Abstract
Over a lifetime, the annual per capita direct and indirect costs associated with cardiovascular disease amount to around 1 year’s salary for the average wage-earner. Additional costs arise from other forms of chronic disease where physical activity could potentially play a preventive role. Questionnaires and other methods of categorizing an individual’s habitual physical activity suggest that per capita health-care costs may be half as great in those members of the community who are classed as physically active, and some authors have thus argued that overall costs could be halved if everyone were to become active. Objective monitoring is now offering the potential for a more precise gradation of the costs attributable to individual diseases in relation to levels of habitual physical activity. Rather than assuming a generic beneficial effect of “activity,” it has become possible to quantitate the magnitude of the economic benefits likely from the small increases of activity that can be achieved in sedentary populations with respect to each of a range of chronic diseases. The application of objective monitoring demonstrates that the greatest economic benefit is likely from changing the behaviour of the most sedentary individuals in a given population. It also identifies specific clinical conditions where an increase of habitual physical activity should yield large financial dividends. If applied on a large scale, objective monitoring offers the potential for prospective monitoring of the effects of defined increases in exercise behaviour upon immediate charges to the health care system, as well as an objective assessment of the costs of motivating defined changes in physical activity patterns. To date, objective monitors have only been applied to two economic analyses in elderly people (where the primary activity of walking is readily monitored, but also where a substantial fraction of population health care costs are incurred). Extension of these analyses to younger adults is desirable, but it will require the development of a second generation of objective monitors that can respond accurately to the full range of sports and pastimes pursued by the younger generation.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Rebelo LP. The origins and the evolution of health economics: a discipline by itself? Led by economists, practitioners or politics? Porto, Portugal: Universita Católica Portuguesa; 2007.
Blumenschein K, Johannesson M. Economic evaluation in healthcare. A brief history and future directions. Pharmacoecon. 1996;10(2):114–22.
Wagstaff A, Cuyler AJ. Four decades of health economics through a bibliometric lens. Washington, DC: World Bank e-Library; 2011.
Tarride J-E, Lim M. Desmeules Mea. A review of the cost of cardiovascular disease. Can J Cardiol. 2009;25(6):e195–202.
Arrow K. Uncertainty and the welfare economics of medical care. Am Econ Rev. 1963;53(5):941–73.
Phelps CE. Health economics. Boston, MA: Addison Wesley; 2003.
Taylor B, Rehm J. When risk factors combine: the interaction between alcohol and smoking for aerodigestive cancer, coronary heart disease, and traffic and fire injury. Addict Behav. 2006;31(9):1522–35.
White KL, Ibrahim MA. The distribution of cardiovascular disease in the community. Ann Int Med. 1963;58:627–36.
Klarman HE. Socio-economic impact of heart disease. In: Andrus EC, editor. The heart and circulation- Second National Conference on Cardiovascular Disease, vol. 2. Washington, DC: U.S. Public Health Service; 1964. p. 693–707.
Juhn C, Potter S. Changes in labor force participation in the United States. J Econ Perspect. 2006;20(3):27–46.
Armstrong JB. Costs of cardiovascular disease in Canada. Notes on Public Health & Preventive Medicine. Dept. of Public Health, University of Toronto, Toronto, ON; 1965.
Garis RI, Farmer KC. Examining costs of chronic conditions in a Medicaid population. Manag Care. 2002;11:43–50.
Wang G, Pratt M, Macera CA, et al. Physical activity, cardiovascular disease, and medical expenditures in U.S. adults. Ann Behav Med. 2004;28:88–94.
Health Canada. Economic burden of illness in Canada. Health Canada, Ottawa, ON, http://www.phac-aspc.gc.ca/publicat/ebic-femc98/ (2002).
Sasser AC, Rousculp MD, Birnbaum H, et al. Economic burden of osteoporosis, breast cancer, and cardiovascular disease among postmenopausal women in an employed population. Womens Health Issues. 2005;15:97–108.
Birnbaum H, Leong S, Kabra A. Lifetime medical costs for women: cardiovascular disease, diabetes, and stress urinary incontinence. Womens Health Issues. 2003;13:204–13.
Leal J, Luengo-Fernandez R, Gray A, et al. Economic burden of cardiovascular diseases in the enlarged European Union. Eur Heart J. 2006;27:1610–9.
American Heart Association. Heart disease and stroke statistics —2006 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation. 2006;113:e85–151.
Mensah GA, Brown DW. An overview of the cardiovascular disease burden in the United States. Health Aff. 2007;26(1):38–48.
Heidenrich PA, Trogdon JC, Khavjou OA, et al. Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association. Circulation. 2011;123:933–44.
Health Canada. Economic burden of illness in Canada, 1998. Ottawa, ON: Health Canada; 1998.
Patra J, Popova S, Rehm J, et al. Economic cost of chronic disease in Canada 1995-2003. Edmonton, AL: Alberta Institute of Health Economics; 2007. http://www.cdpac.ca/media.php?mid=260.
deVol R, Bedroussian A. An unhealthy America: the economic burden of chronic disease- charting a new course to save lives and increase productivity and economic growth. Santa Monica, CA: Milken Institute; 2007.
American Diabetes Association. Direct and indirect costs of diabetes in the United States. Alexandria, VA: American Diabetes Association; 2007. http://www.diabetes.org/diabetes-statistics/cost-of-diabetes-in-us.jsp.
National Heart Lung and Blood Institute. Morbidity and mortality 2004; 2004 chart book on cardiovascular, lung and blood diseases. Bethesda, MD: National Institutes of Health; 2004.
