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Jamile S. Codogno, Henrique L. Monteiro, Bruna C. Turi-Lynch, Romulo A. Fernandes, Subhash Pokhrel and Nana Anokye

; Marlier et al., 2015 ). Although sports participation among adults may play a role in the mitigation of health care costs due to its potential to prevent diseases, the nature of this relationship is not clear. The scarce evidence available is based on cross-sectional data ( Codogno et al., 2015 ). In

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John L. Crompton and Dennis R. Howard

Economic impact studies are frequently commissioned to justify investments in sport projects. However, decisions also should include a consideration of a project’s costs since it is the net return on investment that should drive decisions. Whenever taxpayer funds are expended on a sports project there is an opportunity cost. Three types of opportunity cost are discussed. Explicit costs are those for which a government entity “writes a check.” They are comprised of event costs, land and infrastructure costs, and operations and maintenance costs. Implicit costs are those which remain “hidden” from most taxpayers: foregone property taxes, strategic underestimation of capital costs, displacement costs, and an inequitable nexus between payers and beneficiaries. External costs are those incurred by taxpayers beyond the boundaries of a local jurisdiction.

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Thomas Gotschi

Background:

Promoting bicycling has great potential to increase overall physical activity; however, significant uncertainty exists with regard to the amount and effectiveness of investment needed for infrastructure. The objective of this study is to assess how costs of Portland’s past and planned investments in bicycling relate to health and other benefits.

Methods:

Costs of investment plans are compared with 2 types of monetized health benefits, health care cost savings and value of statistical life savings. Levels of bicycling are estimated using past trends, future mode share goals, and a traffic demand model.

Results:

By 2040, investments in the range of $138 to $605 million will result in health care cost savings of $388 to $594 million, fuel savings of $143 to $218 million, and savings in value of statistical lives of $7 to $12 billion. The benefit-cost ratios for health care and fuel savings are between 3.8 and 1.2 to 1, and an order of magnitude larger when value of statistical lives is used.

Conclusions:

This first of its kind cost-benefit analysis of investments in bicycling in a US city shows that such efforts are cost-effective, even when only a limited selection of benefits is considered.

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Robert M. Kaplan, Alison K. Herrmann, James T. Morrison, Laura F. DeFina and James R. Morrow Jr.

Background:

Despite benefits of physical activity (PA), exercise is also associated with risks. Musculoskeletal injury (MSI) risk increases with exercise frequency/intensity. MSI is associated with costs including medical care and time lost from work.

Purpose:

To evaluate the economic costs associated with PA-related MSIs in community-dwelling women.

Method:

Participants included 909 women in the Women’s Injury Study reporting PA behaviors and MSI incidence weekly via the Internet for up to 3 years (mean follow-up 1.89 years). Participants provided consent to obtain health records. Costs were estimated by medical records and self-reports of medical care. Components included physician visits, medical facility contacts, medication costs, and missed work.

Results:

Of 909 participants, 243 reported 323 episodes of expenditure or contact with the health care system associated with PA. Total costs of episodes ranged from $0–$18,934. Modal cost was $0 (mean = $433 ± $1670). Costs were positively skewed with nearly all participants reporting no or very low costs.

Conclusions:

About 1 in 4 community-dwelling women who are physically active experienced a PA-related MSI. The majority of injuries were minor, and large expenses associated with MSI were rare. The long-term health benefits and costs savings resulting from PA likely outweigh the minor costs associated with MSI from a physically-active lifestyle.

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Katerina Maresova

Background:

Several scientific studies estimate the burden of physical inactivity in different countries, yet in the Czech Republic, this kind of research is still missing. This paper represents one of the first attempts to quantify the costs of physical inactivity in the Czech Republic for 2008.

Methods:

The analysis, based on scientific literature review, uses the comparative risk assessment methodology and applies it on data available in the Czech Republic.

Results:

In 2008, the financial cost of physical inactivity to public health insurance companies was almost 700 million Kč, or 0.4%, of total healthcare costs. Furthermore, physical inactivity caused 2442, or 2.3%, of all deaths in 2008 and 18,065, or 1.2%, of all disability-adjusted life years in 2004.

Conclusions:

The costs of physical inactivity in the Czech Republic are considerable, yet slightly smaller than in other comparable studies. The obtained results could be used as an argument for policymakers when conceiving public or private health policy.

