Abstract
Background
There is strong evidence showing that sedentary behaviour time increase the risk to develop several chronic diseases and to premature death. The economic consequences of this risk ...have never been evaluated in France. The aim of this study was to estimate the economic burden of prolonged sedentary behaviour in France.
Methods
Based on individual sedentary behaviour time, relative risk to develop cardiovascular disease, colon cancer, breast cancer and all-causes of premature mortality were identified. From relative risk and prevalence of sedentary behaviour time, a population attributable fraction approach was used to estimate the yearly number of cases for each disease. Data from the National Health Insurance were used to calculate the annual average costs per case for each disease. Disease-specific and total healthcare costs attributable to prolonged sedentary behaviour time were calculated. Indirect costs from productivity loss due to morbidity and premature mortality were estimated using a friction cost approach.
Results
In France, 51 193 premature deaths/year appear related to a prolonged daily sedentary behaviour time. Each year prolonged sedentary behaviour cost 494 million € for the national health insurance. Yearly productivity loss due to premature mortality attributable to prolonged sedentary behaviour cost 507 million € and yearly productivity loss due to morbidity cost between 43 and 147 million €.
Conclusion
Significant saving and many deaths could be avoided by reducing prolonged sedentary behaviour prevalence in France. To address this issue, strong responses should be implemented to tackle sedentary behaviour, complementary to physical activity promotion.
Physical inactivity is considered a pandemic, requiring strong policy responses to address this major health issue. However, research on the development of Health-Enhancing Physical Activity policies ...(HEPA) remains scarce, particularly at the local level. There is a need to produce evidence to better understand the process to develop local HEPA policies. This study aims to model the development of HEPA policy promotion in French municipalities from empirical data and policy science theories. This research was undertaken in three steps: (1) assess the level of development of HEPA policies from 10 French municipalities using a local HEPA analysis tool, (2) provide a brief overview of core political science theories applied in health promotion, and (3) from these empirical and theoretical perspectives, model a conceptual framework to better understand the development of HEPA policy promotion in French municipalities. Based on empirical data and the Multiple Streams, policy cycles and Institutional Rational Choice theories, a conceptual framework of the development of municipal HEPA policy promotion was modeled. This conceptual framework is comprised of five stages describing the development of municipal HEPA policies. This paper contributes to a better understanding of the development of municipal HEPA policies.
Abstract
Background
There is strong evidence showing that sedentary behaviour (SB) increase the risk to develop several chronic diseases and to premature death (Chau et al., 2015). A dose response ...relation is observed with a more marked risk when people spend more than 7 hours/day in sitting position (Ekelund et al., 2019). The study INCA 3 on the lifestyle habits of French population indicated that 40% of people between 18 and 79 years had a high risk for health conditions with more than 7 hours of daily SB (ANSES, 2017). The economic consequences of this risk have never been evaluated. The aim of this study was to estimate the economic burden of SB-related diseases in France.
Methods
From meta-analysis or large cohorts based on individual SB time, we identified relative risk (RR) to develop cardiovascular disease (CVD), colon cancer, breast cancer and all-causes premature death after co-variables adjustments including physical activity. From RR and prevalence of SB time in France, a population attributable fraction approach was used to estimate the yearly number of cases for each disease. Data from the national health insurance were used to calculate the annual average costs per case for each disease. Then, disease-specific and total health-care costs attributable to prolonged SB time were calculated. Indirect costs for private sector and households were calculated in a second stage.
Results
In France, 66 528 premature deaths/year appear related to a daily SB time ≥ 8,6 hours Each year prolonged SB cost 559 millions € for the national health insurance, including 359 millions € for CVD (≥ 10 hours of daily SB), 170 millions € for breast cancer (≥ 6 hours of daily SB), and 31 millions € for colon cancer (≥ 5 hours of TV/day).
Conclusions
These preliminary results showed that many deaths could be avoided by reducing prolonged SB prevalence in France. Moreover, direct health-care costs attributable to SB related diseases represent a high economic burden for the French health system. To address this issue, strong responses should be implemented to tackle SB, complementary to physical activity promotion.
