Associations between sedentary behavior, physical activity, and out-of-pocket health care expenditure: Evidence from Chinese older adults

Objective: This study examined the associations between sedentary behavior, physical activity, and health care expenditures among Chinese older adults. Method: We conducted a survey on 4,165 older men and women living in major cities in China. Sedentary behavior and physical activity were measured by the Physical Activity Scale for the Elderly questionnaire. Health care costs were assessed by self-reported out-of-pocket health care expenditures across outpatient care, inpatient care, medication, and formal caregiver expenses. Results: Sedentary behavior was associated with an increase in annual out-of-pocket health care expenditures by approximately USD$37 for each additional sedentary hour (p < .001). Physical activity was associated with a decrease in annual health care expenditures by approximately USD$1.2 for each one Physical Activity Scale for the Elderly score (p < .001). Physical activity was a less salient indicator of health care expenditure for men than women. Conclusions: Reducing sedentary behavior among older men and women and promoting physical activity, especially among men, may be important strategies to reduce out-of-pocket health care expenditures in China.