Twelve year trajectories of physical activity and health costs in mid-age Australian women

Abstract

Background: Few studies have examined relationships between physical activity (PA) during mid-age and health costs in women. The aim of this study was to investigate associations between PA levels and trajectories over 12 years with medical and pharmaceutical costs in mid-age Australian women. Methods: Data from 6953 participants in the Australian Longitudinal Study on Women's Health (born in 1946-1951) were analysed in 2019. PA was self-reported in 2001 (50-55y), 2007 (56-61y) and 2013 (62-67y). PA data were linked with 2013-2015 data from the Medicare (MBS) and Pharmaceutical (PBS) Benefits Schemes. Quantile regression was used to examine associations between PA patterns [always active, increasers, decreasers, fluctuaters or always inactive (reference)] with these medical and pharmaceutical costs. Results: Among women who were consistently inactive (< 500 MET.minutes/week) in 2001, 2007 and 2013, median MBS and PBS costs (2013 to 2015) were AUD4261 and AUD1850, respectively. Those costs were AUD1728 (95%CI: 443-3013) and AUD578 (95%CI: 426-729) lower among women who were consistently active in 2001, 2007 and 2013 than among those who were always inactive. PBS costs were also lower in women who were active at only one survey (AUD205; 95%CI: 49-360), and in those whose PA increased between 2001 and 2013 (AUD388; 95%CI: 232-545). Conclusion: Maintaining 'active' PA status was associated with 40% lower MBS and 30% lower PBS costs over three years in Australian women. Helping women to remain active in mid-life could result in considerable savings for both women and the Australian government.

Leisure time physical activity throughout adulthood is associated with lower medicare costs: evidence from the linked NIH-AARP diet and health study cohort

“… 26 The recent 12-year trajectories of physical activity and health costs in mid-age Australian women found that maintaining ‘active’ physical activity status was associated with up to 40% lower health costs over 3 years. 12 This study used a ‘lasange plot’, a method of modelling changes in categorical variables in longitudinal studies, which does not offer the flexible of conducting sensitivity analysis based on the exposure variable. 12 Our longitudinal findings appear to be robust to several potential threats from confounding or bias.…”

“… 12 This study used a ‘lasange plot’, a method of modelling changes in categorical variables in longitudinal studies, which does not offer the flexible of conducting sensitivity analysis based on the exposure variable. 12 Our longitudinal findings appear to be robust to several potential threats from confounding or bias. Association with Medicare costs by LTPA trajectory patterns were generally similar when more stringent trajectory membership requirements were applied and when we excluded the last 12 months of claims data from each respondent.…”

“…To date, only one study has examined long-term physical activity with relation to healthcare costs later in life among Australian women. 12 Information about the influence physical activity throughout adulthood has on later life healthcare costs can help inform public and private decision-makers on research, policy and physical activity programme priorities.…”

Relevance of Life Course Epidemiology for Research on Physical Activity and Sedentary Behavior

“…Another approach still to be further explored in the field of physical activity is the modeling of physical activity trajectories. Recent studies have modeled trajectories of physical activity using a variety of methods 4,5 and investigated whether the risk/protective effect associated with physical activity is different between those who have always been active and those who were always inactive or became inactive. Overall, the findings from these studies have suggested that individuals who were inactive in a period of life but became physically active during mid-age had better health outcomes than those who were always inactive.…”

“…Overall, the findings from these studies have suggested that individuals who were inactive in a period of life but became physically active during mid-age had better health outcomes than those who were always inactive. 4,5 A life course framework is also a powerful tool for better understanding the determinants and social inequalities in physical activity, hence providing important insights into how social inequalities impact the etiology of chronic disease conditions. This has been demonstrated in previous studies that found childhood socioeconomic position may have a lasting impact on physical activity and sedentary behavior even when the adult socioeconomic position is taken into account.…”