Americans Can Save Millions by Being More Active

What if we all stepped up and increased physical activity? By doing so, we could improve our health and collectively help save the American healthcare industry a whole bunch of money annually. A WHO survey and evaluation of the European Union (EU) evaluated this very concept in their “Step Up! Tackling the burden of insufficient physical activity in Europe.” They discovered that increased physical activity could save billions of dollars in healthcare costs and prevent thousands of premature deaths.

Furthermore, it can increase an individual’s medical healthcare cost savings over their lifetime. Therefore, it stands to reason that if Americans increased physical activity, we could save our country billions of dollars.

Step up and save your country money

In 2023, the United States ranks as one of the top 12 nations for obesity. According to the World Population Review, 36.2% of American men and women are obese, the highest among industrialized nations. This isn’t something of which we should be proud. We should do our best to improve this sad statistic.

According to the CDC, among other specialists and researchers, obesity without any other factor increases a person’s risk of type 2 diabetes, stroke, heart-related illness, poorer mental health, and some cancers. In addition to health risks, obesity has economic consequences. The CDC reports that as much as $173 billion are spent annually due to obesity alone.

The WHO’s EU’s Step Up report found that increasing physical activity could prevent over 10,000 premature fatalities per annum, save EU member nations billions, and increase the lifespan of inactive people by 7.5 months. Consider the potential savings for a longer period.

What is physical activity?

Physical activity is not synonymous with sports or exercise. It refers to any bodily action that creates an increase in energy consumption. Factors that influence our activity include what the WHO refers to as the FITT principles.

• Frequency (how often one is active)
• Intensity (how strenuous)
• Time (duration of activity)
• Type (Two flavor types: aerobic/anaerobic vs. leisure-time, work/household activities, or transportation)

One can be active in vacuuming the home, making dinner, doing yard work, and expending as much energy as someone who runs a mile, practices tai chi or yoga, swims, or takes a casual stroll. The accumulated time, not simply the action itself, is crucial. All forms of physical activity can improve health outcomes by minimizing the time spent remaining sedentary. Choosing light exercise over watching TV twice a week for even 30 minutes can improve one's health.

Insufficient exercise

Why people do not reach the recommended daily or weekly fitness levels despite all the literature, research, public health messages, and other avenues demonstrating the benefits of physical activity varies. For some, it is laziness, but for others, it is a lack of motivation, depression or other mental illnesses, endurance, obesity, time, access, or underlying chronic diseases, such as asthma, COPD, heart disease, or arthritis.

Numerous factors affect physical fitness, activity level, and desire to engage in activities. Not everyone is physically or mentally able to achieve the recommended weekly exercise. Still, in general, too many people choose not to exercise, despite knowing the myriad health benefits this activity could bestow them.

Negative effects of inactivity

According to the WHO, insufficient physical activity, a sedentary lifestyle, and a poor fitness level solitarily increase the risk of many diseases. Further, because they are often interlinked, this only heightens risks.

For example, the 2020 WHO physical activity guidelines suggest that adults should achieve 75–150 minutes of vigorous-intensity exercise or 150–300 minutes of moderate-intensity physical activity weekly to remain healthy and lessen the chance of negative health outcomes.

The obesity epidemic

Obesity is multifactorial and occurs due to genetic factors and a lack of available affordable or access to healthy foods. It develops due to unsafe environments in which people can be active. Further, people don’t get enough of the right kind of physical activity to improve their body condition. Mental health concerns, financial well-being, lifestyle, and more all play a role in one’s overall health, including how heavy they are and how much activity one chooses and realistically can get.

Some people have underlying health conditions preventing sufficient physical activity, such as arthritis, or respiratory diseases, such as asthma or COPD. Whatever the reason, Americans do not get enough physical activity. However, obesity only shows a glimpse of the problem.

Even those with an appropriate body condition can be unfit and, thus, at a higher risk of disease. It’s not about singling out individuals. It is about Americans as a whole. Collectively, we need to improve physical readiness and physical fitness. By doing so, we should be able to improve physical and mental well-being and reduce annual spending. Taking the WHO’s EU report and extrapolating, this seems like a no-brainer. Though, it is likely easier said than done.

Sedentary lifestyles

Sedentary behavior globally seems all too common. Sedentary behavior is any awake behavior that involves sitting, laying down, or reclining while using little to no energy (e.g., 1.5 Metabolic equivalents of task [METs] or less). Sadly, sitting for hours a day is commonplace, even necessary in many professions.

Since COVID-19, remote work has become more popular. As a result, video games, unlimited entertainment on the big and little screens, an overall lack of physical fitness, and sedentary behaviors are all too commonplace. A meta-analysis by Buffey et al. showed that sitting for most of the day increased one’s risks of heart problems, diabetes, and other ailments.

"Doing at least the equivalent of 150 minutes to 300 minutes of moderate-intensity physical activity a week"

WHO on activity for adults

Many people fall somewhere between total sedentary behavior and getting the recommended weekly allotted amount of exercise, falling into the insufficient physical activity category. Still, by encouraging and advocating baby steps, such as getting up from one’s desk every hour and walking around the office for 5 minutes or taking the dog for an extra 10–15 minute walk per day, a person can help not just one’s mental health, but over time, can improve one’s overall health and, in turn, the U.S. economy.

Change through policy

If the EU strives to improve fitness and save healthcare costs, can and should the U.S. follow suit? Would the economic benefits of simply having Americans increase physical movement and have more individuals achieve the weekly recommended activity levels benefit the country economically and prevent negative health outcomes? Without research, can we say "YES" for sure? Well, no, but it seems like a no-brainer. If more individuals are active, they are at a lower risk of developing non-communicable chronic diseases such as diabetes and heart disease. Thus, with fewer disease cases, medical expenditures would ultimately be less.

We need various strategies to engage communities in physical activity and encourage individual exercise. The EU stressed that one approach wouldn’t fit all, and complex behaviors are involved in what motivates or fails to motivate people to choose activity over a sedentary lifestyle. For instance, incentives, education, improved access, safe environments, and more must unite people of all races, all economic statuses, health and fitness levels, and ages to become more active.

Strategies for change

Recommendations by the WHO for the EU to help improve overall exercise and lessen healthcare expenditures include improving access to physical activity and promoting individual and community exercise. However, they stress that gaps in policy in many nations exist. By closing these gaps, we can significantly impact outcomes. These gaps extend globally, including in U.S. policy improvements, which can include the following:

• Informing and communicating policies.
• Improving access to outdoor spaces (urban design) and environmental access.
• Ensuring transportation systems and, therefore, access.
• Ensuring facilities providing sports and exercise are more accessible to all.
• Developing programs for schools, workplaces, and even healthcare systems.

These and similar policies can help improve a population’s resilience (ability to adapt to challenges and demands), mental health, and social connectedness. These steps can improve cognitive function, sleep, and sleep quality, keep bones healthy, help fight disease, improve overall fitness, strength, and balance, decrease fall risk, lessen obesity risks, and even help to minimize signs of anxiety and depression.

"Step up" in the U.S.?

A study like the WHO conducted for the EU should be replicated in the U.S. This may help further clarify the actual burden of inactivity on healthcare costs and overall population health. Additionally, it provides the stepping stones for determining what policies, communication strategies, and other means can be implemented to motivate Americans to improve health outcomes and our financial outlook. Most of us recognize that we don’t need a study to know that exercise benefits us. We all have excuses, health reasons, trials, and tribulations that may affect our activity level. However, stepping up is one way to accomplish this, figuratively and literally, if we want to improve ourselves and our nation.