The economic benefits of improving people’s physical activity levels
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Creating enduring change in physical activity is hard as there are significant barriers to change. However if this can be achieved, evidence shows that societies will be healthier and more prosperous.
Four areas worth further exploration include changing behaviour and attitudes, providing an environment that encourages physical activity, promoting participation in physical activity programmes and interventions, and building mutually reinforcing approaches to encourage more physical activity across society.
Background
Regular physical activity has many health benefits and is associated with lower risk of hypertension, cardiovascular disease, breast and colon cancer, as well as diabetes. It is also associated with a positive impact on mental health, possibly reducing the risk of the onset of dementia, as well as improving anxiety and depression.
Despite the documented positive effects of exercise, insufficient physical activity has become more common over the past decades. Globally, about one in three adults is not achieving at least 150 minutes of moderate intensity or 75 mins of vigorous-intensity activity per week. And in high-income Western countries, almost 40 per cent of the population is inactive, compared with about 16 per cent of people in low-income countries.
It is estimated that every year, physical inactivity is associated with up to 5 million deaths worldwide, and contributes to healthcare expenditures, as well as lost productivity.
Goals
The Vitality Group commissioned RAND Europe to examine the potential global economic implications of encouraging people to be more physically active. Researchers aimed to answer the following research questions:
What are the potential global economic benefits associated with getting people to be more physically active, and how do the economic effects vary by country?
What is the contribution of premature mortality associated with insufficient physical activity?
What is the contribution of insufficient physical activity associated with workplace productivity?
What level of healthcare expenditure could be saved?
What can public policy and private stakeholders do to improve people’s physical activity levels?
Methodology
The study included a literature review, statistical modelling to examine the associations between physical activity and a range of outcomes, and a multi-country macroeconomic model that enabled researchers to assess how the overall economic output of a country could be affected by improving the population’s physical activity levels.
Approach
Our analysis focused on how changes in people’s physical activity levels affect each country’s gross domestic product (GDP), and how that would evolve up to the year 2050, taking into account changes in the demographic composition over time. Three different what-if scenarios of physical activity improvements were compared with a baseline scenario with no physical activity improvements of the population.
Scenario 1: This improves the adult population physical activity level so that everyone reaches at least the recommended 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity physical activity per week (or the equivalent of about 600 MET-minutes per week). This scenario set only improves the activity levels of the inactive and the low active.
Scenario 2: This improves the adult population physical activity level of everyone by 20 per cent, shifting everyone across the physical activity distribution to be more active. This scenario only improves the activity levels of those currently active and does not improve the activity levels of those performing no physical activity at all.
Scenario 3: This improves the adult population physical activity levels so that everyone below the recommended 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity physical activity per week (or the equivalent of about 600 MET-minutes per week) reaches this threshold, and everyone above this threshold improves their physical activity level by 20 per cent.
Findings
By 2050 global GDP could increase by between US$314 billion and US$446 billion if the least active members of the population reach at least 150 minutes of moderate activity per week (scenario 1).
If everyone raises their physical activity levels (scenario 3), the estimated global GDP gains are between US$524 billion and US$760 billion by 2050.
Under scenario 3, the US economy experiences the biggest impact (an increase of between US$138-200 billion by 2050), owing to the size of its economy. It is followed by China (between US$100-146 billion), Germany and the UK (both about US$15-22 billion).
Reducing presenteeism — when people are at work but are not able to function to the best of their ability — is responsible for about 70 per cent of the economic GDP gains, pointing to a significant relationship between inactivity and productivity loss.
Furthermore, the findings suggest that billions of dollars in global healthcare could be saved by improving physical activity rates. Overall the models estimate that between US$8.7 billion and US$11.2 billion in present global healthcare expenditure could be saved by making people physically more active, with those savings rising to between $16 billion and $20.6 billion by 2050.
Conclusions
Creating enduring change in physical activity is hard as there are significant barriers to change. However if this can be achieved, evidence shows that we can create healthier and more prosperous societies. Decision-makers could consider a wide array of evidence-based interventions and programmes to improve levels of physical activity. Four key areas, not mutually exclusive, are worth exploring:
Changing behaviour and attitudes
Decision-makers could consider approaches that may encourage individuals to shift behaviour or change attitudes. Interventions could consist of individual or community messaging and incentives for people to change behaviour and take more responsibility for their health. Humans are social animals and often approaches that have a community, social and family dimension tend to be more effective.
Providing an environment that encourages physical activity
Evidence shows that context matters a great deal. There are a number of examples where individuals have poor access to facilities. We find that a range of community-based and school-based strategies can be effective.
Promoting participation in physical activity programmes and interventions
Lack of access to programmes and interventions can be a significant barrier. This may affect certain groups such as poor, ethnic minorities and those on low incomes more. However, along with access, awareness can be an issue. A problem is that interventions can be seen as a tick-box exercise by decision-makers and little thought is given on how to create awareness of and drive participation in interventions.
Building mutually reinforcing approaches to encourage more physical activity across society
Interventions and programmes can often be quite fragmented and even isolated. As such, different interventions may need to sit alongside each other to produce a greater effect.