You have full access to this open access article. Insufficient physical activity PA is a leading risk factor for non-communicable diseases posing a significant economic burden to healthcare systems and societies. The study aimed to examine the differences in healthcare and indirect costs between sufficient and insufficient PA and the cost differences between PA intensity groups. The cross-sectional analysis was based on data from , participants in the baseline examination of the German National Cohort NAKO study.
Healthcare and indirect costs were calculated based on self-reported information on health-related resource use and productivity losses. Two-part models adjusted for relevant covariates were used to estimate mean costs for PA groups. An inverse association was observed between leisure PA and costs, whereas a direct association was found between PA at work and costs.
Adjusting for the number of comorbidities reduced the differences between activity groups, but the trend persisted. The association between PA and costs differed in direction between PA domains. Future research may provide further insight into the temporal relationship between PA and costs. Insufficient physical activity PA is a global pandemic [ 1 ] and is a leading modifiable risk factor for the development of chronic, non-communicable diseases such as coronary heart disease, stroke, type 2 diabetes mellitus, and several types of cancer [ 2 , 3 ].
The disease burden attributable to insufficient PA has substantial economic consequences on both healthcare systems and the society as a whole [ 5 , 6 ]. In their systematic review from , Ding et al. In general, studies using an econometric approach yielded higher estimates than those using a population-attributable fraction PAF approach.
An econometric approach, on the other hand, uses individual-level data on PA and costs e. In addition to methodological heterogeneity, the majority of studies using an econometric approach were based on older populations, an age group in which diseases related to insufficient PA typically occur [ 8 ]. Furthermore, studies examining the economic burden of insufficient PA in Germany are scarce. For example, Karl et al. They found an association of device-assessed but not self-reported insufficient PA with higher healthcare costs.
