title: The Effects of Exercise and Relaxation on Health and Wellbeing.
abstract: Better management by individuals of their long-term conditions is promoted to improve health and reduce healthcare expenditure. However, there is limited evidence on the determinants and consequences of self-management activity. We investigate the determinants of two forms of self-management, exercise and relaxation, and their impact on the health and wellbeing of 3472 individuals with long-term health conditions over a 1-year period. We use simultaneous recursive trivariate models to estimate the effects of these two inputs on three health and wellbeing outcomes: the EuroQol five-dimensional (EQ-5D) score, self-assessed health and happiness. We reflect the opportunity cost of time and knowledge with employment status and education and find that employment reduces relaxation and education increases exercise. We find that neither exercise nor relaxation affects the EuroQol five-dimensional score, but exercise increases self-assessed health and relaxation increases happiness. Our findings show that individuals tailor their self-management activities to their economic constraints, with effects on different aspects of their utility. Interventions to encourage self-management should take account of heterogeneous effects and constraints. © 2017 The Authors. Health Economics Published by John Wiley & Sons, Ltd.
authors.affiliation: Manchester Centre for Health Economics, University of Manchester, Manchester, UK.
authors.forename: Hannah
authors.initials: H
authors.lastname: Forbes
authors.affiliation: Manchester Centre for Health Economics, University of Manchester, Manchester, UK.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Fichera
authors.affiliation: NIHR CLAHRC Wessex, Faculty of Health Sciences, University of Southampton, Southampton, UK.
authors.forename: Anne
authors.initials: A
authors.lastname: Rogers
authors.affiliation: Manchester Centre for Health Economics, University of Manchester, Manchester, UK.
authors.forename: Matt
authors.identifier: 0000-0002-6635-2127
authors.initials: M
authors.lastname: Sutton
mesh_terms: D003430:Cross-Sectional Studies; D059026:Diagnostic Self Evaluation; D015444:Exercise / Q000502:physiology*; D006304:Health Status; D006801:Humans; D015233:Models, Statistical; D011788:Quality of Life; D012063:Relaxation / Q000502:physiology*; D000073278:Self-Management / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors
keywords: long-term conditions; panel data; self-management; simultaneous recursive trivariate regression