Exercise as a way to reduce the cost of healthcare

It’s that spooky time of year, and surely something’s scary…the price of healthcare in the United States. Countries around the world spend on average 9% of their gross domestic product (GDP) on health care. From this graph, which represents the healthcare costs per capita as a percentage of the GDP, you can see that the United States is spending a larger percentage of their GDP than any other country including Italy, the United Kington, Japan, France, Canada, Germany, Sweden, or Switzerland. According to the Commonwealth Fund, [the US spends more per person on health care than many other high-income nations, but experiences worse health outcomes and lower life expectancies] (www.commonwealthfund.org). Dr. David Blumenthal, President of the Commonwealth Fund, notes that, “We have to look at the root causes of this disconnect and invest our health care dollars in ways that will allow us to live longer while enjoying better health and greater productivity.”

I fully agree. Frankly, I think that one of the best areas to put our money is into preventative measures of healthcare. As a scientist, I am often frustrated because the government is not interested in funding preventative medicine. For the past several years, I have been studying the effects of exercise on different aspects of behavior and brain function in healthy populations. Even with all of the exciting, preliminary data we have showing that exercise improves mood and cognitive functioning in healthy individuals, the National Institute of Health does not seem interested in funding this research. Instead, they want to fund research on already ill populations, such as individuals with depression, Parkinson’s disease, or dementia. This type of clinical research is, of course, completely valid and needed, but I think it is equally important to fund research that supports existing and continued health.

Exercise is one of the best defenses we have to keep our bodies and minds healthy and happy. A physically active lifestyle helps prevent weight gain, cardiovascular disease, stroke, diabetes, and cancer. Physical activity also helps prevent cognitive decline and stave off neurodegenerative diseases such as Alzheimer’s, Parkinson’s, and Huntington’s disease. Additionally, exercise can support improved sleep quality and enhanced mood. If you happen to suffer from any of a variety of mental health issues, such as depression, anxiety, bipolar disorder, attention deficit hyperactivity disorder, or schizophrenia, a regular exercise program can be used to improve symptoms. Especially important and relevant to all of us, exercise increases your changes of living longer.

Because of all these reasons, exercise seems like an excellent strategy for preventative healthcare. Just yesterday I went to the annual benefits fair at New York University to help me understand better all of the benefit options that my employer offers. I picked up a pamphlet from one of the health insurance companies and on the front cover was an image of a young couple hiking and an ad that said, “Preventative care can help you stay healthy.” As I read further, I realized that what this company was offering was preventative care services to [discover health issues before they became a serious problem]. Of course, everyone should make sure to attend their annual wellness visits and get screened for obesity, blood pressure, diabetes, cholesterol, vision, hearing, and other issues that may arise as we age. But I think the real problem is that our healthcare system is geared towards dealing with medical issues as they arise rather than preventing them.

So, what can our healthcare system be doing for us to offer actual preventive medicine? What about healthcare companies offering compensation for gym memberships? These fees can often be pricey and prohibitive. For example, a monthly membership to Equinox costs around $200. Even a gym membership to the YMCA can run you $100 a month. The first problem we face is that exercise is too expensive. Of course, you can just grab a pair of sneakers and go running outside. Running, however, is not always an option for everyone. You could also just buy a cheap subscription to an online service like Daily Burn (only $14.95 a month), where you can exercise in the comfort of your own home. The problem there is that finding the motivation to exercise alone in front of your television can be difficult.

In spending the last 4 years trying to motivate people to exercise so that I can study the effects of physical activity on the brain, I have learned a few things. First, it’s difficult to motivate people to exercise, especially those who haven’t been in the habit of exercising. Second, the best way to get people exercising is by giving them easy access (both physical and financial) to a gym or place where they can conveniently workout. Third, people need encouragement to start an exercise routine. We assign what we call “exercise motivators” to each of our participants to help them exercise regularly on a weekly basis. Fourth, once people get into the habit of exercising, they have a much easier time exercising and even want to do it!

I also think that Michelle Obama has the right idea with her “Let’s Move” initiative. The moto of this movement is, “America’s Move to Raise a Healthier Generation of Kids”. This is exactly the right mentality. Our exercise habits as adults are heavily shaped by our relationship with exercise as children. These formative years are extremely important in helping to develop healthy habits as we age.

As a society, the issue is really how we can create a healthy America – full of people who are interested in and motivated to stay healthy as we age. This issues is complicated and needs to be investigated in a scientific way. Communication between scientists and policy makers will certainly help to inform future decisions about healthcare, especially when it comes to creating a healthy population of people. With the upcoming changes in our political milieu (and I know both candidates have suggested some major changes to the healthcare system), I will be excited/anxious to see how things progress.