- Inadequate aerobic physical activity is linked to about $192B/year in U.S. healthcare costs (roughly 12.6% of spending).
- Suboptimal breastfeeding is estimated to cost $17.2B to over $100B annually through higher disease and related impacts.
- CDC DNPAO programs (SPAN, HOP, REACH) expanded access to healthy food, activity spaces, and breastfeeding support for tens of millions from 201812023.
- Large gaps persist in diet, activity, obesity, and breastfeedingespecially in low-income, rural, and some racial/ethnic communitieshighlighting the need for stronger policy and sustained funding.
Read More
Scope and Scale of Economic Impact
A study from mid-2025 estimates that U.S. adults who fail to meet aerobic physical activity guidelines contribute to $192 billion per year in additional healthcare costs, which constitutes roughly 12.6% of national healthcare spending. Insufficient activity and complete inactivity were both significant contributors: the average adult spends $6,566 annually on healthcare, with those insufficiently active paying $1,355 more than active peers, and completely inactive individuals paying $2,025 more.
Parallel to physical inactivity, breastfeeding shortfalls are also imposing substantial economic burdens. The cost of “suboptimal breastfeeding” in the U.S.—that is, rates of initiation, exclusivity at six months, and continuation at 12 months below targets—is estimated at $17.2 billion to over $100 billion annually, based on a recent National Academies report. The gap between intention and practice drives much of this cost, along with higher downstream incidence of disease in both mothers and children.
Programmatic Responses and Public Health Investments
The CDC’s DNPAO implements several major programs aimed at closing gaps in nutrition, physical activity, and obesity prevention. Key among them:
- State Physical Activity and Nutrition Program (SPAN) – funding statewide interventions to promote healthy ECE environments, safe community design, breastfeeding, and healthy options in underserved areas.
- High Obesity Program (HOP) – targets counties with >40% adult obesity to increase access to nutritious foods, physical activity infrastructure, and healthy ECE environments.
- REACH (Racial and Ethnic Approaches to Community Health) – funds culturally tailored interventions to reduce health disparities in chronic disease across state and local organizations.
Recent funding data from 2023 shows multi-million-dollar allocations to states for these programs. For example: Texas received over $3 million spread across SPAN, HOP, and REACH; several states received $500,000-$1.4 million each for HOP or REACH grants targeting specific counties. Between 2018–2023, these programs benefited more than 28 million people with greater access to physical activity, 9 million with improved access to nutritious foods, 3.8 million children through improved ECE settings, and over 3 million people via community breastfeeding support.
Disparities and Shortfalls Remain
Despite improvements, many Americans still do not meet basic nutrition or physical activity guidelines. Less than 10% of adolescents and adults eat the recommended daily amount of vegetables, only ~25% of adults and ~17% of young people meet physical activity guidelines, and obesity affects ~20% of children and ~40% of adults [from DNPAO summary]. Specific groups—Black, Native American/Alaska Native, low-income, rural populations—are especially underserved in breastfeeding initiation, continuation, and supportive infrastructure.
Policy gaps also persist. For instance, the National Academies report urged enactment of national paid family and medical leave, regulatory improvements in formula marketing, and standardization of hospital maternity care practices under the Baby-Friendly Hospital Initiative. These represent structural levers that remain underutilized.
Strategic Implications and Open Questions
Given the high economic stakes—$192 billion from inactivity and tens of billions from breastfeeding gaps—investment in prevention and early intervention offers potential for substantial ROI. Programs like SPAN, HOP, and REACH demonstrate scalable models; however, consistent funding, policy standardization, and addressing inequities will be critical to amplify impact.
Open questions include: What specific interventions deliver the greatest cost savings per dollar invested (e.g., workplace activity programs, infrastructure changes, community breastfeeding supports)? How can federal, state, and local policies more effectively align (e.g., paid leave, hospital accreditation)? What are the most efficient ways to overcome barriers in high-need underserved communities?
Supporting Notes
- Inadequate leisure-time physical activity in U.S. adults causes $192 billion/year in healthcare costs, about 12.6% of national healthcare expenditure.
- Between 2012–2019, 52.4% of adults met aerobic guidelines; 20.4% were insufficiently active; 27.3% completely inactive, with correspondingly higher medical costs ($1,355–$2,025 more than active peers).
- Estimated annual cost of suboptimal breastfeeding in the U.S. ranges from $17.2 billion to above $100 billion, depending on scope of behavior and outcomes included.
- CDC’s SPAN, HOP, and REACH programs from 2018–2023 benefited over 28 million people via improved physical activity access, over 9 million via better nutrition, ~3.8 million children with enhanced ECE environments, and ~3 million with breastfeeding support.
- 2023 funding examples: Texas secured $3,071,812; South Carolina $1,448,038; West Virginia $750,000; all funding state/local entities under SPAN, HOP, REACH.
- Only about 27% of U.S. infants are exclusively breastfed at 6 months; less than 40% receiving breastmilk at 12 months. Black infants or women have notably lower breastfeeding initiation and continuation.
- Less than 10% of adolescents and adults meet recommended daily vegetable intake; only 1 in 4 adults, 1 in 6 young people fully meet physical activity guidelines; obesity prevalence ~20% in children, ~40% in adults [DNPAO data summary].