Is owning a pet really good for our health?

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Health: Even if research is still inconclusive, we would not have so many pets in society were it not for some beneficial gains brought on by the human-animal bond.

The American Veterinary Medical Association (AVMA) and the Human Animal Bond Research Institute (HABRI) describe the human-animal bond (HAB) as a “mutually beneficial and dynamic relationship between people and animals that is influenced by behaviors essential to the health and well-being of both.”1,2

Various human and animal interactions can fall within the HAB purview. HABRI data suggest at least 85 million households in the U.S. benefit from the HAB annually.1,3 According to AVMA 2017-2018 data, about 60 percent of households have some type of pet. However, pet ownership only represents one aspect of the HAB.4 Human-animal connections can be almost endless and include:

  • Pet and pet parent
  • Zoo animal and zookeeper
  • Jockey and horse
  • Therapy pets and patients
  • Animals involved in animal-assisted interventions/activities/therapies

AAIs, AATs, and AAAs

Animal-assisted therapies (AAT) involve the interactions of animals with people in various settings. The goal is to improve psychological affliction, increase compliance with medications and treatments, and improve pain and quality of life. Animal-assisted activities (AAA) would be like pet therapy—animals can interact with various individuals and say hello, but structured activity is not customary.

AATs involve structured interactions with the goal of a specific outcome (e.g. using animals in combination with standard medical therapies to treat and prevent substance abuse relapse). Finally, AAI is the catchall term that includes AATs and AAAs.

Quality of the HAB evidence

While the majority of HAB studies appear to show a positive influence relating to our interactions with animals, some are more equivocal. Current studies have significant limitations, including small sample sizes preventing generalizability and hindering our ability to state the health benefits the HAB may provide with certainty.

Limitations of the available research include few peer-reviewed studies, many being anecdotal reports. Additionally, we see a failure to use equivalent testing protocols and outcome measures and a lack of theoretical rigor. Few studies demonstrate appropriate control groups. In part one of a two-part systematic review,4,5 only nine of the 32 studies that met all inclusion criteria had any type of control group. Further, analyses, except in one study,6 one-sidedly evaluate the benefits of the HAB impacts on human health, failing to assess the animal’s responses to these interactions. Since the goal is to have a mutually beneficial relationship, the animal’s responses should also be evaluated.

Research shows that the endpoints evaluated varied from psychological to physiological in addition to various interventional settings. Psychological endpoints included changes in anxiety, distress, depression, pain, mood, and quality of life. Physiological endpoints evaluated included changes in oxygen saturation, cortisol levels, blood pressure, and respiratory and heart rates. Varying degrees of results have been noted. Given measures of various parameters differed across the studies, accurate comparisons and our ability to confidently say that AAIs improve psychological endpoints are impaired.4–6

Future HAB research should strive to create higher-quality studies that address some of the shortcomings noted above. Further, a more uniform and well-established definition of AAAs and structured use of the various terms, from pet therapy to equine-assisted therapy, to AAIs and AATs, will help the layperson understand the terminology better and permit better comparisons across studies.

Health benefits of the HAB

Despite the lack of robust evidence and various limitations in current HAB studies, we still see measurable benefits. Some may be anecdotal, while others are supported by science. The benefits of the HAB go far beyond everyday perceptions of cute manners and adorable faces.

Studies show animal interrelationships improve mental health and well-being, decrease stress, and promote healthy adult aging. Further, the HAB improves cardiovascular health, workplace wellness, and overall quality of life. Animals help to minimize feelings of social isolation or loneliness. Research has shown significant benefits for cancer patients, patients with chronic pain and illnesses, and those with agoraphobia.1,3,7,8

On mental health

When looking at studies individually, data has shown animals provide stress-alleviating effects, decrease levels of depression, and increase a person’s sense of security. Animals provide routine and structure which aid in mental balance. They provide emotional support and have been used in various healthcare interventions as adjuncts to standard medical therapies for various mental illnesses, including substance abuse.9

