Date and Time
February 8, 2006
2:00 PM - 4:00 PM

Availability
Open to the public
No RSVP required

Physical inactivity is now recognized as a major public health problem. Effective interventions have been identified for promoting physical activity at the community level, but there is a major gap between research findings and their application. In this seminar we will focus on how to use quantitative research-based tools adapted and developed at the Centers for Disease Control and Prevention to inform and guide public policy related to physical activity. Two approaches will be examined: 1) economic analyses including cost of illness and cost effectiveness analyses, and 2) health impact assessment (HIA).

Experience from tobacco control and other fields suggests that policy approaches to changing health behaviors can be critically important, both for placing new public health issues on the agenda and for guiding complex decision making and allocation of resources. Economic factors clearly influence most public policy making, and applying standardized and rigorous methods to defining the cost burden of inactivity and the comparative cost effectiveness of physical activity interventions should allow the economic aspects of physical activity to be factored into decision making.

In this study we applied a decision analysis approach to build a model to evaluate the cost effectiveness of four categories of community interventions to promote physical activity recommended by the Task Force on Community Preventive Services. A comprehensive state-transition Markov model was developed to estimate the discounted costs ($), health gains (QALYs), and cost-effectiveness ($/QALY) of seven specific exemplary interventions to promote physical activity over a lifetime in the adult US population.

The cost-effectiveness ratios of the 7 interventions ranged between $14,000/QALY and $69,000/QALY. Compared with other well-accepted prevention strategies, all of the physical activity promotion strategies evaluated appeared to be good investments of societal resources for improving public health. An additional model was adapted with Brazilian data with the support of the World Bank to assess the cost effectiveness of a comprehensive community campaign to promote physical activity in the state of São Paulo. The Agita São Paulo campaign components targeting adults were found to be cost saving in this analysis.

Health Impact Assessment examines the potential consequences, positive and negative, of proposed policies and programs from sectors outside of health. One of the greatest potential benefits of HIAs is that they can bring public health issues to the attention of decision-makers in a way which allows health to be more appropriately factored into complex policy decisions. The CDC has been working with the University of California-Los Angeles to develop methodology for rigorous, quantitative HIAs. Results from two pilot studies will be presented: 1. an examination of the redevelopment of a dangerous highway and neighborhood in Atlanta, Georgia, and 2. the health effects of a walk-to-school program in Sacramento, California.

This work was carried out as part of Project MOVE and was supported by the CDC Foundation and the Robert Wood Johnson Foundation.

This talk is co-sponsored by CHP/PCOR and the Stanford Prevention Research Center.