2 healthcares vulnerability to ransomware attacks by abhilas

2
HEALTHCARE'S VULNERABILITY TO RANSOMWARE
ATTACKS
By: Abhilash Tati
A Dissertation submitted to:
Date of submission: 09/29/2021
Supervised by: Dr. Mary Lind
Table of Contents
Problem 4
Purpose of the Study 5
Search strategy 5
Literature review 7
Theory/model/Variables 10
Deterrence theory 10
Coping mode 21
Ransomware Lifecycle Attack 24
The Primary Vector of Attack: 27
Secondary vector attack: Remote desktop protocol 29
Ransomware targeted 31
Ransomware Healthcare Violations 33
Healthcare's Cybersecurity Challenges 37
Implications of healthcare Ransomware 40
Testing review 42

Specific Ransomware Strains 42
Ryuk 42
WannaCry 45
SamSam 47
Prevention 49
Healthcare Ransomware Mitigations Strategies 49
Save and Recovery 50
Plan of Incident Response 51
Disappointment Technologies 52
Sharing of Threat Intelligence 52
Segmentation of the network 53
Security of Email 54
Authentication of multi-factor 55
Management of vulnerability 55
Methods of Detection and Analysis 58
Challenges 61
Health is the main objective of the ransom program. 61
Experts dread the consequences of intensive care. 62
The attack surface is becoming larger. 63
Effects of Ransomware on health system operations 64
Paying Ransomware Attack Responsibility 66
Additional analysis 70
Conclusion 73
References 75
Introduction
Ransomware is classified as the latest safety violation, which
has had a substantial effect on patient care. Healthcare has
always been a lucrative target for cyber thieves, who target
personal health information (PHI) through misconfigured cloud
storage and phishing e-mails, which are far more valuable on
the black market than any other SSN or credit card credentials.
In addition, mobile devices and laptops were the leading
sources of information violations, accounting for roughly 75
percent of the total individual infringements, around 30 percent
of overall infringements of business associates, and 33 percent

of violations in covered businesses. This article examines
ransomware assaults in terms of the effects of an attack,
exploited vulnerabilities, and the measures taken by the
organization (Agale, 2020).
Ransomware is malicious software meant to block or disable
entry into a computer system waiting to pay a sum of money.
The hackers demand a ransom for the victims' files. In this
essay, strategies are explored to reduce how ransomware attacks
function and disrupt the day-to-day operations of health systems
and who is accountable. Since 2005, ransomware has been the
unavoidable cyber menace. Most purposes invite the hacker to
gain innocently?? What does this mean? (Ahmed et al., 2019).
The hacker does this by moving?? Moving??? a webpage or
mail, and the target opens it. Then the hacker inserts the
Ransomware virus via malicious code, which infects the
machine and displays a message that the victim's archives are
held in rehabilitation and are only ransomed.
Research Question: To what extent is the healthcare system
vulnerable to ransomware attacks?
Problem
Ransomware has emerged as one of the most severe dangers to
enterprises' routine commercial operations. Healthcare
institutions are particularly vulnerable to ransomware attacks
due to the limits imposed by time constraints, limited resources,
and continuity requirements. For example, as the population
ages and grows larger, healthcare facilities must care for an
increasing number of patients. Increased patient volume implies
shorter time limits for individual patients and a lower tolerance
for downtime and interruption (Ahmed & Ullah, 2017). As a
result, IT teams attempt to accomplish more with fewer
resources while operating costs continue to rise. In addition,
budget constraints limit the resources available for enhancing
security outcomes and adopting an organization-wide holistic
approach to security.
Additionally, the proliferation of specialized care facilities
within and between organizations demands providers to ensure

patient continuity of care and data integrity. These limits
amplify the impact of a ransomware assault. Interruptions in
healthcare are not merely an annoyance; they can be life-
threatening. As a result, we believe it is critical to examine the
healthcare business in light of the ransomware threat and
develop recommendations for prevention, detection, and
mitigation to assist healthcare practitioners and enhance patient
outcomes.Purpose of the Study
The purpose of this paper is to highlight ransomware's threat to
healthcare and how healthcare systems should protect
themselves against attacks by ransomware.You should state
your research question here.
The chapter will have five major parts: theory and models,
literature review, testing review, contribution and
recommendation, and finally, the conclusion.Search strategy
You need to discussion how you will use the theory on
deterrence and protection motivation theory as part of your
search strategy
We began our investigation by gaining a basic understanding of
ransomware. What distinguishes ransomware as a distinct
threat? Following that, we investigate the ransomware infection
process in greater depth to understand the exploitation lifecycle
better. How can ransomware leverage vulnerabilities inflict
such widespread damage in such a short period? Following that,
we will look at the particular computing security concerns faced
by the healthcare business. How can constrained resources,
short time limits, and continuity in healthcare delivery
requirements influence users' behaviour? Next, we delve deeper
into how ransomware uses these particular computing security
problems to enhance its effects and enable attackers to extract
increasing sums from healthcare providers. Why are healthcare
organizations such common targets for ransomware attacks?
Following that, we delved into numerous individual ransomware
strains to provide a context for our findings. What does the data
indicate? Finally, we apply our findings to provide tactics for
ransomware prevention, suggest detection and analysis

approaches, and suggest solutions to aid in mitigation and
recovery efforts. How can we contribute to the reduction of
ransomware's impact on healthcare?
You need your theory in here = deterrence and protection
motivation theory – every paragraph should relate to these
theories – first introduce the theories and then relate
ransomeware to the theories.
What is ransomware, and how does it work?
Ransomware is a form of malware that encrypts and modifies
file data and metadata on a computer system. Victims are left
with useless files and a demand for payment of a specified
"ransom," typically in cryptocurrency, to return their data and
metadata to their previous condition. This form of attack is a
variation on an age-old ruse in which robust technology is used
to exploit human insecurities, such as fear, to cause the victim
significant operational and financial consequences (Ahmadian,
2016). Ransomware has become increasingly prevalent in recent
years as hackers have increased their technological capabilities
and have continued to be rewarded for their efforts.
Individual users and multibillion-dollar organizations are all
susceptible to ransomware assaults. However, these attacks
appear particularly concerning for healthcare providers, who
rely primarily on quick access to virtual communication
networks, electronic health records, and various administrative
information systems to function successfully. Additionally,
there is no guarantee that the "ransom" payment will completely
restore access or data. Due to the substantial operational
expenditures that healthcare providers must bear, most victims
of ransomware attacks choose to pay the ransom as soon as
feasible (Attaran, 2020). Providers are willing to accept a lump-
sum ransom payment and fines for data breaches in exchange
for the potential of avoiding even higher fines and considerable
reputational harm caused by disastrous patient
outcomes.Literature review
According to Ayala (2016), ransomware is harmful software

employed by cyber-criminals that infects computers and makes
the user's files or systems inaccessible until the ransom payment
is paid. In essence, ransomware can control the system or
resources of the victim and block user access. The researchers
categorized ransomware into two categories: data resource
denial and non-data resource denial. You believe this is the first
taxonomy to consider all kinds of ransomware and allocate each
one to a category.
Data resource denial. This is a category of ransomware that
limits access to the organization's files and requires a ransom
payment to recover the encrypted files. Ransomware employs
encryption methods to safeguard data against unauthorized
access to encrypt valuable data and then requests a ransom to
decode it (Beavers & Pournouri, 2019). This is known as
crypto-ransomware and is frequently characterized as
symmetrical, asymmetric or hybrid, by the type of encryption
used.
Symmetric crypto-ransomware employs the same coding and
decryption key. The advantage of this strategy is that the attack
may be carried out quickly. A significant downside of
symmetric key encryption is the necessity of incorporating the
key into the malware file, which security researchers can
uncover (Bhuyan et al., 2020).
Asymmetric crypto-ransomware employs various encryption and
decryption keys. This strategy is also referred to as public-key
encryption. This encryption technique consists of a private eight
key owned only by the attacker (the ransomware owner). The
public encrypts the files, but a private key is needed to decrypt
and restore the files. The apparent advantage of public-key
encryption is that the public key is located elsewhere (the
attacker's machine) on the victim's PC.
Just a list of ransom ware with no discussion of the theory of
deterrence.
Key hybrid Crystal-ransomware is a malware author's tactic
used to mix symmetric and asymmetrical methods of encryption.
It employs symmetric encryption to encrypt the user's files as

