Health Care Costs Associated with Prolonged Sitting and Inactivity

Abstract

Background: Physical inactivity and prolonged sitting are associated with negative health outcomes. Purpose:To examine the health-related costs of prolonged sitting and inactivity in middleaged women.Methods: Australian Longitudinal Study on Women's Health participants (born 1946−1951) answered questions about time spent sitting, walking, and in moderate and vigorous leisure activities in 2001 (n=6108), 2004 (n=5902), 2007 (n=5754) and 2010 (n=5535) surveys.Sitting time was categorized as low (0−4), moderate (5−7), and high (≥8 hours/day). Physical activity was categorized as inactive (<40), low (40−600), moderate (600−1200) and high (≥1200 metabolic equivalent minutes/week). National health insurance claims data averaged over the survey year ±1 year were used to calculate annual costs (Australian Dollars [AU$]).Differences between categories in median costs were estimated using quantile regression over four surveys with bootstrapped 95% CIs. Analyses were performed in 2013. Results:In 2010, annual median costs were AU$689 (interquartile range [IQR]=274, 1541) in highly active participants, AU$741 (IQR=279, 1690) in inactive participants, AU$671 (IQR=273, 1551) in participants with low sitting time, and AU$709 (IQR=283−1575) in participants with high sitting time. The difference in median costs for inactive and highly active participants was AU$94 (CI=57, 131) after adjustment for confounders. No statistically significant associations were found between sitting time and costs. When sitting and physical activity were combined, high sitting time did not add to the inactivity-associated increased costs. Associations were consistent across normal weight, overweight, and obese subgroups. Conclusions:Physical inactivity, but not prolonged sitting, was associated with higher health-related costs in middle-aged women. 3 IntroductionPhysical inactivity is associated with numerous physical and mental health conditions and accounts for approximately 1.5%−3.0% of the total direct health care costs in developed countries.1 It is estimated that a 10% reduction in the prevalence of inactivity could potentially reduce health care expenditures by 96 million Australian Dollars (AU$) and 150 million Canadian Dollars per year in Australia and Canada (equating to 99 and 129 million U.S. Dollars, respectively). 2, 3 Despite the potential health and economic benefits, only about half the population in developed countries meet the recommended levels of physical activity. [4][5][6] In addition to inactivity, prolonged sitting is thought to be associated with negative health outcomes such as weight gain and increased risk of mortality. 7 However, the economic consequences of prolonged sitting remain unknown. Moreover, as some studies have reported interaction effects of physical activity and sedentary time in association with mortality, 8, 9 the combined effects of prolonged sitting and inactivity on direct health care costs may be more important than their individual effects.A previous study by our group found an interaction with BM...

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