The consensus meetings for the development of HEAT recommended, for the time being, focusing only on all-cause mortality for HEAT for walking and for cycling. It should be noted that this method is likely to produce conservative estimates, since it does not account for disease-related benefits.
However, it is fully recognized that physical activity has beneficial effects on many aspects of morbidity as well. From a public health point of view, these benefits materialize more rapidly than reductions in mortality. They can also be important in motivating individuals to walk and/ or cycle, as people may be more likely to increase their physical activity to improve their immediate health and well-being than to prolong their life. Nevertheless, the current evidence on morbidity, both for walking and for cycling, is more limited than that on mortality. Thus including the impact of morbidity in an economic appraisal leads to greater uncertainty.
However, addressing morbidity was identified as an important item for later refinement to broaden HEAT’s appeal.