rapidly as feasible. It encrypts the symmetric key with
asymmetric encryption. Torrent Locker, noted for adopting RSA
and AES encryption methods, is a crypto-ransomware example.
Gpcode is another complement that encrypts files with an
individual AES-256 key and then re-encrypts the key with a
public 1024-bit RSA key (Branch et al., 2019).
Non-data resource denial. This form of ransomware is less
effective at eliminating victims than denying data resources
because it limits the victim from viewing the device but keeps
the user's files intact. Simply put, the information is not
manipulated or deleted. One class found in this category is
Locker ransomware, which locks the victim out of her device
and stops her from using it. The Locker ransomware typically
focuses on computers or cloud storage that contains sensitive
data for mobile, Internet of Things, and industrial control
devices. Medical Internet of Things devices is appealing targets
for such attacks in the health and emergency sectors. Reveton is
an example of Locker ransomware, known to lock computers by
preventing users from signing in and presenting a false message
from the FBI saying that PCs are involved with criminal
internet activities (Brewer, 2016). Trojan. RansomLock.G is
another example that locks the user's screen and shows a whole
ransom letter. Locker rankings frequently lock the computer's
desktop, making it unusable.
Cyber-attacks are becoming more common in the healthcare
industry, which can cause delays or disruptions in patient care
in some cases. In some cases, attackers are interested in the
ransom or cash generated by selling medical data. In other
instances, they impede a patient's treatment. About 13,236,569
files were affected in 2018 alone due to violations and cyber
threats (Collier, 2017). Every medical record on the market
costs $50-$60. Therefore, the translation of violated data into
monetary values would mean around $728,011,295, which is
extremely large. The cost to patients is not statistically
mentioned, as patient losses go beyond financial considerations.
In 1989, the first ransomware attack on healthcare information

systems was disclosed. Joseph Popp, a Ph.D. Becker's Hospital
Review reports that the hack targeted HIV/AIDS researchers in
more than 90 nations. AIDS researchers spread the information
by releasing 20,000 floppy disks with a computer program and a
questionnaire purported to estimate an individual's risk of
contracting AIDS (Coventry, 2018). Regrettably, the disks were
also infected with a ransomware variant known as the AIDS
Trojan. The AIDS Trojan infiltrated computers invisibly and
remained dormant for up to 90 restart cycles. After the 90th
restart, a ransom payment demand was shown, requesting $189
and $378 from the user.
It has been 30 years since the AIDS Trojan first presented a
hazard to healthcare professionals. Over this period, attackers'
capabilities have increased enormously. Today's attackers use
encryption methods that are equal to those used by governments
and the military. Modern delivery mechanisms enable attackers
to target users worldwide. The proliferation of networked
devices allows attackers to zero in on specific targets, devise
unique exploitation tactics, and rapidly scale the attack to
generate enormous leverage for extorting a ransom payment.
Due to the creation and recent accessibility of bitcoin, criminals
can preserve some level of anonymity while demanding a
ransom from their victims (Celdrán et al., 2020). To battle the
ransomware threat to essential healthcare services, it is critical
to understand the infection's nature better and develop
prevention, detection, and mitigation
measures.Theory/model/VariablesDeterrence theory
As Vance & Siponen (2012) discussed, the constructs of
deterrence theory include threat appraisals and coping
appraisals. Both the constructs incorporate habit and intention.
Deterrence theory has long been seen to be a helpful notion for
preventing attacks. Rewards (or benefits) are one of the three
threat appraisal variables, and they result in any inner or
extrinsic reason for expanding or maintaining an unwelcome
behaviour, in this case, an employee's noncompliance with
information security policies.

Intrinsic and extrinsic rewards raise the likelihood of a
maladaptive response, whereas perceptions of threat severity
and vulnerability reduce the possibility of such a response.
Physical or psychological pleasure and peer approbation are
factors that raise the likelihood of a maladaptive reaction
(Ophoff et al., 2019). The authors state denial and revenge
complement a larger strategy that includes resistance,
resilience, and response. Vulnerability refers to the likelihood
of an unpleasant incident occurring if no steps are made to
prevent it.
One of the founders of criminology's deterrence theory, Jeremy
Bentham, presupposes rational individuals capable of
undertaking cost-benefit analyses before acting. The third wave
cast doubt on the analytical actor model, an essential foundation
of deterrence theory, suggesting that groupthink,
misunderstandings, and bureaucratic politics frequently trumped
cost-benefit assessments. The issue of deterrence signalling
determines the other side's rationale because rationality is
subjective (Vance & Siponen, 2012). In addition, cost-benefit
analysis necessitates sentencing clarity and predictability, as
well as proportionality between punishment and violation.
Ambrose et al. addressed the target for deviation in a second
area. Previously, there was a distinction between the structural
and social types of biases in the literature on organizational
justice. The organization has admitted that structural forms of
injustice (distributive and procedural) exist, while
interpersonal, informational interactions between supervisors
and subordinates produce social counterparts. According to
studies, the deviation goal corresponds to the perceived source.
Ambrose et al. put this theory to the test in their study. It is
expected that the objectives of organizational or individual
sabotage activities would be consistent with the perceived cause
of injustice that could be structural (only distributive injustice)
or social (interpersonal and informational). Later on, the idea
was verified, but the connection between the source and the
organizational objectives was more robust than the source and

individual objectives. It was important to back up Ambrose et
al.'s findings with the subsequent study (Vance et al., 2012).
Several studies have demonstrated that injustice can predict the
type and intent of organizational deviation. Chacko & Hayajneh
(2018) discovered that interpersonal, and information injustice
perceptions caused a more significant variance in distributed
and procedural unfairness in the counterproductive workplace
conduct directed towards a supervisor than perceptions of
distributed and procedural injustice. Furthermore, the study
discovered that procedural fairness explained greater diversity
in the organizational behaviour of unproductive workplaces than
distributive and interactional injustices (D'arcy & Herath,
2011). The previous researchers had an intent to develop the
motive behind ransomware attacks and how the behaviour at
work affects the ability to handle ransomware attacks.
Protection motivation theory
According to PMT, habit is referred to as a pattern of
behaviour. According to habit theory, many actions are
performed without conscious deliberation because people are
used to doing them; often, repeated behaviour is more governed
by situational signals than conscious decision making.
Ransomware has emerged as one of the most severe security
concerns facing both businesses and individuals. Ransomware
authors are increasing the sophistication of their attacks as
technical remedies are developed. A mix of technical and
behavioural interventions is required (Boss et al., 2013). Using
protection motivation theory (PMT) as a theoretical
underpinning, this study explores computer users' incentive to
take security measures against ransomware. We used a survey
methodology and gathered data from 118 persons (Ophoff et al.,
2019). Our study supports various aspects of the protection
motivation theory in this setting using partial least squares
structural equation modelling. These include fear-mediated
perceptions of danger intensity and threat vulnerability. Self-
efficacy is an essential coping component. Both maladaptive
rewards and response cost significantly influence protection

drive. The findings support the use of fear appeals and PMT in
the context of ransomware threats to influence protective
motivation in healthcare ransomware. You cannot introduce
hypotheses without discussing each of the constructs in terms of
ransomware – that should be done above. You need section
about on User habit
Table 1
Research question
Hypotheses
To what extent is the healthcare system vulnerable to
ransomware attacks?
User’s Habit positively influences vulnerability.
User’s Habit positively influences perceived severity.
User’s Habit negatively influences rewards.
User’s Habit positively influences response efficacy.
User’s Habit positively influences self-efficacy.
User’s Habit negatively influences response cost
Vulnerability positively affects employees’ intention to comply
with IS security policies.
Research focusing on organizational and personal information
security practices has increased due to the relevance of
behavioural aspects for information security. The following
research is examples: computer security behaviour, home safety
conduct, access controls and perceptions of security, malicious
behaviour, or computer misuse by companies. Some empirical
studies to evaluate the efficiency of the operational security
procedures have been carried out; however, IT administrators or
top management representatives are often respondents in these
studies rather than end-users (Willison & Warkentin, 2013).
Because the respondent in prior research was in significant part
responsible for the establishment and execution of technological
security initiatives, it's also debatable whether they'd be typical
of the business as a whole. For example, while an IT
administrator may claim a written security policy exists, end-
users are not always aware of it.

