Hitting the Target but Missing the Point? Modelling Health and Economic Impacts of Different Approaches to Meeting the Global Action Plan for Physical Activity Target

Sports Med. 2021 Apr;51(4):815-823. doi: 10.1007/s40279-020-01398-2. Epub 2021 Jan 12.

Abstract

Background: The World Health Organization launched the Global Action Plan for Physical Activity (GAPPA) in 2018, which set a global target of a 15% relative reduction in the prevalence of physical inactivity by 2030. This target, however, could be acheived in various ways.

Methods: We use an established multi-state life table model to estimate the health and economic gains that would accrue over the lifetime of the 2011 New Zealand population if the GAPPA target was met under two different approaches: (1) an equal shift approach where physical activity increases by the same absolute amount for everyone; (2) a proportional shift approach where physical activity increases proportionally to current activity levels.

Findings: An equal shift approach to meeting the GAPPA target would result in 197,000 health-adjusted life-years (HALYs) gained (95% uncertainty interval (UI) 152,000-246,000) and healthcare system cost savings of US$1.57b (95%UI $1.16b-$2.03b; 0% discount rate). A proportional shift to the GAPPA target would result in 158,000 HALYs (95%UI 127,000-194,000) and US$1.29billion (95%UI $0.99b-$1.64b) savings to the healthcare system.

Interpretation: Achieving the GAPPA target would result in large health gains and savings to the healthcare system. However, not all population approaches to increasing physical activity are equal-some population shifts bring greater health benefits. Our results demonstrate the need to consider the entire population physical activity distribution in addition to evaluating progress towards a target.

Plain language summary

The World Health Organization launched the Global Action Plan for Physical Activity in 2018, which set a global target to reduce physical inactivity. We explored different ways in which this target could be met and found that some approaches to meeting the target would bring larger health gains and savings to the healthcare system than others.

MeSH terms

  • Exercise*
  • Global Health
  • Humans
  • New Zealand
  • Quality-Adjusted Life Years
  • Sedentary Behavior*