Practice Perfect 813
Do Vacations Improve Health?

Recently, I had the pleasure to take my first real vacation since the pandemic started. Three years is definitely long enough to wait for a fun trip! But being on vacation had me wondering if a short time off is actually beneficial? Do vacations improve health? Or are we fooling ourselves into thinking short breaks from work do anything to improve long-term health? Let’s see what the research tells us.

First, it’s obvious that any research into this topic is fraught with methodological problems simply by the subjective nature of concepts such as “stress”. Additionally, given the complexity of human health and the large number of contributing factors, it’s doubtful that any one research study is going to answer our question. With these limitations, you may not be surprised by the message the research literature sends. 

One interesting piece of information that I hadn’t considered before is the difference between vacation and leisure. Dolnicar et al pointed out this difference by defining their terms with vacations being “infrequent leisure activities away from home” and leisure being regular home-based activities.1 This difference is going to be important a bit later in our discussion.

Hruska and colleagues looked at the relationship between vacations and perceived psychological stress and heart rate before and after a vacation.2 We are going to look only at the post-vacation outcomes because that will get us closer to an answer. They surveyed 54 workers with paid vacations lasting more than three days and had them wear an ambulatory heart rate monitor before and after the vacation. They collected post-vacation data weekly for four weeks. These researchers found a statistically significant relationship between perceived stress levels and heart rate before vacations but not after. I’ll mention here, without boring you with the numbers, that although statistically significant differences were found before the vacations, the effect size was very small, so I doubt their results are clinically significant. Perhaps a larger cohort would have had more power to see a larger effect size or possibly adding a control group of non-vacationing matched controls. Interestingly, they found the pre-vacation association diminished as it came closer to the actual vacation, which they explained as a beneficial anticipatory effect.

In 2013, Chen and Petrick performed a literature review on this subject in regard to the benefits of travel.3 Their review of 28 studies showed that there was a perceived benefit in terms of health and well-being, but, importantly, the benefits did not last after the vacation, correlating well with the Hruska study outcomes.

While metrics of perceived stress level and heart rate improve prior to the vacation, in anticipation of it, their effects do not endure after we return to work.

As one continues to look through the literature, it seems increasingly apparent that the result of vacations, as stated in the title of one study, was “Lots of fun, quickly gone.4” I’m not surprised to see the majority of literature shows some health benefits, especially during the vacation, with an effect that decreases over time as one re-establishes their regular work life with all its stresses and challenges.

So, what do we do with this information? Stop going on vacations? Nihilistically stop taking time off since it won’t have beneficial long-term health effects? I don’t think so. Perhaps a slightly more nuanced view of our time off is in order.

First, anyone who thinks a one- or two-week vacation is going to fix all of our life’s stresses and challenges is deluding themselves. All of my adult life, I’ve listened to people speak about their upcoming vacations as if those vacations would eliminate all the stress and trouble in a person’s life. We know that’s a pipe dream. Vacations do, though, add to our personal store of experiences, expanding our viewpoints, adding color to our lives. They are also an important break from what is, for many people, a monotonous daily work experience (not all of us are lucky enough to be podiatrists). They clearly have a role in improving our quality of life; they’re just not going to make the stress of work life disappear.

If an extended vacation of a week or more isn’t the answer to maintaining our mental and physical health, what is? I believe the answer lies in the idea of leisure as defined by Dolcinar et al: regular home-based activities. Each of us must define what these home-based activities are. For me, it boils down to two things: spending focused quality time with my family and making my time off productive. I’ve experienced that feeling in the past where, during the weekend, I’m waiting for Monday to come. I don’t like this feeling. Instead, I like to be productive, doing work around the house, fixing something here, building something there. For example, my wife and I did some finished carpentry work in a couple of bedrooms. We spent quality time together, did something new, and had a great time doing it. I went back to work on Monday invigorated and ready to take on the week.

Stress reduction during time off on a more regular basis is probably of greater benefit than vacations.

The other side of this coin is about how we spend our workdays. When I was younger, I worked at a fast-food restaurant, and, though I enjoyed many of the people with which I worked, I did not enjoy the job. It was a means to an end (paying for college and going to medical school). Now that I’m a medical professional, I find many aspects of my job highly satisfying and focused on my purpose: to make the world around me better than I found it. Like anyone, I have good days and bad, and there are some aspects of my job I don’t love. However, keeping the big picture in mind maintains that perspective, making my generally stressful job enriching.

To gauge the benefit of vacations, look more to the making of memories, the expanding of your life experience and the excitement of doing something new, than a measurable health benefit.

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So, do vacations improve health? Probably not directly, although as part of a larger goal of maintaining resilience and quality of life, it definitely plays an important part. 

All my best.

Jarrod Shapiro, DPM
PRESENT Practice Perfect Editor
jarrod@podiatry.com

References
  1. Dolnicar S, Yanamandram V, Cliff K. The contribution of vacations to quality of life. Annals of Tourism Research. 2012 Jan;39(1):59-83.
  2. Hruska B, Pressman SD, Bendinskas K, Gump BB. Do vacations alter the connection between stress and cardiovascular activity? The effects of a planned vacation on the relationship between weekly stress and ambulatory heart rate. Psychol Health. 2020 Aug;35(8):984-999.
  3. Chen CC, Petrick JF. Health and wellness benefits of travel experiences: A literature review. J Travel Res. 2013 Nov;52(6):709-719.
  4. de Bloom J, Geurts SA, Taris TW, Sonnentag S, de Weerth C, Kompier MA. Effects of vacation from work on health and well-being: Lots of fun, quickly gone. Work & Stress. 2010 Apr 1;24(2):196-216.

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