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Direct healthcare costs of sedentary behaviour in the UK
  1. Leonie Heron1,
  2. Ciaran O'Neill1,
  3. Helen McAneney1,
  4. Frank Kee1,
  5. Mark A Tully2
  1. 1 Centre for Public Health, Queen's University Belfast, Belfast, UK
  2. 2 School of Health Sciences, Ulster University, Newtownabbey, UK
  1. Correspondence to Leonie Heron, Centre for Public Health, Queen's University Belfast Centre for Public Health, Belfast BT12 6BA, UK; lheron01{at}


Background Growing evidence indicates that prolonged sedentary behaviour increases the risk of several chronic health conditions and all-cause mortality. Sedentary behaviour is prevalent among adults in the UK. Quantifying the costs associated with sedentary behaviour is an important step in the development of public health policy.

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 (£424 million), type 2 diabetes (£281 million), colon cancer (£30 million), lung cancer (£19 million) and endometrial cancer (£7 million). After adjustment for potential double-counting, the estimated total was £0.7 billion. If prolonged sedentary behaviour was eliminated, 69 276 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.

  • public health
  • sedentary behaviour
  • sitting time
  • cost analysis
  • health expenditure
  • healthcare cost
  • physical activity

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  • Correction notice This article has been corrected since it first published. Changes to the data in the sentence starting 'More realistically, if levels of sedentary behaviour were 10%, 30% or 50% lower in 2016…' in the Results section have been made.

  • Contributors CO, FK, LH and MAT developed the research question. LH did the analysis, with methodological guidance from CO. HM provided statistical expertise. LH drafted the manuscript. All authors read and approved the final manuscript.

  • Funding LH is funded by a Department for the Economy (Northern Ireland) studentship.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.