Ill health associated with sedentary behaviour costs the NHS at least £0.7bn per year – UK study

Spending large amounts of time sitting during the day is linked to almost 70,000 deaths a year in the UK and treating the health consequences of sedentary behaviour costs the NHS in excess of £0.7bn (€0.8 bn) a year, a new UK study has suggested.

Previous studies have shown that spending large parts of the day sitting down increases the risk of cardiovascular disease, type 2 diabetes, cancer and death and is a burden on health services.

However, this new study by researchers from Queen’s University Belfast and Ulster University, is the first of its kind to estimate the financial impact sedentary behaviour has on the NHS.

Figures calculated by other researchers on the impact sedentary behaviour has on the relative risks of five specific health conditions (type 2 diabetes, cardiovascular disease, colon cancer, endometrial cancer and lung cancer) and deaths from all causes were combined with figures on the percentage of adults who are sedentary on any given day of the week to estimate the overall impact sedentary behaviour has at a UK population level.

Figures on sedentary behaviour were taken from the Health Survey for England 2012, which reported that 30 per cent of adults in England spent at least six hours a day sitting down at weekdays and that this increased to 37 per cent on weekends.

Actual overall NHS spending on each of the five conditions, uplifted for inflation, was used to estimate the financial impact sedentary behaviour had on the NHS for each of the conditions in the UK in 2016-17. For all five conditions combined, this amounted to £0.8bn in 2016-17.

As a proportion of patients will have more than one of the five conditions, for example around 30 per cent of people with type 2 diabetes will also have cardiovascular disease, the researchers revised their figures to adjust for double-counting caused by comorbidity. This reduced the overall cost of sedentary behaviour to the NHS for these five health conditions to £0.7bn in 2016-17.

Next, they took the figure calculated for the fraction of deaths from all causes that could be attributed to a sedentary lifestyle and multiplied it with the actual numbers of deaths that occurred in the UK in 2016.

According to researchers, their results suggest that 11.6 per cent of all deaths were associated with sedentary behaviour and that 69,276 deaths might have been avoided in 2016 if sedentary behaviour was eliminated in the UK.

This is an observational study, and as such, can’t establish cause, and it also relied on estimates of people’s self-reported activity levels, which may not be accurate. The study was also limited by the evidence available for the link between sedentary behaviour and health outcomes.

The authors pointed out that these costs were probably a conservative estimate of the true burden of sedentary behaviour because sedentary behaviour was likely to be associated with several other cancers, musculoskeletal disorders, and mental health disorders, not included in their analysis.

Lead Investigator, Leonie Heron from the Centre of Public Health at Queen’s University Belfast, said, “Many individuals in the UK spend their leisure time in sedentary behaviour, and the workplace represents a significant proportion of unavoidable daily sitting time for many people.”

Measures should be taken to reduce sedentary behaviour with the aim of improving population health and reducing the financial burden to the health service, the researchers concluded.

The Irish Heart Foundation has been highlighting the negative impact of sedentary behaviour on health since the launch of its innovative campaign ‘Chairs can Kill,’ last year.

This campaign highlighted the fact that sitting down for long periods of time increases the risk of heart disease and stroke.

A survey carried out last year by the Irish Heart Foundation revealed that the average person in Ireland sits down for 7.3 hours a day.

Commenting Dr Angie Brown, Medical Director of the Irish Heart Foundation said, “many studies have shown that sedentary lifestyles such as spending large parts of the day sitting increases the risk of cardiovascular disease, type 2 diabetes, cancer and death. We know in Ireland a large portion of the population have sedentary jobs – this study suggests that this has a significant impact in terms of morbidity and mortality and huge financial impact for the NHS in the UK.

“It’s likely that lack of physical activity will cause an equivalent health and financial burden on the population in Ireland. We all need to try an increase our physical activity levels and our workplaces should support any initiatives leading to less sedentary behaviour.”

This study was published in the Journal of Epidemiology & Community Health. (http:// dx. doi. org/ 10. 1136/ jech- 2018- 211758)