Pay Now or Pay More Later

Pay now or Pay More Later! Recreation reduces health care, social service and police/justice costs!

• 6.1 Fitness and well-being reduces both the incidence and severity of illness and disability LOWERING HEALTHCARE COSTS
• 6.2 Recreation supports families REDUCING COSTS OF SOCIAL SERVICE
• 6.3 Recreation reduces crime and social dysfunction REDUCING POLICE, JUSTICE, AND INCARCERATION COSTS

6.1 Fitness and well-being reduces both the incidence and severity of illness and disability LOWERING HEALTHCARE COSTS

Researchers (Keeler et al., 1989) calculated discounted lifetime costs and concluded that increasing physical activity saves $1,900 (U.S.) per person compared with inactivity. At an individual level, being active saves almost twice as much per person as being a non-smoker. Almost 40% of Canadians are not active compared to 26% who smoke regularly and 11% who have high blood pressure. At the community level, there are about 1.5 times as many inactive people as there are smokers. The lifetime estimate in Canada of costs that could be avoided amount to $18 billion from inactive persons compared to $5.7 billion from those who smoke. In Ontario, this amounts to a potential cost avoidance of $5.5 billion from inactive people, compared with $2 billion from smokers.

Overall, Canada's physical activity strategy is paying off. A total of 3.4 billion dollars in costs have been avoided due to the successful increase in the rate of physical activity over the 10 year period of 1981 to 1991. (CFLRI, 1995)

It is estimated that Canadians spent between $1.6 - $2.8 billion to treat ischemic heart disease alone in 1986. If 48% of Canadians were sufficiently physically active (moderate or vigorous level in 1986, as opposed to the 24% of the population physically active in 1981, the annual savings to the health care system would have been about $350 million per year. (Wood et al., 1994)

If the average blood pressure of the total population were lowered by one or two units through a provincial campaign promoting physical activity, this response would have profound implications on the health of the province and the provincial health bill. Similarly, to increase the physical activity level of all individuals who are now sedentary by a relatively small amount, the implications at the provincial Level would be profound. (CFLRI, 1995)

Back injuries among workers is an issue for one out of every two Ontario companies employing 20 or more people; companies are concerned with the physical risk of physical strain on the job lost productivity is one side of the equation; the other side is cost to WCB and the claimants. In 1990, claimants paid $182 million in out of pocket, non-reimbursable expenses and the Workers' Compensation claims amounted to $1.1 billion. (CFLRI, 1995)

If all adults 20 to 69 years of age reached a modest level of aerobic fitness, the immediate annual savings in health insurance payments would be $79.8 million, and associated decrease of coronary factors would lower future health costs by an additional $33 million per year (1990 consumer price index - Government of British Columbia, 1991)

The national cost of treating all fractures associated with osteoporosis in Canada was estimated at $250-300 million in 1988. (Health and Welfare Canada, 1988)

Young women who increase their level of physical activity and calcium intake by a modest amount can reduce the risk of osteoporosis at age 70 by almost one-third. The resulting reduction in hip fractures due to osteoporosis through increased physical activity and calcium supplementation could result in substantial savings. (Osteoporosis Society of Canada, 1992)

A study conducted by the Canadian Fitness and Lifestyle Research Institute (CFLRI) for the Ontario Ministry of Culture, Tourism and Recreation (1995) examined the potential economic impact of an increase in the percentage of the Ontario population who are physically active (33% participation rate in 1995). One (1%) and 25% point increases (up to 34% and 58%) over the 1995 participation rate were calculated as having the following direct economic impact.

• A 1 percent point increase in physical activity participation rates would reduce government health care costs by $31 million in 1995 dollars.
• A 25 percent point increase in the 1995 physical activity participation rates would result in direct government health savings of $778 million in 1995 dollars.
• An inactive person turned active reduces direct health costs by $364.00 per convert in 1995 dollars.
• 25 percent increase in 1995 physical activity participation rates increases labour productivity in the whole economy between .25 and 1.5 per cent.
• Excluding chronic health conditions, increased physical fitness reduces government health costs by $322.30 per worker.

