Catarina F. Martins1*
Jorge P. Soares1
António Cortinhas1Luís Silva1Luís Cardoso2,3
Maria A. Pires2,3Maria P. Mota1- 1Research Centre in Sports Sciences, Health and Human Development (CIDESD), Department of Sport, Exercise and Health Sciences, School of Life and Environmental Sciences (ECVA), University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
- 2Animal and Veterinary Research Centre (CECAV), Department of Veterinary Sciences, School of Agrarian and Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
- 3Associate Laboratory for Animal and Veterinary Sciences, University of Trás-os-Montes and Alto Douro (UTAD), Vila Real, Portugal
Abstract: The benefits of the human-animal bond on owners’ health and quality of life have been the focus of research in recent decades. However, the results are still inconsistent. Thus, this study aims to investigate whether the presence of a pet, compared to a control group, influences daily physical activity levels and mental health using a meta-analytic method.
Methods: The PubMed, Web of Science, and Scopus databases were searched for all research articles that included pets as an object of study and related mental health and quality of life variables between pet owners and non-owners until April 2022. The PRISMA 2020 checklist was used, and the Downs and Back checklist was used to assess the methodological quality of the studies. Standardized mean differences and 95% confidence intervals were used to assess the difference between a group of pet owners and non-pet owners.
Results: An initial search located 11,389 studies, but only 49 studies fulfilled all requirements. Our results indicate that pets have a moderately significant positive effect on the physical activity of owners compared to non-pet owners. Among the moderating variables, the frequency of physical activity showed a highly significant effect, indicating that owners had a higher frequency of physical activity than non-owners. Moreover, our results indicate a significant impact but with a low effect size of pets on owners’ mental health when compared to non-pet owners.
Conclusion: Pet ownership does not seem to influence owners’ mental health, but it does influence their physical activity. Specifically, owners show a higher frequency of physical activity than non-owners.
1. Introduction
Pets play an important role in human life and human health (1). Improvements in physical, mental, psychological, and social health have been described in several works (1–7).
Physical activity (PA) is a determinant of health and quality of life and has been indicated for the prevention and treatment of various diseases (8, 9). There is also evidence that the strength of the relationship between owner and pet is strongly associated with increased PA (10, 11). Once again, dogs are the most commonly reported animals related to the increase in PA (7, 12) possibly due to social support (13), increased motivation to exercise (14, 15), or even the sense of responsibility to take care of the pet (16). Responsibility is often highlighted as a potential strategy to increase PA levels in older adult individuals (10, 17, 18) and in general population (19). However, confounding variables such as housing conditions, pet attachment, and the number of household members can modify the frequency of walks with the pet and interfere with the magnitude of the results.
Nowadays, mental health is one of the main global concerns, with an estimated 970 million people in the world having a mental disorder (20). A mental disorder is a syndrome characterized by cognitive, emotional, or behavioral dysfunction that reflects an impairment in the psychological, biological, or developmental processes underlying mental and behavioral functioning (20). These disorders not only have an impact on an individual’s daily life but also entail substantial costs to society (21). According to the OECD, up to 13% of total health spending is directed toward mental health services (22). According to Statista Research, Portugal invested approximately 136.2 million Euros in mental health hospitals in 2019 (23). As a result, several studies have investigated the possible influence of pets on human mental health, including loneliness, depression, anxiety, stress, satisfaction with life, happiness, social support, and other factors.