Current research has focused on security policies and end-user
policy compliance. Ophoff et al. (2019) describe practical
security management components, including IT security
policies, while Ophoff et al. (2019) provides an organizational
information security conceptual framework. Both of these
studies discuss the role of human factors in the success of
safety initiatives. In a similar spirit, Ophoff et al. (2019)
maintain that security in information is a multi-faceted
discipline with intertwined roles for safety and governance. A
more empirical study is needed to identify essential concepts for
preventing negative occurrences from a socio-organizational
perspective to help manage the information system's security, as
pointed out.
In an empirical sense, Ophoff et al. (2019) has developed a
theoretical model to examine the effect of dissuasive security
measures on the assurance that sanctions are certain and severe,
leading to intentions of IS abuse, while Ophoff et al. (2019)
finds that dissuasive measures are a reduction in the computer
abuse of organizations. Ophoff et al. (2019) discovered that the
user does not perform many information securities actions and
that other job activities predominate over information security
in a qualitative user perspective study. One of the biggest
challenges with user roles in information security work,
according to Ophoff et al. (2019), is their lack of desire and
competence in information security and related work. According
to Post & Kagan's (2007) study, end-users viewed safety
precautions impeding their daily routine. Apart from auto
efficiency, Chan et al. (2005) discovered that management
practices and coworker socializing impact employees' views of
the International Information System Security Certification
Consortium (ISC), positively impacting safety compliance
behaviour. They also looked at the policy on safety compliance.
The impact of organizational commitment on several security
compartments, including compliance with security policies, has
been investigated by Ophoff et al. (2019). According to Ophoff
et al. (2019), employee attitudes, standards, and practices

significantly impact employee intentions to comply with IS
safety policy. Still, threat assessment and conducive conditions
have a significant impact on moulding compliance attitudes.
Despite the recent focus of some academics on this subject, the
study of policy compliance remains at the beginning and offers
many opportunities for empiric research. PMT also includes
coping appraisal criteria dependent on the adaptive response (in
this case, employees' adherence to information security
policies). Compliance with IS security policies should be an
effective defense against IS security threats in our situation.
Table 2: Main constructs and related theories same for these
constructs they need to be discussed in separate sections above.
Construct
Theory
Construct
Theory
Punishment severity
GDT
Security policy compliance
PMT and TPB
Detection certainty
GDT
Attitude
PMT and TPB
The perceived probability of security breach
PMT
Subjective norm
PMT and TPB
Perceived severity of security breach
PMT
Descriptive norm
TBP
Security breach concern level
PMT
Resource availability
TBP

Response efficacy
PMT
Response cost
PMT
Note: General Deterrence Theory (GDT); Protection Motivation
Theory (PMT); Theory of Planned Behaviour (TPB)
Response efficacy: The conviction is that the prescribed coping
response will effectively lessen the threat referred to as reaction
efficacy. An employee's impression of the success of the
organization's computer security policy, in this case, could be
the subject of this research. It is possible to analyze the
effectiveness of a given action using perceived utility in DTPB.
A factor taken into consideration in the studies by Boss et al.
(2015) on the information security behaviours of home users has
perceived citizen efficacy, which refers to an individual's belief
that their actions can make a difference in the security of the
Internet, as well as perceived citizen efficacy.
Response efficacy will have a beneficial impact on the
behavioural intention of ISSP participants to comply. When
people perceive a threat, they typically alter their behaviour in
response to the level of risk they are exposed to and determine
whether or not they are willing to accept the danger (Milne et
al., 2000; Workman et al., 2008). As a result, an individual's
assessment of the seriousness of a situation is positively
associated with their intentions to take preventative steps
(Pechmann et al., 2003).
If individuals perceive a threat to their organization's
information technology assets, they are more likely to adhere to
the ISSP's principles and standards (Bulgurcu et al., 2010;
Pahnila et al., 2007). Suppose an individual does not see a
threat in their environment when accessing corporate
information technology resources. In that case, they may be less
worried about adhering to the policies and procedures outlined
in their ISSP. In their study, Herath and Rao found that their
perception of severity highly influences employees' intentions
to adopt ISSP.

Attitudes: This refers to how a person feels about the conduct of
interest, whether favourable or harmful. It is necessary to take
into consideration the ramifications of engaging in the
behaviour. According to Boss et al. (2015), individuals have
more favourable security sentiments when sound judgments of
citizen efficacy. In addition to having an optimistic attitude
toward security laws, employees who believe their activities
have a positive impact on their organization are also more likely
to have a positive attitude toward security regulations
The attitude toward ISSP compliance will positively impact the
behavioural intention to comply with ISSP requirements. As
previously stated, self-efficacy is concerned with an individual's
belief in their ability and competence to execute a task or make
a choice in a given situation (Bandura, 1977, 1991). It has been
discovered that an individual's sense of self-efficacy
significantly impacts their ability to fulfill task behaviour,
including information technology (Compeau and Higgins, 1995;
Workman et al., 2008). Compeau and Higgins (1995) discovered
that people who have higher levels of self-efficacy in using
information systems are more likely than those who have lower
levels of self-efficacy to use information systems in their
professions.
Individuals with good information security capabilities and
competence are more likely to realize the need to adhere to
organizational information security policies and procedures, and
they may be better positioned to perceive the consequences of
non-compliance. In several studies, self-efficacy is associated
with complying with ISSP requirements. (2010); Pahnila et al.,
2007; Herath and Rao, 2009a; Workman et al., 2008; Bulgurcu
et al., 2010; Workman et al., 2010
Behavioural intention: It is more likely to occur when the
decision to engage in a behaviour is more meaningful than less
significant (Boss et al., 2015). A habit is a pattern of behaviour
that is repeated over time. Because people have been
accustomed to performing specific tasks, many can be carried
out without conscious thinking. According to habit theory,

repeated behaviour is frequently influenced by environmental
cues rather than conscious decision-making.
It was determined that their ISSP behavioural compliance was
not positively influenced by perceived severity in the threat
assessment component. This is surprising because one would
expect an individual's perception of risks, vulnerability,
security breaches, and assaults to impact compliance with an
organization's information security management system. This
outcome could have been influenced by variables in the
surrounding environment or from outside.
Another possibility is that this specific component has nothing
to do with ISSP behavioural compliance in the first place. In the
studies by Herath and Rao (2009a) and Bulgurcu et al. (2010),
which investigated ISSP behavioural compliance by employees
with TPB, PMT, and other theories, concern levels and attitude
were modelled as mediators of the link between perceived
severity and ISSP behavioural compliance.
In some cases, it's possible that an alternative conception would
lead to a different result from the one reached here. According
to the data analysis, employees who are more likely to comply
with their organization's ISSP also acknowledge that
organizational information technology resources are vul nerable
to compromise and destruction.
Subjective and Social norms: In this context, "subjective and
societal norms" allude to the assumption that most people
favour or disapprove of a given behaviour. As a result of the
person's thoughts, peers and other key people believe that the
person should engage in a specific course of action (Boss et al.,
2015). There are conventional rules of behaviour that exist
within a community or a culture. Social norms are accepted as
typical or standard behaviour among a group of individuals.
Subjective norms are …
A

i
Understanding female sport fandom is not only important to
teams who want to increase
attendance and merchandise sales, but also to brands and
sponsors interested in connecting with
this demographic. In the most lucrative North American
professional leagues (NHL, NASCAR,
MLS, NBA, MLB, and the NFL) females account for between
37% and 45% of the total market.5
Furthermore, women purchase 46% of official NFL
merchandise, spend 80% of all sports apparel
dollars, and control 60% of all money spent on men’s clothing.7
Clearly, being a ‘sport fan’ is no
longer exclusive to men. However, sport organizations sti ll
struggle to effectively manage the
female fan experience and cater to their specific behaviors,
attitudes, and motivations.
The purpose of this white paper is to help practitioners in the
sport industry enhance their
understanding of this consumer segment. To do so, we gathered
and analyzed a dataset of 1796
female sport fans from all geographies, age groups, socio-
economic backgrounds, and households.
They are fans of a wide range of professional sports – including
stalwarts like the NFL, NBA, and
MLB, and niche sport organizations like MLS, eSports, and
stock car racing. This group likely
represents the most diverse and representative sample of female
fans gathered.
Highlights from the data analysis and the relevant implications
for sport practitioners include:

