Is promotion of physical activity a wise use of societal resources? Issues of cost-effectiveness and equity in health.

Physical activity creates health benefits, and society makes large contributions in order to promote physical activity within the population. However, the cost-effectiveness and equity-in-health effect of these efforts is seldom evaluated. A model for economic evaluation of community-promoted physical activity has been constructed based on referenced works on the health effects of physical activity, standard methods of economic evaluation, and targets for equity in health. This model was then used to assess published evaluations. A search for programs of community-promoted physical activity aimed to promote health or prevent illness found only eight economic evaluations. Three were based on models, and five evaluated actual interventions. Almost every aspect of the model proposed in this article is included in some of the earlier studies, but several important aspects were excluded in each previous study. A cost-effectiveness analysis of community-promoted physical activity is possible, but adequate knowledge of the components of cost-effectiveness and equity-in-health effect are still limited. The most important determinants of cost-effectiveness are adherence to new habits, experience and value of time spent on physical activity, and selection of the target group.