Burden of Inadequate Levels of Physical Activity in the United States Pubblico
Carlson, Susan (2014)
Abstract
Despite the health benefits of physical activity, less than half of U.S. adults meet current aerobic physical activity guidelines and almost one-third of adults are physically inactive. Levels of physical activity inadequate to meet guidelines (i.e., inactive and insufficiently active) can be a substantial public health burden in the U.S.
The first article examined the association between inadequate physical activity and health care expenditures. Compared to being physically active, the mean difference (after adjusting for covariates and body mass index category) in annual health care expenditures was $1248 (percent difference: 26.6%) for those inactive and $661 (percent difference: 14.4%) for those insufficiently active. Overall, 11.5% of aggregate health care expenditures were associated with inadequate physical activity. When adults who reported any difficulty walking due to a health problem were excluded, the mean difference for those inactive was $871 (percent difference: 20.7%) and $504 (percent difference: 11.7%) for those insufficiently active. After this exclusion, 8.9% of health care expenditures were associated with inadequate physical activity.
The second article estimated the percentage of depression- and anxiety-specific health care expenditures associated with inadequate physical activity using both attributable fraction (AF) and regression based (RB) approaches. The percentage of depression- and anxiety-specific health care expenditures associated with inadequate physical activity was significantly higher (21.2%) when using the RB approach than with the AF approach (11.1%). Percentage estimates were higher when examining depression and anxiety separately with the RB approach (depression: 21.9%, anxiety: 17.2%) compared to the AF approach (depression: 13.2%, anxiety: 7.5%); however, differences were not significant.
The third article estimated the percentage of premature deaths attributable to inadequate physical activity. For adults age 40-69 and 70 or older, inactive (hazard ratio (HR) for 40-69: 1.24; 70+: 1.19) and insufficiently active adults (HR for 40-69: 1.11; 70+: 1.12) had an increased risk of mortality compared to active adults. Among adults age 25-39, there was no association between levels of physical activity and mortality. Among adults 40-69, 10.1% of premature deaths in the U.S. were attributed to inadequate physical activity. Among adults 70 or older, 9.0% of deaths were attributed to inadequate physical activity.
Table of Contents
Chapter 1: Motivation and Key Research Question...1
Motivation...1
Key Research Questions...2
References...3
Chapter 2: Background, Rationale, and Study Objectives... 4
Inadequate Physical Activity and Health Care Expenditures in the United States...4
Physical activity and Depression- and Anxiety-Specific Health Care Expenditures...7
Inadequate Physical Activity and Mortality in the United States...12
References...17
Chapter 3: Guiding Theoretical Frameworks...24
Inadequate Physical Activity and Health Care Expenditures in the United State...24
Physical activity and Depression- and Anxiety-Specific Health Care Expenditures...27
Inadequate Physical Activity and Mortality in the United States...28
References...30
Chapter 4: Inadequate Physical Activity and Health Care Expenditures in the United
States...32
Abstract...32
Introduction...33
Methods...34
Results...38
Discussion...41
References...46
Tables and Figure...51
Chapter 5: Physical activity and Depression- and Anxiety-Specific Health Care
Expenditures...59
Abstract...59
Introduction...60
Methods...62
Results...66
Discussion...69
References...76
Tables...81
Chapter 6: Inadequate Physical Activity and Mortality in the United States..88
Abstract...88
Introduction...89
Methods...91
Results...95
Discussion...98
References...103
Tables...107
Chapter 7: Conclusions, Implications, and Further Research...115
Conclusions...115
Comparison of Burden...119
Policy Implications...120
Future Research...121
References...126
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