• The following subgroups of females reported more frequent
consumption behaviors, more
fervent attitudes about sport consumption, and stronger
motivations for consuming sport.
eXeCUtIVe sUMMARY
- Young women and girls
- Women living in urban communities
- Minorities (Black, Hispanic, Asian, Native American, or
Other)
- Working females (employed full time, part time, or self-
employed)
- Single females
• The number of children in the household had little to no
bearing on female fans’ consumption
behaviors, attitudes towards sport consumption, or motivations
for consuming live sport.
This means that fan traits like passion for their favorite team
and intent to buy tickets did not
dissipate with children and family obligations
• The consumption behaviors most reliably predicted commonly
referenced digital and mobile
technology. These behaviors included consuming online
content, learning about, engaging with,
and finding content about their favorite teams, listening to
podcasts, and streaming live games.
• Women commonly reported that their sport consumption
behaviors were ‘dependent upon’
technology and that technology was essential to their sport
fandom. They also reported engaging
with brands via a wide range of social media platforms.

1
Despite the ubiquity of sport
fandom in the United States, there
are far too many assumptions about
and limited research conducted on
female fandom.1 Understanding
female fandom is not only important
to teams who want to increase
attendance and merchandise sales,
but also to brands and sponsors
interested in connecting with this
demographic.
According to Repucon2, 46% of women
are ‘interested’ or ‘very interested’
in sport, with 41% interested in
watching live sport events and 39%
interested in watching sport on TV.
Being a sport fan is no longer exclusive
to men. With the passing of Title IX, a
law that prevented sex discrimination
in schools, girls, and women were
afforded vastly expanded opportunities
to participate in sport.3
Assumption: Women only go to sport
events to be with their husbands or
boyf riends
Assumption:
Women are only

superficial fans;
they don’t know
the technical part
of the game
Assumption: Women only watch sports to socialize.
WHAt
We
KnoW
Unfortunately, while participation
in sport grew, females as major
athletes, employees, fans, and
sport consumers have often not
been taken seriously.1
FeMALe FAnDoM MAtteRs
Female fandom is growing, but their needs
are not being met as sport consumers,
which results in sport organizations and
brands missing critical revenue streams.4
Females make up a significant percentage
of the sport consumer market – ranging
from 37% to 45% for the NHL, NASCAR,
MLS, NBA, MLB, and the NFL.5 However,
sport organizations fail to counteract the
narrative that women are only at games
to spend time with friends, to appease
for women, ignores the myriad interests,
needs, and wants of the female sport

fan.8,9
While some teams are moving away from
everything pink, many of the women’s
jerseys are highly sexualized or cut for
thinner, more petite women. Women
who don’t prefer this sizing have limited
options. Much of the decisions tied to
consumer products are tied to gender
schema theory, where there is a
husbands or boyfriends, or to take their
children – mainly boys.6
Sport organizations should also care about
women because of their purchasing power
in the household. Women purchase 46%
of official NFL merchandise and spend
80% of all sports apparel dollars.7 Further,
women control 60% of all money spent
on men’s clothing.7 Therefore, marketers
who take the time to learn about female
consumers will likely be able to engage
fans beyond gimmicks like pink jerseys,
tiaras, and boas. The ‘shrink it and pink
it’ mentality, where men’s products are
reduced in size and changed in color
tendency to classify everything as male
or female.10 So, assumptions are made
about products for women based on
gender stereotypes rather than asking
what they want.4 While there have been
efforts made to broaden the merchandise
offerings for women, there is still much
that needs to be done in relation to the

female fan experience.4 When the imagery
in venues and ads are of highly sexualized
cheerleaders or ‘hot fans’, clearly the
intended audience is for males, not females.
Teams need to consider what female fans
want in their fan experience.2, 11
3
We neeD to KnoW tHeM
As women gain more control over their activities, including
sport, gender is
less likely to influence consumption of sport.12 Therefore,
marketers must
move past assumptions and stereotypes about the female fan.
Sexism and
stereotypical role expectations of women are omnipresent in
sport. Academic
studies as well as posts on mainstream social media suggest that
women are
viewed as inauthentic fans who are less knowledgeable and only
follow sport
for their partners or social interaction (see figure).2, 11
Therefore, its essential
to understand the interests and behaviors that identify female
fandom; and
to realize that it will not look like the traditional male fan
behavior.4
The purpose of this study was to chart the trends
that characterize female sport fans’ consumption
behaviors, at titude s, and moti vations.

4
tHe PLAYeRs
This section contains an overview of the female
fan characteristics and the insights. In an effort
to streamline the information and ensure that
relevant details are communicated effectively,
the more technical aspects of the analyses and
findings are included as footnotes.
Of the 1,796 total female participants in the
study, 76.2% were white, 8.7% were black,
6.7% were Hispanic, 4.4% were Asian, 2.2%
were Native American, 1.1% were ‘other’,
and 0.8% preferred not to answer. Over 45%
were married, 37.7% were unmarried (single,
divorced, widowed), and 17% were underage
or did not respond.
T h e f i g u r e s b e l o w i l l u s t r a t e t h e o t h e r
demographic details of the female sample.
76.2% white
45.2% married
18.5%
kids in
house
hold
41.9%
income

over
$50k
5
The first goal of our
analysis of female fans
was to build a general
modeli that sought
to predict a series of
behaviors, attitudes,
and motivations most
commonly associated
with sport fandom. In
this stage, we used eight
demographic variables
to predict 40 individual
We wanted answers to
t wo key que stions:
1. Which ch arac te r is t ics
could predict female
fans’ consumption
behaviors?
2. Which c ate gor ie s of
female fans’ behaviors
can be predicted?
behaviors and 15 attitudes
toward sport consumption, and
12 motives for consuming live
sports.

The second goal of this analysis
was to develop a deeper
understandingii of the trends
highlighted in the first portion
of the analysis by exploring
how groups and subgroups of
females differed in fan behaviors,
attitudes, and motivations.
i Fifteen attitudes, 12 motivations, and 13 behaviors produced
cross sectional data that were examined using OLS
linear regression with fixed effects for community type,
ethnicity, employment status, marital status, annual
income, and geography – region. Number of children in the
household and age were treated as continuous
variables. Another 28 behaviors were analyzed as dichotomous
outcomes, phrased in such a way as to allow us
to model the likelihood that a female fan would engage in the
consumption behavior at least once per week.
These 28 behaviors were modeled using a logistic model
specification.
iiThis stage of the analysis involved using a series of ANOVAS
and post-hoc tests to isolate group differences.
6
FInDInGs
7
There were a handful of insights that broadly inform

this study’s main research questions. Table 1 depicts
the 40 outcomes related to sport consumption
behaviors. Each column represents a predictor variable
included in the model. Purple blocks connote that the
predictor was useful,iii while the white boxes
Table 1. Predictive Sport Consumption Behaviors
iii Statistically signficant at the .05 level or better
Strong Predictor Weak Predictor
A
cc
ur
at
el
y
P
re
di
ct
ed
Le
ss
A
cc
ur

at
el
y
P
re
di
ct
ed
indicate no bearing on the outcome. To clarify the interpretation
of the tables,
the eight demographic predictors are arranged from left to right
in order of most
to least predictive. Additionally, the outcomes for each category
are arranged
from top to bottom in order of most accurately to least
accurately predicted.
8
Table 2 depicts the 15 outcomes related to sport consumption
attitudes. As
with Table 1, each column represents a predictor variable
included in the
model - purple indicating a useful predictor.
Table 2. Predictive Sport Consumption Attitudes
Finally, Table 3 depicts the 12 outcomes related to sport
consumption
motives.V

iv Statistically significant at the .05 level or better
v Statistically significant at the .05 level or better
Table 3. Predictive Motives for Live Sport Consumption
Le
ss
A
cc
ur
at
el
y
P
re
di
ct
ed
A
cc
ur
at

el
y
P
re
di
ct
ed
Le
ss
A
cc
ur
at
el
y
P
re
di
ct
ed
A
cc
ur
at

el
y
P
re
di
ct
ed
9
InsIGHts
Younger female fans reported stronger fan
behavior and positi ve at titude s than older fans
Younger female fans displayed stronger
moti ve s for li ve sport than older fans
Urban female fans use technology to consume
sport more than those outside of citie s
Minorit y female fans believe li ve sport is more
authentic to watch than white fans
Minorit y female fans use more technology to
consume sport than white fans
10
Several broad themes appear from the model.

