Motives and costs of physical exercise with

regard to health production:

The DR's EXTRA Study Virpi Kuvaja-Köllner a, Hannu Valtonen a, Pirjo Komulainen b, Maija

Hassinen b and Rainer Rauramaa b,c

a Department of Health and Social Management, University of Eastern Finland, Kuopio Campus, Kuopio, Finland

b Kuopio Research Institute of Exercise Medicine, Kuopio, Finlandc) Department of Clinical Physiology and Nuclear Medicine, Kuopio

University Hospital, Kuopio, Finland

The content of presentation

• The aim of the study

• Theory

• Data

• Methods

• Results

• Conclusion

• Acknowledgements

The idea and aim of the study

How motivation and labour market

position (time) explain the time

used for

Physical exercise

Health outcomes

by older adults

Theory• Grossman’s health production function

• The individual’s health investment

• The individual’s own effort

• The allocation of time (working or retired)

• Opportunity cost of time (Hatziandreu et al. 1988; Hagberg et al 2009 & 2010)

Data• We used 2-year data (n=1292) from

the Dose-Responses to Exercise

Training (DR’s EXTRA) Study.

• the target population was a

representative sample of Eastern

Finnish men and women who were 55-

74 years of age in 2002

Variables• Moderate-to-heavy physical exercise

(hours/week)

• Health-related quality of life was

evaluated by Rand 36-item survey

using Physical and Mental Component

Summary (PCS, MCS) scores.

• Metabolic risk factor (MetS) score was

defined by NCEP criteria.

What motivates people to exercise?

Methods• Motivational factors were asked in the

baseline in the form: Which of the

following factors motivate (encourage)

you to do physical exercise?

• Also freely worded answers

• Motivation; principal component

analysis

Methods continue• In the statistical analysis, exercise and

health outcomes were assumed to be

endogenous variables explained with

a set of exogenous variables.

• The statistical modelling was done by

panel data instrumental variable

regressions.

Results• The motivational factors, "joy" or “exercise is

good for me”, increased the amount of

exercise (p<0.001)

• Retirement increased the time spent on

moderate-to-heavy exercise

• The instrumented variable, moderate-to-

heavy exercise increased the PCS and MCS

scores and decreased the MetS score

Conclusion

The opportunity cost of time,

measured with the labour market

position, either retired or working, and

motivation, such as joy, had a

significant effect on the amount of time

spent on exercise.

Enjoyment!

Connection to the healthpolicy

• The employers should put more effort and

make it possible for the age group of people

over 55 years old to do more physical

exercise, perhaps even during working time

• Health policy should be open minded

towards all different kind of physical

exercise. If people enjoy dancing, they

should have the possibility to do that also

elsewhere than in restaurants

Acknowledgements* the DR’s EXTRA participants

*Financial support:

• Ministry of Education in Finland, Academy of Finland,

European Union/ EXGENESIS, City of Kuopio,

• Kuopio University Hospital,

• Finnish Diabetes Association,

• Finnish Heart Association,

• the Social Insurance Institution of Finland and

• Päivikki and Sakari Sohlberg Foundation

• Yrjö Jahnsson Foundation

* the DR’s EXTRA study group