Interactions with pets have positive influences on the owner, with overall positive effects on mental health, such as reducing depression and anxiety (6, 24). Moreover, owning a pet may increase social connections (25–27). The human-animal bond, strengthened by the acquisition of a pet, is associated with psychological and physical benefits in children, adults, and elders (6, 10, 25, 28, 29). These aspects have a significant overall effect on the mental health of the human population, as their continued failure or dysfunction can translate into poor mental health, possibly contributing to increased morbidity and mortality (30–32). Growing evidence indicates that pets may trigger feelings of comfort, security, and emotional support, which probably have positive effects on humans by counteracting feelings of anger, sadness, anxiety, and depression (24, 33, 34). Considering the importance of social health, evidence supports that relationships with pets confer similar support to humans (35, 36), particularly in cases of mental disorders (37). Dogs have been proposed as promoters for the initiation of shared interpersonal interactions that enhance social networks (e.g., daily walks) (38). Despite the growing literature, contradictory results have been described regarding different human dimensions, namely human health variables and quality of life (15, 39). A possible explanation may rely on the value that the family or the subject gives to the pet, which may interfere with the overall mental and physical benefits of the pet’s relationship (40). Some authors have suggested a negative influence of the pet’s non-psychological parameters (41, 42) such as lower psychological well-being (18, 30), depression (41), and anxiety (41) compared to Non-Pet Owners (NPOs). Moreover, pet owners (POs) showed a lower perception of health as well as a higher prevalence of disease than non-pet owners (NPOs) of different ages, which may contribute to a worse quality of life in specific situations such as the COVID-19 pandemic (43). Although some studies have pointed out this trend, Mueller et al. (4) highlighted that POs may have adopted the pet as a way to cope with depressive symptoms or other mental disorders they were already experiencing.
As mentioned, despite a large number of studies, some results are contradictory, possibly due to the different variables considered in each study and the different study designs. To our knowledge, no meta-analysis considering this evidence has been published. Therefore, this article aims to (a) estimate the levels of physical activity (PA) of pet owners (PO) and non-pet owners (NPO) and their relation with the quality of life and human health, and (b) quantify the effect of pets on mental health and, consequently, on the quality of life of human beings. The hypotheses tested in this meta-analysis are: H1: PO tends to show higher levels of daily PA than NPO. H2: Pets have a significant and positive influence on the mental health of PO. H3: PO shows better results regarding anxiety, loneliness, depression, stress, life satisfaction and happiness, social support, quality of life, health and well-being, general mental health and resilience, and mood and self-regulation (affections, emotions, relationships) than NPO.
2. Methods
2.1. Search strategy
Electronic database searches were conducted in PubMed, Web of Science, and Scopus for all articles published before April 2022, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (44, 45). The search terms were “Pets” OR “Pet” OR “Pet companion” OR “Pet owner” OR “Human-animal relationship” OR “Pet-interaction” OR “Dog walking” AND “Human health” OR “Quality of life” OR “Benefit” OR “Mental health” OR “Physical health” OR “Health” OR “Life satisfaction” OR “Well-being.” The search was adapted for each database as needed, and filters were used to exclude observational studies, reviews, posters, and other studies that were not eligible for meta-analysis.
2.2. Inclusion/exclusion criteria
No studies were excluded based on the type of pet selected since the focus of this study is to investigate the influence of pet ownership on human mental health, daily physical activity, and quality of life. The inclusion criteria for article selection include reporting the impact of animals on human mental health or quality of life, having a control group without any kind of pet, statistical treatment and feasible data for meta-analysis, and writing in English, Portuguese, or Spanish. Articles are excluded if they are reviewing articles, systematic reviews, meta-analyses, or conference reports, have no focus on live animals (for example, robot pets), use pets for animal-assisted therapy, or are studies conducted with working animals. Study selection parameters were not limited to the year of publication, intra-human variability, age of participants, or sample size since the goal of this meta-analysis was to conduct a comprehensive search. However, studies that were published only in abstract form or were not accessible via inter-library loan were excluded from this meta-analysis. Study eligibility was determined individually by the group members, with each study classified as include, exclude, or unclear. Articles that were classified as “include” or “unclear” by both reviewers were included for full-text review, and any discrepancies in the determination of study eligibility were resolved through mutual consensus.
2.3. Review strategy
After the articles were searched, duplicates were removed using Zotero. The article selection process involved screening the titles and abstracts for inclusion and exclusion criteria. In cases of doubt, the articles were read in their entirety to verify if the study design was suitable for the aim of this meta-analysis. Another reviewer then checked all the excluded and included articles for validity. Subsequently, the included articles were read in their entirety by two reviewers, and any inclusion/exclusion conflicts were resolved by a third and fourth reviewer. An acceptable concordance rate of 90% was predefined. The reviewers achieved a concordance rate of 93%, resolving 19 inclusion/exclusion conflicts.
The references of the included articles were manually searched to identify possible relevant articles that were not included in the initial search, to achieve a wider scope of relevant studies and reduce publication bias. This search was conducted from December 20th, 2021 to April 3rd, 2022.
