Abstract MP31: State-Level Impact of Low Physical Activity on All-Cause Disease Burden

Introduction: While a consensus for the beneficial effects of physical activity exists, the optimal level of exercise and its effect on the disease burden across all states of the United States has not been evaluated. Objective: To systematically quantify the attributable burden to physical inactivity in all states of the United States by age, sex, year, and cause. Methods: We obtained data on categorical prevalence of domain-specific and total physical activity levels from nationally or subnationally representative surveys. Risk-outcome effect sizes of total physical activity were gathered from a meta-analysis of prospective cohort studies. The optimal level of physical activity was determined based on the activity levels associated with lowest risk of mortality in prospective observational studies. A comparative risk assessment analysis then quantified the proportion of death and disability attributable to low physical activity. The variation of physical activity levels and its associated burden was further evaluated across each state of the United States. Results: In 2016, physical inactivity accounted for 87 (95% UI: 122.6- 44.5) thousand DALYs in the United States (84.4% from CVD, 9.1% from DM, and 6.5% from cancers), with 59% of DALYs coming from men and 41% in women. Only 5 states (WY, ME, MT, AK, VT) demonstrated mean total physical activity levels above our suggested physical activity level of 3500 MET-mins per week. The highest burden attributable to physical activity was seen in Mississippi, while the lowest was seen in Colorado (955 & 458 DALYs per 100,000, respectively). Conclusion: Our findings suggest that population inventions to increase physical activity at the population level could save hundreds of thousands of life years across the United States.