This same study reports that:

• A Houston Texas Tenneco Study of 500 employees who were physically active after one year of a worksite health and fitness program showed a 48% decrease in medical costs as compared to the inactive, and a 3 day per year tower absenteeism rate.
• For 500 subjects at two major life assurance companies, medical cost savings after a one year fitness program were $84.50 per emloyee or $84,500 per thousand employees.
• An active life, involvement, and exercise can save $800 per year on behalf of institutionalized seniors. (Shephard, 1986)

Several researchers reviewed employee fitness programs at Prudential Life Insurance, Kimberly Clark, Blue Cross/Blue Shield of Indiana, Johnson & Johnson, Canada Life Insurance, and Mesa Petroleum and determined there were reductions in health care costs from the fitness programs. (Kaman et al., 1994)

Each additional mile walked or run by a sedentary person would give him/her an extra 21 minutes of life and save (U.S.) society an average of 34 cents in medical and other costs. (Rand Corporation, 1993)

A 3% increase in participation by Canadian citizens would save taxpayers $41 million in annual health care costs. (Saskatchewan Parks and Recreation Association, 1997)

If 40% of the Canadian population became involved in regular physical activity, the net savings to health care atone would be $6.5 million per day. (Manitoba Sports Federation, undated; Fitness and Lifestyle at the Workplace, 1988)

Active life, involvement and exercise can save $800 per year on behalf of institutionalized seniors . (Manitoba Sports Federation, undated, quoting The Economic Impact of Sports and Recreation Regular Physical Activity, 1988)

A study in 1976 of the Ontario Health Insurance Plan (OHIP) participants indicated that if at[ adults 20 to 69 years of age reached a modest level of aerobic fitness, the immediate annual savings in OHIP payments would be $31 million. Also, the associated decrease of coronary factors would lower future OHIP costs by an additional $13 million per year (significantly higher in today's dollars). (Fitness Canada, 1988)

Another Canadian study done in 1983 which focused on health-care costs, showed that OHIP costs increased sharply at one corporation white showing almost no change at an experimental company that had a fitness program for employees. A direct saving to OHIP was calculated at $130/per participant. (Fitness Canada, 1988)

The Saskatchewan Public Service Commission in a 1988 pilot project with staff from four government departments found there was a return on investment of $1.82 for every $1.00 spent on employee wellness. This figure represented improved absenteeism only. (Vance, 1991)

A 1988 Australian study looking at heart disease, estimates potential savings of $103.75 million for every 10% of the population which is active. When examining low back pain, the potential estimated saving was $48.8 million. Considering reduced absenteeism, the savings to industry is $84.8 million for each 10% of the population which is active. (Australia Department of Arts, Sport, Environment, Tourism and Territories, 1988)

The national benefits of greater personal fitness include reductions in both direct and indirect costs of illness, improvement of overall lifestyle, and a reduction of charges for geriatric care. The direct costs include expenditures for personal services and supplies (hospital care, services of nurses/doctors, drugs) together with nonpersonal items (medical research, training, public health services, capital construction, and insurance). The indirect costs include losses of production from illness, premature death, and grief. (Klarman, 1981)

Shephard (1986) published the 'Economics of enhanced endurance fitness' which includes a detailed summary of individual studies as follows:

The Conference Board of Canada study (1996) on physical activity and the cost of treating illness provided the following potential health-care savings from increased physical activity. They stated the direct treatment costs, including hospitals, physicians, drugs and research, for three sample diseases are:

Assuming a 1% point increase in the number of persons who are physically active, the annual treatment cost savings for the three diseases are also shown above. They stated, "Rediscovering disease prevention through regular physical activity as a means of reducing health care costs may well be a powerful strategy."