Jazzy, a FS mixed breed dog, on her “gotcha” day, with her fur-parents, author, Erica, and husband Scott.
Photo courtesy Erica Tramuta-Drobnis

Many additional studies suggest the possible benefits of various species in various formats and their effects on mental health and well-being. Positive results have included:3,9–12

  • Stress-alleviating effects
  • Decreased depression
  • Sense of security
  • Routine and structure aiding in mental balance
  • Emotional support
  • Opioid recovery assistance. When used in combo with standard medical therapies, AAT modalities have been shown to lessen the chance of relapse13–15

On PTSD

Post-traumatic stress disorder (PTSD) represents a specific, often crippling, mental health illness that can genuinely benefit from the HAB. Many who have incorporated animals into their management of PTSD feel they get their life back by sharing it with a four-legged friend.

While, most commonly, PTSD is perceived to be associated with war veterans, it can actually occur in anyone and at any age. Approximately one out of every 11 Americans may be diagnosed with this condition at some point in their lives.16 People with PTSD may experience intrusive thoughts and flashbacks and demonstrate avoidance behaviors to prevent triggers. They may suffer from moodiness and cognitive deficits, anger and other strong emotions, and have abnormally intense alterations in reactivity and arousal.16

AAT is included in a list of treatment options for PTSD on the American Psychiatric Association website.17 Various research studies suggest the benefits service dogs confer in managing PTSD. Service animals support patients with PTSD by helping to:1,10

  • Decrease symptoms of PTSD
  • Decrease depression
  • Increase QOL and well-being
  • Decrease social isolation and anxiety
  • Increase participation in social activities
  • Minimize time lost at work

On cardiovascular (CV) health

The American Heart Association (AHA) acknowledges pet ownership benefits CV health. Cat owners who suffer a heart attack vs. those who do not are more likely to survive one-year post-myocardial infarction (MI). When comparing dog owners to non-dog owners, those with dogs show a 65 percent reduced mortality risk post-MI. Further, those with dogs have a 24 percent decreased all-cause mortality rate vs. non-dog owners.3,9,10,18

Numerous studies on CV risk minimization with pet ownership exist, and new studies are ongoing. In a 2013 systematic review,19 improvements in CV health from pet ownership include decreasing systolic blood pressure, lower resting heart rates, and lower mean arterial pressures. Additionally, some studies showed that patients with pets had increased physical activity; other benefits included improved autonomic function.

A prospective study20 showed petting a familiar dog mimicked the relaxation effects of quietly reading. Another study looked at reading aloud versus petting a dog and demonstrated lower blood pressure when petting the dog. Taken as a whole, dog ownership likely decreases CV disease risk.

It is more than just a placebo effect

Positive animal interactions trigger a physiological response. Why do people often feel relaxed, relieved, happy, and joyful when they pet a dog, especially their own or one they know well?

A study12 looked at AAT to determine if responses were rooted in physiology. The research showed elevated hormone levels to include β-endorphin, prolactin (nurture), oxytocin (happiness), phenylethylamine (elated), and dopamine (energized) while also causing a decrease in the stress hormone cortisol. Hormone release was elicited when humans pet dogs. Additionally, the dogs were evaluated and experienced the same neurochemical changes, suggesting they also benefited from the interaction.9,21

The bottom line

From AAI to pet and pet-parent relationships, animals can positively impact our lives. While, as veterinarians, our job is to ensure the health and well-being of the animal side of the HAB equation, we must also educate animal caretakers about zoonotic diseases, proper pet nutrition, proper preventive care, and more to help maintain a healthy HAB. However, further research is needed to demonstrate causal relationships for various health outcomes.

While the current body of evidence hints at benefits and improved health outcomes when animals and humans interact positively, we need more vigorous studies. More uniformity in reporting results, evaluating parameters, and defining AAIs and related activities is warranted to enable us to make generalizable statements supporting the HAB’s positive health outcomes and benefits.

