1. The high costs of inactivity in Scotland (and England) Dr Charlie Foster BHF Health Promotion Research Group University of Oxford Physical Activity for Health Research Centre (PAHRC)

2. Question 1 Which cost Scots more per annum? Hangovers at work Clearing smoking-related litter from streets Atorvastatin Income from parking penalties in City of Edinburgh (includes Midlothian) http://www.edinburgh.gov.uk/info/1268/pay_and_display_parking/1126/parking_facts_and_figures

3. Question 2 Which mode of transport.. runs on money and makes you fat…. or runs on fat and saves you money?

4. Question 3 How many GP and PN consultations were related to physical inactivity (2011-2012) in Scotland? http://www.isdscotland.org/Health-Topics/General-Practice/GP-Consultations/http://www.isdscotland.org/Health-Topics/General-Practice/GP-Consultations/ accessed June 1 st 2013. Over 100,000 Over 500,000 Over 1 Million Over 2 million

5. Question 3 How many GP and PN consultations were related to physical inactivity (2011-2012) in Scotland? http://www.isdscotland.org/Health-Topics/General-Practice/GP-Consultations/http://www.isdscotland.org/Health-Topics/General-Practice/GP-Consultations/ accessed June 1 st 2013. Over 100,000 Over 500,000 Over 1 Million Over 2 million But add in other conditions where physical activity could be used to help symptoms….

6. Question 3 How many GP and PN consultations were related to physical inactivity (2011-2012) in Scotland? http://www.isdscotland.org/Health-Topics/General-Practice/GP-Consultations/http://www.isdscotland.org/Health-Topics/General-Practice/GP-Consultations/ accessed June 1 st 2013. Over 100,000 Over 500,000 Over 1 Million Over 2 million But add in other conditions where physical activity could be used to help symptoms…. (Depression, Osteoarthritis, Dementia)

7. Economic comparisons should be easy to understand

8. Economic value Burden of disease Cost benefit of physical activity interventions Cost effectiveness of physical activity interventions Cost utility of physical activity interventions

9. Economic value Burden of disease Cost benefit of physical activity interventions Cost effectiveness of physical activity interventions Cost utility of physical activity interventions SUBSTANTIAL & RISING SUBSTANTIAL & LONG TERM HIGH IMPACT & SUSTAINABLE CHEAP & DELIVERABLE

10. National costs of physical inactivity to the NHS Scotland are £94.1 million / £18 per resident Every Scottish GP has at least 2 consultations per day regarding a condition which could be helped by being active

11. Burden of physical inactivity related mortality in Scotland (2009-2010) There were just under 16,000 deaths per year in physical inactivity disease categories Physical inactivity contributes to 2,565 deaths (16.3%) Source http://www.isdscotland.org/isd/

12. – £94.1M – Cost of prescriptions ~ £58M – Costs of GP consultations ~ £8.3M Contributors to the cost of physical inactivity to Scotland (2009-2010)

13. This is an underestimate as it does not include hospital related costs or prescription costs of disease where physical activity can prevent and aid treatment of particular conditions For example Obesity – prescription costs ~ £3.3M Mental Health prescription costs Dementia ~ £35.8M Depression ~ £12.2M Total cost of physical inactivity to Scotland

15. Why is this figure an underestimation? Other disease areas direct health service costs – Mental health, Obesity, Dementia, Falls, Indirect social and economic costs – Lost productivity – Premature mortality – Social care

16. Meanwhile south of the border…. The primary care trusts (PCT) in England in excess of £940 million Each PCT on average £6.2 million (6).

17. £17.35 £18.29 £17.36 £13.91 £18.93 £19.20 £17.60 £20.18 £22.03 £18.37 Cost of physical inactivity (£/population) related disease by SHA Foster & Townsend (2013)

18. £17.35 £18.29 £17.36 £13.91 £18.93 £17.60 £20.18 £22.03 £18.37 Cost of physical inactivity (£/population) related disease by SHA Foster & Townsend (2013) £19.20

19. £17.35 £18.29 £17.36 £13.91 £18.93 £17.60 £20.18 £22.03 £18.37 Cost of physical inactivity (£/population) related disease by SHA Foster & Townsend (2013) Cost of doing nothing £17.60 £19.20

20. £17.35 £18.29 £17.36 £13.91 £18.93 £17.60 £20.18 £22.03 £18.37 Cost of physical inactivity (£/population) related disease by SHA Foster & Townsend (2013) Cost of doing nothing £17.60 Spend in London is £1.07 per head £19.20

21. Economic value Burden of disease Cost benefit of physical activity interventions Cost effectiveness of physical activity interventions Cost utility of physical activity interventions

22. Economic value Burden of disease Cost benefit of physical activity interventions Cost effectiveness of physical activity interventions Cost utility of physical activity interventions SUBSTANTIAL & RISING SUBSTANTIAL & LONG TERM HIGH IMPACT & SUSTAINABLE CHEAP & DELIVERABLE

25. Healthy Places.org

26. Thanks to Dr Steve Allender Dr Nick Townsend charlie.foster@dph.ox.ac.uk The high costs of inactivity in Scotland (and England) Physical Activity for Health Research Centre (PAHRC)