Economic benefits of physical activity

Background Physical inactivity is one of the contributors to the rise in non-communicable diseases worldwide. Active transport offers a means of raising physical activity (PA) at the population level. However, forecasting and valuing the health benefits of transport projects that increase PA is challenging. Purpose To develop a best-practice method to estimate the health benefits of changes in active transport behaviour and translate these benefits to an economic value. Methods The Active Transport Health Model is a proportional multi-state lifetable that quantifies the health impacts of changes in active transport behaviour over a population’s lifetime. The Model is parameterised to New South Wales (NSW), a state in Australia. Health outcomes related to PA, air pollution and road trauma exposures are considered. Model outputs include age- and sex-specific changes in disease incidence, prevalence, and mortality, summarised as health adjusted life years (HALYs). The HALYs are then translated to monetary terms. Results Compared to car use, preliminary results value the health benefits at A$5.00 to A$6.50 for a km walking, and between A$2.50 to A$3.00 for an additional km cycled. These values are sensitive to a range of factors including age and prior PA level. Conclusions The per-km values in our study were higher than those of previous similar studies, which is largely due to the inclusion of a direct link between PA and mortality, and the use of accelerometry-derived relative risks. Practical implications The Model is pending approval for adoption by relevant state and local agencies in NSW. The values can allow the monetised health benefits of PA to be factored into decision making on transport projects. The Model could also be used to determine the potential health benefits of other policies aimed at increasing populations’ PA levels. Funding The project was funded by the NSW Ministry of Health, Sydney, Australia.

Background: Promoting active mobility (e.g. cycling, walking) provides win-win opportunities but requires consideration of these often overlooked modes in transport policy and practice. Purpose: This presentation will introduce the well-tested, evidence-based practical Health Economic Assessment Tool (HEAT) for Walking and Cycling, and a recently added e-biking functionality.
Methods: The HEAT calculates: if x people walk or cycle a distance of y on most days, what is the economic value of impacts on premature mortality, taking into account effects of physical activity, air pollution and road fatalities, as well as effects on carbon emissions. It is developed through an open-ended, evidence- and multidisciplinary-based approach, led by the WHO and an interdisciplinary coordinating team. Each development step is done through consensus meetings with ad-hoc invited international experts from various fields. Since 2023, an e-biking functionality is included, taking into account intensity, travel parameters such as speed or default distance, age and crash risk as well as carbon effects and exposure of e-bikers to air pollution.
Results: HEAT has been named the “most-used tool for health-impact assessment in transport”, with scientific, policy and practice-related applications across the world. Selected global case studies will be presented to illustrate different use-cases.
Conclusions:
Since its launch in 2009, the HEAT provides a win-win opportunity for sustainable physical activity promotion, particularly by allowing to also assess carbon-related emission reductions of different transport options on a population level.
Practical implications: The HEAT fosters advocating for transport-solutions that prioritize active transport by using an economic approach customarily used in transport planning.
Funding: The HEAT has been supported by a range of donors, the WHO Regional Office for Europe and WHO Headquarters as well as European Union research projects. A full list of donors can be found on www.heatwalkingcycling.org.

Background: Physical inactivity raises the risk of developing various non-communicable diseases (NCDs). Brief advice as part of routine care intervention for physical activity promotion has been implemented in Thailand to reduce physical inactivity, however, information on its cost-effectiveness is lacking. Purpose: This study aims to estimate the cost-effectiveness of brief advice implementation from the perspective of health outcomes in Thailand during 2021–2030. Methods: This study used the concept of health economics to analyze cost-effectiveness by using OneHealth Tool program. The input data including the costing, quantity assumption, and unit price of implementing brief advice as part of routine care intervention on physical activity promotion on all level was obtained from Ministry of Public Health in Thailand. The data management includes exploration, model development, and verification. Results: The findings of the study found that physical activity promotion with brief advice as part of routine care may help to reduce the mortality of Thai population. The intervention may averted 673 death from NCDs per year. The current implementation with brief advice counseling may also generate additional 114,313 person with sufficient MVPA per years. The cost of implementing such measures is approximately 437 US dollar per person to achieve sufficient level of physical activity and approximately 74,190 US dollar per person to avert death from NCDs. Conclusion: The results informed that the promoting physical activity through brief advice as part of routine care intervention in Thailand may contribute to mortality reduction from NCDs. Practical implication: This study will help the Ministry of Public Health in Thailand plan to improve the efficiency of implementing BA more efficiently. Funding: This research was funded by Thai Health Promotion Foundation grant number: 63-00178.

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)

Background: Insufficient physical activity has caused substantial medical costs, yet little is known about the longitudinal changes in medical costs of insufficient physical activity. Purpose: The aim of this study was to examine the changes in medical costs of insufficient physical activity in middle-aged (≥ 45 years old) Chinese inpatients from 2004 to 2021. Methods: The medical cost of insufficient physical activity each single year was assessed using the population attributable fraction (PAF) approach. First, the adjusted relative risks of coronary heart disease, stroke, type 2 diabetes, breast cancer, and colon cancer associated with insufficient physical activity were extracted from the published literature. Then, the medical cost of each noncommunicable disease (NCD) was calculated as a product of PAF%, the number of inpatients with a given NCD, and the average medical expenditure per inpatient. For this purpose, data on the number of inpatients with a given NCD and average medical expenditure per inpatient were extracted from the 2019 Chinese National Healthcare Annual Report. Finally, the changes in medical costs of insufficient PA were assessed using the linear regression model. Results: There were significant increases in medical cost of insufficient physical activity in middle-aged Chinese inpatients (from Chinese Yuan 0.19 billion in 2004 to 14.98 billion in 2021, p for trend < 0.01), demonstrating a linearly increasing trend in changes of medical costs of insufficient physical activity in middle-aged Chinese inpatients from 2004 to 2021. The cost of cancer associated with insufficient physical activity accounted for the largest across all the targeted NCDs. Conclusions: This study shows substantial medical costs of insufficient physical activity and further highlights the public health importance of encouraging middle-aged adults to participate in more physical activity.

Background: Community-wide initiatives in physical activity (CWIPA) is considered as a best-buy for NCDs prevention. However, despite the ongoing efforts to promote PA, there remains a dearth of comprehensive assessments regarding the return on investment in PA promotion initiatives, including CWIPA. Purpose: This study investigated local residents’ willingness-to-pay (WTP) for CWIPA programs in Thailand. Methods: The contingent valuation method (CVM) using the payment card approach was employed to elicit the WTP of 472 residents aged 45 years and over in selected provinces in which CWIPA programs had been implemented. Respondents were asked to indicate their WTP for the continuous offering of CWIPA by choosing how much they were willing to pay from eight bid-value options, payable through their monthly electricity bills. Results: The mean WTP of Thai older adults was found to be 72 baht/month (US$2/month) or 868 baht/year (US$25/year). More than half of the sample (54.2%) chose zero as their answer while there was a fairly large variation in other levels of WTP. The WTP was lower among older respondents and those who resided in rural areas, but was higher among those with a history of participation in an organized PA program. Conclusion: The extent of the variance in WTP indicates different valuations of CWIPA, with a high bid-value indicating satisfaction with the existing program, and also their affordability to purchase participation in the program. Low WTP may indicate dissatisfaction toward the program, disagreement with the payment vehicle, or the low affordability of the community. Practical implications: The findings should provide valuable information and guidelines for the local and central government in allocating limited resources toward promoting community-based PA, particularly for older adults. Also, to design future interventions tailored to the needs of all community members to ensure inclusivity. Funding: Thailand Physical Activity Knowledge Development Centre (TPAK)