FOUR KEY HEALTH BENEFITS FROM PETS
Even if research is still inconclusive, we would not have so many pets in society were it not for some beneficial gains brought on by the HAB. One group of researchers provides22 a good explanation of key benefits pets bestow on human health. These results are not due to neurochemical changes in the brain but are factors that improve overall QOL. Pets act as9,22

1) Builders of social capital. “The interpersonal relationships, institutions, and other social assets of a society or group that can be used to gain advantage”.23

2) Agents of harm reduction. People may engage in dangerous activities. Still, knowing that an activity, such as smoking in the home may harm the pet, owners may hold back or even quit.

3) Motivators of healthy behavior change. Walking dogs increases one’s physical activity.

4) Potential aids in intervention & treatment plans. AAI, AAT, and AAAs may occur in the community, hospital setting, or home. Anything from equine therapy to opioid substance abuse therapy to PTSD treatment and more.

Erica Tramuta-Drobnis, VMD, MPH, CPH, is the CEO and Founder of ELTD One Health Consulting LLC. Dr. Tramuta-Drobnis works as a public health professional, emergency veterinarian, freelance writer, researcher, and consultant. She is a member of the Evidence-Based Veterinary Medical Association (EBVMA), with different members writing this column. While all articles are reviewed for content, the opinions and conclusions of the author(s) do not necessarily reflect the views of the EBVMA or Veterinary Practice News. For information about the association or to join, visit https://www.ebvma.org.

