Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.
Intramural Research Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland.
JAMA Health Forum. 2024 Mar 1;5(3):e240088. doi: 10.1001/jamahealthforum.2024.0088.
There are considerable socioeconomic status (SES) disparities in youth physical activity (PA) levels. For example, studies show that lower-SES youth are less active, have lower participation in organized sports and physical education classes, and have more limited access to PA equipment.
To determine the potential public health and economic effects of eliminating disparities in PA levels among US youth SES groups.
An agent-based model representing all 6- to 17-year-old children in the US was used to simulate the epidemiological, clinical, and economic effects of disparities in PA levels among different SES groups and the effect of reducing these disparities.
Anthropometric measures (eg, body mass index) and the presence and severity of risk factors associated with weight (stroke, coronary heart disease, type 2 diabetes, or cancer), as well as direct and indirect cost savings.
This model, representing all 50 million US children and adolescents 6 to 17 years old, found that if the US eliminates the disparity in youth PA levels across SES groups, absolute overweight and obesity prevalence would decrease by 0.826% (95% CI, 0.821%-0.832%), resulting in approximately 383 000 (95% CI, 368 000-399 000) fewer cases of overweight and obesity and 101 000 (95% CI, 98 000-105 000) fewer cases of weight-related diseases (stroke and coronary heart disease events, type 2 diabetes, or cancer). This would result in more than $15.60 (95% CI, $15.01-$16.10) billion in cost savings over the youth cohort's lifetime. There are meaningful benefits even when reducing the disparity by just 25%, which would result in $1.85 (95% CI, $1.70-$2.00) billion in direct medical costs averted and $2.48 (95% CI, $2.04-$2.92) billion in productivity losses averted. For every 1% in disparity reduction, total productivity losses would decrease by about $83.8 million, and total direct medical costs would decrease by about $68.7 million.
This study quantified the potential savings from eliminating or reducing PA disparities, which can help policymakers, health care systems, schools, funders, sports organizations, and other businesses better prioritize investments toward addressing these disparities.
年轻人的身体活动（PA）水平存在相当大的社会经济地位（SES）差异。例如，研究表明，较低 SES 的年轻人活动较少，参与组织的体育活动和体育课的比例较低，获得 PA 设备的机会也较少。
确定消除美国青少年 SES 群体之间 PA 水平差异的潜在公共卫生和经济效益。
使用代表美国所有 6 至 17 岁儿童的基于代理的模型来模拟不同 SES 群体之间 PA 水平差异的流行病学、临床和经济影响，以及减少这些差异的效果。
人体测量学指标（例如，体重指数）以及与体重相关的风险因素的存在和严重程度（中风、冠心病、2 型糖尿病或癌症），以及直接和间接成本节约。
该模型代表了美国所有 5000 万 6 至 17 岁的儿童和青少年，发现如果美国消除了 SES 群体之间年轻人 PA 水平的差异，超重和肥胖的绝对患病率将下降 0.826%（95%CI，0.821%-0.832%），导致大约 383000（95%CI，368000-399000）例超重和肥胖病例减少，101000（95%CI，98000-105000）例与体重相关的疾病（中风和冠心病事件、2 型糖尿病或癌症）减少。这将在青少年群体的一生中带来超过 156 亿美元（95%CI，150.10 亿美元-161.00 亿美元）的成本节约。即使仅仅减少 25%的差异，也会有显著的好处，这将避免 18.5 亿美元（95%CI，17.00 亿美元-20.00 亿美元）的直接医疗费用和 24.8 亿美元（95%CI，20.40 亿美元-29.20 亿美元）的生产力损失。每减少 1%的差异，总生产力损失将减少约 8380 万美元，直接医疗费用将减少约 6870 万美元。
本研究量化了消除或减少 PA 差异的潜在节省，这可以帮助政策制定者、医疗保健系统、学校、资助者、体育组织和其他企业更好地优先投资解决这些差异。
