What's the proper amount of dog for optimal health?

Humans have had dogs as companions for thousands of years. Over that time, dogs have evolved to become ever-better companions, as we humans selectively bred them for traits that we like, such as friendliness and loyalty.

Dog owners already know that owning a dog reduces stress. But it turns out that the health benefits of owning a dog go quite a bit further: two new studies published this month in the journal Circulation both found that owning a dog reduces your risk of dying.

The first study, by Carolyn Kramer and colleagues at the University of Toronto, reviewed ten other studies dating back more than 50 years, covering 3.8 million people. They compared dog owners to non-owners and found that dog owners had a 24% lower risk of dying, from any cause, over a 10-year period. The benefit was even greater for people who'd suffered a heart attack: those who had a dog at home after their heart attack had a 65% lower risk of dying.

The second study, by Tove Fall and colleagues at Uppsala University, focused on the benefits of owning a dog for people who have had a heart attack or a stroke. They used the Swedish National Patient Register to identify 335,000 patients who'd suffered one of these events between 2000 and 2012, about 5% of whom were dog owners. They found even greater benefits than the first study: among people who'd had a heart attack, their risk of dying was 33% lower if they owned a dog as compared to people who lived alone. The benefits were smaller but still significant for people who lived with a companion (a spouse or a child): they still had a 15% lower risk of dying if they also owned a dog. For those who'd had a stroke, the risk of dying for dog owners was 27% lower than for people who lived along, and 12% lower than for people who lived with a companion but didn't have a dog. This study measured the risk over a 4-5 year followup period.

These studies are consistent with many other scientific reports, stretching back decades. They're all consistent, and they all point in the same direction: dog ownership is good for your health. In fact, back in 2013 the American Heart Association issued an official statement on "Pet Ownership and Cardiovascular Risk" with this recommendation:

"Pet ownership, particularly dog ownership, may be reasonable for reduction in cardiovascular disease risk."

However, because the evidence was not very strong, the AHA also advised that people shouldn't get a pet "for the primary purpose of reducing CVD risk." In other words, don't get a dog if you don't want one. As every dog owner knows, owning a dog is much more trouble than simply taking a daily pill.

The new studies strengthen the existing evidence for the health benefits of owning a dog. In an accompanying editorial in Circulation, Dhruv Kazi from Harvard Medical School asks a critical question: is the association between dog ownership and reduced mortality just a correlation, or is it causal? He points out that studies have shown that dog ownership reduces blood pressure and other signs of stress, and that dog owners tend to get outside and walk more (with their dogs). Thus it's very plausible, medically speaking, that dog ownership is good for you. For these and other reasons, Kazi concludes that

"the association between dog ownership and improved survival is real, and is likely at least partially causal."

One final question is still nagging at me, though. Now that we know that dog ownership is good for your health, what's the optimal dose? Would it be even healthier to own two dogs rather than one? And what if we throw in a cat, does that strengthen or reduce the effect? Finally, is it healthier to own a larger dog, or is a small one just as good?

Clearly, more research is needed.

[Note: the author discloses that he owns a rescue dog, a rather small terrier.]