The Health and Economic Impactv2.0
Who could have thought that walking would be part of your organization’s
strategic plan? The fact is it may be the answer ...
The High Costs of Inactivity
Inactivity costs $670-$1125/person annually.1
If the more than
88 million inactive Americans ...
3
1. Has a clear, positive impact on health
Physicians often prescribe walking as an effective, doable way to help
prevent...
Health Benefits of Walking
Examples of health-related findings specifically associated with walking follow.
Decreases Hear...
Other Important Advantages
Further research shows additional advantages of physical activity. Although these
other studies...
R E S O U R C E S
• American Hiking Society (www.americanhiking.org)
• American Journal of Epidemiology (aje.oxfordjournal...
The Health and Economic Impactv2.0
Health Enhancement Systems
712 Cambridge Street
Midland MI 48642
800.326.2317
www.Healt...
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Walking

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The Health and Economic Impact v2.0
- How walking impacts health and productivity
- Why walking programs make sound economic sense
- Where to go from here at your organization.

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Walking

  1. 1. The Health and Economic Impactv2.0
  2. 2. Who could have thought that walking would be part of your organization’s strategic plan? The fact is it may be the answer to our nation’s epidemic of obesity and related conditions — as well as the single most effective, cost-efficient intervention you can offer your employees, members, clients, or patients. The growing body of research documented here reveals significant benefits for individuals and employers, health plans, public health agencies, nonprofit institutions, and other organizations that support ongoing walking programs. Regular fitness walking requires only a modest investment, yet it can lead to considerable bottom-line savings from reduced health insurance costs and increased productivity. Staying active is great for physical and mental health. It’s a critical component, along with a healthy diet, of any program for long-lasting weight management. Fitness walking also is easy for most individuals to take up and continue; it’s more accessible in today’s busy lives than swimming, bicycling, or many other physical activities. Walking programs can: l Aid in long-lasting weight management l Be effective with only a modest investment l Enhance energy and reduce stress l Increase employee productivity l Lower disease risk l Promote physical and mental health l Support better sleep l Target all groups. Walking... the single most effective, cost-efficient intervention you can offer. The Health and Economic Impactv2.0 1
  3. 3. The High Costs of Inactivity Inactivity costs $670-$1125/person annually.1 If the more than 88 million inactive Americans over age 15 were to increase regular moderate physical activity, annual healthcare costs might be reduced by as much as $76.6 billion.2 Inactivity is closely linked to obesity — in fact, a sustained reduction of just 10% in body weight can lead to substantial health and economic benefits.3,4 Conversely, consider these specific costs associated with remaining inactive and obese: l Obesity costs employers more than $12 billion each year in higher healthcare utilization/benefit claims, lower productivity, and increased absenteeism5 l About 9.1% of the nation’s total annual medical expenditures are attributable to overweight and obesity6 l Annual healthcare costs are higher among obese individuals than others, including: − 36% higher inpatient and outpatient costs − 45% more inpatient days − 77% higher medication costs − 48% more expenditures over $5000.7 Obesity’s Rise and Its Impact on Health The number of overweight Americans is soaring. In fact, the percent of obese US adults doubled in 1980 to 2000 — from 15% to 31%. Now, over 72 million, or 34% of adults, are obese9 , with nearly 2 in 3 adults (64%) being either overweight or obese.8 The increase is linked to a wide range of costly health problems due to a far higher risk of these conditions: l Breast, endometrium, prostate, and colon cancers l Depression l Diabetes l Heart disease l High blood pressure l Musculoskeletal ailments l Poor female reproductive health l Sleep apnea l Stroke.4, 10 In fact, obese individuals have been shown to suffer 30%- 50% more chronic medical problems than those who smoke or drink heavily. In addition, the effect of being obese on the number of chronic conditions is similar to aging 20 years.11 Yet people still aren’t moving. In 2005, 40% of US adults did not participate in any physical activity during their leisure time,12 and only 15% met the recommended 30 minutes a day of brisk walking 5 times a week.13 Sedentary lifestyles are on the rise. The number of adults who spent most of their day sitting jumped from 36.8% in 2000 to almost 40% in 2005, and those who were never active increased from 9.4% to 10.3% in the same period.12 Obesity costs US employers over $12 billion each year.5 Even a 10% reduction in body weight can lead to substantial health and economic benefits. 3, 4 Walking: The Health and Economic Impact • 2
