The burden of disease caused by insufficient physical activity has economic consequences for both the healthcare system and society. NAKO researchers from the University Medical Centre Hamburg-Eppendorf (UKE) have investigated the relationship between physical activity and healthcare costs as well as societal costs. In their analysis, they were able to confirm that a lack of physical activity is associated with higher costs. They observed a positive effect on costs through recreational sport, while high levels of physical activity at work were associated with higher costs in this study.
The World Health Organisation (WHO) recommends 150 minutes of moderate to strenuous exercise per week to stay healthy and prevent illness. However, estimates for Germany suggest that less than 25 per cent of the adult population achieves this target.
The analysis by the researchers from the University Medical Center Hamburg-Eppendorf (UKE) was based on data from 157,648 participants in the German National Cohort (NAKO), Germany’s largest epidemiological population study. The participants provided information on physical activity in the areas of “leisure”, “work” and “locomotion”, whereby “work” included both physical activities in paid and unpaid work and “locomotion” included activities on the way to work or in everyday life, such as going to the shops. The level of physical activity across all areas was categorised as “adequate” or “inadequate” according to WHO recommendations and separately for each area as “very low” to “high”. The estimate of healthcare costs was based on information provided by the NAKO participants surveyed on the utilisation of healthcare services in the last 12 months. In addition, other social costs such as productivity losses were also taken into account, based on information on sickness-related absences and health-related early retirement.
The researchers found that insufficiently active people had higher estimated (health) costs compared to sufficiently active people. “Interestingly, higher levels of activity during leisure time were associated with lower costs for the healthcare system and society, while higher levels of physical activity at work were associated with higher costs,” reports Dr Sophie Gottschalk, researcher at the Institute of Health Economics and Health Services Research at the UKE. “Risk factors in the workplace, including heavy physical labour, poor posture or environmental factors, could play a role as a possible explanation for this paradox.”
The results of the study provide important information on the economic impact of insufficient physical activity, for different areas of activity and taking into account not only the costs for the healthcare system, but also socially relevant costs due to productivity losses. It should be noted, however, that the data on physical activity and the utilisation of healthcare services and productivity losses are based on self-reported data and are therefore subject to possible distortions. Furthermore, the analysis is a snapshot, as only one survey date, the NAKO baseline survey, has been taken into account to date. Nevertheless, the findings are an important point of reference for further studies and future scientific questions. For example, by including further repeated surveys of NAKO participants, it could be possible to analyse how physical activity and (health) costs are related over a longer period of time and what influence the general state of health or the occurrence of chronic diseases have on this relationship.