Does government spending help to promote healthy behavior in the population? Evidence from 27 European countries

Background The aim of this study was to examine if government spending is associated with an individual’s decision to participate in physical activity and sport which is regarded as healthy behavior given the positive health effects documented in previous research. Methods Individual-level data (n ¼ 25 243) containing socio-demographic information are combined with national-level data on government spending (5-year average) in 27 European countries. Given the hierarchical data structure, i.e. individuals are nested within countries; multi-level analyses are applied. Results The multi-level models show that it is mainly education spending that has a significant positive association with participation in sport of various regularities. Health spending has some association with participation in other physical activity and sport of a lower regularity. Conclusions While health spending can be considered a relevant policy tool for increasing sport participation rates, education spending is required more since the effects are larger and it affects both physical activity and sport. This suggests that health spending will have most effect combined with earlier influences from education spending.