Physical inactivity and its associated health problems have substantial economic consequences for the U.S. health care system. In the long run, physical inactivity threatens to reverse the decades-long progress that has been made in reducing the morbidity and mortality associated with many chronic conditions such as cardiovascular disease. A physically inactive population is at both medical and financial risk for many chronic diseases and conditions including heart disease, stroke, colon cancer, diabetes, obesity, and osteoporosis.

The increasing prevalence of chronic medical conditions and diseases related to physical inactivity are associated with two types of costs. First, there are health care costs for preventative, diagnostic, and treatment services related to these chronic conditions. These costs may include expenditures for physician visits, pharmaceuticals, ambulance services, rehabilitation services and hospital and nursing home care. In addition, there are other costs associated with the value of lost wages by people unable to work because of illness and disability, as well as the value of future earnings lost by premature death. In 2000, the total cost of overweight and obesity was estimated to be $117 billion. In addition, the total estimated cost from chronic diseases is substantial.

Individuals suffering from chronic diseases bear a substantial portion of these medical costs. A recent study demonstrated that obese individuals spend approximately 36 percent more than the general population on health services and 77 percent more on medications. Furthermore, the study found that the effects of obesity on health spending were significantly larger than effects of current or past smoking.

The Medicare and Medicaid programs currently spend $84 billion annually on five major chronic conditions that could be significantly improved by increased physical activity, specifically diabetes, heart disease, depression, cancer, and arthritis. Medicare spent $10.4 billion on diabetes treatment and services in 2000 and is estimated to spend $12.7 billion in 2004.

Since regular physical activity helps prevent disease and promote health, it may actually decrease health care costs. A study performed by researchers at the Centers for Disease Control and Prevention found that physically active people had, on average, lower annual direct medical costs than did inactive people. The same study estimated that increasing regular moderate physical activity among the more than 88 million inactive Americans over the age of 15 years might reduce the annual national direct medical costs by as much as $76.6 billion in 2000 dollars. Further, it found that physically active people had fewer hospital stays and physician visits and used less medication than physically inactive people. The cost savings were consistent for men and women, for those with and without physical limitations, and even for smokers and nonsmokers. In this study, the biggest difference in direct medical costs was among women 55 and older, supporting the belief that the potential gain associated with physical activity is especially high for older women. The researchers concluded that adoption of a population-wide physical activity strategy might produce health care cost savings among most adult age groups.

Employers can benefit too. Workplace physical activity programs can reduce short-term sick leave by six to 32 percent, reduce health care costs by 20 to 55 percent, and increase productivity by 2 to 52 percent. In 1998, 93 percent of employers had programs that fostered employee health, up from 76 percent in 1992, according to Hewitt Associates. Such “wellness” programs typically offer help in smoking cessation, managing stress, prenatal care, nutrition, and fitness.