Engaging in physical activity lowers healthcare costs

Researchers at the University of Groningen have conducted research for the municipalities of Rotterdam and Amsterdam into the relationship between sports and exercise and healthcare costs. The results of the study ‘The relationship between sports and exercise and socioeconomic differences in healthcare costs’ clearly show that in neighborhoods where more residents exercise weekly and where more residents meet the guidelines for physical activity, healthcare costs are lower.

The study took differences in prosperity into account by looking at the socioeconomic status (SES) of the participating neighborhoods. This SES takes into account the income, education, and employment status of the population of a neighborhood. In addition, the analyses took into account differences in the population structure of neighborhoods, by age and gender. The researchers from the University of Groningen compared neighborhoods with a similar SES in Amsterdam and Rotterdam with each other and with national averages.

Previous research has already shown that SES influences health and well-being and how much people exercise and participate in sports. The new research shows that in most cases, of two neighborhoods with a similar SES, the neighborhood where people exercise or participate in sports more has substantially lower healthcare costs.

Savings per neighborhood

On average, Dutch neighborhoods where 1% more people exercise weekly have €9 lower healthcare costs per resident per year. Neighborhoods where 1% more residents meet the guidelines for physical activity have €8 lower annual healthcare costs per resident on average. At first glance, the annual savings seem limited, but when converted to a district in Amsterdam or an urban area in Rotterdam, this is a large amount per year.

If 1% of all Amsterdam residents— around 9,350 people who currently do not get enough exercise—start exercising weekly or meet the physical activity guidelines, this will save society an estimated € 14 million in healthcare costs per year. If 1% of Rotterdam's residents (approximately 6,700 people who currently do not get enough exercise) start exercising weekly or become more physically active, this is expected to save more than € 11 million in healthcare costs per year.

Exercise and physical activity are not the same thing

A second striking finding of the study is that exercising more or being more physically active does not have the same effects everywhere. For example, the differences in healthcare costs between neighborhoods where people exercise more and those where they exercise less are greatest in neighborhoods with relatively few affluent people (low SES neighborhoods). This effect of sports diminishes as the prosperity of the neighborhoods increases. In more prosperous neighborhoods (higher SES), healthcare costs are lower when more residents meet the physical activity guidelines. The effect of sports and exercise on healthcare costs therefore seems to vary considerably between neighborhoods, depending on the SES of the neighborhood.

If 1% of the residents in Amsterdam Nieuw West (approximately 1,700 people) were to exercise more each week, this would save an estimated total of € 2.7 million per year in healthcare costs. If 1% of residents (around 700 people) in Rotterdam Charlois were to exercise more each week, this would save an estimated total of € 1.2 million per year in healthcare costs.

The amounts mentioned above are average potential healthcare cost savings that can be realized year after year. The study also implies that investing in sports and exercise can yield immediate savings in healthcare costs and is therefore not just a long-term effect.

Prosperity is the most important factor explaining healthcare costs

In addition to the results comparing neighborhoods with similar SES, this study also shows that differences in prosperity (SES) are the most important factor explaining differences in healthcare costs between neighborhoods. Healthcare costs in the 10% most prosperous neighborhoods are on average more than €1,000 per person lower than in the 10% least prosperous neighborhoods. Sport and exercise are also important explanatory factors in this regard.

The least prosperous neighborhoods offer the greatest potential for higher participation in sports and exercise and lower healthcare costs. While 54% of people in the most prosperous neighborhoods meet the guidelines for physical activity, this figure is 46% in the least prosperous neighborhoods. The differences between the most and least affluent neighborhoods are even greater when it comes to weekly sports participation (59% versus 39%) and membership of sports clubs (29% versus 12%).

Finally, the study shows that physical activity, weekly sports participation, and sports club membership are all clearly and significantly related to perceived health at the neighborhood level. These factors therefore have a positive effect on health and the affordability of healthcare.

Research design and research team

The study “The relationship between sports and exercise and socioeconomic differences in healthcare costs” was conducted using healthcare cost data from 2019 in order to exclude the effects of COVID-19. The study utilized, among other things, cost data for all individuals covered by the Health Insurance Act (Vektis) and the Health Monitor of the Public Health Service (GGD), the National Institute for Public Health and the Environment (RIVM), and Statistics Netherlands (CBS).

The study was conducted under the supervision of Dr. Willem de Boer, who recently obtained his PhD at the University of Groningen and is now an associate professor of applied sciences in the field of the social value of sport and exercise at the HAN University of Applied Sciences. Jochen Mierau (professor of Health Economics at the University of Groningen until August 2025) and Laura Viluma (assistant professor of Health Economics at the University of Groningen) also contributed to the study.

Conclusions

It can be concluded that more sport and physical activity contribute to lower healthcare costs and that encouraging this could lead to considerable savings. Sport and exercise are important factors in reducing social inequality. This is an important insight for the government and health insurers, among others, to consider investing more in prevention through sports and exercise. The differences in the effects of sport and exercise per neighborhood type demonstrate the importance of encouraging more sport in lower SES neighborhoods.

More information

Read the full research report on the University of Groningen website. (in Dutch)

Questions? Please contact Willem de Boer