Child’s Play Is Good for All of Us

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If all of the children who currently are sedentary started exercising every day, societies could save enormous amounts of money in the coming decades and have healthier citizens as a whole, according to a remarkable new study. In the United States alone, we could expect to save more than $120 billion every year in health care and associated expenses.

The study is the first to use sophisticated computer simulations to arrive at a literal and sobering societal price tag for allowing our children to be sedentary.

Inactivity is, of course, widespread among young people today. Recent research shows that in the United States and Europe, physical activity tends to peak at about age 7 for both boys and girls and tail off continually throughout adolescence. More than two-thirds of children in the United States rarely exercise at all.

The immediate health consequences for inactive children and their families are worrisome. Childhood obesity, which is linked to lack of exercise, is common, as is the incidence of Type 2 diabetes and other health problems related to being overweight among children as young as 6.

But the long-term financial costs of inactivity in the young, both for them and society as a whole, have never been quantified.

So for the new study, which was published this week in Health Affairs, researchers with the Global Obesity Prevention Center at Johns Hopkins University in Baltimore and other institutions decided to create a bogglingly complex computer model of what the future could look like if we do or do not get more of our children moving.

The researchers began by gathering as much public data as is currently available about the health, weight and physical activity patterns of all 31.7 million American children now aged 8 to 11, using large-scale databases from the Census Bureau, the Centers for Disease Control and Prevention, and other groups.

The researchers fed this information into a computerized modeling program that created an electronic avatar for every American child today. In line with reality, two-thirds of these children were programmed to rarely exercise and many were overweight or obese.

The scientists then had the simulated children grow up. Using estimations about how calorie intake and activity patterns affect body weight, the program changed each virtual child’s body day-by-day and year-by-year into adulthood. Most became increasingly overweight.

As the simulated children became adults, the scientists then modeled each one’s health, based on obesity-associated risks for heart disease, diabetes, stroke and cancer, and also the probable financial price of dealing with those diseases (adjusted for future inflation), both in terms of direct expenses for hospitalizations, drugs and so on, and lost productivity because of someone’s being ill.

The results were staggering. According to the computer model, the costs of today’s 8- to 11-year-olds being inactive and consequently overweight would be almost $3 trillion in medical expenses and lost productivity every year once the children reached adulthood and for decades until their deaths.

But when the researchers tweaked children’s activity levels within their model, the numbers began to look quite different. If they presumed that, in an imaginary America, half of all children exercised vigorously for about 25 minutes three times a week, such as during active recess or sports or, more ambitiously, ran around and moved for at least an hour every day, which is the amount of youth exercise recommended by the C.D.C., their virtual lives were transformed.

Most obviously, the incidence of childhood obesity fell by more than 4 percent, a change that resonated throughout the simulated children’s lives and society. There were about half a million fewer cases of adult-onset heart disease, diabetes, cancer and strokes in this simulation, and the society-wide costs associated with these illnesses dropped by about $32 billion every year if the children romped about for 25 minutes three times per week and by almost $37 billion if they moved for an hour every day.

The impacts were even more substantial when the researchers assumed that 100 percent of the children who are now sedentary got regular exercise.

In this scenario, the annual total costs during adulthood from obesity-associated medical expenses and lost productivity plummeted by about $62 billion when children were active three times a week and by more than $120 billion every year when all of the virtual children played and moved for at least an hour each day.

The implication of these numbers is that all of us, including people who are not parents, have selfish reasons to be concerned about childhood inactivity, says Bruce Lee, the director of the Global Obesity Prevention Program at Johns Hopkins and lead author of the study.

“We all will share the costs” of future medical treatments and lost work time among children who move too little now, he says.

Of course, this was a computer model and not a time machine, he says. It can provide predictions but not certainties. The simulations also relied on broad generalizations about how physical activity affects body weight and health, with the presumption being that more movement leads to less weight, which might not be true for all young people.

Still, this peek into our possible future strongly suggests that we should find ways now to encourage more children to move, Dr. Lee says. Show this study to school administrators who are mulling curtailing recess and physical education classes, he suggests. Talk to local planning authorities about more playing fields and parks. And if you are a parent, take your child for a bike ride, swim or jog.