Socio-Spatial Determinants of Health Laboratory, Population and Community Health Sciences Branch, Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland.
Public Health Informatics, Computational, and Operations Research, CUNY Graduate School of Public Health and Health Policy, New York, New York.
JAMA Netw Open. 2024 Nov 4;7(11):e2446775. doi: 10.1001/jamanetworkopen.2024.46775.
Sex disparities in physical activity (PA) and sports participation among US children and adolescents have been persistent. Quantifying the impact of reducing or eliminating these disparities may help determine how much to prioritize this problem and invest in interventions and policies to reduce them.
To quantify what might happen if existing PA and sports participation disparities were reduced or eliminated between male and female children and adolescents.
DESIGN, SETTING, AND PARTICIPANTS: This simulation study used an agent-based model representing all children (aged 6 to 17 years) in the US, their PA and sports participation levels, and relevant physical and physiologic characteristics (eg, body mass index) as of 2023. Experiments conducted from April 5, 2024, to September 10, 2024, simulated what would happen during the lifetime of each cohort member if PA and sports participation levels for female participants were increased (to varying degrees) to match male participants in the same age group.
Health outcomes, such as body mass index, incidence of weight-related conditions (eg, stroke, coronary heart disease, type 2 diabetes, and cancer), and economic outcomes (eg, direct medical costs and productivity losses).
This simulation study modeled 8 299 353 US children and adolescents (4 240 119 [51.1%] male and 4 059 234 [48.9%] female) aged 6 to 17 years. Eliminating PA sex disparities averted 28 061 (95% CI, 25 358-30 763) overweight and obesity cases per cohort by age 18 years, which in turn averted 4869 (95% CI, 4007-5732) weight-related disease cases during their lifetimes and resulted in recurring savings of $333.45 million (95% CI, $290.22 million to $376.68 million) in direct medical costs and $446.42 million (95% CI, $327.39 million to $565.44 million) in productivity losses (in 2024 US dollars) for every new cohort of 6- to 17-year-olds. Reducing PA disparities by 50% averted 9027 (95% CI, 6942-11 112) overweight and obesity cases. Eliminating sex disparities in sports participation averted 41 499 (95% CI, 37 874-45 125) cases of overweight and obesity and 8939 (95% CI, 8088-9790) weight-related disease cases during their lifetimes, generating recurring savings of $713.48 million (95% CI, $668.80 million to $758.16 million) in direct medical costs and $839.68 million (95% CI, $721.18 million to $958.18 million) in productivity losses.
In this simulation study of youth PA and sports participation, eliminating sex disparities could save millions of dollars for each new cohort of 6- to 17-year-olds, which could exceed the cost of programs and investments that could enable greater equity.
美国儿童和青少年在体力活动（PA）和运动参与方面的性别差异一直存在。量化减少或消除这些差异的影响可能有助于确定应优先考虑这个问题的程度，并投资于干预措施和政策，以减少这些差异。
量化如果减少或消除男女儿童和青少年之间现有的 PA 和运动参与差异可能会发生什么。
设计、设置和参与者：这项模拟研究使用了一个基于代理的模型，代表了美国所有（6 至 17 岁）的儿童，以及他们的 PA 和运动参与水平，以及相关的身体和生理特征（例如，体重指数）截至 2023 年。从 2024 年 4 月 5 日至 2024 年 9 月 10 日进行的实验模拟了如果女性参与者的 PA 和运动参与水平（在不同程度上）增加到与同年龄组的男性参与者相匹配，那么每个队列成员在其有生之年可能会发生什么。
健康结果，如体重指数、与体重相关的疾病（如中风、冠心病、2 型糖尿病和癌症）的发生率，以及经济结果（如直接医疗成本和生产力损失）。
这项模拟研究对 8,299,353 名 6 至 17 岁的美国儿童和青少年（4,240,119 [51.1%] 男性和 4,059,234 [48.9%] 女性）进行了建模。消除 PA 性别差异可避免每批新的 6 至 17 岁儿童在 18 岁前出现 28,061 例（95%CI，25,358-30,763）超重和肥胖病例，进而避免在其一生中出现 4,869 例（95%CI，4,007-5,732）与体重相关的疾病病例，并节省 3.3345 亿美元（95%CI，2.9022 亿美元至 3.7668 亿美元）的直接医疗费用和 4.4642 亿美元（95%CI，3.2739 亿美元至 5.6544 亿美元）的生产力损失（2024 年以美元计），每批新的 6 至 17 岁儿童。将 PA 差异减少 50%可避免 9,027 例（95%CI，6,942-11112）超重和肥胖病例。消除运动参与方面的性别差异可避免 41,499 例（95%CI，37,874-45125）超重和肥胖病例和 8,939 例（95%CI，8088-9790）与体重相关的疾病病例，从而节省 7134.80 万美元（95%CI，6688.00 万美元至 7581.60 万美元）的直接医疗费用和 8396.80 万美元（95%CI，7211.18 万美元至 9581.80 万美元）的生产力损失。
在这项关于青少年 PA 和运动参与的模拟研究中，消除性别差异可为每批新的 6 至 17 岁儿童节省数百万美元，这可能超过为实现更大公平而投资的项目和投资的成本。
