The Health and Economic Impact of Promoting Physical Activity

Abstract

1469 Background: Physical inactivity is an important public health problem. The Task Force on Community Preventive Services has recommended several effective population-wide interventions to promote physical activity. PURPOSE: To estimate the clinical benefits, costs, and cost-effectiveness of alternative strategies to increase physical activity. Four “strongly recommended” population-wide interventions were evaluated and compared to no intervention: community-wide campaigns; individuallyadapted health behavior change; social support; and, enhanced access to physical activity opportunities. Methods: A Monte Carlo model of the natural history of physical activity was created to simulate the transition among 4 levels of physical activity and the associated development of long term outcomes; including coronary heart disease, ischemic stroke, type 2 diabetes, and colon and breast cancers, over the lifetime of a hypothetical cohort of 100,000 individuals, aged 25 to 64 years. Results: The baseline distribution of cohort members across physical activity levels and the transition probabilities among them over time were based on 2001 data from the Behavioral Risk Factor Surveillance System. Sex, age, and physical activity levelspecific risks of developing health outcomes of interest were derived from the literature as were measures of quality of life, mortality rates, and costs of complications related to each outcome. Intervention exposure to an intervention was associated with a potential transition to the next highest physical activity level which was maintained for a specified time, thereby changing the cumulative incidence of long-term outcomes and costs. The probabilities for improving physical activity were specific for each intervention. Intervention effects driving these transition probabilities are shown below.TableConclusion: Main outcome measures will include long term health outcomes of interest, average per-person lifetime costs in 2004 US dollars, life expectancy, qualityadjusted life expectancy, and incremental cost-effectiveness ratios.