Physical activity can be increased effectively and at surprisingly low cost at the population level. Simple approaches, such as individually tailored online or print-based advice, can increase physical activity by an average of one hour per week at a cost of less than one euro per participant. At the same time, a new study reveals a significant gap: the costs and real-world impacts of measures promoting physical activity are rarely measured with sufficient accuracy.

A joint study by the University of Oulu and the Department of Sports and Exercise Medicine, Oulu Deaconess Institute Foundation highlights the need for better evaluation of both the effectiveness and the costs of interventions designed to increase physical activity.

The study is an international systematic review examining the effectiveness and cost-effectiveness of population-level physical activity interventions. Researchers screened more than 10,000 studies with the aim of identifying approaches and interventions that had successfully increased physical activity in the population and assessed their economic impacts. Only five studies met the strict inclusion criteria.

“Although many initiatives aim to promote physical activity, their cost-effectiveness is rarely evaluated in a reliable way,” says postdoctoral researcher Anna-Maiju Leinonen.

Costs and impacts are rarely measured
Only studies in which increases in physical activity were demonstrated using reliable measurement methods and where costs were assessed as part of the study design were included in the review. Reliable comparisons require precise and transparent cost calculations for implementing the intervention, as well as, where possible, other costs incurred by society and individuals.

These include, for example, healthcare expenditure as well as productivity costs related to sickness absence and work disability. In addition, physical activity should be measured using validated questionnaires or wearable activity monitors.

The studies included in the review were conducted in Europe, the United States and Australia. They focused mainly on adults and particularly on physically inactive groups.

According to the results, the most cost-effective interventions were simple and low-resource measures, such as printed or web-based advice tailored individually using computer algorithms to encourage people to increase their physical activity. In these interventions, physical activity increased modestly but at relatively low cost per participant.

By contrast, more expensive and complex programmes were less cost-effective in this dataset. The study highlights that promoting physical activity at the population level does not necessarily require large investments or complex programmes.

Health benefits appear slowly
The health benefits of physical activity, such as a reduced risk of chronic diseases and improved work ability, often emerge only over a longer period. However, the follow-up period in the studies included in the review was only one to two years.

During this time, no significant changes were observed in health-related costs or quality of life. According to the researchers, such a short follow-up period is insufficient to demonstrate the real long-term economic benefits of increased physical activity.

“If physical activity can be increased at low cost, it is not only a matter of public health but also of economic sustainability. The key question is not only how to get people moving, but how to do so in a smart and effective way,” Leinonen summarises.

The researchers emphasise that more high-quality and long-term studies are needed in the future in which costs and impacts are assessed systematically and using consistent methods. Only then can limited resources be directed to the measures that achieve the greatest possible health and societal benefits.

In particular, stronger research evidence is needed on the cost-effectiveness of interventions aimed at increasing physical activity among children and young people.

The study has been published in the journal Preventive Medicine: Anna-Maiju Leinonen, Sanna Huikari, Mikko Kärmeniemi, Jaana T. Kari, Raija Korpelainen, Urho M. Kujala, Ding Ding, Marjukka Nurkkala, Economically viable population-based interventions to promote physical activity behavior based on a systematic review, Preventive Medicine, Volume 206, 2026.