  4. 4. 3 1. Has a clear, positive impact on health Physicians often prescribe walking as an effective, doable way to help prevent or delay the progression of several chronic diseases including high blood pressure, heart disease, osteoporosis, diabetes, and arthritis. (See Health Benefits of Walking on page 4 for details.) 2. Is an inexpensive program to implement No dedicated facilities are needed, and the cost is next to nothing to post walking trail maps around or through a facility or neighborhood or highlight neighborhood routes on websites like MapWalk™ (www.MapWalk.com). A walking competition between groups nearly promotes itself. 3. Encourages high participation among all ages l Walking is the only exercise where participation rates don’t decrease as individuals reach middle age and older. One national survey found that compared with any other group, men 65 and older had the highest percent of regular walkers — 39.4%.14 l It’s the most popular physical activity in America. More than 56 million people walk for fitness at least 100 days a year.15 l Walking is inexpensive and easy. All a person needs is a pair of comfortable, supportive shoes.16 l It comes naturally and can be done in connection with other daily activities — for example: walking to work, circling the mall or grocery aisles, walking the dog, or pacing while on the phone. l Walking is a low impact, safe form of exercise — even for those who are obese or have arthritis. 4. Becomes a stepping-stone to other forms of exercise It carries particular appeal for people who are new to or self-conscious about exercise. Walking can also differ in intensity by varying workouts with stairs, hills, or Nordic walking. 5. Burns about the same number of calories/mile as running Walking 1 mile briskly in 12 minutes burns about as many calories as jogging the same distance in 8.5 minutes.17 A study among healthy women at the Washington University School of Medicine shows that when going at the same pace, walking very briskly will burn at least as many calories as jogging.18 Walking is the most popular physical activity in America. 5Reasons to PromoteWalking Walking offers distinct advantages for those who do it and the organizations that promote it — walking:
  5. 5. Health Benefits of Walking Examples of health-related findings specifically associated with walking follow. Decreases Heart Disease Risk Compared with women who engaged in no physical activity, women who walked as little as 1 hour a week — even at a gentle pace — had only about half the risk of heart disease, according to a study of 39,372 health professionals 45 and older. Women doing more vigorous exercise had an even lower risk.19 Helps Prevent Weight Gain A study of inactive, overweight men and women ages 40-65 showed 30 minutes a day of walking helped them lose weight, decrease their waist size, and increase their lean body mass — even with no special dietary changes.19 Walking reduces the risk of heart attack, stroke, diabetes, and heart disease. Walking: The Health and Economic Impact • 4 Lowers Overall Mortality Men ages 61-81 who walked more than 1 mile a day had 1/3 fewer deaths in a 12-year follow-up period compared with men who didn’t. The beneficial effects were evident even after taking into account other activities and risk factors.21 A study of male Harvard graduates revealed those who burned 2000 or more calories a week by walking lived 1-2 years longer than men who burned under 500 calories a week through exercise.22 Maintains a Healthy BMI A University of Tennessee study found women who accumulated 10,000 steps or more each day had lower body fat percentages.23 Protects Against Heart Attack and Stroke An 8-year study of 72,000 female nurses ages 40-65 found women who walked 3 or more hours a week had a 40% lower risk of heart attack and stroke than women who didn’t walk. Brisker walking produced greater benefits.24 Reduces Risk of Diabetes A study of 2900 adults with diabetes indicated those who walked at least 2 hours a week had a 39% lower risk of death from any cause than adults who didn’t walk at all. People who walked more — at least 3 hours a week — had a 54% lower risk of death from any cause.25 Another study found walking 30 minutes a day nearly twice as effective as the prescription drug metformin in preventing diabetes.26
