The public health impact of private fitness expansion

The public health, medical, and scientific research communities call for cost-effective interventions that expand access to physical activity infrastructure and services to promote urban health. This study evaluates the public health impact of the private sector expansion of fitness infrastructure in Singapore. Leveraging the phased introduction of a chain of on-demand gym facilities across residential subzones between 2020 and 2022, we find that increased access to on-demand gym facilities is associated with a decrease in monthly doctor visits per capita and overall healthcare costs. We further provide community-level evidence to support a plausible pathway where access to these gym facilities prompts residents to engage in physical activity, ultimately reducing healthcare utilization. First, increased access to on-demand gym facilities is associated with higher use of public exercise amenities, as reflected by increased parking lot utilization near public fitness facilities. This pattern suggests that overall physical activity at the community level rises following the introduction of on-demand gyms. Second, the public health impact of access to on-demand gym facilities is greater in subzones with greater access to green spaces and community fitness venues, suggesting a positive synergy between private and public fitness infrastructure. Collectively, these findings demonstrate that private-sector investments in improving physical activity opportunities can produce public health benefits.