Physical Activity, Health & Economic OutcomesAjay Mahal, Monash University

February 11, 2014

Outline

• Linking Physical Activity to Economic Outcomes

• So Why Don’t People Exercise More?

• Key Research Gaps

I. Physical Activity & Economic Outcomes

• Physical Activity Indirectly Impacts Economic Outcomes via Health

• Physical Activity directly impacts Economic Outcomes

Health and Economic Outcomes

• Labour Market Effects of Ill Health

Poor Health and Lower Productivity

Poor Health and Work Force Participation (Ill Person, Caregiver, Income Generation) • Expenses associated with Ill Health

Obesity Penalty: % Body Fat versus Earnings Evidence from the US

(Source: Tome 2010)

SRH and Labour Force Participation in Australia, 15-59 years, 2001

Sources: Kavetsos 2011, Morris 2006, Cai 2006)

Adult Employment (%) is Lower in Households with Members with Chronic Disease in India, 2004

Variables Households With Chronic

Condition

Matched Households

Heart Disease 43.61 46.38

Cancer 48.50 51.82

Mahal et al (2013); Mahal et al (2014)

Out of Pocket Spending on Cancer by Indian Households, 2004Source: Mahal et al. (2013)

Variables Households With Cancer

Matched Households

OOP Spending in 15-day reference period (INR) 118.33 44.77

OOP Expenditure on individuals without cancer

(15-day period) (INR)38.30 48.98

OOP Expenditure on conditions other than

cancer (15-day period, INR)15.54 28.83

Physical Activity and Health

Physiological influence of Physical Activity (PA): cognitive ability (Angevaren 2008)

physical functionality (Maiorana 2001)

energy levels/motivation (Puetz 2006)

mental ill health (Dunn 2001)

risk chronic conditions (Warburton 2006)

all-cause mortality (dose-response) (Bauman 2003)

Physical Inactivity main cause globally for:

•21-25% breast and colon cancers

•27% diabetes mellitus

•30% ischaemic heart disease

(WHO 2013)

Effect of sports activity on over 16 year period in Europe (2000 Euros)

(Source: Lechner 2006)

Direct Effects: Physical Activity and Appearance

• Fitness-related facial cues create the same impressions as faces that vary in attractiveness

• Fitness creates a perception as being more outgoing, socially competent, intelligent, and healthy

(Lakdawalla 2006, Zebrowitz 2008)

II. So Why Don’t People Exercise More?Health: Illness, Overweight/Obesity

Demographics: Older Ages, Women, Families with Infant Children

Socioeconomic Status: Educational Attainment, Income, Opportunity cost of time

Psychological/Cultural: Belief in Sporting Ability, Deemphasize athletic endeavours

Environment: Availability of Facilities, Networks

US Adults meeting Federal Physical Activity Guidelines

Population Group Prevalence, 2011 (Age ≥ 18y), %

Total (Both sexes) 21.0

All Males 24.9

All Females 17.1

Non-Hispanic White only 23.0

Non-Hispanic Black only 18.0

Hispanic or Latino 15.4

American Indian/Alaskan Native only 17.0

Asian only 16.7

(Go 2012)

III. Key Research Gaps in Low- and Middle-Income Countries

• Economic Outcomes: Research on Physical Activity and its Implications for Economic Outcomes (particularly labor market outcomes) in Low- and Middle-Income Countries

• Economic Roots of Physical Inactivity (income and occupational status, neighbourhood effects, migrant workers, urbanization)

• Evaluation of Interventions/Policies