Association of physical inactivity with circulatory disease events and hospital treatment costs

Abstract

Purpose

Epidemiological studies of chronic disorders need to consider more responsive outcomes, particularly those that manifest themselves across a defined population over a shorter time period, to improve our ability to detect the causes of and intervene in the global epidemics of today. We explore the use of hospital episode statistics as a candidate for this role and estimate the strength of the association of circulatory disease-related events with physical inactivity, considered here as an undesirable health behavior.

Settings, patients, and methods

The primary research was set in a mid-sized city in central England. Aggregation was at output area level (comprising ~300 residents); 51 of which were included. A random sample of 761 adults was selected to obtain estimates of the mean level of physical activity within each area. Circulatory disease hospital events were recorded and aggregated by output area over a 2-year period. Hierarchical linear modeling was used to establish the strength of the association between area-level physical activity and circulatory disease events. Sex, age, and reporting quarter were included as additional individual-level explanatory variables.

Results

Areas reporting greater activity were less likely (event rate ratio = 0.855; 95% confidence interval [CI]: 0.78–0.94) to have a circulatory disease event, as were females (0.593; 95% CI: 0.47–0.75). Areas with older residents (1.578; 95% CI: 1.5–1.66) and later reporting quarters (1.095; 95% CI: 1.04–1.15) were more likely to report circulatory disease events.

Conclusion

This study supports the use of hospital episode statistics as an outcome measure in the epidemiology of circulatory disease and reaffirms the potential importance of physical inactivity in the disease process.

Keywords:

• exercise
• cardiovascular disease
• lifestyle
• physical environment
• chronic disease epidemiology

Acknowledgments

The research was partially funded under the National Prevention Research Initiative, managed by the Medical Research Council, UK (MRC Grant G0501287). The opinions expressed are those of the authors and not necessarily those of the Funding Bodies.

Disclosure

The authors report no conflicts of interest in this work.