Economic analysis of participation in physical activity in England: implications for health policy

Abstract

BackgroundChanging the relative price of (in) activity is an important tool for health policies. Nonetheless, to date, analyses of correlates of physical activity (PA) have excluded the notion of price. Using the first nationwide dataset on prices of PA for England, we explore for the first time how money and time prices are associated with PA (in general) and specific activities.MethodsA nationally representative telephone follow-up survey to Health Survey for England (HSE) 2008 was undertaken in 2010. The sample covered individuals who reported to have undertaken some PA in the HSE 2008. Questions focussed on: ex-post money and time prices; type and quantity of PA; perceived benefits of PA and socio-economic details. Count regression models (all activities together, and swimming, workout, walking separately) were fitted to investigate the variation in quantity of PA.ResultsOf 1683 respondents, 83% participated in PA (one or more activities), and spent an average of £2.40 per occasion of participation in PA and 23 minutes travelling. Participation in PA was negatively associated with money prices per occasion (i.e. family member/child care fees, parking fees, and facility charges) and travel time price. Participation in PA was more sensitive to travel time price than money price. Among the specific activities, the money price effect was highest for swimming with a 10% higher price associated with 29% fewer occasions of swimming; followed by workout (3% fewer occasions) and walking (2% fewer occasions). Only swimming and workout were sensitive to travel time price. People who felt doing PA could help them ‘get outdoors’, ‘have fun’, or ‘lose weight’ were likely to do more PA.ConclusionsTwo main policy implications emerge from the findings. First, the results support the notion that positive financial incentives, e.g. subsidising price of participation, could generally lead to an increase in quantity of PA among those already exercising. Second, such policies could lead to desired policy goals if implemented at an individual activity level (e.g. 50% subsidy on swimming entrance charges) rather than a blanket implementation (e.g. subsidising average entrance charges across all activities by 50%).

Leisure centre entrance charges and physical activity participation in England

“…This research also supports existing evidence that leisure centre users often had to overcome other barriers alongside cost, before they accessed the facilities (Raymore, 2002). Previous research has indicated that travel to leisure centres can be a significant additional cost (Anokye et al, 2014) but in this study people were more likely to speak about travel in in terms of accessibility rather than cost. It was evident that people on lower incomes who needed to walk or travel by bus were more constrained and had to use the nearest facility unless they could rely on a friend for a lift: they did not have the flexibility of using other centres for different activities or for sessions at more convenient times and so were less likely to participate if the nearest provision was not suitable.…”

“…A reduction in cost may have a more positive impact in the short term (Coalter, 2006), for those already exercising (e.g. Bullough et al, 2015) or for particular activities (Anokye et al, 2014). Studies have also suggested that people who were previously inactive and were encouraged to participate in free sessions often returned to inactivity once the free provision came to an end (Adams & Steer, 2016).…”

Gender differences in related influential factors of regular exercise behavior among people in Taiwan in 2007: A cross-sectional study

“…Few studies have examined how cost will influence exercise behavior. According to the literature, exercise is negatively associated with the costs and travel time required per occasion, including member fees, parking fees, facility charges, and depending on the exercise, the cost of the exercise itself [28]. Rather than the actual money spent on exercise, in this study we examined the perception of how worthwhile it was to spend money on exercise and found that it was only significant for the female participants.…”

Fiscal measures to promote healthier choices: an economic perspective on price-based interventions

“…Apart from some extreme exceptions, everyone spends some time in some level of physical activity and is sedentary for some time. Whilst shifting the balance towards greater physical activity may involve financial costs for some activities, the main cost to individuals may be time costs, which have been shown to be a greater barrier to physical activity than monetary costs 34 . Physical activity required in the workplace, which could be considered as physically active time which was being paid for, has declined over time.…”