2.4. Data extraction
Data from each study included in the meta-analysis were double-extracted by two authors into a table using Microsoft Excel software. Disagreement between the extractors, which consisted mainly of small additional details, was easily resolved between all authors.
Data extracted from each study included: title, author(s), journal, year of publication, study, characteristics (date of data collection, study design), participant characteristics (age, sample sizes), outcomes, intervention description, control condition description, adverse effects, adherence, dropouts, and results.
The identified studies were divided into two groups and assigned to two pairs of reviewers, who independently conducted data extractions and assessed the quality of the studies using the Downs and Black (DB) quality assessment tool (46). The DB tool consists of 27 criteria that assess study reporting (10 items), external validity (3 items), and internal validity, including design, bias, and power (14 items). The maximum score achievable is 27 points. For cross-sectional studies, the modified version of the DB tool was used, which includes 16 criteria that assess study reporting (9 items), external validity (2 items), and internal validity, including design, bias, and power (5 items). The maximum achievable score was 16 points. Any discrepancies in the DB scoring were resolved through consensus among the reviewers (Supplementary material A).
2.5. Data analysis
The Comprehensive Meta-Analysis V2.2.057 software was used for the meta-analysis. Design-specific meta-analyses were conducted for cohort and cross-sectional studies on mental health and PA. Preference was given to the use of mean and standard deviation, and if the not possible, mean difference with a 95% CI was used in all analyses. Separate analyses were performed for PA and mental health.
The statistical heterogeneity was assessed using the Cochran Q (47) test and I2 statistics (48). We used the random effects model and set the significance level at p ≤ 0.05. We evaluated the risk of publication bias by visually inspecting the funnel plot and using the Egger test (49) and Begg’s test (50). Subgroup analyses of mental health were performed by grouping the age of the sample into three categories: children and adolescents (≤18), adults (≥18 to ≤60), and older adults (≥60). Subgroup analyses also included domain-specific analyses of mental health, such as loneliness, depression, anxiety, stress, life satisfaction and happiness, social support, quality of life, health and well-being, general mental health and resilience, and humor and self-regulation (affections, emotions, relationships). Subgroup analyses of PA considered the domain-specific of physical activity (measured by minutes, frequency, counts, and mets), as well as the form of data collection and defined age groupings. Notably, if a study reported results for more than one specific type or domain of PA separately (e.g., walking and gardening), all types of PA were included in the analysis as independent variables. However, if a study also reported on the wider spectrum of physical activity measures (e.g., total PA, total LTPA), only the broader measure was used to avoid duplication.
3. Results
3.1. Search and screening
A total of 11,389 records were identified in the electronic databases. After removing duplicates and articles irrelevant to the analysis, 289 full-text publications were assessed for eligibility. Based on the inclusion and exclusion criteria, 238 articles were also excluded. A total of 49 articles met the eligibility criteria and were included in this meta-analysis. Details of the search strategy are provided in Figure 1.
Figure 1. Flowchart of the search strategy to include studies.
3.2. Included study characteristics
From a total of 320,971 participants, 10,233 were children and adolescents, 79,108 adults, and 2,308 were old adults.
Of the 49 included studies that evaluated pet ownership and its influence on mental health and daily PA parameters. Regarding mental health, 27 were concerned (4, 24, 25, 30, 43, 51–73). The distribution of these articles by subcategory of mental health can be observed in Table 1. Relative to physical activity 22 studies were considered for analysis (10, 12, 13, 16, 29, 74–77, 79–90). Additionally, 5 studies were included in both analyses (13, 74–77). Descriptive data of the included studies are presented in Tables 2, 3 for PA and mental health, respectively.
Table 1. Distribution of articles by subcategory of mental health.
Table 2. Studies reference to physical activity.
Table 3. Studies concerning mental health.
3.3. Pet influence on physical activity
The main analysis showed that pets had a significant and positive effect on the PA of owners compared to non-owners, with an effect of moderate and significant magnitude (Cohen’s d = 0.554; p = 0.000; Figure 2). The studies showed high heterogeneity (I2 = 99.586%; p = 0.000). Although the asymmetry in the funnel plot indicated a likelihood of publication bias, it was not confirmed by Begg’s (p = 0.06171) and Egger’s (0.21448) tests.