6.2 Recreation supports families REDUCING COSTS OF SOCIAL SERVICE - intervention and foster care

Tucson, Arizona Parks and Recreation Department saw the number of people falling below the poverty line increase to 20% of the population by 1990. This statistic reflects an 80% increase of individuals living in poverty between 1980 and 1990. Parks and recreation responded by creating KIDCO for elementary school children, youth and families. KIDCO is a place and opportunity to:

• pursue academic goals and engage in 'bi-literacy lab';
• promote self-esteem, listening, stress release, and reinforce positive values;
• enhance physical fitness, learn to respect the body;
• develop children's interests and practice recreation skills;
• involvement in day programs and sports/arts camps;

In 1993-94, KIDCO served 6,500 children between 5 and 12 years; reported crime declined by 52% and police attribute this phenomenal development to KIDCO and other enhanced park and recreation programs. (NRPA, 1994)

6.3 Recreation reduces crime and social dysfunction REDUCING POLICE, JUSTICE, AND INCARCERATION COSTS

Olympia, Washington Parks, Recreation and Cultural Services initiated a program "Street Outreach to 'Edge Kids' in 1990. Their assumptions included:

• It is more cost-effective to provide proactive programs for troubled youth than incarcerate them.
• Given the high rate of recidivism, youth who avoid the juvenile justice system have a better chance of Living a 'rewarding Life' than youth who do not.
• Street counseling is the most effective way to reach this high risk population.

Rather than expecting "social loners" to come to a traditional recreation site, recreation staff developed a program that had counselors meet with "edge kids" one-to-one in the downtown area. Their mandate was to connect them with health, social, education, and recreation services. Based on the tracking done, each month:

• Approximately 90 children, youth and young adults (1080 annually) are directed to agencies that begin to meet their needs.
• About 15 homeless youth return home with support.
• 8 to 10 youth are positively diverted from the juvenile justice system - a crime is prevented and the city saves the cost of police and judicial action. (NRPA, 1994)

Columbia, Missouri Parks and Recreation Department Launched a pilot program; - CARE - Career Awareness and Related Experience for economically disadvantaged Columbians.

During the past 12 years (including 13 summer programs) there have been 1,440 participants. Results showed that 1,050 remained with CARE for one year and 400 were employed by the program for two years; 80% of the total have successfully completed the program by entering the workforce and/or continuing education. (NRPA, Beyond Fun and Games, 1994)

The Dallas, Texas, Parks and Recreation Department initiated a program "Cooperative Gang Prevention Program". In 1991, Dallas officials estimated 150 gangs stating "Gang activity adds to the cost of public services, promotes an anti-social anti-family ethic that is often 'murderous', and leads some communities to decline." The program is comprised of 4 components: education; counseling services; recreation services and programs; and job training and placement.

Results showed the program had 3,000 participants in 1993 and referred another 300 youth for special services. Parks and recreation staff tracked 79 registered youth and found:

• 60% were promoted.
• 13% transferred; either earned GED or became employed.
• 16% stayed in their grade.
• 11% dropped out.

Dallas Police noted in 1993 there was a 26% decrease in juvenile arrest - they stated the Juvenile Gang Prevention Program has played a significant role. (National Recreation and Parks Association, 1994)

The Phoenix Arizona Parks, Recreation and Library Department added late night/weekend recreation programs for teens plus expanded leisure programs for them over the summer months. The result was a 52% reduction in juvenile crime. A series of programs were provided at a cost of 74 cents per person, Whereas it costs $38,000/year to lock up one teen. (Phoenix Parks/Recreation, 1994)

The British Sports Council financed a project that targeted recreation programs for reducing delinquency and crime among young people, specifically first time offenders and young people considered to be at risk. Results indicated a number of benefits such as self-esteem and personal growth. Also, the program results to date are indicating a recidivism rate of approximately 50%. The annual costs of the program were $200,000 for 300 clients. The savings realized for 90 youth not being incarcerated for 1 year are $1,800,000 and for 150 youth not being incarcerated are $3,000,000/year (Burlington Parks and Recreation Department, 1993)

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Canadian Parks/Recreation Association
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