Motives and costs of physical exercise with regard to health production: The DRs EXTRA StudyVirpi Kuvaja-Köllner a, Hannu Valtonen a, Pirjo Komulainen b, Maija Hassinen b and Rainer Rauramaa b,c a Department of Health and Social Management, University of Eastern Finland, Kuopio Campus, Kuopio, Finland b Kuopio Research Institute of Exercise Medicine, Kuopio, Finlandc) Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
The content of presentation• The aim of the study• Theory• Data• Methods• Results• Conclusion• Acknowledgements
The idea and aim of the studyHow motivation and labour market position (time) explain the time used for Physical exercise Health outcomes by older adults
Theory• Grossman’s health production function• The individual’s health investment• The individual’s own effort• The allocation of time (working or retired)• Opportunity cost of time (Hatziandreu et al. 1988; Hagberg et al 2009 & 2010)
Data• We used 2-year data (n=1292) from the Dose-Responses to Exercise Training (DR’s EXTRA) Study.• the target population was a representative sample of Eastern Finnish men and women who were 55- 74 years of age in 2002
Variables• Moderate-to-heavy physical exercise (hours/week)• Health-related quality of life was evaluated by Rand 36-item survey using Physical and Mental Component Summary (PCS, MCS) scores.• Metabolic risk factor (MetS) score was defined by NCEP criteria.
Methods• Motivational factors were asked in the baseline in the form: Which of the following factors motivate (encourage) you to do physical exercise?• Also freely worded answers• Motivation; principal component analysis
Methods continue• In the statistical analysis, exercise and health outcomes were assumed to be endogenous variables explained with a set of exogenous variables.• The statistical modelling was done by panel data instrumental variable regressions.
Results• The motivational factors, "joy" or “exercise is good for me”, increased the amount of exercise (p<0.001)• Retirement increased the time spent on moderate-to-heavy exercise• The instrumented variable, moderate-to- heavy exercise increased the PCS and MCS scores and decreased the MetS score
ConclusionThe opportunity cost of time,measured with the labour marketposition, either retired or working, andmotivation, such as joy, had asignificant effect on the amount of timespent on exercise.
Connection to the health policy• The employers should put more effort and make it possible for the age group of people over 55 years old to do more physical exercise, perhaps even during working time• Health policy should be open minded towards all different kind of physical exercise. If people enjoy dancing, they should have the possibility to do that also elsewhere than in restaurants
Acknowledgements* the DR’s EXTRA participants*Financial support:• Ministry of Education in Finland, Academy of Finland,European Union/ EXGENESIS, City of Kuopio,• Kuopio University Hospital,• Finnish Diabetes Association,• Finnish Heart Association,• the Social Insurance Institution of Finland and• Päivikki and Sakari Sohlberg Foundation• Yrjö Jahnsson Foundation* the DR’s EXTRA study group