Figure 2. Forest plot of pet influence in physical activity ownership.
Regarding the analysis of moderating variables by owner’s age group there was a significant and positive influence but of low magnitude in adults (Cohen’s d = 0.009; 95% CI [0.001–0.016]; p = 0.000), and older adults (Cohen’s d = 0.009; 95% CI [0.135–0.184]; p = 0.000). No significant values were observed in children. The results indicated a moderate and high heterogeneity (I2 = 99.932%, I2 = 99.063%, respectively, for adults and older adults).
Considering the analysis of the PA moderator variables, the frequency of performing physical activity showed a high magnitude (Cohen’s d = 1.386; 95% CI [1.297–1.476]; p = 0.000), with high heterogeneity (I2 = 99.574%). The moderator variables of PA counts (Cohen’s d = 0.423; 95% CI [0.295–0.551]; p = 0.000) and Met (Cohen’s d = 0.147; 95% CI [0.124–0.171]; p = 0.000) showed low but significant effect magnitude. Duration did not show a significant value. The heterogeneity presented in the significant variables was high (I2 = 99.917%, I2 = 72.678%, respectively for met and counts).
The analysis of the moderating variables regarding the instruments used for measuring PA revealed a small effect magnitude for the objective (Cohen’s d = 0.180; 95% [0.136–0.224)]; p = 0.000) and subjective measure (Cohen’s d = 0.018; 95% [0.010–0.025]; p = 0.000), but significant. The heterogeneity presented was high for both objective (I2 = 81.523%) and subjective (I2 = 99.923%) moderating variables.
3.4. Pet influence on mental health
In the main analyses, it was found that pets have a significant and positive effect on owners. Additionally, a significant and positive effect on owners’ mental health was reported, albeit of low magnitude (p = 0.021; Cohen’s d = 0.068; Figure 3). The studies showed high heterogeneity (I2 = 95.987%; p = 0.000). However, the symmetric funnel plot analysis revealed a low risk of publication bias, as evidenced by Begg’s (p = 0.11060) and Egger’s tests (p = 0.34245) (Supplementary material B).
Figure 3. Forest plot of pet influence on mental health.
Owner’s age group as a moderating variable has a significant and positive influence but of low magnitude in children (Cohen’s d = 0.030; 95% CI [0.009–0.05; p = 0.005]), adults (Cohen’s d = 0.037; 95% CI [0.0024–0.05]; p = 0.000), and older adults (Cohen’s d = 0.091; 95% CI [0.061–0.121]; p = 0.000). The results indicated a moderate and high heterogeneity of moderating variables by owner’s age group (I2 = 98.397%, I2 = 77.605%, I2 = 60.934%, respectively for children, adults, and older adults).
Considering the analysis of moderating variables by mental health, all showed a low effect magnitude but with a significant and positive influence on the humor and self-regulation (affections, emotions, relationships; Cohen’s d = 0.241; 95% CI [0.203–0.280]; p = 0.000), social support (Cohen’s d = 0.100; 95% CI [0.064–0.137]; p = 0.000) life satisfaction and happiness (Cohen’s d = 0.063; 95% CI [0.044–0.081]; p = 0.000). Loneliness had a significant influence, but a negative effect (Cohen’s d = −0.036; 95% CI [−0.088–0.017]; p = 0.005), anxiety, loneliness depression, stress, life satisfaction and happiness, social support, quality of life, health and well-being, general mental health and resilience showed low magnitude and non-significant values. Despite exploration among the moderating variables, heterogeneity remained moderate to high (I2 = 0.000%, I2 = 82.205%, I2 = 65.479%, I2 = 66.963%, I2 = 83.883%, I2 = 67.735%, I2 = 740,739%, I2 = 76.147%, I2 = 97.371%, respectively for anxiety, loneliness depression, stress, life satisfaction and happiness, social support, quality of life, health and well-being, general mental health and resilience, humor and self-regulation (affections, emotions, relationships).
4. Discussion
To our knowledge, this is the first comprehensive meta-analysis to investigate the influence of pet ownership on owners’ daily PA levels and mental health. The main findings indicate a moderate positive impact of pets on PA compared to non-pet owners (NPO).
