The crowding-out effect of physical fitness activities on medical expenditure in the aged group

China is facing the challenge of "deep aging", and promoting healthy aging has become a key research topic. Both medical care and physical exercise are important for health, but while medical services focus on treating illness, physical fitness activities focus on prevention, making them a more effective approach for promoting healthy aging. This study uses data from the China Health and Retirement Longitudinal Study (CHARLS), focusing on individuals aged 60 to 80, to investigate the relationship between physical fitness activities and medical expenditures. A Tobit model was employed to analyze the data. (1) Active participation in physical fitness activities significantly improves the health of older adults, making physical activity an essential pathway to achieve healthy aging. (2) Participation in sports and fitness activities leads to a crowding-out effect on medical expenditures, significantly reducing healthcare costs for participants. (3) High-intensity physical activities are most suitable for individuals aged 60-65, moderate-intensity activities for those aged 66-70, and low-intensity activities for those aged 71-80. (1) Policies should focus on raising awareness of physical fitness benefits among older adults, encouraging regular physical activity to improve health and reduce medical costs. (2) A shift from treatment to prevention in health management is needed, promoting exercise as a cost-effective way to reduce healthcare spending. (3) Age-specific fitness guidelines should be developed to provide tailored exercise recommendations for different older aldult age groups.