7 Irrespective of the amount and method of calculating the monetary costs of physical inactivity the predominantly positive influence of physical activity on individual health remains undis puted However this does not fully apply to sporting activity which can also be associated with significant health damaging aspects Edwards Rowe 2019 These range from short term sports injuries to long term physical and psychological overuse of competitive and competitive athletes and athletes Excursus Bearers of the direct costs of physical inactivity in in ternational comparison An international comparison shows that in Germany a relatively high proportion of direct costs 77 is borne by the public sector global 58 9 of costs are borne by private institutions globally 24 and 14 by private households globally 18 Fig 2 Direct costs of physical inactivity and distribution to cost units ac cording to Ding et al 2016 Source Ding et al 2016 Own illustration For Europe non EU countries are also taken into account although there are enormous differ ences within Europe not tabulated the share of cost coverage is comparable to that in Ger many 75 is borne by public institutions 8 by private institutions and 17 by private house holds This distribution is mainly due to the solidarity based health care systems prevailing in Europe This means that direct health care costs as a whole and the direct health care costs caused by inactivity are mainly borne by the solidarity community via contribution financing 53 8 0 6 3 2 25 7 2 3 0 9 9 2 11 7 2 2 Direct Costs in billion US 58 52 54 48 58 41 68 75 77 24 30 15 40 9 11 7 8 9 18 17 31 12 33 49 25 17 14 Households Private Sector Public Sector

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