Among the PA moderating variables, frequency showed a highly significant effect, indicating that pet owners have a higher frequency of physical activity than NPO. However, no significant impact of pet ownership on mental health compared to NPO was found. One of the most promising results of this meta-analysis is the evidence that pet owners are more physically active than NPO, which may be related to pet care such as walking and going outside. A previous study (19) found that dog owners walk moderately more than non-dog owners. Of all the analyzed studies, five were conducted in dogs and other different species (13, 29, 77, 87, 90). The analysis of these studies showed that the benefits related to PA were more evident in dog owners than in owners of other pets. These findings led us to analyze PA specifically regarding dog owners DO and NDO.
About the moderating variables of PA (frequency, duration, counts, and mets), PO significantly had a higher frequency of walking. However, duration was not significant, as found in a previous meta-analysis (19). Owners with a stronger attachments to their dogs were more likely to walk with them, but at a shorter distance than owners with weaker pet attachments (17). These results may be based on the owner’s commitment to meet the pet’s needs, which may lead to an increase in the owner’s willingness and frequency to take a walk, even if it is not perceived, as opposed to non-owners. On the other hand, it is possible that dog characteristics, such as age and breed, could influence the relationship between physical activity and mental health outcomes (92). For example, younger dogs may require more physical activity than older dogs, which could demand more attention and owners’ general activity. Moreover, it is known that some breeds have higher exercise requirements than others (92). Future studies could take into account factors such as age, breed, and dogs’ physical activity needs, and how they influence health outcomes of pet owners.
Objective and subjective measurement methods revealed a significant, but low effect size. For the assessment of owners’ PA, most previous studies have used subjective physical activity measures, with only eight studies using objective assessment measures (10, 74, 76, 77, 80, 81, 84, 89). One of the limitations of subjective measures is that they are based on the perception or recall of PA performed before the date of completing the questionnaire, which may generate bias in the results or overestimation compared to objective measures (93). Comparative studies comparing the two measurement methods have found that the results obtained through the IPAQ are not reflected in the PA measurements with the accelerometer (77, 79). Despite our results covering both methodologies, subjective measures were the most commonly reported method among studies, similar to the meta-analysis conducted in 2013 (19). Although studies conducted with objective measures have been increasing, more studies that examine the application of these methods are needed, particularly studies that quantify both pet and owner levels of PA. Moreover, such an analysis would allow us to establish a more reliable role of pets in owners’ PA and possibly define guidelines for the population that can benefit the most from owning a pet.
Besides the relationship between pet ownership and physical health, there may also be a relationship with mental health. There is some evidence that suggest that physical activity and pet ownership can both have positive effects on mental health outcomes (11). Engaging in regular physical activity has been shown to be associated with improved mental health, including decreased symptoms of depression and anxiety, as well as increased feelings of well-being and self-esteem (32). Thus, it is possible that physically active pet owners may have better mental health outcomes compared to non-pet owners, as they may benefit from both the physical activity and the social support and companionship provided by their pets (28, 94). However, more research is needed to fully understand the complex relationship between physical activity, pet ownership, and mental health outcomes.
Regarding the relationship between mental health and pet ownership, this meta-analysis included 135 results from 32 studies, whose methodological quality ranged from good to excellent. Despite the significant influence of pets on owners’ mental health, it must be considered that the effect size was low. The high heterogeneity of the sample characteristics, the variables used to measure mental health, and other methodological issues might explain this low effect size. Nevertheless, this result has already been described in previous systematic reviews (91, 95).
To better understand the heterogeneity found, various moderating variables related to mental health were considered (95). Among these moderating variables, only loneliness, social support, life satisfaction, happiness, and mood and self-regulation were significantly related to pet ownership.
Regarding loneliness and social support, this meta-analysis suggests that PO are more likely to experience loneliness than NPO, but owning a pet can confer greater social support to the owner. Despite the differences between these concepts, they complement each other. Loneliness refers to the discrepancy between actual and desired social relationships. Social isolation (included in the social support moderating variable of this meta-analysis) arises in the absence of such contact with society (96). Kretzler (3) suggests that a pet tends to be associated with an increased frequency of social interactions, allowing for the increase of social and community ties (57), which may favor increased feelings of belonging and decreased loneliness and social isolation (70). Among the activities shared between pets and owners, walking and visits to parks appear to be most strongly associated with the social support felt by owners (13). Dogs are the most frequently reported pets in these activities (13, 57, 75) and seem to produce better results compared to other pets (65, 96). However, these differences between species are mostly dependent on the type of activities performed with the pet. Therefore, it may be important to consider other types of daily life activities with pets in future studies, as they may also promote greater social support for owners and decrease feelings of loneliness.