  6. 6. Other Important Advantages Further research shows additional advantages of physical activity. Although these other studies looked at a variety of exercise forms, their findings can be applied to walking. Supports Productivity Employee productivity increases with physical activity. Findings include: l Better concentration27 l Enhanced memory and learning28 l Improved ability to make complex decisions27 l Increased physical stamina.29, 30 Prevents Disease Regular exercise aids in managing chronic illnesses and related risk factors: l Controls weight, cholesterol, and blood pressure; reduces the need for blood pressure, diabetes, and cholesterol medications29, 30, 31, 32 l Contributes to a healthy pregnancy and delivery34, 35, 36, 37 l Improves immune system function38 l Lengthens lifespan13 l Lowers the risk of obesity-related illnesses — including sleep apnea and osteoarthritis4 l Minimizes the effects of diabetes, arthritis, and osteoporosis28, 39 l Prevents constipation40 l Reduces the risk of heart disease, stroke, breast cancer, colon cancer, type 2 diabetes, osteoporosis, impotence, blood clots, and gallstones28, 30, 41, 42, 43 l Relieves back pain.32 More Promotes an overall sense of wellness by helping people to: l Control appetite and increase the body’s metabolism30, 44 l Improve mood and well-being28, 30 l Maintain healthy muscles, bones, and joints28, 30 l Reduce symptoms of depression and anxiety28 l Relax, feel more energetic, and control stress30, 45 l Sleep better.46, 47 Conclusions l Physical inactivity contributes to obesity, negatively affecting employee health and resulting in soaring healthcare costs and decreased productivity. l Employer-sponsored walking programs will result in reduced health risks, improved productivity, and better quality of life for employees. l Walking programs may be the jumpstart that employees need; it’s simple, straightforward, and less demanding on the body than many other activities. Where to Go From Here? Acknowledging these findings, Health Enhancement Systems has developed Walktober, a program to implement during October, National Walking Month — the ideal time for a walking campaign. The temperatures are moderate and colors are spectacular, vacations are over and the holidays haven’t arrived. Making the most of this great season, Walktober is a month-long walking campaign designed to: l Guide participants through the benefits of walking l Help them incorporate walking into their daily routine l Dramatically boost the amount participants walk l Inspire everyone to make walking a priority — in October and beyond. There is every reason for all organizations to promote walking. 5 Learn more at www.Walktober.com
  7. 7. R E S O U R C E S • American Hiking Society (www.americanhiking.org) • American Journal of Epidemiology (aje.oxfordjournals.org) • American Journal of Lifestyle Medicine (ajl.sagepub.com) • American Journal of Public Health (www.ajph.org) • Archives of Internal Medicine (archinte.ama-assn.org) • British Medical Journal (www.bmj.com) • Centers for Disease Control and Prevention (www.cdc.gov) • Health Affairs (www.healthaffairs.org) • Hypertension (hyper.ahajournals.org) • Journal of the American Medical Association (jama.ama-assn.org) 1 Colditz GA. Economic Costs of Obesity and Inactivity. Medicine & Science in Sports & Exercise 1999;31(11):S663-S667. 2 Pratt M, Macera CA,Wang G. Higher Direct Medical Costs Associated With Physical Inactivity. The Physician and Sportsmedicine October 2000;28(10):63-70. 3 Oster G,Thompson D, Edelsberg J, Bird AP, Colditz GA. Lifetime Health and Economic Benefits of Weight Loss Among Obese Persons.American Journal of Public Health 1999;89(10):1536- 1542. 4 National Heart, Lung, and Blood Institute Obesity Education Initiative.The Practical Guide: Identification, Evaluation, and Treatment of Overweight and Obesity in Adults. National Institutes of Health. October 2000. 5 Thompson D, Edelsberg J, Kinsey KL, Oster G. Estimated Economic Costs of Obesity to US Business.American Journal of Health Promotion 1998;13(2):120-127. 