Toward a cost/benefit analysis of physical fitness.

This article, which is based, in part, on a paper presented to the Canadian Association of Sport Sciences, Quebec City, in November 1985, evaluates the principles of cost/benefit and cost-effectiveness analysis in the specific context of fitness programming. Because of difficulties in valuing all aspects of fitness and health-particularly survival after retirement-cost-effectiveness analysis is generally preferred. Allowance must be made for inflation, the discount rate (except in a "steady state" analysis), marginal costs of program expansion, opportunity costs incurred by participants, the changing fabric of society, the economic multiplication of investment in fitness, and anticipated participation rates. Benefits may be observed by the individual (improved health), the corporation (reduced turnover and absenteeism, increased productivity, fewer injuries), and the state (reduced direct and indirect costs of illness, improved lifestyle, reduced demand for geriatric services). Program costs vary widely with the activity that is undertaken, but even daily walking involves the participant in some expense. Employee programs often cost $500-$750 per participant/year, while, depending on the sport and local speculation by land "developers", community programs may cost $175-$1,000 per participant/year. Cost/effectiveness analyses allow governments to reach informed decisions, but they cannot always answer associated ethical problems such as determining the value of human life, and the rights of the individual as opposed to those of society.