Thesis Abstracts 1996

This paper quantifies the potential medical cost savings that may be achievable if a significant proportion of the middle-aged and elderly population in the U.S. came to enjoy a heightened level of fitness. The initial part examines the literature regarding specific diseases and health domains. The best available data on the impact of physical fitness on the disease states are summarized, and the attendant risk reductions, if any, are explicitly noted. In the final part of the paper, the most rigorously derived available estimates of total health care expenditures in the areas discussed are presented. Based on the previously expressed risk reductions, dollar amounts for potential cost savings in each category are derived. Thus it is demonstrated that improved physical fitness would not only reduce suffering and extend functional life-span in older Americans, but also generate tangible and substantial cost savings for the medical care delivery system as a whole. The dollar amount of potential savings is found to be significant. Building on the savings estimates derived for each category of disease examined, a $90 billion (10 percent) total reduction in health-care expenditures can be postulated. Decreases in costs due to cardiovascular disease, institutionalization/nursing home admission, occupational and other injuries, and osteoporosis contribute the largest shares. A variety of other disease processes, notably stress urinary incontinence, diabetes, certain location-specific cancers, upper respiratory tract infection, and depression, account for an additional $20 billion in unincurred costs. In sum, the effects of physical fitness on health and medical costs are unequivocal. Especially in the elderly, regular physical activity directly contributes to the postponement or avoidance of significant morbidity, thus reducing utilization of medical services.