6 Finkelstein EA, Fiebelkorn IC,Wang G. National Medical Spending Attributable to Obesity: How Much, and Who’s Paying? Health Affairs 14 May 2003;Web Exclusive 219-226. 7 Health Risks and Behavior:The Impact on Medical Costs, Control Data Corporation; 1987, cited in National Business Group on Health Institute on the Costs and Health Effects of Obesity Primary Fact Sheet. 8 Flegal KM, Carroll MD, Ogden CL, Johnson CL. Prevalence and Trends in Obesity Among US Adults, 1999-2000. Journal of the American Medical Association 2002;288(14):1723-1727. 9 Ogden CL, Carroll MD, McDowell MA, Flegal KM. Obesity Among Adults in the United States — No Statistically Significant Change Since 2003-2004. NCHS Data Brief No. 1. Hyattsville, MD: National Center for Health Statistics, 2007. 10 National Heart, Lung, and Blood Institute Obesity Education Initiative. Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults:The Evidence Report. National Institutes of Health September 1998. 11 Sturm R.The Effects of Obesity, Smoking, and Drinking on Medical Problems and Costs. Health Affairs 2002;21(2):245-253. 12 Barnes P. Physical Activity Among Adults: United States, 2000 and 2005. Hyattsville, MD: National Center for Health Statistics, 2007. 13 US Department of Health and Human Services. Healthy People 2010: Understanding and Improving Health. 2nd Ed.Washington, DC: U.S. Government Printing Office, November 2000. 14 The President’s Council on Physical Fitness and Sports.Walking for Exercise and Pleasure. Available online: www.washingtonwalking.org/docs/Walking_for_Exercise.pdf. 15 Sporting Goods Manufacturers Association. 2009 SGMA Sports & Fitness Participation Topline Report: Fitness Activities. 16 Blue Cross Blue Shield Association.Walking Works:The Blue Program for a Healthier America. Available online: www.fitness.gov/BCBSAfinalfinalWalkGuide.pdf. 17 The President’s Council on Physical Fitness and Sports. Secondary source: Pep Up Your Life:A Fitness Book For Mid-Life and Older Persons.Available online: www.fitness.gov/pepup.htm. 18 Greiwe JS, Kohrt WM. Energy Expenditure During Walking and Jogging. Journal of Sports Medicine and Physical Fitness 2000;40(4):297-302. 19 Lee I, Rexrode KM, Cook NR, Manson JE, Buring JE. Physical Activity and Coronary Heart Disease in Women: Is “No Pain, No Gain” Passe?. Journal of the American Medical Association 2001;285(11):1447-1454. 20 Slentz CA, Duscha BD, Johnson JL, Ketchum K,Aiken LB, Samsa GP, Houmard JA, Bales CW, Kraus WE. Effects of the Amount of Exercise on Body Weight, Body Composition, and Measures of Central Obesity.Archives of Internal Medicine 2004;164(1):31-39. 21 Hakim AA, Petrovitch H, Burchfiel CM, Ross GW, Rodriguez BL,White LR,Yano K, Curb JD, Abbott RD. Effects of Walking on Mortality Among Nonsmoking Retired Men.The New England Journal of Medicine 1998;338(2):94-99. 22 Lee I, Paffenbarger RS.Associations of Light, Moderate, and Vigorous Intensity Physical Activity With Longevity.The Harvard Alumni Health Study.American Journal of Epidemiology 2000;151(3):293-299. 23 Thompson DL, Rakow J, Perdue SM. Relationship Between Accumulated Walking and Body Composition in Middle-Aged Women. Medicine & Science in Sports & Exercise 2004;36(5):911-914. 24 Manson, JE, Hu FB, Rich-Edwards JW, Colditz GA, Stampfer MJ,Willett WC, Speizer FE, Hennekens CH.A Prospective Study of Walking as Compared With Vigorous Exercise in the Prevention of Coronary Heart Disease in Women.The New England Journal of Medicine 1999;341(9):650-658. • Journal of Obstetric, Gynecologic, and Neonatal Nursing (jognn.awhonn.org) • The Journals of Gerontology (www.gerontologyjournals.org) • Medicine & Science in Sports & Exercise (www.ms-se.com) • National Center for Health Statistics (www.cdc.gov/nchs) • National Heart, Lung, and Blood Institute (www.nhlbi.nih.gov) • The New England Journal of Medicine (content.nejm.org) • The Physician and Sportsmedicine (www.physsportsmed.com) • The President’s Council on Physical Fitness and Sports (www.fitness.gov) • Sporting Goods Manufacturers Association (www.sgma.com) • US Department of Health and Human Services (www.hhs.gov) 25 Gregg EW, Gerzoff RB, Caspersen CJ,Williamson DF, Narayan KMV. Relationship of Walking to Mortality Among US Adults With Diabetes.Archives of Internal Medicine 2003;163(12):1440- 1447. 26 Anonymous. Reduction in the Incidence of Type 2 Diabetes With Lifestyle Intervention or Metformin.The New England Journal of Medicine 2002;346(6):393-403. 27 Loehr J, Schwartz T.The Power of Full Engagement; New York, NY, 2003. 