1 Female fans’ age was the strongest predictor with
younger females most associated with stronger and
more frequent fan behaviors, more positive attitudes,
and stronger motivations for consuming live sports. For
example, younger female fans are more likely to consume
general online content, stream games, use technology
sources to learn about their team, and follow their favorite
team on social media.
2 Community type - whether the participant lives in an urban,
suburban, or rural
community - was the next strongest predictor. Urban fans were
more likely to attend
ancillary events and watch on demand programming about their
favorite team and
were more technology dependent. Urban fans also were highly
motivated by live sport
programming.
BRoADeR InsIGHts
Minorit y fans cle arly stand out in the data - e specially
related to moti ve s to watch sport li ve
3 Female fans’ race predicted female fans’
motivations especially, in addition to quite a
few behaviors and attitudes. For the ethnicity
variable, respondents indicated whether
they were white, black, Latino, Asian, Native
American, or other. Minority fans were
highly motivated by live sport content than
white fans. In particular, watching live made
the fan experience more memorable, helped
them to feel part of a greater community, and
was the most thrilling way to consume sport.

11
4 For working status, follow
up analyses found that working
females (employed full-time,
self-employed, and employed
part-time) engaged in more
frequent consumption behaviors,
significantly more favorable
attitudes, and significantly stronger
motivations for consuming sport
than did non-working females
(students, unemployed, and retired).
Working female fans consume online content,
watch sport li ve, and buy merchandise more than
non-working fans
5 The number of children present in the female fans’
households is an important predictor. This is important for
female fandom because children can have two differing
effects on consumption kids can cause: (a) time and attention
tradeoffs that reduce consumption, or (b) opportunities for
the transference of fandom (parent to child) that can increase
fandom. Surprisingly, the number of children in the household
had little to no bearing on female fans’ consumption behaviors,
attitudes towards sport consumption, or motivations for
consuming sport.
Female fans with children reported the same
levels of passion and fan identit y as those
without children

Female fans with children reported higher levels of sport
consumption addiction than those without children.
12
Women, and sometimes especially girls, tend to be discounted
as a target market by sport
practitioners based on traditional gender norms and
expectations.10 Sport consumption can be
‘branded’ using traditionally masculine qualities in the news
media and popular press, but the rapid
dilution of traditional gender norms has motivated a new crop
of young sport consumers, many of
whom are female. 2, 4, 9 Thus, sport practitioners would do
well to prioritize this market opportunity
to a greater extent than they have to date. Women and girls can
be incorporated into organizations’
Women watch sport li ve because:
• it builds a sense of communit y
• it’s an authentic way to watch
• it’s the most thrilling way to
consume it
• it provide s re al drama in their
li ve s
• they can witne ss histor y
target audience using updated marketing
frameworks that de-gender sport
consumption, or especially by creating brand

and marketing materials that speak directly
to this segment, their interests, and their
motivations.
The urban setting was highly predictive,
especially of technology consumptive
behaviors. Given the closer proximity to
teams in the urban setting, it is unsurprising
that female fans in these areas would express
more sport consumption behavior. However,
region (west, midwest, south, and mideast)
was not at all predictive. Meaning female
fans tend to manifest these behaviors
Antiquated notions of gender stereotypes
around females in sport have long
dominated the thinking about what it
means to be a female in sport.1, 3, 4, 5, 8, 9,
10,11,12 Practitioners in sport organizations
can leverage these insights by creating
opportunities for females to engage in
the ways that they prefer. Moving beyond
stereotypes, providing a fan experience
that is catered to them specifically, and
listening can enhance the relationship
sport organizations have with a major
household decision-maker and spender.
Doing so can enhance revenue streams,
cultivate stronger relationships with
build a fanbase that is truly there for their
own leisure experience.
tHe WRAP UP

13
1. Pope, S. (2017). The feminization of sports fandom: A
sociological study. New York, NY:
Routledge.
2. Author Unknown (2017). Women and Sport: Insights into the
growing rise and importance
of female fans and damela athletes. Repucom. Retrieved
February 2020 from http://
nielsensports.com/wp-content/uploads/2014/09/Women-and-
Sport-Repucom.pdf.
3. Staurowsky, E. J. (2019). The impact of Title IX and other
equity laws on the business of
women’s sport. In (Eds.) Lough, N., & Geurin, A. N. Routledge
Handbook of the Business of
Women’s Sport. New York, NY: Routledge.
4. Harrolle, M. & Kicklighter, K. (2019). Women are sport fans!
An examination of female sport
fandom. In (Eds.) Lough, N., & Geurin, A. N. Routledge
Handbook of the Business of Women’s
Sport. New York, NY: Routledge.
5. Funk, D. C., Alexandris, K., & McDonald, H. (2016). Sport
consumer behaviour: In (Eds.)
Mothersbaugh, D. & Hawkins, D. Consumer behavior: Building
Marketing Strategy. New York,
NY: McGraw-Hill Higher Education.
6. Lange, J. (2018, September). Women love baseball, why
doesn’t baseball love them back? The
Week. Retrieved from,
https://theweek.com/articles/793920/women-love-baseball-why-
doesnt-baseball-love-back.

7. Watson, C. (2015). Fanbase Economics: Engaging female
fanbases. Futureof.org. Retrieved
February 2020 from http://futureof.org/sports-2015/fanbase-
economics/.
8. Brown, B. & Nutler, B. (2019). Authentically communicating
with women consumers:
examining successful (and non-successful) branding and
marketing efforts. In (Eds.) Lough,
N., & Geurin, A. N. Routledge Handbook of the Business of
Women’s Sport. New York, NY:
Routledge.
9. Newland, B. (2019). The delivery and management of
women-only sport events and their
future sustainability. In (Eds.) Lough, N., & Geurin, A. N.
Routledge Handbook of the Business of
Women’s Sport. New York, NY: Routledge.
10. Staurowsky, E. J. (2016). Women and sport: From liberation
to celebration. Champaign, IL:
Human Kinetics.
11. Sveinson, K., & Hoeber, L. (2016). Female sport fans’
experiences of marginalization and
empowerment. Journal of Sport Management, 30(1), 8-21.
12. McGinnis, L., Chun, S., & McQuillan, J. (2003). A review
of gendered consumption in sport and
leisure. Bureau of Sociological Research-Faculty Publications,
2.
ReFeRenCes
http://nielsensports.com/wp-content/uploads/2014/09/Women-

and-Sport-Repucom.pdf
http://nielsensports.com/wp-content/uploads/2014/09/Women-
and-Sport-Repucom.pdf
doesnt-baseball-love-back
doesnt-baseball-love-back
http://Futureof.org
http://futureof.org/sports-2015/fanbase-economics/
14
APPenDICes
This section provides a brief snapshot of the preferences of
female sport fans by favorite sport,
favorite sport to watch live, interest in sport by favorite athlete
or team, and self-reported fan
affinity for sport generally and their favorite sport. The key
takeaways are as follows:
• All generations chose the NFL as their favorite, with strong
interest in the NCAA basketball and
football, and MLB (for older generations).
• All generations enjoy watching NCAA basketball and football
as well as motorsport live. Older
generations enjoy watching MLB live.
• Female Gen Zs and millennials had the largest portion that felt
more attached to their favorite
athlete than team. However, all four generations follow the team
more than the athlete.
• When asked to rate their fan affinity, all generations felt they
were an average fan, generally.

