Do investments in sport pay off: a systematic review and exploratory quasi meta-analysis of social return on investment in sport and physical activity.

Authors

Ágoston Koch, Erika Kendelényi-Gulyás, Tamás Sterbenz, Gergely Csurilla

Published in

The international journal of behavioral nutrition and physical activity. Volume 23. Issue 1. Jul 27, 2026. Epub Jul 27, 2026.

Abstract

Physical inactivity remains one of the most pressing global health concerns, contributing to millions of deaths each year and placing a considerable financial burden on public health systems through increased healthcare expenditure. Sport and physical activity have been recognised as effective tools for promoting health, strengthening social inclusion, and improving overall well-being. Traditional evaluation approaches, such as cost-benefit and cost-effectiveness analyses, have helped demonstrate economic value but often fail to capture wider social outcomes. The Social Return on Investment (SROI) framework provides a more comprehensive approach by assessing the combined health, economic, and social value generated per unit of investment.
This systematic review with an exploratory quasi-meta-analytic synthesis examined studies applying the SROI framework to sport and physical activity interventions published between 2018 and 2024. Following PRISMA guidelines, five academic databases and the Social Value UK repository were searched. Studies were included if they reported an SROI ratio for an empirical sport or physical activity intervention. Data were extracted on study and intervention characteristics, outcome domains, and methodological quality, the latter assessed using Krlev et al.'s 12-point framework. Because most studies did not report standard deviations or confidence intervals, formal variance-weighted pooling was not possible. Therefore, descriptive unweighted and sample-size-weighted averages were calculated, supported by sensitivity analyses and exploratory correlation analyses between SROI and study characteristics.
Sixteen studies met the inclusion criteria, providing 17 SROI estimates across interventions ranging from preventive health programmes to sport-for-development initiatives. The median SROI was 5.07:1, with estimates ranging from 0.03:1 to 101.05:1. The unweighted mean was 12.22:1, but this value was strongly influenced by the highest estimate; excluding the 101.05:1 outlier reduced the unweighted mean to 6.67:1 and the sample-size-weighted mean from 7.07:1 to 2.72:1. These findings indicate that median and sensitivity-adjusted estimates provide a more conservative summary of the available evidence.
Overall, the evidence indicates that investment in sport and physical activity generally generates positive social value, often returning several times the initial cost. However, pooled averages are sensitive to extreme SROI values, and large variations across studies highlight the need for greater methodological consistency, clearer reporting, and broader geographical coverage.

PMID:
42919394
Bibliographic data and abstract were imported from PubMed on 24 Oct 2026.

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