Measuring the value of swimming and physical activity Paul Barnsley - - PowerPoint PPT Presentation

Measuring the value of swimming and physical activity

Paul Barnsley PhD Senior Health Economist Royal Life Saving Society - Australia

Benefits of aquatic activity

• Physical inactivity leads to

massive health costs

– 5% of Australia’s burden of disease and injury is due to inactivity – Total annual costs due to inactivity are at least $55 billion

• 40% of Australians are

classified as “inactive”

– For most of these people, an additional weekly swimming pool visit would move them to “low activity”

Current distribution of physical activity

WHO cut-offs for physical activity levels:

• <600 MET.minutes/week – Physically

inactive

• 600-4,000 MET.minutes/week – Low

activity

• 4,000-8,000 MET.minutes/week –

Moderate activity

• >8,000 MET.minutes/week – High

activity

39% 53% 7% 1% Inactive Low activity Moderate activity High activity

• Categories of gains from increased

activity:

– Value of reduced mortality and morbidity – Reduced healthcare spending – Reduced absenteeism

Valuing increases in activity

0% 5% 10% 15% 20% 25% 30% 35% Inactive Low activity Moderate activity

Average increase in relative risk, compared to high activity

Valuing reduced death and disability

Delaying premature mortality:

• Delaying mortality for one year is

valued using the Value of a Statistical Life Year (VSLY)

– RLSSA calculated the 2016 VSLY at $198,000 – Same methodology is used to value public health interventions

Reducing disability

• A Disability Adjusted Life Years

(DALYs) measure the proportional impairment caused by disability or morbidity

– Living four years with a 25% impairment (eg moderate traumatic brain injury) generates one DALY – AIHW figures for physical inactivity list total DALYs, combining mortality and morbidity

Valuing health care costs

• Project annual spending on

inactivity-linked conditions

– Type II Diabetes ($3 bn) – Cardiovascular disease ($11 bn) – Breast & bowel cancers ($7 bn)

• AIHW figures show % of

burden attributable to inactivity for each condition

– Assume cost share is equal to burden share – Ignores general health system costs due to inactivity-linked morbidity – Inactivity generates 5% of burden, but

• nly 2.15% of costs

Valuing lost productivity

• Hard to link physical inactivity

to specific workplace

• utcomes

– We adopt a conservative approach – Medibank study suggests inactivity leads to two extra sick days per year – No evidence for differences between low, moderate and high activity levels

• Sick days are valued using

average weekly earnings

– Estimate includes costs of managerial hours to replace absent employee – Includes a partial overtime premium – Ignores presenteeism: reduced productivity for low activity persons

Where do the gains come from?

$0 $500 $1,000 $1,500 $2,000 $2,500 $3,000 $3,500 $4,000 $4,500 $5,000

Inactive Low activity Moderate activity

$2,447 $202 $742

Breakdown of gains from becoming active

Health value Health care costs Absenteeism

Extra pool visits reduce inactivity

• We used a Monte Carlo

simulation to randomly assign millions of extra pool visits across the Australian population

– Simulation used exact distribution of MET.minutes within each category

• We calculated how much one

pool visit changed national activity profile on average

– Most gains come from getting “inactive” people up to “low activity”

How much extra value?

• An average pool visit is 555

MET.mins of exercise

– “inactive” is <600 MET.mins/week

• An average visit has health

benefits worth $26.39

• An average facility creates

$2.72m in health benefits each year

• The aquatic industry creates

$2.8 billion in wider economic benefits annually

What else do we need to know?

• These figures are for an

average Australian aquatic facility

• Different visitor demographics

lead to different benefit profiles

• With the right data, we can

tailor estimates to a specific facility, whether existing or proposed

• Figures are for a marginal, not

average visit

What about the other benefits?

• Economic contribution to the

area

– Important, but difficult to measure and govt increasingly sceptical

• Gains from improved aquatic

education

– Hard to tie a particular facility to any future reduction in drowning

• Visitors’ enjoyment

– Some evidence on this, can be improved by looking at how far people are willing to travel

• Community/inclusion benefits

– Important, but hard to pin down to a dollar figure

What are the policy implications?

• The aquatic industry generates

value to the public far above the money it collects from visitors

• Government decision making

should keep physical activity benefits in mind when making changes impacting on access to pools