However, Gen Zs rated their general sport fandom as a ‘strong
fan’, as well.
• When asked the same question about fan affinity about their
favorite team, all four generations
rated themselves as ‘strong fans’ on average. Very few rated
themselves as obsessed or addicted
fans, which is consistent with their passion findings - most were
found to have harmonious
passion over obsessive passion or addiction.
15
GENERATION X FAVORITE SPORT
16
GENERATION X FAVORITE SPORT TO WATCH LIVE
17
GENERATION X FAVORITE ATHLETE OR TEAM
18
GENERATION X GENERAL FAN AFFINITY

19
GENERATION X FAVE SPORT FAN AFFINITY
Dr. Bri Newland
and
Dr. Ted Hayduk
Special acknowledgements to Ben Valenta and FOX Sports for
sponsoring this research partnership
EXECUTIVE SUMMARYWHAT WE KNOWFEMALE
FANDOM MATTERSWE NEED TO KNOW THEMTHE
PLAYERSFINDINGSINSIGHTSBROADER INSIGHTSTHE
WRAP UPREFERENCESAPPENDICESAcknowledgments
CLOSING THE SPORTS FAN GENDER GAP
Women make up less than half of global sports fans. But many
sports are closing the fan
gender gap, some by more than 40% since 2017.
This Sunday marks International Women’s Day, and an
opportunity to reflect on and celebrate
the massive strides over recent years towards parity for women
in the world of professional
sports.
While we have seen significant progress in terms of increased
female representation on the

field and across sports media, increasing (though not
consistently equal) pay and prize money,
greater sponsor engagement, and sporting feats of individual
brilliance by female athletes, the
reality is that many sports still attract a predominantly male fan
base.
in Sport (http://thegembagroup.com/gemba-
March 6, 2020
http://thegembagroup.com/gemba-news/?cat=sport
http://thegembagroup.com/
Has the recent increased focus and exposure for women’s sport
helped reduce the gender
imbalance among sports fans? Are we closing the sports fan
gender gap?
There are many positive signs that sports around the world are
working to be more accessible
and appealing to a wider, more diverse audience. Many sports
see this as critical to their long-
term sustainability – sports can’t expect to focus on a
traditional “pale, male and stale” fan base
and hope to grow sustainable revenues, attract new fans, and
continue to build participant
pathways.
From shorter formats (e.g. T20 cricket), more entertainment

around a sporting event (e.g.
Formula 1 Grand Prix, Australian Open tennis), and marketing
campaigns that speak to different
and diverse fan segments, the sports fan experience has become
increasingly accepting (and
acceptable) for all fans.
But which sports are most balanced in terms of gender among
passionate fans? Which have
the biggest fan gender gap? And which sports and regions
around the world are moving the
needle the most to close the gap?
APPROACHING PARITY
If success on gender parity in sports fandom is that the
population of sports fans reflects the
gender split in the overall population, we should be aspiring to
a roughly 50:50 split
(https://en.wikipedia.org/wiki/World_population#Global_demog
raphics) of males and females
among passionate sports fans.
In 2020, according to Gemba Insights global sports fan
research, across a basket of 13 of the
world’s most popular sports, women make up 47% of highly
engaged, passionate sports fans.

This is up from 45% three years ago, so the fan gender gap is
closing.
However, these figures mask some larger gender gaps in
specific sports and regions. A relatively
high proportion of female fans in Swimming, Tennis and
Volleyball (especially in China) skew the
data closer to parity.
Globally, football (soccer) has only 42% of its fan base being
female, almost unchanged since
2017 despite the success of the Women’s World Cup
tournament, won by the USA, in 2019.
And in key markets around the world, including Australia, the
UK, Japan and the US, sports
fandom remains largely the preserve of men, although the fan
gender gap has closed by as
much as 40% in some sports over the past three years.
A NATIONAL SPORT LENS
https://en.wikipedia.org/wiki/World_population#Global_demogr
aphics
We might expect that the biggest sports in each country could
be the ones that appeal most to
female fans; they have more existing fans, more people talk

about them and it’s almost
impossible to miss them in the media – hence we’d expect the
major national sports to be at
the vanguard of closing the fan gender gap.
In the US, the fan base of American Football (gridiron) is
strongly male dominated, with almost
two-thirds of fans being male. Notably, this has not changed
since 2017 – the NFL is not closing
its fan gender gap. Yet Basketball, starting from the same level
as American Football in 2017,
closed the fan gender gap in 2020 from 11 percentage points to
just 7 points – a 36% reduction
in the gender gap to parity in just over three years.
It is no coincidence that Basketball has seen continued growth
in both cultural relevance and
commercial outcomes during this time (a key commercial lesson
to all rights-holders – expand
your appeal).
Cricket is a major sport in Australia, India and the UK. As a
sport, Cricket has closed the fan
gender gap in Australia by 21% since 2017 (from women
making up 31% of fans, to 35% in 2020),
and by 27% in the UK (from a low base of 28% up to 34% of
fans being female). The strength of

the local women’s leagues (WBBL, for instance) has
contributed greatly to the increasing
interest in the sport amongst women. In India, where Cricket is
akin to a religion, the gender gap
is much smaller – 47% of Cricket fans there are female.
Football is perhaps the sport with the most compelling global
story to tell around female
engagement over the past few years, with a highly successful
World Cup, positive publicity and
strengthening women’s leagues around the world. This has led a
narrowing of the gender gap in
Brazil, the US and the UK.
SPORTS BUILDING PASSION AMONGST FEMALES
We’ve observed a number of other patterns emerging from the
data. Gemba’s global research
in 2017 covered 10 countries (Australia, UK, US, Brazil, China,
Italy, Spain, Germany, India and
Japan) – though the study has now expanded to 20. When we
looked at each country, we
largely saw what one might expect given the frequent gender
bias reported in sport. While there

was an overall male skew, we saw certain sports presenting a
larger gender imbalance. American
Football, Boxing and Rugby Union present higher skewed fan
profiles toward males, while others
such as Tennis, Volleyball and Swimming demonstrated a more
balanced profile.
And in the three intervening years we can demonstrate some
positive shifts in this pattern. In
the 13 sports shown in the chart below, the average proportion
of female sports fans increased
by 3 percentage points closer to parity, and has increased for all
sports apart from Swimming
and Tennis (two sports that already had an equitable fan gender
balance). Rugby Union, Rugby
League, American Football and Boxing – largely archetypal
male supported sports – all
experienced a balance shift in favour of females and closer to
parity (though their fan bases
remain predominantly male).
CHANGES BY MARKET
What about the fan gender gap at the country level? In 2017 all
countries we analysed apart

from China and India had large fan gender skews towards
males. The biggest gender gaps were
in Australia, the UK, the US and Japan.
When we look at the same countries in 2020, most countries
have attracted a larger proportion
of females into their fan base. Impressive gains were noted in
the UK, the US, Italy (all +5
percentage points closer to parity) and Germany (+6 points
closer to parity). In Germany there
is an increasing push to include women in sport – and a
recognition of previous under-
acknowledgement of past achievements. It now honours the
country’s best female footballers
in a Hall of Fame, and 2020 marks 50 years since a ban on
women’s football was overturned in
Germany.
The overall shifts noted means that women are increasingly
more engaged in sport and express
a growing passion toward it.
A GENERATIONAL SHIFT
The shift in fan balance is a positive outcome for all the hard
work currently being undertaken by

the emerging sports stars and administrators alike. Not all
women’s sports are achieving the
attention of Football or Cricket, yet the perseverance to grow
the game needs to be
acknowledged.
There are a range of reasons why a person becomes involved in
a sport – sometimes it is a
parent taking a child to a game; sometimes it’s kids talking
about the sport in the playground or
simply being unavoidably exposed to it if it’s a national
pastime.
But there is one sure way to grow passion for a sport and that is
to be able to see yourself in the
faces on the sporting field. The last three years has experienced
unprecedented growth in
female sport, with more leagues and greater exposure and
airtime – and we’ve seen the
emerging passion of female fans as they can increasingly see
female athletes on the playing
field.
Those sports that embrace the growth in women’s participation
and fandom will continue to
build a new, more diverse generation of fans that will sustain
the sport for years to come.
Find out more about Gemba’s global sports and entertainment
research at

www.thegembagroup.com/insights
(http://www.thegembagroup.com/insights)
http://www.thegembagroup.com/insights
Research parameters:
Fandom defined as 4 or 5 on a 5-point self-rated passion scale
for the given sport
Age 16+
Sample size n=1,000 per country per year
Surveys conducted in each market October/November 2017 and
January 2020
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Across the world, the sports scene and its many tribes are
changing in step with wider trends.
This is particularly true for women’s sports, and female sports
fans - which are both surging.
Yet the commercialization of women’s sports has not been fully
realised. With nearly a quarter
of women saying they like to watch sport, what are the
opportunities for brands to make a
lasting impact?
In this report find out more about the most popular women's
sports, consumption habits, and
how media coverage of women in sport is changing.
The popularity of women's sports