28 US Department of Health and Human Services. Physical Activity Fundamental to Preventing Disease Washington, DC: U.S. Government Printing Office, June 2002. 29 Murphy MH, Nevill AM, Murtagh EM, Holder RL.The Effect of Walking on Fitness, Fatness and Resting Blood Pressure:A Meta-Analysis of Randomised, Controlled Trials. Preventive Medicine 2007;44(5):377-385. 30 Fentem PH. Benefits of Exercise in Health and Disease. British Medical Journal 1994;308(6939):1291-1295. 31 Tucker, LA, Friedman GM.Walking and Serum Cholesterol in Adults.American Journal of Public Health 1990;80(9):1111-1113. 32 American Hiking Society.A Step in the Right Direction:The Health Benefits of Hiking and Trails Fact Sheet. Silver Spring, Maryland.Available online: www.americanhiking.org/news/pdfs/ health_ben.pdf. 33 Williams PT. Reduced Diabetic, Hypertensive, and Cholesterol Medication Use With Walking. Medicine & Science in Sports & Exercise 2008;40(3):433-443. 34 Sorensen TK,Williams MA, Lee I, Dashow EE,Thompson ML, Luthy DA. Recreational Physical Activity During Pregnancy and Risk of Preeclampsia. Hypertension 2003;41(6):1273-1280. 35 Lewis B,Avery M, Jennings E, Sherwood N, Martinson B, Crain AL.The Effect of Exercise During Pregnancy on Maternal Outcomes: Practical Implications for Practice.American Journal of Lifestyle Medicine 2008;2(5):441-455. 36 Leiferman JA, Evenson KR.The Effect of Regular Leisure Physical Activity on Birth Outcomes. Maternal and Child Health Journal 2003;7(1):59-64. 37 Bungum TJ, Peaslee DL, Jackson AW, Perez MA. Exercise During Pregnancy and Type of Delivery in Nulliparae. Journal of Obstetric, Gynecologic, and Neonatal Nursing 2000;29(3):258-264. 38 Nieman DC, Henson DA,Austin MD, Brown VA. Immune Response to a 30-Minute Walk. Medicine & Science in Sports & Exercise 2005;37(1):57-62. 39 Lange RMS, Nies MA. Benefits of Walking for Obese Women in the Prevention of Bone and Joint Disorders. Orthopaedic Nursing 2004;23(3):211-215. 40 Daley AJ, Grimmett C, Roberts L,Wilson S, Fatek M, Roalfe A, Singh S.The Effects of Exercise Upon Symptoms and Quality of Life in Patients Diagnosed With Irritable Bowel Syndrome:A Randomised Controlled Trial. International Journal of Sports Medicine 2008;29(9):778-782. 41 McTiernan A, Kooperberg C,White E,Wilcox S, Coates R,Adams-Campbell LL,Woods N, Ockene J. Recreational Physical Activity and the Risk of Breast Cancer in Postmenopausal Women.The Women’s Health Initiative Cohort Study. Journal of the American Medical Association 2003;290(10):1331-1336. 42 Derby CA, Mohr BA, Goldstein I, Feldman HA, Johannes CB, McKinlay JB. Modifiable Risk Factors and Erectile Dysfunction: Can Lifestyle Changes Modify Risk? Urology 2000;56(2):302- 306. 43 Leitzmann MF, Rimm EB,Willett WC, Spiegelman D, Grodstein F, Stampfer MJ, Colditz GA, Giovannucci E. Recreational Physical Activity and the Risk of Cholecystectomy in Women.The New England Journal of Medicine 1999;341(11):777-784. 44 Cheng MH, Bushnell D, Cannon DT, Kern M.Appetite Regulation via Exercise Prior or Subsequent to High-Fat Meal Consumption.Appetite 2009;52(1):193-198. 45 Puetz TW, Flowers SS, O’Connor PJ.A Randomized Controlled Trial of the Effect of Aerobic Exercise Training on Feelings of Energy and Fatigue in Sedentary Young Adults With Persistent Fatigue. Psychotherapy and Psychosomatics 2008;77(3):167-174. 46 Galantino ML, Cannon N, Hoelker T, Iannaco J, Quinn L. Potential Benefits of Walking and Yoga on Perceived Levels of Cognitive Decline and Persistent Fatigue in Women With Breast Cancer. Rehabilitation Oncology 2007;25(3):3-16. 47 King AC, Pruitt LA,Woo S, Castro CM,Ahn DK,Vitiello MV,Woodward SH, Bliwise DL. Effects of Moderate-Intensity Exercise on Polysomnographic and Subjective Sleep Quality in Older Adults With Mild to Moderate Sleep Complaints.The Journals of Gerontology 2008;63A(9):997-1004. End Notes Walking: The Health and Economic Impact • 6
  8. 8. The Health and Economic Impactv2.0 Health Enhancement Systems 712 Cambridge Street Midland MI 48642 800.326.2317 www.HealthEnhancementSystems.com For more white papers to support wellness at your organization, free from Health Enhancement Systems, go to: http://whitepapers.HealthEnhancementSystems.com. For Wellness Resources, a guide to our suite of online and paper-based wellness products, go to: http://hesonline.com/catalog.aspx. Copyright © 2011, Health Enhancement Systems. No part of this document may be distributed, reproduced, or posted without written permission from Health Enhancement Systems.

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