The economic burden of physical inactivity: a systematic review and critical appraisal

Ding, Ding and Kolbe-Alexander, Tracy and Nguyen, Binh and Katzmarzyk, Peter T. and Pratt, Michael and Lawson, Kenny D. (2017) The economic burden of physical inactivity: a systematic review and critical appraisal. British Journal of Sports Medicine, 51 (19). pp. 1392-1409. ISSN 0306-3674

Abstract

Objective: To summarise the literature on the economic burden of physical inactivity in populations, with emphases on appraising the methodologies and providing recommendations for future studies.

Design: Systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO registration number CRD42016047705).

Data sources: Electronic databases for peer-reviewed and grey literature were systematically searched, followed by reference searching and consultation with experts.

Eligibility criteria: Studies that examined the economic consequences of physical inactivity in a population/population-based sample, with clearly stated methodologies and at least an abstract/summary written in English.

Results: Of the 40 eligible studies, 27 focused on direct healthcare costs only, 13 also estimated indirect costs and one study additionally estimated household costs. For direct costs, 23 studies used a population attributable fraction (PAF) approach with estimated healthcare costs attributable to physical inactivity ranging from 0.3% to 4.6% of national healthcare expenditure; 17 studies used an econometric approach, which tended to yield higher estimates than those using a PAF approach. For indirect costs, 10 studies used a human capital approach, two used a friction cost approach and one used a value of a statistical life approach. Overall, estimates varied substantially, even within the same country, depending on analytical approaches, time frame and other methodological considerations.

Conclusion: Estimating the economic burden of physical inactivity is an area of increasing importance that requires further development. There is a marked lack of consistency in methodological approaches and transparency of reporting. Future studies could benefit from cross-disciplinary collaborations involving economists and physical activity experts, taking a societal perspective and following best practices in conducting and reporting analysis, including accounting for potential confounding, reverse causality and comorbidity, applying discounting and sensitivity analysis, and reporting assumptions, limitations and justifications for approaches taken. We have adapted the Consolidated Health Economic Evaluation Reporting Standards checklist as a guide for future estimates of the economic burden of physical inactivity and other risk factors.


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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: Third place winner, USQ Publication Excellence Awards for Journal Articles (April - June 2017). BJSM Online First, published on April 26, 2017 as 10.1136/bjsports-2016-097385. Permanent restricted access to Online First version, in accordance with the copyright policy of the publisher.
Faculty / Department / School: Current - Faculty of Health, Engineering and Sciences - School of Health and Wellbeing
Date Deposited: 19 Jun 2017 02:17
Last Modified: 07 Feb 2018 00:57
Uncontrolled Keywords: physical activity, economic evaluation
Fields of Research : 14 Economics > 1402 Applied Economics > 140208 Health Economics
11 Medical and Health Sciences > 1106 Human Movement and Sports Science > 110699 Human Movement and Sports Science not elsewhere classified
Socio-Economic Objective: C Society > 92 Health > 9204 Public Health (excl. Specific Population Health) > 920401 Behaviour and Health
E Expanding Knowledge > 97 Expanding Knowledge > 970111 Expanding Knowledge in the Medical and Health Sciences
Identification Number or DOI: 10.1136/bjsports-2016-097385
URI: http://eprints.usq.edu.au/id/eprint/31903

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