Increasing disability-free life expectancy is a crucial issue to optimize active ageing and to reduce the burden of evitable medical costs. One of the main challenges is to develop pragmatic and ...personalized prevention strategies in order to prevent frailty, counteract adverse outcomes such as falls and mobility disability, and to improve quality of life. Strong evidence reports the effectiveness of exercise interventions to improve various physical parameters and muscle function that are cornerstones of frailty. Other findings also suggest that the interactions between nutrition and physical exercise with or without health behavior promotion prevent the development of frailty. Multimodal programs, including structured exercise, adequate dietary intervention and health behavior promotion, appear increasingly consensual. However, in order for implementation in real-life settings, some pitfalls need to be addressed. In this perspective, structuring and tailoring feasible, acceptable and sustainable interventions to optimize exercise training responses are essential conditions to warrant short, medium and long-term individual benefits. The different components of exercise programs appear to be fairly consensual and effective. However, specific composition of the programs proposed (frequency, intensity, type, time, volume and progressiveness) have to be tailored to individual characteristics and objectives in order to improve exercise responses. The intervention approaches, behavioral strategies and indications for these programs also need to be refined and framed. The main objective of this work is to guide the actions of healthcare professionals and enable them to widely and effectively implement multimodal programs including exercise, nutrition and behavioral strategies in real-life settings.
Policy is a lever for initiating the structural and environmental changes that foster health-enhancing physical activity (HEPA) promotion. However, little is known about the evidence in support of ...local governments regarding their HEPA-promoting policies. The aim of this study was to collect comprehensive information on municipal HEPA policies on the French Riviera (Alpes-Maritimes and Var counties) to provide an overview of the development of these policies in this territory. Mid-sized cities from the two counties constituting the French Riviera were targeted (
= 17). In each city, a local tool for HEPA policy analysis, CAPLA-Santé, was used to gain information from key informants heading the departments of sports, health services, and social services. Data were collected through semi-structured interviews and document analysis. Ten mid-sized cities volunteered to participate. Key informants from the sports (
= 10), health services (
= 5), and social services (
= 6) departments were interviewed. Written HEPA policy documents were formalized in six cities. These documents (
= 14) were mainly from the sports (
= 8) and health services (
= 4) sectors. The key informants reported that support from national policy, the commitment of elected officials, and large local stakeholder networks facilitated HEPA promotion, whereas the lack of intersectoral collaboration and limited resources were limitations. The results provide insight into the development of municipal HEPA policies, highlighting some of the barriers, facilitators, and perspectives. These findings could be valuable to scale up HEPA promotion at the local level.
The promotion of health-enhancing physical activity (HEPA) has become a key objective in public health policy. Therefore, based on the national HEPA Policy Audit Tool Version 2 (HEPA PAT v2) of the ...World Health Organization, a tool was designed to support local governments in assessing HEPA policies. This study aims to describe the adaptation and testing of the HEPA policy analysis tool (CAPLA-Santé) at the local level in France. The work was conducted in three stages: (1) an intersectoral group of experts was constituted, and the group adapted each item of the HEPA PAT v2 tool to the local level; (2) a testing phase with seven local governments helped to collect data and feedback on the tool; and (3) a final workshop was organized to adjust and finalize the tool. The final version of CAPLA-Santé contains 21 items divided into six major sections: overview of HEPA stakeholders in the local government area, policy documents, policy contents, funding and political engagement, studies and measures relating to physical activity in the local government area, and progress achieved and future challenges. CAPLA-Santé allows the collection and in-depth analysis of local level policies to assess the progress in promoting HEPA and intersectoral collaboration as well as identifying successful policy levers and remaining challenges.
Abstract
Issue and problem
In France according the group of age, 37% to 81% of the population are insufficiently active (ANSES, 2017). In addition, more than 40% of adults have prolonged sedentary ...behaviours (? 7 hours of day) (ANSES, 2017). Moreover, 7,6% of premature deaths in France could be attributable to physical inactivity (GOPA, 2021). In many territories, opportunities to adopt a physical active lifestyle need to be improved (IGAS, 2018). To tackle these major issues, the French government have implemented the Sport-Health Houses (SHH) program through the national sport health strategy 2019-2024.
Problem description
SHH have been launched in 2019 across the country. SHH are places were communities are welcomed and informed about multiples benefits of physical activity and sport. SHH also offer opportunities to evaluate people's fitness and to refer them to a ‘sport health' program through their own resources or through local stakeholders network. How the SSH program have been implemented across the country? Did SHH reach inactive people? How SHH impacted communities?
