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A Spatial Analysis of Linkages between Health Care Expenditures, Physical Inactivity, Obesity and Recreation Supply

Randall S. Rosenberger, Yoav Sneh, Tim T. Phipps, Rachel Gurvitch


Rates of physical inactivity and obesity in the United States have reached epidemic proportions. This study estimates the linkages between health care expenditures for treatments of circulatory problems, physical inactivity, obesity, and the supply of recreation opportunities in West Virginia. Estimation of a spatial econometric model shows that rates of physical inactivity for counties are positively related to expenditures on health care treatments of diseases and disorders of the circulatory system. Results also show that quantities of variously measured recreation opportunities are negatively related to rates of physical inactivity, but not to obesity. The recursive nature of our model demonstrates that physical inactivity explains spatial patterns of obesity, but not vice versa. Therefore, increasing recreation opportunities have the potential to decrease health care expenditures and rates of obesity through increasing rates of physical activity.


Health care expenditures, obesity, physical inactivity, recreation supply, spatial analysis.

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