Economic evaluation of Community Outdoor gyms:Promoting Physical Activity and Well-Being in Cape Town, South Africa

Background: Physical activity (PA) is a public health challenge, with a considerable number of South African adults not meeting the recommended PA levels. To mitigate this trend, community parks and gyms are being introduced to promote PA and wellbeing. However, there is limited evidence evaluating their economic returns in order to guide resource allocation.We conducted a cost-benefit analysis to compare economic costs of outdoor gym (OG) initiatives in Cape Town against the potential benefits expressed in terms of prevention of premature deaths. Methods: We evaluated the economic impact of OGs in 17 parks and recreational facilities using the System for Observing Play and Recreation in Communities (SOPARC). We also conducted brief intercept interviews (N=242). The World Organisation Health Economic Assessment Tool (HEAT) was adapted for analysis.Results: We observed 1271 gym users (1 wk day, 1 wkend day), 405 of whom were adults. Based on intercept surveys, estimated moderate to vigorous PA (MVPA) was 45mins per person/per day for gym users. Extrapolating findings to the approximately 250 OGs situated in Cape Town, it was estimated that 5955 individuals engage in active gym use weekly. Over 12 months, these projections indicate that approximately 309705 people will actively engage in MVPA in the OGs of Cape Town. As a result, the OG initiatives are expected to prevent 827 premature deaths annually, corresponding to an annual economic value of $774,000,000.00. Adjusted for changes in the value of money overtime, the economic impact was $5,970,000,000.00 in 2024 terms. Conclusion: These figures reflect the estimated monetary benefit accrued each year due to the reduction in premature mortality resulting from increased PA facilitated by OG installations. Consequently, calculated economic benefits encapsulate not only immediate savings in healthcare costs and productivity losses,but also the long-term societal gains due to enhanced well-being and longevity. Funding:Cape Higher Education Consortium (CHEC)