Results
Each year since 2019, the ministry of sport and the ministry of solidary and health have launched a call for project to local stakeholders to their organization become a SHH by complying selection requirements. In January 2022, 436 SSH were created on metropolitan and overseas territories with attention to the most vulnerable. Since 2020, beyond information about the benefits and opportunities to practice locally a physical activity, almost 697 000 inactive people were supported following a sport-health program of SHH in primary prevention of which 45 000 people in secondary or tertiary prevention. The impact evaluation of SHH to the communities is in progress
Lessons
A strong national policy can support the local level to develop Health-Enhancing the Physical Activity (HEPA) promotion. Moreover, it seems to be particularly relevant to develop SHH in territories with social inequalities to attract people generally far away of an active lifestyle.
Main messages
An approach linking the national and the local level is promising to develop HEPA.
Policy is a powerful tool used to influence physical activity levels of populations. The World Health Organisation has specifically acknowledged the role of local governments in developing policies ...to promote Health-Enhancing Physical Activity (HEPA). However, scientific knowledge remains scant about the involvement of local governmental HEPA promotion policies. This scoping review aims to provide an overview of the scientific peer-reviewed literature emerging on local government policies promoting HEPA. Two researchers searched 7 databases to extract peer-reviewed research articles published in English between January 2006 and December 2018. A total of 28 articles were included; mainly from the USA (n = 15). Different types of HEPA policies, including those from local governments, were reported in this scoping review but they were usually not detailed enough to have a comprehensive overview of the aspects of interest for research and practice. Researchers used various methods in their studies; however, they were not systematically based on theoretical or conceptual frameworks. Findings extracted from articles in this scoping review indicated that inter-sectoral collaborations seemed to be a key factor to lead effective HEPA policies. Moreover, some specific local factors seemed to positively or negatively influence their development. Intensifying research on HEPA policies and in different contexts is now needed. Future research should be expanded to evaluate HEPA policies from adoption to implementation and maintenance and to evaluate health outcomes from such policies.
Abstract
Background
There is strong evidence of the multiple benefits of physical activity on health in primary, secondary and tertiary prevention (WHO, 2020). However, economic evaluations are still ...needed to estimate direct and indirect costs that could be saved from various Health-Enhancing Physical Activity (HEPA) promotion strategies (Ding et al., 2020). Moreover, these savings might be influenced by specificities of the national health system. The aim of this study is to explore the economic impact of HEPA from different settings in France.
Methods
A systematic scoping review of grey and scientific literature was conducted. Relevant articles were identified through searching from PubMed, ScienceDirect, SportDiscus databases and from google. Searches were conducted in English and French between January 2000 and December 2020. A data extraction template was used to collect, organize and summarize data regarding the following variables: aim of the study, study population, study settings, methods, and main results.
Results
A total of 17 studies were included from the grey literature (n = 10) and the scientific peer-reviewed literature (n = 7). Data from each variables of interest were heterogeneous, making comparisons difficult. Studies were categorized in 5 types: studies aiming to estimate the cost of physical inactivity or the cost that could be saved from HEPA promotion in general population (n = 8); studies aiming to evaluate the medico-economic impact of a physical activity adapted program (n = 5); studies aiming to assess the economic benefit of active travel in a city (n = 3); study aiming to estimate the economic impact of physical activity from a company and its employee's perspectives (n = 1). Whatever the methods, the study population or the study setting, several tens of millions of euros to several billions of euros could be saved each year by investing in HEPA promotion.
Conclusions
HEPA promotion can lead to substantial saving. Methods should be standardized to more precisely estimate its extent in different settings in France. This could help policy-makers in their decision to invest in HEPA promotion, especially in phases of epidemics, where sedentarity and physical inactivity account for major health risks.
The implementation of strategies to prevent mobility disability in seniors at-risk with a strong focus on exercise is a public health imperative. These strategies must follow a pragmatic, structured ...and personalized approach. In order to obtain short, medium and long-term benefits, it is essential to consider the coordination of adapted physical exercise programs and to harmonize good practices. In support of national policies for the prevention of loss of autonomy, it is important to define clear guidelines to conduct effective programs. These programs should have a strong emphasis on evidence-based literature and should be validated by a consensus of multi-professional experts. The aim of this consensus is to outline the steps implementing these programs, to present their constituent elements and their practical application. Conception and elaboration of these programs should include frequency, intensity, duration, type of work, volume and individual progressiveness. Programs should also be focused on a personalised approach to develop participant health education, self-efficacy and empowerment for physical activity to ensure long-term health related behaviours. Moreover, trained professionals must supervise these programs in order to assure participants safety and program effectiveness. These guidelines will support policies for the prevention of loss of autonomy and mobility, throughout their development over the national territory.
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