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Grand Valley State University
[email protected]
Peer Reviewed Articles Psychology Department
2012
Sex Differences in Sports Across 50 Societies
Robert O. Deaner
Grand Valley State University, [email protected]
Brandt A. Smith
University of Texas at El Paso
Follow this and additional works at:
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Recommended Citation
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Sports Across 50 Societies" (2012). Peer Reviewed Articles. 2.
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Cross-Cultural Research
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3687
The online version of this article can be found at:
DOI: 10.1177/1069397112463687
published online 29 October 2012Cross-Cultural Research
Robert O. Deaner and Brandt A. Smith
Sex Differences in Sports Across 50 Societies
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463687CCRXXX10.1177/106939711246368
7Cross-Cultural ResearchDeaner and Smith
© 2011 SAGE Publications
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1Grand Valley State University, Allendale, MI, USA
2University of Texas at El Paso, El Paso, TX, USA
Corresponding Author:
Robert O. Deaner, 1 Campus Drive, Department of Psychology,
Grand Valley State University,
Allendale, MI 49401, USA
Email: [email protected]
Sex Differences in
Sports Across 50
Societies
Robert O. Deaner1 and Brandt A. Smith2
Abstract
Sports have been frequently explored in cross-cultural studies,
yet scant atten-
tion has been paid to female participation. Here we coded the
occurrence of
sports and related activities for males and females in the
societies comprising
the Human Relations Area Files (HRAF) probability sample. We
then tested
several predictions derived from evolutionary theory. As
predicted, in all 50
societies with documented sports, there were more male sports
than female
sports; hunting and combat sports were almost exclusively male
activities; and
the sex difference in sports was greater in patriarchal than in
nonpatriarchal
societies. These results show that a robust sex difference in
direct physical

competition co-occurs with meaningful variation in its
expression.
Keywords
evolutionary psychology, anthropology, athletics,
competitiveness, gender
differences, aggression, universal
A game can be defined as an organized activity where two or
more sides
compete to win according to agreed-upon rules (Chick, 1984;
Guttmann,
2004; Roberts, Arth, & Bush, 1959). Games occur in most or all
societies
(Chick, 1984, 1998; Craig, 2002; Sutton-Smith & Roberts,
1981), and, from
2 Cross-Cultural Research XX(X)
a cross-cultural perspective, they are the most extensively
studied expressive,
noninstrumental aspect of culture (Chick, 2000). Previous
studies have
revealed, for example, that games of chance are associ ated with
supernatural
involvement in human affairs (Roberts et al., 1959), combative
games cor-
relate with the frequency of homicide (Chick, Loy, &
Miracle,1997) and war-

fare (Sipes, 1973; see also Chick et al.,1997; Schlegel &
Herbert, 1989), and
games of strategy are associated with the severity of child
training (Roberts
& Sutton-Smith, 1962) and societal complexity (Chick, 1998;
Roberts et al.,
1959; Roberts & Barry, 1976; Sutton-Smith & Roberts, 1970).
Surprisingly, the sex of game participants has received almost
no attention
in previous cross-cultural studies (but see Schlegel & Herbert,
1989). This
neglect might be due to assumptions that only males
substantially participate
or that there is insufficient information available for coding
participants’ sex
in most societies. In any event, the present study is designed to
redress this
gap. In particular, we will systematically code participants’ sex
in games and
related activities for the 60 societies in the Human Relations
Area Files
(HRAF) probability sample (Lagacé, 1979; Naroll, 1967). We
will then test
predictions regarding sex differences in participation and
attempt to link vari-
ation in sex differences to social structure.
For two reasons, our study focuses on games that require
physical skill,
which we hereafter call “sports” (see Loy & Coakley, 2007).
First, sports are
by far the most common kind of game across societies (Chick,
1998; Roberts
et al., 1959; Roberts & Sutton-Smith, 1962). Second, the
theoretical predic-

tions regarding sex differences seem strongest for sports (see
below).
Nonetheless, we will code other kinds of games, and some of
our predictions
address them.
We note that Schlegel and Herbert (1989) assessed the
occurrence and
importance of competitive games for male and female
adolescents in the
186 societies that comprise the Standard Cross-Cultural Sample
(Murdock
& White, 1969). They reported that competitive games for
males were doc-
umented in 60% of societies, whereas competitive games for
females
occurred in 30% of societies. Although highly valuable, this
study did not
differentiate kinds of games (i.e., sports, games of chance,
games of strat-
egy) or report whether there were any societies where female
participation
was similar to or greater than male participation.
In the next section, we provide the theoretical rationale for a
hypothesis of
a pronounced sex difference in sports participation and develop
specific pre-
dictions to test it. We conclude the Introduction with a section
explaining
why variation in sex differences can be predicted to correlate
with social
structure, especially the empowerment of women.

Deaner and Smith 3
Sex Differences
Numerous functions for sports have been hypothesized, all of
which appear
mutually compatible (Chick, 1984; Lombardo, 2012; Schlegel &
Herbert,
1989). However, from an evolutionary perspective (i.e., linked
to survival
and reproduction), three hypotheses seem plausible (Lombardo,
2012). First,
sports may function as culturally invented courtship rituals that
reliably
advertise quality to the opposite sex (de Block & Dewitte, 2009;
Miller,
2000). Second, sports may function as physical competitions for
status, dif-
fering from unrestrained combat or warfare because they reduce
the risk of
physical harm to competitors and more publicly and efficiently
reveal the
competitors’ underlying competitive qualities (de Block &
Dewitte, 2009;
Faurie, Pontier, & Raymond, 2004; Lombardo, 2012; see also
Miller, 2000).
Third, sports may function to build skills necessary for
physically demanding
activities, especially combat, warfare, and hunting (e.g., Chick
et al., 1997;
Craig, 2002; Lombardo, 2012; Sipes, 1973).

To the extent that these hypotheses hold, especially the second
and third
hypotheses, it can be further hypothesized that, compared to
girls and
women, boys and men will, on average, have a far greater
motivational pre-
disposition to participate and monitor sports, especially sports
involving
combat-relevant skills and/or team play. This hypothesis
follows from the
following points. First, throughout human evolutionary history
and during
contemporary periods, men have been substantially more likely
than women
to engage in contests involving extreme physical aggression
(Archer, 2009;
Daly & Wilson, 1988; Walker, 2001), between-group raiding
and warfare
(Adams, 1983; Gat, 2006; Keeley, 1996), and cooperative
hunting of large
game (Marlowe, 2007; Murdock & Provost, 1973). Second, this
history is
revealed by pronounced sexual dimorphism in strength and
related attri-
butes (Lassek & Gaulin, 2009; Mayhew & Salm, 1990; Seiler,
De Koning,
& Foster, 2007). Similarly, men (but not women) possess
secondary sexual
characteristics (e.g., beards, pronounced jaws, deep voices) that
function to
threaten rivals (Neave & Shields, 2008; Puts, 2010). Third,
another legacy
of this history is a predisposition(s) to behaviorally prepare for
physical
contests, both individually and in groups. This is indicated by
the fact that

