In order to prioritise physical inactivity in public health, one of the most important aspects is to understand its economic burden.

There is a very limited number of economic analyses on physical inactivity in relation to health outcome. Many of the analyses are limited to a small scope and very few countries.

Estimation of cost will need to include direct and indirect cost. Direct cost includes expenditure related to diseases and taking care of an ill person such as hospitalisation, clinic visits and medication. Indirect cost is loss due to illness, premature deaths, work absenteeism and productivity loss.

One study was done in 2013 to estimate the economic burden of physical inactivity on a global level. The study includes 142 countries which represent 93 per cent of the world population.

The study includes four diseases related to physical inactivity, which include breast and colon cancer, stroke and coronary heart disease. It showed that physical inactivity cost US$53.8 billion (RM231 billion) worldwide (in direct cost), which is 0.64 per cent of total health expenditure.

An additional US$13.7 billion is indirect cost and most of the cost is borne by the public sector ($31.2 billion).

Even though the burden of chronic disease is greatest in low and middle-income country (80 per cent), the economic burden is higher in high-income countries (80.8 per cent).

For Malaysia, the direct cost is US$284 million (1.03 per cent of health care cost) and indirect cost is US$119 million (in 2013).

The total amount that could be saved if all the Malaysian population are physically active is US$403 million, which is about RM1.3 billion. That’s a huge amount of money.

State Housing and Local Government, Water Supply, Water Resources and Energy Committee chairman Datuk Badrol Hisham Hashim said within the first three years in power, the BN-led state government had built 19,535 houses with a RM1.7 billion allocation. Pic by AMRAN HAMID

In 1992, the first benefit and recommendation for physical activity for Americans was published. In 1995, the Center for Disease Control and Prevention (CDC) and the American College of Sports Medicine (ACSM) gathered an expert panel to review and publish a recommendation on physical activity in public health.

ACSM has continued updating the recommendation since then. The latest update was published in 2017.

World Health Organisation has started working with CDC in 1998 for global physical activity promotion. During the 55th World Health Assembly, it addressed the physical inactivity problem, which then led to the WHO Global Strategy on Diet, Physical Activity and Health.

In 2010, WHO released a global recommendation for physical activity.

The WHO Global Action Plan and Monitoring Framework for the Prevention and Control of Non-Communicable Diseases was adopted in 2013, which includes a target of a “10 per cent reduction in prevalence of insufficient physical activity by 2025”.

In Malaysia, physical activity recommendation was found in clinical practice guideline for management of hypertension, obesity, hyperlipidaemia and type 2 diabetes.

Recommendation for physical activity is also found in the Malaysian Dietary Guideline. More work should be done to put physical activity as a priority in public health and as a national agenda.


In my opinion, few steps have to be taken in order to increase the level of physical activity, and reducing the burden of many chronic diseases.

These are some actions that can be considered:

1.To have a clear national policy and recommendation in physical activity and health.

2.Collaboration between many sectors and agencies to improve sports facilities, promote healthy lifestyle and put physical activity as an important agenda.

3.Intensive physical activity promotions using multiple media channel.

4.Monitoring and surveillance of physical activity level and diseases related to physical inactivity.

5.Increase knowledge and skills of physical activity and health among primary care practitioners.

Leave some flexibility to your travel plans so you can go off the beaten tracks and discover something different. This hanging bridge over the river in Kiulu Valley in Sabah leads to farms, padi fields and the local school.

An avid sportsman who believes in the healing powers of exercise, Assoc. Prof. Dr. Ahmad Taufik Jamil is Universiti Teknologi Mara’s public health consultant and exercise physician. Reach him at atjamil@gmail.com.

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