Non‐communicable diseases (NCDs) such as cardiovascular disease, diabetes, cancer, and mental health disorders are the leading causes of premature death worldwide. Among the many risk factors, physical inactivity stands out as a major modifiable behavior that significantly contributes to the rising global NCDs burden.
WHO defines physical activity as ‘any bodily movement produced by skeletal muscles that requires energy expenditure.1 Any form of movement your body makes qualifies as physical activity—whether it’s during your leisure time, while commuting, or as part of your work or household responsibilities.1
Despite the clear evidence linking regular exercise with improved health outcomes, an alarmingly high proportion of the global population remains inactive. In this article, we explore the multifaceted impact of physical inactivity on health, its economic implications, and the urgent need for policy‐driven interventions to reverse this trend.
The Global Landscape of Physical Inactivity
Current estimates reveal that nearly one third of adults worldwide fail to meet the World Health Organisation’s (WHO) recommended levels of physical activity 2 – at least 150 minutes of moderate‐intensity or 75 minutes of vigorous‐intensity activity per week.3 This statistic is particularly concerning, as approximately 1.8 billion people did not meet the recommended levels of physical activity in 2022. 2 For instance, while high-income countries often report higher percentages of inactive individuals, the sheer population size of middle-income countries means that the absolute number of inactive individuals and consequently the disease burden is greatest in these regions. 4,51.8 billion people, did not meet WHO’s recommended levels of physical activity in 2022
Additionally, gender disparities are evident; globally, women are less active than men, a pattern that has significant implications for health outcomes, given the established association between inactivity and several NCDs. 5
Figure 1 – Prevalence of physical inactivity, by WHO region and age, 2022. Source: WHO
Health Impacts: Linking Inactivity to Non-Communicable Diseases
The evidence linking physical inactivity to NCDs is robust and multifaceted. Physical inactivity is associated with an increased risk of coronary heart disease, stroke, type 2 diabetes, several types of cancer, dementia, and depression. 4,6 For example, in a comprehensive analysis, Katzmarzy et al., estimated that 69% of total deaths and 74% of cardiovascular disease deaths associated with physical inactivity are occurring in middle-income countries. 4 Regular physical activity improves cardiovascular function, enhances insulin sensitivity, reduces systemic inflammation and supports mental well-being. Conversely, a sedentary lifestyle contributes to obesity, metabolic dysregulation, and deteriorating mental health, creating a vicious cycle that further escalates NCD risk 7. This evidence underscores the fact that physical activity is not just a lifestyle choice—it is a critical determinant of public health.69% of total deaths and 74% of cardiovascular disease deaths associated with physical inactivity are occurring in middle-income countries
Economic Costs: The Price of Inaction
The economic implications of physical inactivity are profound. A recent global study estimated that the direct healthcare costs attributable to physical inactivity could reach approximately US$47.6 billion per year. 6 This figure reflects the cost of treating new cases of NCDs and mental health conditions that could potentially be prevented through increased physical activity. Notably, the cost burden is not evenly distributed. Although 74% of new cases of NCDs are projected to occur in low- and middle-income countries, high-income countries bear a larger share of the economic cost per case due to more expensive healthcare services. 6
In low- and middle-income countries, the situation is equally dire. Limited resources coupled with the increasing prevalence of NCDs result in substantial health-related expenditures. One study focused on these regions estimated that the direct healthcare costs due to physical inactivity amounted to around $10.3 billion in 2013, which represents nearly one-fifth of the global costs. 8
These staggering figures emphasise that the price of inaction is not merely measured in human lives but also in economic losses that can strain public health systems.
Direct healthcare costs attributable to physical inactivity could reach approximately US$47.6 billion per year
Physical Activity as a Natural Cure
While the cost of inactivity is high, the benefits of adopting regular physical activity cannot be overstated. Physical activity serves as a natural and accessible “cure” for many NCDs. Evidence suggests that increasing physical activity can dramatically improve health outcomes by reducing the incidence and severity of chronic diseases. 7 Exercise not only mitigates the risk factors associated with NCDs but also enhances overall quality of life, cognitive function, and mental health.
