Cost-benefit analysis of walking to prevent coronary heart disease
T. F. Jones and C. B. Eaton
Department of Family Medicine, Brown University School of Medicine/Memorial Hospital of Rhode Island, Pawtucket.
OBJECTIVE: To quantify the cost-benefit relationship of walking to prevent
coronary heart disease. DESIGN: Cost-benefit analysis. PARTICIPANTS:
Hypothetical cohorts of sedentary men and women aged 35 to 74 years. MAIN
OUTCOME MEASURES: Decision-analysis simulation was used to evaluate the
cost-benefit relationship of walking, varying level of benefit from
exercise, frequency of exercise to achieve benefit, participation rates,
and costs of exercise and injury. RESULTS: At a relative risk of 1.9 for
heart disease associated with sedentary behavior, $5.6 billion would be
saved annually if 10% of adults began a regular walking program. A $4.3
billion savings is predicted if the entire sedentary population began
walking regularly and the cost of the time an individual spends exercising
is accounted for in those who dislike exercising. According to our baseline
assumptions, walking is economically beneficial for men aged 35 to 64 years
and for women aged 55 to 64 years. The threshold of relative risk at which
economic benefit is found for walking in this population overall is
estimated at 1.7, and under a volunteer model, most adults would benefit
even at a relative risk of 1.15. CONCLUSIONS: There are significant sex and
age differences in the economic benefits of walking to prevent heart
disease. The value assigned to the time an individual spends exercising has
a significant impact on the results. Overall, a substantial savings is
predicted from encouraging sedentary individuals to participate in a
regular walking program.
