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.

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 2006–2011^a,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.