Immobility costs Finns more than smoking and substance abuse combined.
Physical activity can even lead to better pay.
Only one in four Finnish adults exercise sufficiently for their health, which means that a significant majority are moving too little.
A recent report calculated the costs of immobility and arrived at a price tag of between 3.2 and 7.5 billion euros, an amount which far exceeds the total cost of substance abuse and smoking.
This sum includes the direct costs of health care for the treatment of chronic illnesses, the loss of income tax and productivity, unemployment benefits, and the costs of home and institutional care for older people. The margins of the cost estimate are wide because it is difficult to accurately calculate some indirect costs.
“If we had kept to the direct costs, we would have been able to calculate the exact amount. However, we also wanted to pay attention to the indirect costs, such as social exclusion, loss of tax revenue and emissions caused by immobility, because they are known to increase the sum. We know for sure that 3.2 billion is just the minimum,” says researcher Päivi Kolu from the UKK Institute in Tampere.
Kolu and Tommi Vasankari co-edited the recently published report, “Costs of physical activity are increasing”, which has attracted a lot of attention. Political decision-makers have also been interested in the findings.
“Saving money by investing in exercise has obviously now been understood,” Kolu says.
Where can the savings come from?
According to the report, the costs – caused by premature deaths, for example – could be reduced by some three billion euros if the entire working-age population did the recommended amount of weekly aerobic exercise.
In the home and institutional care of older people, physical exercise would generate savings if the benefits of physical activity prevented premature institutionalisation. At the same time, physical exercise would improve the quality of life of older people and increase their autonomy, potentially enabling them to live in their own homes for longer.
In working life, savings could be achieved by a decline in the amount of sick leave taken. For example, a recent study on back pain in nursing staff noted that the number of absences decreased when their pain was treated with a combination of counselling and strength training.
According to Kolu, the most cost-effective option would be “light” counselling, where people in various risk groups are guided as a preventative measure.
“The counselling would not even have to involve visiting a clinic, so no heavy organisational machinery would be needed. For example, remote access would suffice so long as the health professionals are committed to long-term co-operation and interested in helping people and advising them individually,” Kolu explains.
According to Kolu, exercise counselling should start in the doctor’s office.
“Another matter is if doctors have the time for this or feel that it is their job to counsel patients about exercise,” Kolu says.
One of the report’s most interesting observations is that exercising at a young age has a positive effect on both careers and incomes. This is especially true for boys and men. Those who play sports stay in education longer, find jobs more easily, are unemployed for shorter periods, and earn more than those who exercise less.
According to Kolu, several mechanisms play a background role. For example, physical activity improves concentration and attention, which are preconditions for learning and enable successful studying.
In particular, team sports and sports clubs promote social relationships, thus improving the social skills needed in school and other areas of life.
“Team sports also enable the forming of social networks that are beneficial in later life,” Kolu says.
For employers, the physical activity and good condition of a potential employee indicate health and good working ability. Thus, a sporty young job seeker can be seen as a more productive recruit than less active applicants. It is a question about both the real and imagined effects of physical activity on work ability. Physical activity is currently often seen as a positive.
Although the report primarily focuses on young people’s sports activities, it is the case that exercise also improves the work opportunities of adults.
“At least it improves the preconditions to continue working longer and reduces the amount of sick leave. Adults also change jobs and even careers, and being physically active also helps adults to find jobs.
If people have spent time on the computer, watching television or reading books in their youth, a change is not too late, even in middle age. Furthermore, a period of unemployment may be just the time to start exercising. Although exercise does not automatically lead to re-employment, it can improve the quality of life.
It thus seems clear that exercise and physical activity are good for both the individual and society. The next step should be to reduce the barriers to exercise as much as possible.
Kolu is delighted by the Ministry of Transport and Communications’ recently published programme and government resolution to promote walking and cycling.
“The fact that the government wants to invest in walking and cycling means that they want to improve people’s everyday exercise opportunities. This is very important. When the conditions for mobility improve, the threshold to start exercising is lowered,” Kolu explains.
Kolu points out that even a small increase in activity has an impact. People do not have to begin by training for a marathon; they can start by choosing the stairs instead of the lift or cycling to work instead of driving.
Even though the impacts may not be immediately apparent in the pay packet or work ability, mobility does bring pleasure and helps with coping at work.
“It pays off to start moving. Every step counts,” Kolu says.
The aim of the report was to encompass the fields of sports, health and business studies in order to discover the effects minimal physical activity, poor physical condition, and sedentary behaviour have on the costs caused by chronic illnesses (use of health services, medicines) and reduced productivity (loss of life due to premature deaths, sick leave and disability pensions).
In addition, the role of physical activity in childhood and youth was analysed in view of the length of education and career advancement in adult life.
The project also assessed the effect of immobility on the costs of home and institutional care for older people, social exclusion and social benefits.
Several population records and registers were used in the calculations.
According to the study, the unnecessary annual costs caused by a lack of physical activity include:
– 1.5–4.4 billion in health care costs and loss of productivity caused by illness,
– 150 million for the home and institutional care of the elderly,
– 1.4–2.8 billion euros in lost income tax,
– 30–60 million euros in unemployment benefits,
– 70 million euros in social exclusion costs.
These annual costs and productivity losses add up to between 3.2 and 7.5 billion euros.
The recommendation for health-enhancing physical activity in adults is at least 2 hours 30 minutes per week of moderate-intensity aerobic activity or at least 75 minutes per week vigorous-intensity aerobic activity. In addition, everyone should do some form of strength training at least twice a week.
The report ends with four suggestions for action:
1. The social costs of immobility must be assessed periodically.
2. The calculation of the social costs of immobility should be based on the measured physical condition and sedentary behaviour of different age groups as well as simultaneous surveys. Surveys alone produce unreliable results that tend to overestimate the amount of activity.
3. Particular attention should be paid to the other social costs caused by immobility in future studies.
4. Significantly more efficient and cost-effective measures should be implemented in risk groups with increased social costs, such as people with chronic illnesses or other high risks, young people at risk of social exclusion, people of all ages in poor physical condition, and older people with impaired functional ability.
Text: Hanna Hyvärinen
Photographs: Jonne Renvall