More than one in four American adults are completely sedentary, and the toll it takes is not just physical.
A new study in the American Journal of Health Promotion finds that inadequate aerobic activity now costs the United States $192 billion annually in healthcare expenses. That’s 12.6% of total national health spending, driven by preventable chronic disease in inactive adults.
How Inactivity Drains the Nation
Researchers analyzed data from over 76,000 adults collected between 2012 and 2019 through two major U.S. health surveys. They found:
- 52.4% of adults met aerobic activity guidelines
- 20.4% were insufficiently active
- 27.3% were completely inactive
On average, each adult in the study incurred $6,566 per year in healthcare costs. But compared to those who were active:
- Insufficiently active adults incurred $1,355 more per year
- Completely inactive adults incurred $2,025 more annually
“Aerobic physical activity is an investment in health—it strengthens the heart, reduces chronic disease burdens, and empowers us to live with energy and freedom,” said Dr. Adam Chen of the University of Georgia’s College of Public Health, one of the study’s co-authors.
Why the Costs Keep Rising
The U.S. has seen modest gains in physical activity over the past decade, but those improvements have not been enough to counter the skyrocketing costs of chronic disease. The study’s authors believe that increasing age in the population, expanded insurance coverage, and rising medical prices may be contributing to the sharp increase in cost compared to a previous estimate of $117 billion in 2015.
“These findings provide further economic reasons for health systems, payers, and clinicians to integrate physical activity assessment, prescription, and referral into health care delivery,” said Laurie Whitsel, PhD, of the American Heart Association and the Physical Activity Alliance.
Small Steps, Big Impact
Jennifer Matjasko, PhD, of the CDC’s Division of Nutrition, Physical Activity, and Obesity, highlighted the potential of simple changes: “Moving more throughout the day can help improve health and reduce health care costs. Every step counts toward a healthier future.”
The Physical Activity Alliance, the country’s largest coalition focused on promoting movement, is calling for systemic action:
- Make physical activity a standard of care. Health providers should assess and prescribe it like any other vital sign.
- Redesign workplaces. Employers should build in opportunities for daily movement to combat sedentary culture.
- Transform communities. Urban planning should prioritize safe and accessible spaces to walk, bike, and play.
“We’re spending nearly one out of every eight health care dollars on something we can prevent,” said Michael Stack, President of the Physical Activity Alliance. “We need to view physical activity as an essential health care solution to inspire people to move across their day in recreation, to and from work, in their jobs, at home and in schools.”
What Comes Next?
The study authors acknowledge limitations, including reliance on self-reported physical activity and medical costs. But the message remains clear: physical inactivity is a modifiable behavior with profound economic and health consequences. As the nation struggles with ballooning medical costs, is it time to treat exercise not just as a lifestyle choice—but as medicine?
Journal: American Journal of Health Promotion
DOI: 10.1177/08901171251357128
Article Title: Inadequate Aerobic Physical Activity and Healthcare Expenditures in the United States: An Updated Cost Estimate
Publication Date: July 11, 2025
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