Alzheimer’s Association. Alzheimer’s disease facts and figures. http://www.alz.org/national/documents/Report_2007FactsAndFigures.pdf (2007).
Fox S, Skinner JS. Physical activity and cardiovascular health. Am J Cardiol. 1964;14:731–46.
Shephard RJ. Endurance fitness. Toronto, ON: University of Toronto Press; 1969.
Katzmarzyk P, Gledhill N, Shephard RJ. The economic burden of physical inactivity in Canada. Can Med Assoc J. 2000;163(11):1435–40.
Katzmarzyk P, Janssen I. The economic costs associated with physical inactivity and obesity in Canada. Can J Appl Physiol. 2004;29(1):90–115.
Moore R, Mao Y, Zhang J, Clarke K. Economic burden of illness in Canada Health Canada. Ottawa, ON: Canadian Public Health Association; 1997.
Katzmarzyk P. The economic costs associated with physical inactivity and obesity in Ontario. Health Fitness J Canada. 2011;4(4):31–40.
Colman R. The cost of physical inactivity in Nova Scotia. Halifax, NS: GPI Atlantic for Recreation Nova Scotia and Sport Nova Scotia; 2002.
Colman R, Walker S. The cost of physical inactivity in British Columbia. Victoria, BC: GPI Atlantic for the BC Ministry of Health; 2004.
Dyrstad SM, Hansen BH, Holme IM, et al. Comparison of self-reported versus accelerometer-measured physical activity. Med Sci Sports Exerc. 2014;46(1):99–106.
Prince SA, Adamo KB, Hanmel ME, et al. A comparison of direct versus self- report measures for assessing physical activity in adults: a systematic review. Int J Behav Nutr Phys Act. 2008;5:56.
Wang F, McDonald T, Reffitt B, et al. BMI, physical activity, and health care utilization/costs among Medicare retirees. Obes Res. 2005;13:1450–7.
Aoyagi Y, Shephard RJ. A model to estimate the potential for a physical activity-induced reduction in healthcare costs for the elderly, based on pedometer/accelerometer data from the Nakanojo study. Sports Med. 2011;41(9):1–14.
Simmonds B, Fox K, Davis M, et al. Objectively assessed physical activity and subsequent health service use of UK adults aged 70 and over: a four to five year follow up study. PLoS One. 2014;9(5), e97676.
Woolcott JC, Ashe MC, Miller WC, et al. Does physical activity reduce seniors’ need for healthcare? A study of 24,281 Canadians. Br J Sports Med. 2010;44(12):902–4.
Sari N. Exercise, physical activity and healthcare utilization: a review of literature for older adults. Maturitas. 2011;70:285–9.
Colditz GA. Economic costs of obesity and inactivity. Med Sci Sports Exerc. 1999;31(11 Suppl):663–7.
Garrett NA, Brasure M, Schmitz KH, et al. Physical inactivity. Direct cost to a health plan. Am J Prev Med. 2004;27(4):304–9.
Haapanen-Niemi N, Miilunpalo S, Vuori I, et al. The impact of smoking, alcohol consumption, and physical activity on use of hospital services. Am J Publ Health. 1999;89(5):691–8.
Keeler EB, Manning WG, Newhouse JP, et al. The external costs of a sedentary lifestyle. Am J Public Health. 1989;79:975–81.
Martin MY, Powell MP, Peel C, et al. Leisure-time physical activity and health- care utilization in older adults. J Aging Phys Act. 2006;14(4):392–410.
Sari N. Physical inactivity and its impact on healthcare utilization. Health Econ. 2009;18:885–901.
Aoyagi Y, Shephard RJ. Steps per day: the road to senior health? Sports Med. 2009;39:423–38.
Aoyagi Y, Park H, Kakiyama T, et al. Yearlong physical activity and regional stiffness of arteries in older adults: the Nakanojo Study. Eur J Appl Physiol. 2010;109:455–64.
Park H, Togo F, Watanabe E, et al. Relationship of bone health to yearlong physical activity in older Japanese adults: cross-sectional data from the Nakanojo Study. Osteoporosis Int. 2007;18(3):285–93.
Shephard RJ. The economic benefits of enhanced fitness. Champaign, IL: Human Kinetics; 1986.
Russell LB. Is prevention better than cure? Washington, DC: Brookings Institution; 1986.
Russell LB. Preventing chronic disease: an important investment, but don’t count on cost savings. Health Aff. 2009;28:42–5.
Fries JF. Aging, natural death and the compression of morbidity. N Engl J Med. 1980;303:130–6.
Shephard RJ. Maximal oxygen intake and independence in old age. Br J Sports Med. 2009;43(5):342–6.
Pahor M, Guralnik KJM, Ambrose WT, et al. Effect of structured physical activity on prevention of major mobility disability in older adults. The LIFE S tudy randomized clinical trial. JAMA. 2014;311(23):2388–96.
Woolf SH, Husten CG, Lewin LS, et al. The economic argument for disease prevention: distinguishing between value and savings. Washington, DC: Partnership for Prevention; 2009.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Shephard, R.J. (2016). The Economic Benefits of Increased Physical Activity as Seen Through an Objective Lens. In: Shephard, R., Tudor-Locke, C. (eds) The Objective Monitoring of Physical Activity: Contributions of Accelerometry to Epidemiology, Exercise Science and Rehabilitation. Springer Series on Epidemiology and Public Health. Springer, Cham. https://doi.org/10.1007/978-3-319-29577-0_11
Download citation
DOI: https://doi.org/10.1007/978-3-319-29577-0_11
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-29575-6
Online ISBN: 978-3-319-29577-0
eBook Packages: MedicineMedicine (R0)