Inadequate physical activity and health care expenditures in the United States

Abstract

This study estimates the percentage of health care expenditures in the non-institutionalized United States (U.S.) adult population associated with levels of physical activity inadequate to meet current guidelines. Leisure-time physical activity data from the National Health Interview Survey (2004-2010) were merged with health care expenditure data from the Medical Expenditure Panel Survey (2006-2011). Health care expenditures for inactive (i.e., no physical activity) and insufficiently active adults (i.e., some physical activity but not enough to meet guidelines) were compared with active adults (i.e., ≥150minutes/week moderate-intensity equivalent activity) using an econometric model. Overall, 11.1% (95% CI: 7.3, 14.9) of aggregate health care expenditures were associated with inadequate physical activity (i.e., inactive and insufficiently active levels). When adults with any reported difficulty walking due to a health problem were excluded, 8.7% (95% CI: 5.2, 12.3) of aggregate health care expenditures were associated with inadequate physical activity. Increasing adults' physical activity to meet guidelines may reduce U.S. health care expenditures.

Keywords: BMI; Body Mass Index; Exercise; Health care; Health expenditures; MEPS; Medical Expenditure Panel Survey; NHIS; National Health Interview Survey; Physical activity; U.S.; United States.

Published by Elsevier Inc.

Figures

Fig 1

Mean Expenditure Differences per Capita of Inactive and Insufficiently Active Versus Active Physical Activity Levels, after Selected Exclusions – US Adults, NHIS and MEPS 2006–2011a,b. Abbreviations: BMI, body mass index; CI, confidence interval; MEPS, Medical Expenditure Panel Survey; NHIS, National Health Interview Survey. aPhysical activity level is defined as active (≥150 minutes/week moderate-intensity equivalent activity), insufficiently active (some moderate-intensity equivalent activity but not enough to meet active definition), and inactive (no moderate-intensity equivalent activity that lasted at least 10 minutes). Models adjust for: sex, age group, race/ethnicity, census region, metropolitan statistical area, marital status, education, poverty level, health insurance status, smoking status, BMI category, and MEPS year. bExcludes adults who were pregnant and those who reported being unable to do physical activity. The number of adults excluded for each subanalysis was: 1861 reported ever having a heart attack at baseline (i.e., NHIS interview); 1544 reported ever having a stroke at baseline; 514 reported at baseline needing help getting in/out of bed or chairs, using toilet, or getting around the home; 3206 reported at baseline difficulty walking (without the use of equipment) because of a health problem; 520 died during MEPS survey year; or 3298 ≥ 80 years of age. cExpenditures adjusted to 2012 dollars using the Personal Health Care Expenditure Price Index. Upper and lower error bars represent upper and lower bounds of the 95% CI. Dashed vertical lines represent overall estimates.