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Caterina Pesce and Michel Audiffren

This study investigated the effects of acute exercise on 53 young (16–24 years) and 47 older (65–74 years) adults’ switch-task performance. Participants practiced sports requiring either low or high cognitive demands. Both at rest and during aerobic exercise, the participants performed two reaction time tasks that differed in the amount of executive control involved in switching between global and local target features of visual compound stimuli. Switch costs were computed as reaction time differences between switch and nonswitch trials. In the low demanding task, switch costs were sensitive only to age, whereas in the high demanding task, they were sensitive to acute exercise, age, and sport-related cognitive expertise. The results suggest that acute exercise enhances cognitive flexibility and facilitates complex switch-task performance. Both young age and habitual practice of cognitively challenging sports are associated with smaller switch costs, but neither age nor cognitive expertise seem to moderate the relationship between acute exercise and switch-task performance.

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Tatiana Andreyeva and Roland Sturm

Background:

Physical activity has clear health benefits but there remains uncertainty about how it affects health care costs.

Objective:

To examine how physical activity is associated with changes in health expenditure for a national sample age 54 to 69 y, and estimate how this association varies across people with different chronic diseases and health behaviors.

Methods:

Data were from the Health and Retirement Study, a national longitudinal survey of late middle age Americans.

Results:

Correcting for baseline differences in active and inactive groups, physical activity was associated with reduced health care costs of about 7% over 2 y (or $483 annually).

Conclusions:

Regular physical activity in late middle age may lower health expenditure over time, and the effect is likely to be more pronounced for the obese, smokers, and individuals with some baseline health problems. While substantially large for the health care system, our estimates are much smaller than health-unadjusted comparisons or cross-sectional effects.

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Jeremy D. Smith and Philip E. Martin

Unilateral, transtibial amputees exhibit walking asymmetries and higher metabolic costs of walking than nonamputees walking at similar speeds. Using lightweight prostheses has previously been suggested as a contributing factor to walking asymmetries. The purpose was to investigate the effects of prosthesis mass and mass distribution on metabolic costs and walking asymmetries among six unilateral, transtibial amputees. Kinematic and temporal symmetry did not improve when mass was added at different locations on the limb. Stance and swing time asymmetries increased by 3.4% and 7.2%, respectively, with loads positioned distally on the limb. Maximum knee angular velocity asymmetries increased by 6% with mass added to the thigh, whereas maximum thigh angular velocity asymmetries increased by approximately 10% with mass positioned near the prosthetic ankle. Adding 100% of the estimated mass difference between intact and prosthetic legs to the ankle of the prosthesis increased energy costs of walking by 12%; adding the same mass to the prosthesis center of mass or thigh center of mass increased metabolic cost by approximately 7% and 5%, respectively. Unless other benefits are gained by increasing prosthesis mass, this should not be considered as a possible alternative to current lightweight prosthesis designs currently being prescribed to unilateral amputees.

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Josh Trout and Eddie Vela

In 2009, California State University-Chico implemented a unique system of course redesign with the aim of improving student learning, increasing instructional efficiency, and reducing university costs. Inspired by and modeled after the National Center for Academic Transformation, the “Academy e-Learning” program involves a 3-week training covering models of course design, learning theories, assessment methods, and a host of instructional technologies. This paper summarizes data from 40 courses, across five separate cohort groups from 2009–2013, with respect to the efficacy of Academy e-Learning (re)design training. Data show improvements in student learning outcomes in over half of the course redesigns. Benefits of course redesign included increased instructional efficiency, enhanced student learning, and a reduction in university costs by offering some instruction online and increasing enrollment caps. Barriers to a successful course redesign included lack of time, technology malfunction, and workload concerns. This paper outlines the redesign process at California State University-Chico, discusses similar redesign initiatives at other institutions, and offers solutions for measuring effectiveness of a redesigned course.

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Scott A. Conger and David R. Bassett Jr.

The purpose of this study was to develop a compendium of wheelchair-related physical activities. To accomplish this, we conducted a systematic review of the published energy costs of activities performed by individuals who use wheelchairs. A total of 266 studies were identified by a literature search using relevant keywords. Inclusion criteria were studies utilizing individuals who routinely use a manual wheelchair, indirect calorimetry as the criterion measurement, energy expenditure expressed as METs or VO2, and physical activities typical of wheelchair users. Eleven studies met the inclusion criteria. A total of 63 different wheelchair activities were identified with energy expenditure values ranging from 0.8 to 12.5 kcal·kg-1·hr-1. The energy requirements for some activities differed between individuals who use wheelchairs and those who do not. The compendium of wheelchair-related activities can be used to enhance scoring of physical activity surveys and to promote the benefits of activity in this population.