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击中目标却不得要领?不同方法实现全球身体活动行动计划目标的健康和经济影响建模

Hitting the Target but Missing the Point? Modelling Health and Economic Impacts of Different Approaches to Meeting the Global Action Plan for Physical Activity Target.

作者信息

Mizdrak Anja, Ding Ding, Cleghorn Christine, Blakely Tony, Richards Justin

机构信息

Department of Public Health, University of Otago (Wellington), 23 Mein Street, Newtown, Wellington, New Zealand.

Prevention Research Collaboration, Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Camperdown, NSW, Australia.

出版信息

Sports Med. 2021 Apr;51(4):815-823. doi: 10.1007/s40279-020-01398-2. Epub 2021 Jan 12.

Abstract

BACKGROUND

The World Health Organization launched the Global Action Plan for Physical Activity (GAPPA) in 2018, which set a global target of a 15% relative reduction in the prevalence of physical inactivity by 2030. This target, however, could be acheived in various ways.

METHODS

We use an established multi-state life table model to estimate the health and economic gains that would accrue over the lifetime of the 2011 New Zealand population if the GAPPA target was met under two different approaches: (1) an equal shift approach where physical activity increases by the same absolute amount for everyone; (2) a proportional shift approach where physical activity increases proportionally to current activity levels.

FINDINGS

An equal shift approach to meeting the GAPPA target would result in 197,000 health-adjusted life-years (HALYs) gained (95% uncertainty interval (UI) 152,000-246,000) and healthcare system cost savings of US$1.57b (95%UI $1.16b-$2.03b; 0% discount rate). A proportional shift to the GAPPA target would result in 158,000 HALYs (95%UI 127,000-194,000) and US$1.29billion (95%UI $0.99b-$1.64b) savings to the healthcare system.

INTERPRETATION

Achieving the GAPPA target would result in large health gains and savings to the healthcare system. However, not all population approaches to increasing physical activity are equal-some population shifts bring greater health benefits. Our results demonstrate the need to consider the entire population physical activity distribution in addition to evaluating progress towards a target.

摘要

背景

世界卫生组织于2018年发布了《全球身体活动行动计划》(GAPPA),设定了到2030年将身体活动不足患病率相对降低15%的全球目标。然而,这一目标可以通过多种方式实现。

方法

我们使用一个既定的多状态生命表模型,来估计如果在两种不同方法下实现GAPPA目标,2011年新西兰人口一生中将获得的健康和经济收益:(1)均等转变方法,即每个人的身体活动绝对增加量相同;(2)比例转变方法,即身体活动的增加与当前活动水平成比例。

研究结果

采用均等转变方法实现GAPPA目标将带来19.7万个健康调整生命年(HALYs)的收益(95%不确定区间(UI)为15.2万 - 24.6万),医疗保健系统成本节省15.7亿美元(95%UI为11.6亿 - 20.3亿美元;贴现率为0%)。向GAPPA目标的比例转变将带来15.8万个健康调整生命年(95%UI为12.7万 - 19.4万),医疗保健系统节省12.9亿美元(95%UI为9.9亿 - 16.4亿美元)。

解读

实现GAPPA目标将带来巨大的健康收益并节省医疗保健系统成本。然而,并非所有增加身体活动的人群方法都是等同的——一些人群转变带来更大的健康益处。我们的结果表明,除了评估朝着目标取得的进展外,还需要考虑整个人口的身体活动分布情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bead/7981302/e0d6cdd8be8b/40279_2020_1398_Fig1_HTML.jpg

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