Hitting the Target but Missing the Point? Modelling Health and Economic Impacts of Different Approaches to Meeting the Global Action Plan for Physical Activity Target.

BACKGROUND: The World Health Organization launched the Global Action Plan for Physical Activity (GAPPA) in 2018, which set a global target of a 15% relative reduction in the prevalence of physical inactivity by 2030. This target, however, could be acheived in various ways.

METHODS: We use an established multi-state life table model to estimate the health and economic gains that would accrue over the lifetime of the 2011 New Zealand population if the GAPPA target was met under two different approaches: (1) an equal shift approach where physical activity increases by the same absolute amount for everyone; (2) a proportional shift approach where physical activity increases proportionally to current activity levels.

FINDINGS: An equal shift approach to meeting the GAPPA target would result in 197,000 health-adjusted life-years (HALYs) gained (95% uncertainty interval (UI) 152,000-246,000) and healthcare system cost savings of US$1.57b (95%UI $1.16b-$2.03b; 0% discount rate). A proportional shift to the GAPPA target would result in 158,000 HALYs (95%UI 127,000-194,000) and US$1.29billion (95%UI $0.99b-$1.64b) savings to the healthcare system.

INTERPRETATION: Achieving the GAPPA target would result in large health gains and savings to the healthcare system. However, not all population approaches to increasing physical activity are equal-some population shifts bring greater health benefits. Our results demonstrate the need to consider the entire population physical activity distribution in addition to evaluating progress towards a target.