CCBYNC Open access

The health and socioeconomic impacts of major multi-sport events: systematic review (1978-2008)

BMJ 2010; 340 doi: (Published 20 May 2010) Cite this as: BMJ 2010;340:c2369
  1. Gerry McCartney, specialist registrar in public health1,
  2. Sian Thomas, systematic reviewer2,
  3. Hilary Thomson, senior investigator scientist1,
  4. John Scott, public health librarian3,
  5. Val Hamilton, freelance information scientist4,
  6. Phil Hanlon, professor of public health5,
  7. David S Morrison, clinical senior lecturer in cancer epidemiology and director6,
  8. Lyndal Bond, professor and associate director1
  1. 1Medical Research Council Social and Public Health Sciences Unit, Glasgow
  2. 2Sandside, Isle of Graemsay, Stromness, Orkney
  3. 3Public Health Resource Unit, NHS Greater Glasgow and Clyde, Glasgow
  4. 4VRH Information Services, Aundorach House, Nethy Bridge, Highlands
  5. 5Section of Public Health and Health Policy, University of Glasgow, Glasgow
  6. 6West of Scotland Cancer Surveillance Unit, University of Glasgow, Glasgow
  1. Correspondence to: G McCartney gmccartney{at}
  • Accepted 2 March 2010


Objective To assess the effects of major multi-sport events on health and socioeconomic determinants of health in the population of the city hosting the event.

Design Systematic review.

Data sources We searched the following sources without language restrictions for papers published between 1978 and 2008: Applied Social Science Index and Abstracts (ASSIA), British Humanities Index (BHI), Cochrane database of systematic reviews, Econlit database, Embase, Education Resources Information Center (ERIC) database, Health Management Information Consortium (HMIC) database, International Bibliography of the Social Sciences (IBSS), Medline, PreMedline, PsycINFO, Sociological Abstracts, Sportdiscus, Web of Knowledge, Worldwide Political Science Abstracts, and the grey literature.

Review methods Studies of any design that assessed the health and socioeconomic impacts of major multi-sport events on the host population were included. We excluded studies that used exclusively estimated data rather than actual data, that investigated host population support for an event or media portrayals of host cities, or that described new physical infrastructure. Studies were selected and critically appraised by two independent reviewers.

Results Fifty four studies were included. Study quality was poor, with 69% of studies using a repeat cross-sectional design and 85% of quantitative studies assessed as being below 2+ on the Health Development Agency appraisal scale, often because of a lack of comparison group. Five studies, each with a high risk of bias, reported health related outcomes, which were suicide, paediatric health service demand, presentations for asthma in children (two studies), and problems related to illicit drug use. Overall, the data did not indicate clear negative or positive health impacts of major multi-sport events on host populations. The most frequently reported outcomes were economic outcomes (18 studies). The outcomes used were similar enough to allow us to perform a narrative synthesis, but the overall impact of major multi-sport events on economic growth and employment was unclear. Two thirds of the economic studies reported increased economic growth or employment immediately after the event, but all these studies used some estimated data in their models, failed to account for opportunity costs, or examined only short term effects. Outcomes for transport were also similar enough to allow synthesis of six of the eight studies, which showed that event related interventions—including restricted car use and public transport promotion—were associated with significant short term reductions in traffic volume, congestion, or pollution in four out of five cities.

Conclusions The available evidence is not sufficient to confirm or refute expectations about the health or socioeconomic benefits for the host population of previous major multi-sport events. Future events such as the 2012 Olympic Games and Paralympic Games, or the 2014 Commonwealth Games, cannot be expected to automatically provide benefits. Until decision makers include robust, long term evaluations as part of their design and implementation of events, it is unclear how the costs of major multi-sport events can be justified in terms of benefits to the host population.


  • Contributors: Sally Macintyre had the original idea for the review. GMcC, ST, and HT designed and planned the review. GMcC was the lead reviewer and ST was a co-reviewer. Both reviewers undertook study selection and appraisal, and data extraction and tabulation. HT provided advice on each aspect of the review methods. GMcC, ST, HT, JS, PH, DSM, and LB formed a review advisory group. JS and GMcC were responsible for searching the grey literature, and VH was responsible for database searching. Mary Robins, the staff at Glasgow University Library, and the staff of the Public Health Resource Unit library at NHS Greater Glasgow and Clyde assisted in the retrieval of articles. Adam Brown and Susie Palmer provided additional grey literature. Nigel Rice and Ken Gibb gave advice on the appraisal of economic studies. Erik Lenguerrand and Elena Sautkina assisted with translation of foreign language articles. GMcC, ST, and HT synthesised the data, and GMcC wrote the manuscript. All the authors critically revised the manuscript and approved the final version. The views expressed here are those of the authors and do not necessarily reflect the views of the Medical Research Council, the Chief Scientist Office at the Scottish Government Health Directorate, the University of Glasgow, or the NHS. GMcC is the guarantor.

  • Funding: GMcC, ST, HT, VH, and LB were funded by the Chief Scientist Office at the Scottish Government Health Directorate as part of the Evaluating Social Interventions programme at the Medical Research Council Social and Public Health Science Unit (wbs U.1300.00.002.00024.01). JS works as part of the Public Health Resource Unit at NHS Greater Glasgow and Clyde. PH and DSM are funded by the University of Glasgow. DSM is also partially funded by NHS Greater Glasgow and Clyde. This study was not commissioned and no project specific funding was received. The funders had no role in the study design; data collection, analysis, and interpretation; writing the manuscript; or the decision to submit the research for publication.

  • Competing interests: GMcC is a member of the Scottish Socialist Party and was previously involved in a project to have a velodrome built in the west of Scotland. All authors have completed the Unified Competing Interest form at (available on request from the corresponding author) and declare: (1) No financial support for the submitted work from anyone other than their employer; (2) No financial relationships with commercial entities that might have an interest in the submitted work; (3) No spouses, partners, or children with relationships with commercial entities that might have an interest in the submitted work; (4) No non-financial interests that may be relevant to the submitted work.

  • Ethics approval: No ethics approval was required for this study.

  • Data sharing:No additional data available.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: and

View Full Text

Sign in

Log in through your institution