Health Economics, Diabetes and the Daily Trip to School

Jane WardIn March 2013, the American Diabetes Association released their most recent five-year update “The Economic Cost of Diabetes in the US in 2012,” which found that in 2012, diabetes cost the US a total of $245 billion, an increase of 41 percent from 2007. By helping establish lifelong habits of active commuting and physical activity, Safe Routes to School programs may be able to help decrease these costs.

The staggering costs of diabetes include $176 billion in direct medical costs plus $69 billion from reduced productivity from individuals with diabetes. On average, a diabetic patient’s health care costs $13,700 per year, 2.3 times more than a non-diabetic. One of five healthcare dollars in the US goes towards care of diabetic patients. Approximately 7 percent of the US population is currently diagnosed with diabetes, and 5 percent more may be undiagnosed, but have diabetes. Another 56 million or so Americans may be “pre-diabetic.” If present trends continue, the Centers for Disease Control and Prevention (CDC) estimates that up to one of three US citizens may be diabetic by 2050.

The study found that costs increased significantly from 2007 to 2012 due to an increase in the numbers of people with diabetes, particularly type 2 diabetes, and increases in treatment costs. This is where we are able to make the leap to Safe Routes to School. Type 2 diabetes, formerly called “adult onset diabetes” as it was largely seen only in adults, is linked to sedentary lifestyles and being overweight. This type of diabetes is by far the most common, representing more than 90 percent of all diabetes cases among all ages. While it is still relatively rare among children, several thousand children are now diagnosed each year with Type 2 diabetes, and there are concerns about the impact of the tripling of childhood obesity in the past 30 years and its potential effects on the rates of type 2 diabetes in children.

Furthermore, type 2 diabetes is preventable in possibly 90 percent of individuals if they achieve a modest daily activity level, such as a 30 minute walk, maintain a healthy body weight, and avoid smoking. Safe Routes to School programs provide a wonderful opportunity to begin lifelong habits of active lifestyles. A recent study funded by the Robert Wood Johnson Foundation shows the possible impacts: the study found that the rate of obesity among grade school and high school students decreased if the students lived in communities with higher walkability index scores. Increased physical activity by students walking to school was a primary factor thought to be responsible for lower obesity rates.

Based on what we know about type 2 diabetes and its link to obesity and inactivity, children who walk or bicycle to school have the potential to lower their risk of type 2 diabetes and the expensive medical costs for diabetes care.


Jane Ward, MD, MPH is our research advisor, responsible for updating our research section and blogging on research topics. She completed a career in the US Air Force as a pediatric ophthalmologist with a strong interest in international humanitarian work. Her lifelong interest in fitness and active living led her to pursue a Masters of Public Health with a focus on Physical Activity and the built environment. For her MPH internship in the spring of 2012, she bicycled cross- country advocating and fundraising for Safe Routes to School and the League of American Bicyclists Bike Friendly America programs. She is an Assistant Professor at the Uniformed Services University of Health Sciences and retains close ties with the George Washington University Department of Exercise Science. She enjoys bicycling for fun and transportation, triathlons, travel and spending time with family and friends on active vacations.

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