Moreover, regular physical activity contributes to the achievement of several of the United Nations’ Sustainable Development Goals (SDGs), particularly SDG 3, which aims to ensure healthy lives and promote well-being for all. 7 By investing in policies and infrastructure that promote physical activity – such as creating safe walking and cycling paths, supporting community sports programs, and integrating physical education into school curricula – governments can address both the health and economic burdens of inactivity.
Policy Interventions and Global Action
The WHO Global Action Plan on Physical Activity 2018–2030 provides a framework for governments to address physical inactivity. 2 This plan outlines evidence-based policy recommendations aimed at enabling more people to engage in regular physical activity. Yet, despite these clear guidelines, many countries have struggled to implement effective strategies. The lack of coordinated multisectoral action and the fragmentation of efforts across different governmental departments have hindered progress, making it unlikely that many nations will achieve the targeted 15% relative reduction in insufficient physical activity by 2030. 5
To reverse this trend, there is a pressing need for stronger advocacy and more substantial investments in public health infrastructure. The cost-effectiveness of such investments is clear: every dollar spent on promoting physical activity can yield significant returns in reduced healthcare costs and improved productivity. Furthermore, comprehensive public health campaigns that educate the public on the benefits of exercise and reduce barriers to physical activity are crucial for fostering long-term behavioral change. 6,8
Looking Ahead: The Road to a More Active Future
The evidence is unequivocal: physical inactivity is a major driver of the global NCD epidemic, with serious implications for both public health and the economy. Addressing this issue requires a multifaceted approach that combines public policy, community-based initiatives, and individual behavioral changes. Governments must prioritize physical activity as a key public health intervention, not only to reduce the incidence of NCDs but also to alleviate the associated economic burden.
As we look to the future, there is hope that a renewed focus on physical activity will lead to healthier populations and more sustainable healthcare systems. The integration of physical activity promotion into urban planning, education, and healthcare services can create environments that support active lifestyles. Additionally, leveraging technology—such as wearable fitness devices and mobile health applications—can provide individuals with the tools they need to monitor and improve their physical activity levels.
In conclusion, the fight against non-communicable diseases must include a robust strategy to combat physical inactivity. By embracing the benefits of regular exercise, societies can not only reduce the burden of chronic diseases but also foster a culture of health and well-being. It is time for governments, healthcare providers, and communities to work together to ensure that physical activity becomes a cornerstone of public health policy, paving the way for a healthier, more active future.
References
- World Health Organization. Physical activity. 2024. Available from – https://www.who.int/news-room/fact-sheets/detail/physical-activity
- World Health Organization. WHO Global Action Plan on Physical Activity 2018–2030. 2018. Available from – https://iris.who.int/bitstream/handle/10665/272722/9789241514187-eng.pdf
- World Health Organization. Nearly 1.8 billion adults at risk of disease from not doing enough physical activity. 2024. Available from – https://www.who.int/news/item/26-06-2024-nearly-1.8-billion-adults-at-risk-of-disease-from-not-doing-enough-physical-activity#:~:text=New%20data%20show%20that%20nearly,of%20physical%20activity%20in%202022.
- Katzmarzyk PT, Friedenreich C, Shiroma EJ, Lee IM. Physical inactivity and non-communicable disease burden in low-income, middle-income and high-income countries. Br J Sports Med. 2022;56:101–106.
- World Health Organization. Global Levels of Physical Inactivity in Adults Off Track for 2030: Summary Report. 2022. Available from – https://iris.who.int/bitstream/handle/10665/378026/9789240096905-eng.pdf
- Costa Santos A, Willumsen J, Meheus F, Ilbawi A, Bull FC. The cost of inaction on physical inactivity to public health-care systems: a population-attributable fraction analysis. Lancet Glob Health. 2023;11:e32–39.
- Masanovic B, Akpinar S, Halasi S, Stupar D, Popovic S. Editorial: Physical activity as a natural cure for non-communicable diseases. Front Public Health. 2023;11:1209569.
- Liu W, Dostdar-Rozbahani A, Tadayon-Zadeh F, Akbarpour-Beni M, Pourkiani M, Sadat-Razavi F, Barfi V, Shahedi V. Insufficient Level of Physical Activity and Its Effect on Health Costs in Low- and Middle-Income Countries. Front Public Health. 2022;10:937196.
