Economic cost of physical inactivity as a global health signal

When economists and public health agencies try to quantify what inactivity costs, they are not counting new gyms or jogging shoes. They are counting extra cases of heart disease, stroke, diabetes, cancer and depression, and the hospital bills, medications and lost work days that follow. The result is a financial picture that places physical inactivity alongside tobacco and poor diet as one of the most expensive risk factors in modern societies. Global estimates now show that inactivity is quietly extracting tens of billions of dollars each year from health systems alone, before any loss of productivity is considered.

Global price tag in health care and lost productivity

The first comprehensive global estimate of the economic burden of physical inactivity, based on data from 142 countries representing more than 90 percent of the world’s population, found that in 2013 physical inactivity cost health care systems 53.8 billion international dollars. Of this, 31.2 billion was paid by the public sector, 12.9 billion by the private sector and 9.7 billion by households. In addition, deaths related to physical inactivity contributed 13.7 billion dollars in productivity losses and inactivity was responsible for 13.4 million disability adjusted life years worldwide.

When those components are combined, the same analysis concluded that physical inactivity cost the world economy about 67.5 billion international dollars in 2013 in health care expenditure and lost productivity. These figures have since been widely used as a benchmark for the global financial burden of inactive lifestyles. Other summaries, drawing on the same underlying work, describe the global cost of physical inactivity as 54 billion US dollars per year in direct health care, with an additional 14 billion US dollars in lost productivity, while noting that these estimates exclude mental health and musculoskeletal conditions and so are likely to be conservative.

More recent projections highlight how these burdens accumulate over time. The World Health Organization’s 2024 fact sheet on physical activity states that the global estimate of the cost of physical inactivity to public health care systems between 2020 and 2030 is about 300 billion US dollars, or roughly 27 billion per year, if current inactivity levels are not reduced. (World Health Organization) In parallel, a modelling study published in The Lancet Global Health estimates the cost of inaction on physical inactivity at about 47.6 billion dollars per year in treatment costs for preventable non communicable diseases.

These numbers show that inactivity is not simply a personal lifestyle issue. It is a recurring charge on health systems and economies, with costs that show up every year and compound over decades.

Share of national health budgets

Global and regional analyses converge on the conclusion that physical inactivity claims a measurable slice of national health spending. Estimates compiled by the World Health Organization and cited in several policy documents indicate that between 1 and 3 percent of national health care expenditures are attributable to physical inactivity in both high income and low and middle income countries.

The 2013 global costing study also found that high income countries bear a large share of the economic burden. According to its summary, these countries account for 80.8 percent of health care costs and 60.4 percent of indirect costs linked to physical inactivity, while low and middle income countries carry 75 percent of the disease burden measured in disability adjusted life years. This imbalance reflects both higher medical costs and older populations in richer countries and higher premature mortality in poorer ones.

Country specific work illustrates how large the numbers become when inactivity is measured against a single national budget. A 2025 analysis of inadequate leisure time aerobic physical activity among United States adults, published in the American Journal of Health Promotion, estimated that inadequate activity accounts for 192 billion US dollars in annual health care costs, or about 12.6 percent of total national health care spending. Although this study focuses on aerobic activity rather than all domains of inactivity, it underlines how deeply movement patterns are woven into health expenditure.

Productivity losses and the wider economy

Health care spending is only one channel through which physical inactivity affects the economy. The global 2013 estimate separated out productivity effects by valuing deaths attributable to inactivity. It found that these deaths led to 13.7 billion dollars in lost productivity in that year. (PubMed) This figure captures only the value of life years lost due to mortality, not the broader productivity impact of people who live with chronic disease and reduced capacity to work.

Health organizations emphasize this wider impact explicitly. The Pan American Health Organization notes that societies that are more active can minimize economic burdens due to medical costs and years of lost productivity, and that physical activity can generate additional returns on investment for societies. (Pan American Health Organization) These returns come partly from healthier workers who take fewer sick days and maintain their ability to work longer, and partly from secondary benefits such as reduced congestion and cleaner air where activity replaces motorized transport.

Workplace specific evidence adds more detail. A United States report on physical activity and disease prevention from the Department of Health and Human Services concludes that workplace physical activity programs can reduce short term sick leave by 6 to 32 percent and reduce health care costs by 20 to 55 percent. The American Heart Association similarly states that a worksite physical activity program and a culture of activity can increase productivity, reduce absenteeism, lower employee turnover and reduce health care costs. These findings link the abstract idea of “lost productivity” to concrete outcomes in businesses: fewer missed days, lower staff turnover and higher output.

Investing in active living as economic policy

Because inactivity has measurable costs, interventions that increase physical activity can be evaluated not just in terms of health benefits but also in terms of financial return. The World Cancer Research Fund and the World Health Organization describe physical activity interventions delivered in primary care as part of a menu of cost effective policy options for tackling non communicable diseases, noting that evidence is growing that such approaches provide value for money and have positive returns on investment.

Broader public health reviews point in the same direction. A systematic review of local public health interventions across countries found that such interventions are often cost saving and offer substantial returns on investment, with median returns well above one to one. While this work covers many types of intervention, physical activity promotion is a recurring example in its case studies.

At the societal level, the Pan American Health Organization summarizes the economic rationale in a single sentence. It states that, in addition to its multiple health benefits, societies that are more active can minimize economic burdens due to medical costs and years of lost productivity, while generating additional returns, for example through reduced fossil fuel use and safer, less congested roads. In other words, active living initiatives do not simply avoid costs, they can also create wider economic value.

WHO repeatedly characterizes physical activity as a highly cost effective intervention area. The report states that there are few areas in public health, such as physical activity, where the evidence on required action is so convincing, cost effective and practical. This assessment reflects a body of modelling work showing that policies which enable walking, cycling, sport and active recreation typically cost far less to implement than the medical treatment they help to avoid.

The same global analysis that produced the 300 billion dollar treatment projection was built around a simple contrast. One scenario assumed no improvement in physical activity levels and projected nearly 500 million new preventable cases of major noncommunicable diseases by 2030 along with the associated health care costs. The alternative scenario examined what would happen if countries met existing global targets to reduce inactivity. In that case, a considerable share of the projected disease burden and its associated treatment costs could be avoided.

A smart long term investment in people and finances

Taken together, the data support a simple but profound conclusion. Physical inactivity creates a recurring economic burden through higher health care spending and lost productivity. The global estimates of 53.8 billion international dollars in annual health care costs and 13.7 billion in productivity losses in 2013, and projections of roughly 27 billion dollars per year in additional treatment costs between 2020 and 2030, show that this burden is large, persistent and predictable.

At the same time, workplace studies and public health evaluations demonstrate that programs which increase physical activity can reduce health care costs, cut sick leave, improve productivity and deliver positive returns on investment. In this sense, investing in active living initiatives is not just a health decision. It is an economic strategy that protects public budgets, strengthens workforce capacity and supports long term growth. The statistics reveal that every country already pays a price for inactivity. The choice now is whether to keep paying those costs passively or to invest deliberately in movement as a core component of economic as well as public health policy.