Wednesday, October 15, 2008

The Social Costs of Physical Inactivity

Healthcare, and healthcare reform, is a major policy issue that often dominates political debates. This is evident in both recent Canadian elections (especially 2004, though the issue did not really get much attention in the 2008 election) and the upcoming US Presidential election.

Of the various things we can ask of our elected officials, perhaps no question is more important than the question- how will you improve our health prospects?

But do we ever stop and think that we, the citizenry, also have a responsibility to take action that could ease the demands on healthcare and improve the health prospects of the population? We seldom hear much about this. Sure our family doctor might encourage us to live a more active lifestyle and modify our diet, but do we really see this as a moral obligation that goes beyond basic "self-regarding" concerns? Most do not, but we ought to.

On many occasions on this blog (here, here and here) I have lamented the fact that obesity and physical inactivity is one of the most pressing issues of our times. And framing the costs of inactivity in terms of self-regarding concerns (like our increased risk of cancer, heart disease.... even death!) does not always prove an effective strategy for getting governments and individuals to tackle the situation.

If only someone could quantify what the social costs of inactivity are .... wait, the latest issue of Health Economics has this interesting paper on that very topic!

So what are the social costs of physical inactivity? The paper examines the Canadian situation and concludes:

This paper suggests that, on average, active people use significantly fewer healthcare services compared with inactive people, and physical inactivity imposes substantial costs on the publicly funded healthcare system. The paper provides an estimate for the excess use of healthcare services by physically inactive people. The use of inpatient services for an inactive individual is about 38% more than that of an active individual. Inactive people also use more physician and nurse services. On average, an inactive individual uses 5.5% more family physician visits, about 13% more other physician services, and 12% more nurse services compared with an active individual.

A moderate level of physical activity also increases utilization of healthcare services. Although the difference is not statistically significant for inpatient services, moderately active individuals use more physician services compared with active individuals. Holding other things constant, moderately active people use 2.4% more family physician services, and 5.8% more other physician services compared with
active people.

These results imply that the total social cost of physical inactivity imposed on the publicly funded healthcare system is substantial. Total numbers of additional healthcare utilization due to insufficient level of physical activity is about 2.37 million family physician visits, 1.33 million other physician visits, 0.47 million nurse visits, and 1.42 million hospital stays. These are the estimates of social cost for the publicly funded healthcare system in Canada. However, there are other healthcare services such as pharmaceuticals covered by other health insurance programs. Therefore, it is likely that there are additional external costs due to excess use of pharmaceuticals and other healthcare services not covered by public insurance programs.

Like aging, we are blind to the social costs of physical inactivity. By opening our eyes to the self-regarding and other-regarding costs of physical inactivity, we get a better sense of the demands of justice and the urgent action that is needed to create a more fair and humane society. So be kind to your compatriots- get out and exercise today! That is something everyone can do and it really will make the world a better place to live.