References

  1. Human Animal Bond Research Institute (HABRI). HABRI. HABRI: The Human Animal Bond Research Institute. Published 2021. Accessed November 28, 2021. https://habri.org
  2. American Veterinary Medical Association (AVMA). Human-animal bond. American Veterinary Medical Association. Published 2021. Accessed November 10, 2022. https://www.avma.org/one-health/human-animal-bond
  3. Tramuta-Drobnis EL. Exploring the human-animal bond from a One Health framework: A veterinarian’s role. IndeVets. Published January 13, 2022. Accessed July 29, 2022. https://indevets.com/blog/exploring-the-human-animal-bond-from-a-one-health-framework-a-veterinarians-role/
  4. Holder TRN, Gruen ME, Roberts DL, Somers T, Bozkurt A. A Systematic Literature Review of Animal-Assisted Interventions in Oncology (Part I): Methods and Results. Integr Cancer Ther. 2020;19:1534735420943278. doi:10.1177/1534735420943278 https://journals.sagepub.com/doi/full/10.1177/1534735420943278
  5. Holder TRN, Gruen ME, Roberts DL, Somers T, Bozkurt A. A Systematic Literature Review of Animal-Assisted Interventions in Oncology (Part II): Theoretical Mechanisms and Frameworks. Integr Cancer Ther. 2020;19:1534735420943269. doi:10.1177/1534735420943269 https://pubmed.ncbi.nlm.nih.gov/32698731/
  6. McCullough A, Ruehrdanz A, Jenkins M, Ganzert R. The Importance of Assessing Behavioral and Physiological Stress in Therapy Dogs. Austin J Vet Sci & Anim Husb. 2015;2(1):1008. Accessed April 10, 2023. https://austinpublishinggroup.com/veterinary-science-research/fulltext/avsah-v2-id1008.php
  7. Bartges J, Kushner RF, Michel KE, Sallis R, Day MJ. One Health Solutions to Obesity in People and Their Pets. Journal of Comparative Pathology. 2017;156(4):326-333. doi:10.1016/j.jcpa.2017.03.008 https://pubmed.ncbi.nlm.nih.gov/28460797/
  8. Reinisch AI. The human-animal bond: A benefit or a threat to the integrity of the veterinary profession? Can Vet J. 2009;50(7):713-718. Accessed November 6, 2022. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2696701
  9. Tramuta-Drobnis EL. The Human-Animal Bond (HAB) & One Health Benefits. PowerPoint Presentation presented at: PVMA 3 Rivers Symposium; November 13, 2022; Mars, PA.
  10. Zenithson N, Feldman S. Course: Human-animal bond: Know the science. Webinar Presentation, on demand presented at: 2021. Accessed November 9, 2022. https://axon.avma.org/course/view.php?id=302&pageid=1659
  11. Human Animal Bond Research Institute (HABRI). Mental Health and Well-Being. HABRI. Published n.d. Accessed November 9, 2022. https://habri.org/research/child-health/mental-health
  12. Human Animal Bond Research Institute (HABRI). Mental Health Conditions. HABRI. Published n.d. Accessed November 9, 2022. https://habri.org/research/mental-health/conditions
  13. Monfort Montolio M, Sancho-Pelluz J. Animal-Assisted Therapy in the Residential Treatment of Dual Pathology. Int J Environ Res Public Health. 2020;17(1):120. doi:10.3390/ijerph17010120 https://pubmed.ncbi.nlm.nih.gov/31877972/
  14. Kern-Godal A, Brenna IH, Kogstad N, Arnevik EA, Ravndal E. Contribution of the patient–horse relationship to substance use disorder treatment: Patients’ experiences. International Journal of Qualitative Studies on Health and Well-being. 2016;11(1):31636. doi:10.3402/qhw.v11.31636 https://www.tandfonline.com/doi/full/10.3402/qhw.v11.31636
  15. Kern-Godal A, Arnevik EA, Walderhaug E, Ravndal E. Substance use disorder treatment retention and completion: a prospective study of horse-assisted therapy (HAT) for young adults. Addiction Science & Clinical Practice. 2015;10(1):21. doi:10.1186/s13722-015-0043-4 https://ascpjournal.biomedcentral.com/articles/10.1186/s13722-015-0043-4
  16. O’Haire ME, Rodriguez KE. Preliminary efficacy of service dogs as a complementary treatment for posttraumatic stress disorder in military members and veterans. Journal of Consulting and Clinical Psychology. 2018;86:179-188. doi:10.1037/ccp0000267 https://pubmed.ncbi.nlm.nih.gov/29369663/
  17. American Psychiatric Association (APA). What is Posttraumatic Stress Disorder (PTSD)? American Psychiatric Association (APA). Accessed November 10, 2022. https://www.psychiatry.org:443/patients-families/ptsd/what-is-ptsd
  18. HABRI. Cancer. HABRI. Published n.d. Accessed November 9, 2022. https://habri.org/research/healthy-aging/cancer
  19. Levine GN, Allen K, Braun LT, et al. Pet Ownership and Cardiovascular Risk. Circulation. 2013;127(23):2353-2363. doi:10.1161/CIR.0b013e31829201e1 https://pubmed.ncbi.nlm.nih.gov/23661721/
  20. Baun MM, Bergstrom N, Langston NF, Thoma L. Physiological effects of human/companion animal bonding. Nurs Res. 1984;33(3):126-129. https://pubmed.ncbi.nlm.nih.gov/6563527/
  21. Odendaal JSJ. Animal-assisted therapy — magic or medicine? Journal of Psychosomatic Research. 2000;49(4):275-280. doi:10.1016/S0022-3999(00)00183-5 https://pubmed.ncbi.nlm.nih.gov/11119784/
  22. Hodgson K, Barton L, Darling M, Antao V, Kim FA, Monavvari A. Pets’ Impact on Your Patients’ Health: Leveraging Benefits and Mitigating Risk. J Am Board Fam Med. 2015;28(4):526-534. doi:10.3122/jabfm.2015.04.140254 https://pubmed.ncbi.nlm.nih.gov/26152446/
  23. Dictionary.com. Definition of social capital. www.dictionary.com. Published 2022. Accessed November 10, 2022. https://www.dictionary.com/browse/social-capital
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