The literature suggests that pets may play a beneficial role in providing social support and companionship, particularly for older adult individuals who live alone (24, 51). However, while pets may serve as a form of social support, they cannot completely alleviate feelings of loneliness. Despite these findings, the low effect size of the relationship between pet ownership and mental health can be attributed to the high heterogeneity of the samples. Studies with individuals with chronic low back pain (75), members of the LGBT community (64), and those experiencing the COVID-19 pandemic (43, 78) have further demonstrated the high variability of samples. Certain contexts may even contribute to increased inconsistencies and incoherence in the role of pets in social isolation and feelings of loneliness. For instance, during the COVID-19 pandemic, social isolation was not significantly associated with pet ownership, but loneliness may have been reduced (3). Further research is needed to fully understand the impact of pets on social support and levels of loneliness.
This meta-analysis also indicates that pets may promote greater life satisfaction and happiness in their owners. The concept of life satisfaction is subjective and may depend on individuals’ experiences. Curl (57) reported that pet owners experience greater social engagement and life satisfaction, especially in the older adult population. Additionally, pet owners who experienced the death of a pet during the previous year were significantly less happy and satisfied compared to those who did not have a pet and those who did not experience the death of a pet (54). On the other hand, it is also plausible to consider that owners’ personalities, conditions of the pets’ presence, as well as expenses associated with the pet’s care, might influence owners’ life satisfaction. Therefore, it is important to understand the relationship between pet ownership and life satisfaction and happiness, considering different variables such as life satisfaction before and after the adoption of the pet.
This meta-analysis also shows that the presence of a pet may lead to better mood, coping skills, affection, and relationships, particularly regarding humor and emotions. Moreover, having a pet throughout life was predictive of more positive relationships (56). However, high heterogeneity was found, which could be explained by the attachment to the pet, as the human-animal bond may differ among members of the same family, influencing their responses to the same questionnaire. Most analyzed studies did not control for this variable, which makes it difficult to understand the possible influence of the human-animal bond. Therefore, in future studies, it will be important to consider this variable.
Concerning the remaining moderator variables, no significant effect of pets was found, and the magnitude of the effect was low. These results may be due, in part, to the diversity of instruments and methodological procedures used in the included studies. In fact, in the different studies analyzed the variable mental health and resilience were quantified by using different scales, which most frequently was the Short Form Health Survey with 36 items (43, 59, 61), with Whight (73) using a reduced version with 12 items, the Moca (53), Patient Health Questionnaire (66), Psychological Symptoms (67), and BSI- Brief Symptom Inventor (70) were also used, along with 3 other studies (43, 59, 61) that assessed resilience. This fact may cause bias and variability, as it depends on the reading and interpretation of the self-administered questionnaire. Therefore, the high variety of instruments used to measure the same or different mental health variables was probably the main reason for the high heterogeneity observed. Similar results were observed for the depression and anxiety variables.
Therefore, 12 studies were included in this meta-analysis that explored the effect of pet presence on depressive symptoms (13, 24, 43, 52, 53, 59, 60, 70, 71, 74–76), and 8 studies on anxiety (24, 43, 52, 59, 70–72, 76). However, no significant effect was observed, which is consistent with other reported literature (91, 95). Symptoms of anxiety and depression are frequently analyzed together since they are highly comorbid and share common etiological processes (97). In this meta-analysis, only one study (72) analyzed anxiety independently of depression. In the remaining studies, the authors used the same instrument to analyze both variables: the Depression, Anxiety, and Stress scale (24, 43, 52, 59, 70) and the Hospital Anxiety and Depression Scale (76).
