Economics of sedentary behaviour: A systematic review of cost of illness, cost-effectiveness, and return on investment studies

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A paper titled “Economics of sedentary behaviour: A systematic review of cost of illness, cost-effectiveness, and return on investment studies” has recently been published in Preventive Medicine. The full-text article can be found here. Citation details and the summary of the paper are re-posted below.

Citation

Nguyen P, Le LK-D, Ananthapavan J, Gao L, Dunstan DW, Moodie M. Economics of sedentary behaviour: A systematic review of cost of illness, cost-effectiveness, and return on Investment Studies. Preventive Medicine. 2022;156:106964. doi:10.1016/j.ypmed.2022.106964

Abstract

Aims

Sedentary behaviour is an established risk factor for several diseases; however, its economic impacts are less understood. This study systematically reviews the literature on the economic costs associated with excessive sedentary behaviour and the cost-effectiveness of interventions targeting sedentary time.

Methods

A systematic search was conducted across electronic databases including MEDLINE, PsycINFO and CINAHL up to March 2021. Screening and data extraction were conducted by two reviewers. Data extraction focused on study design, intervention details, costs and cost-effectiveness results. Findings were summarised in a narrative synthesis.

Results

We identified nine articles (conducted in Australia (n = 5), Europe (n = 3) and China (n = 1)); three reported healthcare costs associated with excessive sedentary time, whilst six were economic evaluations of interventions targeting sedentary behaviour. Healthcare costs associated with excessive sedentary time as reported in cost of illness studies were substantial; however, none explored non-health sector costs. In contrast, all full economics evaluations adopted a societal perspective; however, costs included differed depending on the intervention context. One sedentary behaviour intervention in children was cost-saving. The five interventions targeting occupational sitting time of adults in office workplaces were cost-effective. Physical environmental changes such as sit-stand desks, active workstations etc., were the key cost driver.

Conclusions

Sedentary behaviour is likely associated with excess healthcare costs, although future research should also explore costs across other sectors. Cost-effectiveness evidence of sedentary behaviour reduction interventions in workplaces is limited but consistent. Key gaps relate to the economic credentials of interventions targeting children, and modelling of long-term health benefits of interventions.

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