Mind and Body
The Effects of Sitting for Over 6 Hours a Day Are Both Deadly and Costly
A lack of physical activity is projected to put nearly 1.4 billion people worldwide at risk for chronic diseases like diabetes or heart disease. As if the health risks themselves weren’t enough to illustrate the costs of sitting idly, a team of scientists in England have put a hard number on both the astronomical health and financial costs of a sedentary lifestyle.
Prolonged sedentary behavior is defined as sitting — whether at a work desk or in front of the TV — for at least six hours per day. For most people who work a typical workday in an office, that’s probably on the low side, and even that amount of sitting around seems to extract high costs.
Leonie Heron, the Ph.D. candidate at Queens University Belfast who authored this work, shows in her paper that prolonged sedentary behavior cost the UK an estimated £762 million between 2016 and 2017 and was associated with 69,279 deaths in the UK in 2016. The paper was published Monday in the journal Epidemiology and Community Health.
“I hope that the public are more aware of how their own behavior affects their health, which in turn costs the healthcare services money,” Heron tells Inverse.
Why is Sitting So Bad?
Heron analyzed the findings of six longitudinal studies each identifying a link between sedentary activity and one of the following conditions: cardiovascular disease, type two diabetes, all-cause mortality (even death has its costs), colon cancer, lung cancer, and endometrial (uterine) cancer.
She relied on longitudinal studies because the UK’s National Health System doesn’t actually keep track of deaths or expenditures related to sitting around all day. The findings of her study suggest that it should.
She estimates that sedentary behavior was the root cause behind 16.9 percent of type two diabetes cases, 4.9 percent of cardiovascular disease cases, and 11.6 percent of deaths due to all-cause mortality in the UK. It also may have been behind 7.5 percent of lung cancers, 9 percent of colon cancers and 8 percent of endometrial cancers, she writes.
Attempts to treat patients with all of these conditions is what costs the UK millions of pounds per year, she says. The high death count is due to the failure of those treatments.
The situation may seem bleak, but Heron says that even modest reductions in sedentary activity could have big effects on the population level.
If even 10 percent of people managed to sit for less than six hours per day, then 4,802 lives could have been saved in 2016, she says. If 30 percent of people achieved that task, 12,006 people could have been saved. And if 50 percent of the country managed to do so, then 24,012 people might not have died.
How Do We Save Ourselves From Sitting?
Getting massive amounts of the population to reduce sedentary is a big ask, and as Heron notes is “probably unrealistic.” As it stands, 29 percent of men and women in the UK were sedentary for at least six hours per weekday in 2016. Sitting is is an inescapable part of working a desk job, but there are still ways to mitigate the risks.
"However there are considerable health benefits from moving from sedentary behavior to light physical activity."
Heron’s suggestion is to incorporate small amounts of exercise into the day — not becoming a world-class cross-fitter. She recommends going for a walk at lunchtime or standing during a coffee break instead of sitting. The idea is just to push the needle from “no movement at all” to “even just a small amount of movement.”
“If you are standing or moving while expending more energy, you are no longer sedentary,” Heron says. “Guidelines have typically focussed on achieving more moderate-vigorous physical activity, however there are considerable health benefits from moving from sedentary behaviour to light physical activity.”
She isn’t the only person to highlight the impacts of even small amounts of movements. For example, some research has shown that walking, dancing, or gardening for as little as 10 minutes per day is associated with an 18 percent reduced risk of death.
As costly and deadly as sitting may be, the cures seem to be simple — doing anything is always better than doing nothing. Just breaking up the seated monotony a little bit can go a long way.
Methods: National Health Service (NHS) costs associated with prolonged sedentary behaviour (≥6 hours/day) were estimated over a 1-year period in 2016–2017 costs. We calculated a population attributable fraction (PAF) for five health outcomes (type 2 diabetes, cardiovascular disease [CVD], colon cancer, endometrial cancer and lung cancer). Adjustments were made for potential double-counting due to comorbidities. We also calculated the avoidable deaths due to prolonged sedentary behaviour using the PAF for all-cause mortality.
Results: The total NHS costs attributable to prolonged sedentary behaviour in the UK in 2016–2017 were £0.8 billion, which included expenditure on CVD (£424million), type 2 diabetes (£281million), colon cancer (£30million), lung cancer (£19million) and endometrial cancer (£7million). After adjustment for potential double-counting, the estimated total was £0.7 billion. If prolonged sedentary behaviour was eliminated, 48 024 UK deaths might have been avoided in 2016.
Conclusions: In this conservative estimate of direct healthcare costs, prolonged sedentary behaviour causes a considerable burden to the NHS in the UK. This estimate may be used by decision makers when prioritising healthcare resources and investing in preventative public health programmes.