Regarding the influence of pets on the owner’s quality of life, health, and well-being, no significant results were found, contradicting a previous systematic review that reported the potential benefits of pets to impact owner well-being (28). Once again, different scales and procedures were used in the reviewed studies. Quality of life was measured in 17 studies using subjective health items (57, 96), the European Health Interview Surveys-Quality of Life questionnaire (43), the Warwick-Edinburgh Mental Well-Being Scale (59), the Kidscreen-10 index (67), items from the SF-36 scale (vitality, pain, and role physical) (30, 76, 77), and items from the shortened version SF-12 (physical health) (66, 73). The physical health scales were used in studies on physical illnesses (52, 65, 75, 96). The World Health Organization Quality of Life Instrument (70) and the Well-being Index (58) was also used to measure well-being.
Quality of life, health, and well-being questionnaires may be subject to bias due to the subjectivity of interpretation inherent in the different dimensions evaluated. Moreover, the confounding factors considered by the authors, depending on the study goal, are different in each study, which could also be a limitation of our analysis.
Overall, although this meta-analysis did not aim to understand the effect of different pet species on mental health, it is worth mentioning that they seem to have an influence. Pruchno (65) found a higher positive association between quality-of-life outcomes and dog ownership than cat ownership, while Hajek (96) found a similar association regarding social isolation and loneliness. In another study with Portuguese adolescents, pets were associated with a better perception of well-being, more life satisfaction, and overall mental health. However, when analyzed by species, dogs showed more evident results (67). This may also contribute to explaining the high heterogeneity of the obtained results.
5. Limitations
This meta-analysis has identified several limitations and methodological issues that limit the generalizability of the results. These flaws include the absence of randomized controlled trials and a small number of longitudinal studies. Additionally, there is a lack of studies that compare health-related variables before and after pet ownership. It is also important to differentiate between participants, distinguish between the main and secondary responsible owners, and to sure attachment to the pet. Furthermore, it would be valuable to include other moderating variables such as age group, gender, economic factors, social status, ethnicity, and pet species to reduce the heterogeneity of the analysis. Finally, the use of diverse instruments to assess mental health and physical activity increases the heterogeneity of the results.
6. Conclusion
In general, pet ownership has been found to have a positive influence on owners’ physical activity, with pet owners showing a higher frequency of physical activity than non-owners. However, pets do not seem to have a significant impact on owners’ mental health. There were some moderating variables related to mental health, such as loneliness, social support, life satisfaction, happiness, mood, and self-regulation, which were significantly associated with pet ownership but with low effect sizes. This suggests that pet owners may have higher levels of social support, life satisfaction, happiness, mood, and self-regulation and lower levels of loneliness than non-owners.
The results of this meta-analysis provide a nuanced understanding of the potential impact of pets on owners’ mental health and physical activity from a one health perspective.
We suggest that future researchers explore theoretical frameworks and methodological approaches that can explain the uniqueness of the relationships between pets and people, and how these influence them.
Author contributions
CM, JS, MM, MP, and LC: the conception of the research, the design of the research protocol, and review of the final draft of the manuscript. CM, JS, and MM: literature review and manuscript drafting. CM and MM: publication search. CM, JS, MM, and AC: publication screening and data extraction. LC and LS: third and fourth reviews. AC: statistical analysis. CM, AC, JS, and LS: data analysis and interpretation of results. All authors contributed to the article and approved the submitted version.
Funding
This work was funded by the R&D&I project “oneHcancer – One health approach in animal cancer,” operation no.: NORTE-01-0145-FEDER-000078, co-funded by the European Regional Development Fund (ERDF) through NORTE 2020 (North Portugal Regional Operational Program 2014/2020).
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Publisher’s note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
Supplementary material
The Supplementary material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fpubh.2023.1196199/full#supplementary-material
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Keywords: active lifestyle, health, pet ownership, physical activity, quality of life
Citation: Martins CF, Soares JP, Cortinhas A, Silva L, Cardoso L, Pires MA and Mota MP (2023) Pet’s influence on humans’ daily physical activity and mental health: a meta-analysis. Front. Public Health 11:1196199. doi: 10.3389/fpubh.2023.1196199
Edited by:
Yasuhiro Mochizuki, Waseda University, JapanReviewed by:
Susanna Toivanen, Mälardalen University, SwedenMarija Jevtic, University of Novi Sad, Serbia
Copyright © 2023 Martins, Soares, Cortinhas, Silva, Cardoso, Pires and Mota. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Catarina F. Martins, YW5hX2NhdGFyaW5hXzk1QGhvdG1haWwuY29t