in all societies studied so far, boys engage in more rough-and-
tumble play
and play-fighting (DiPietro, 1981; Geary, 2010; Whiting &
Edwards, 1973,
1988). Studies also consistently indicate that boys are more
likely to form
large same-sex groups, to differentiate roles within such groups,
and to seek
competition with other groups (Geary, 2010; Lever, 1978; Rose
& Rudolph,
2006). Fourth, several kinds of evidence indicate that these sex-
differentiated
play patterns are due, at least in part, to boys’ typically greater
exposure to
androgens prior to birth (Berenbaum & Beltz, 2011).
There is considerable evidence for the hypothesis that males
have an inborn
predisposition to be interested in sports. First, studies in large
contemporary
societies ubiquitously report greater male interest in
participating, watching,
and excelling in sports. Evidence comes from self-reports of
interest (summa-
rized in Ellis et al., 2008) and from actual participation (e.g.,
Larson & Verma,
1999; Lunn, 2010; Stamatakis & Chaudhury, 2008). There is

even a large sex
difference in sports interest and participation in the
contemporary United
States, a society where great efforts have been made to equalize
opportunities
for females (Deaner et al., 2012). Second, females with
congenital adrenal
hyperplasia (a disease characterized by heightened prenatal
androgen expo-
sure) are more likely than typical females to show strong
interest in stereotypi-
cally masculine sports (Berenbaum, 1999; Berenbaum & Snyder,
1995; Frisén
et al., 2009). Third, historical reviews of sports in large, literate
societies docu-
ment that many societies had substantial female participation,
but males are
reported as being substantially more involved in most or all
cases (Craig, 2002;
Guttmann, 1991, 2004). Finally, as noted above, cross-cultural
ethnographic
studies of sports appear consistent with the prediction of greater
male participa-
tion (e.g., Chick, 1984, 1998; Chick et al., 1997; Roberts et al.,
1959; Sipes,
1973), and this is true of the one study that provided the most
direct evidence
(Schlegel & Herbert, 1989).
For the present study, it would be desirable to obtain data on
the frequency of
sports participation, but this cannot be extracted from
ethnographic materials.
Instead, we will focus on documenting the number of games and
sports described
in each society and whether males, females, or both regularly

participate. To
address the possibility that a larger number of male games
might merely reflect
ethnographers focusing more attention on males, we will also
code nonsport
games and noncompetitive play activities (i.e., amusements: see
Roberts et al.,
1959; Schlegel & Herbert, 1989). If there is substantial
ethnographer bias, the
sex difference should be similar in sports and in these other
activities.
Additional predictions can be derived from the hypothesis of an
evolved
male tendency to be interested in sports. First, the sex
difference should be
especially pronounced for combat sports, such as wrestling and
boxing, and
for hunting sports, such as archery and spear throwing. The
basis for this
prediction is that combat and hunting generally have been male
activities dur-
ing human evolutionary history (see above). Nonetheless, sports
that do not
involve actions directly related to combat or hunting are still
expected to
show greater male participation because males appear generally
more predis-
posed to engage in direct competition of almost any kind
(Campbell, 1999,

Deaner and Smith 5
2002; Deaner, 2012; Niederle & Vesterlund, 2011).
Furthermore, many sports
that do not require actions patently used in combat or hunting
require related
skills. For example, baseball, although not a hunting or combat
sport, involves
running, overhand throwing, and tracking projectiles.
A second prediction is that the sex difference should be
especially pro-
nounced for sports involving physical contact between
opponents. This pre-
diction follows because combative sports invariably entail
aggressive
physical contact and even noncombat sports often involve this.
Thus, males
are expected to participate relatively more in sports involving
physical con-
tact, even after combat and hunting sports are excluded.
A third prediction is that the sex difference should be especially
pro-
nounced for team sports rather than individual sports. This
prediction follows
from the male predispositions hypothesis because team sports
require both
motivation to engage in physical competition and motivation to
engage in
cooperative group challenges, especially in between-group
contexts. Both
kinds of motivation apparently are greater in males (Campbell,
1999, 2002;
Geary Byrd-Craven, Hoard, Vigil, & Numtee, 2003; Puts, 2010;

Rose &
Rudolph, 2006; van Vugt, 2009). However, individual sports
require only one
kind of motivation, whereas team sports require both,
suggesting that the sex
difference should be larger there.
Female Power
Although we anticipate that males’ sports participation will be
substantially
greater than females’ in most or all societies, there is evidence
of appreciable
female sports participation in many of them (Craig, 2002;
Guttmann, 1991;
Schlegel & Herbert, 1989). Although we know of no existing
framework to
predict the cross-cultural variation, the three functional
hypotheses outlined
above provide a useful starting point.
If sports function, first, as culturally invented courtship rituals
(de Block &
Dewitte, 2009; Miller, 2000) or, second, as physical
competitions for status that
publicly and efficiently reveal underlying competitive qualities
(de Block &
Dewitte, 2009; Faurie et al., 2004; Lombardo, 2012), then
females might be
expected to participate in sports more in societies where
females compete more
to be chosen as mates or to gain status. There is a problem with
this hypothesis,
however: The qualities females mainly advertise when seeking
mates or com-
peting for status are physical attractiveness (e.g., youthfulness,
femininity,

health) and personal integrity (e.g., good sexual reputation;
Campbell, 1999,
2002; Cashdan, 1996; Schmitt & Buss, 1996), and these
qualities do not seem
emphasized in most sports, which generally involve direct (i.e.,
simultaneous)
competition and potential physical contact. Indeed, playing
sports is associated
with greater attractiveness and higher status for males but not
for females
(Holland & Andre, 1994; see also Brewer & Howarth, 2012;
Chase & Dummer,
1992). Similarly, physical dominance (a typical correlate of
sport success) gen-
erally increases the attractiveness of men but not of women
(Bryan, Webster, &
Mahaffey, 2011; Sadalla, Kenrick, & Vershure, 1987). Although
there are judged
sports (e.g., figure skating, gymnastics, cheerleading) that
emphasize physical
attractiveness and do not involve direct competition, these
sports apparently
only occur in large nation-states and thus will be largely
irrelevant for the HRAF
probability sample.
The third functional hypothesis, that sports function to build

skills needed
for physically demanding activities, might also seem improbable
for explain-
ing cross-societal variation female sports. The reason is that
this hypothesis
was developed by evolutionarily oriented scholars in reference
to warfare and
cooperatively hunting large game (e.g., Chick et al., 1997;
Lombardo, 2012;
Sipes, 1973), and females rarely participate in these activities in
any society
(Adams, 1983; Gat, 2006; Keeley, 1996; Marlowe, 2007;
Murdock & Provost,
1973). Nonetheless, if this hypothesis is conceived more
broadly, namely that
sports foster skills for physically or socially demanding
activities, then it
becomes quite plausible (see Schlegel & Herbert, 1989). In fact,
in large soci-
eties with organized sports, both historical and contemporary,
there have been
countless claims that sports promote physical and social
development, includ-
ing “building character” (e.g., Guttmann, 2004; Eccles, Barber,
Stone, &
Hunt, 2003). Although it has proven difficult to establish causal
relationships,
many studies document that sports participation correlates with
a variety of
positive outcomes outside of the sporting arena, and this holds
for both males
and females (Eccles et al., 2003; Rees & Sabia, 2010;
Stevenson, 2010).
This “sports as training” hypothesis generates the prediction
that female

sports participation should be relatively greater in
nonpatriarchal than in
patriarchal societies. The logic for this prediction is that
patriarchal societies
can be generally considered low in female power, which can be
defined as the
capacity for women to control resources and exert pol itical
influence (Low,
1992; Yanca & Low, 2004). We will define patriarchal societies
as those char-
acterized by both patrilocality and patrilineality (Yanca & Low,
2004; see
also Hrdy, 1999; Low, 1992; Smuts, 1995).
Methods
We used the electronic HRAF materials (eHRAF:
http://ehrafworldcultures.
yale.edu) and focused on the probability sample of 60 societies.
The probability
Deaner and Smith 7
sample is a cross-cultural sample designed to ensure
representative coverage of
traditional and peasant cultures of the world. Its developers
randomly selected
one well-described culture from each of 60 world regions
(Lagacé, 1979;
Naroll, 1967). We searched with three Outline of Cultural
Materials (OCM)

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