Article Text

Download PDFPDF
High hopes: lower risk of death due to mental disorders and self-harm in a century-long US Olympian cohort compared with the general population


Objective To determine the risk of death due to prominent mental disorders, substance abuse, and self-harm among US Olympians compared with the general population.

Methods All female (n=2301) and male (n=5823) US Olympians who participated in the summer or winter Games between 1912 and 2012 were followed until 2016. The National Death Index certified their vital statuses and causes of death. We performed a Standard Mortality Ratio (SMR) analysis for all causes studied and applied the years-saved (YS) method to quantify differences in the risk of death for (1) anxiety, depression and self-harm and (2) substance abuse and eating disorders. Additionally, we examined the YS across sports with greater than 100 total deaths and between medalists and non-medalists.

Results US Olympians had a 32% (SMR=0.68, 95% CI 0.49 to 0.91) lower risk of death compared with the general population, resulting in a longevity advantage of 0.21 YS (95% CI 0.14 to 0.29) for deaths by depression, anxiety and self-harm and 0.12 years (95% CI 0.08 to 0.15) for substance abuse and eating disorders. There were no significant differences between medalists and non-medalists, but findings varied by sports. Most sports (eg, athletics, swimming, rowing) had significantly lower risks of deaths than the general population with the exceptions of fencing and shooting. Shooting showed a trend towards a higher risk through suicide by firearm.

Conclusion Olympians have a lower risk of death, favouring an increased longevity compared with the general population for mental disorders, substance abuse and suicides.

  • olympics
  • suicide
  • psychiatry
  • elite performance
  • depression

Data availability statement

Data may be obtained from a third party and are not publicly available. Data regarding death certification are strictly subjected to the confidential data control plan according to the specification set by the National Death Index.

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.