Estimating the burden of disease attributable to physical inactivity in Scotland

About this release

This report builds on the 2023 publication Estimating the burden of disease attributable to physical inactivity in Scotland by applying the methodology and formula developed to other health conditions where the relative risk of ‘very low’, ‘low’ and ‘some’ physical activity can be calculated and the population attributable fraction for physical inactivity applied.

Main points

Key findings from this study:

• An estimated 3,185 deaths and over eleven thousand (11,474) disability-adjusted life years (DALYs) are attributable to physical inactivity in Scotland.
• More than 80% of these deaths and DALYs are due to the 'very low' physical activity category (those doing less than 30 mins/week of moderate physical activity per week).
• These estimations are larger than those produced by the Global Burden of Disease (GBD) study due to differences in methodology, detailed in the report.
• Estimates indicate substantial regional inequalities within Scotland in the burden of disease attributable to physical inactivity.
• Efforts to reduce the disease burden of physical inactivity should focus on those who are least active.

Figure 1 is a bar graph showing the number of deaths from all cause mortality, cancers and cardio vascular disease attributed to physical inactivity activity level category; very low activity, low activity and some activity.

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Figure 1. Number of deaths attributable to physical inactivity, by activity level

Mortality

The study estimates that of the 62,941 deaths that occurred in Scotland in 2022, 3,185 were attributable to physical inactivity, with cancer and cardio-vascular disease (CVD) accounting for around one third of these. Over 80% of these deaths, equivalent to around 2,500 deaths from all causes, occur in those in the very low activity category (Figure 1).

Disability Adjusted Life Years

Applying the Population Attributable Fractions (PAFs) for physical inactivity to DALYs - estimated as the sum of YLL and YLD - we estimate that more than eleven thousand (11,474) DALYs are attributable to physical inactivity in Scotland, with more than 80% of these due to individuals in the very low activity category, and more than one third (37%) due to IHD (Figure 2).

Figure 8 presents the number of disability adjusted life years attributed to physical inactivity by disease and level of activity; very low, low and some as defined in the Scottish Health Survey.

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Figure 2: Number of DALYs attributable to physical inactivity, by disease and activity level category

Background

In 2022 the Scottish Burden of Disease (SBOD) study predicting an annual disease burden increase of 21% over the next 20 years. A report published in 2023 examined how to estimate the burden of disease attributable to physical inactivity in Scotland to better understand the relationship between physical activity and the burden of disease.

The role of physical activity in the prevention of noncommunicable disease (NCD), is well evidenced, and understanding the extent of disease attributable to physical inactivity provides strong evidence over its potential impact in improving health.

NCDs remain the most common cause of deaths globally and account for more than two thirds of deaths within Scotland. The role of physical activity in preventing NCD morbidity and mortality is articulated through the WHO 5x5 NCD agenda which includes insufficient physical activity as one of the leading NCD risk factors, along with tobacco use, harmful use of alcohol, unhealthy diet, and poor air quality, for five NCDs: cardiovascular diseases (CVD), cancer, diabetes, chronic respiratory diseases, and mental health.