TY - JOUR
T1 - The potential impact of food taxes and subsidies on cardiovascular disease and diabetes burden and disparities in the United States
AU - Peñalvo, José L
AU - Cudhea, Frederick
AU - Micha, Renata
AU - Rehm, Colin D
AU - Afshin, Ashkan
AU - Whitsel, Laurie
AU - Wilde, Parke
AU - Gaziano, Tom
AU - Pearson-Stuttard, Jonathan
AU - O'Flaherty, Martin
AU - Capewell, Simon
AU - Mozaffarian, Dariush
N1 - FTX; DOAJ
PY - 2017
Y1 - 2017
N2 - BACKGROUND: Fiscal interventions are promising strategies to improve diets, reduce cardiovascular disease and diabetes (cardiometabolic diseases; CMD), and address health disparities. The aim of this study is to estimate the impact of specific dietary taxes and subsidies on CMD deaths and disparities in the US.METHODS: Using nationally representative data, we used a comparative risk assessment to model the potential effects on total CMD deaths and disparities of price subsidies (10%, 30%) on fruits, vegetables, whole grains, and nuts/seeds and taxes (10%, 30%) on processed meat, unprocessed red meats, and sugar-sweetened beverages. We modeled two gradients of price-responsiveness by education, an indicator of socioeconomic status (SES), based on global price elasticities (18% greater price-responsiveness in low vs. high SES) and recent national experiences with taxes on sugar-sweetened beverages (65% greater price-responsiveness in low vs. high SES).RESULTS: Each price intervention would reduce CMD deaths. Overall, the largest proportional reductions were seen in stroke, followed by diabetes and coronary heart disease. Jointly altering prices of all seven dietary factors (10% each, with 18% greater price-responsiveness by SES) would prevent 23,174 (95% UI 22,024-24,595) CMD deaths/year, corresponding to 3.1% (95% UI 2.9-3.4) of CMD deaths among Americans with a lower than high school education, 3.6% (95% UI 3.3-3.8) among high school graduates/some college, and 2.9% (95% UI 2.7-3.5) among college graduates. Applying a 30% price change and larger price-responsiveness (65%) in low SES, the corresponding reductions were 10.9% (95% UI 9.2-10.8), 9.8% (95% UI 9.1-10.4), and 6.7% (95% UI 6.2-7.6). The latter scenario would reduce disparities in CMD between Americans with lower than high school versus a college education by 3.5 (95% UI 2.3-4.5) percentage points.CONCLUSIONS: Modest taxes and subsidies for key dietary factors could meaningfully reduce CMD and improve US disparities.
AB - BACKGROUND: Fiscal interventions are promising strategies to improve diets, reduce cardiovascular disease and diabetes (cardiometabolic diseases; CMD), and address health disparities. The aim of this study is to estimate the impact of specific dietary taxes and subsidies on CMD deaths and disparities in the US.METHODS: Using nationally representative data, we used a comparative risk assessment to model the potential effects on total CMD deaths and disparities of price subsidies (10%, 30%) on fruits, vegetables, whole grains, and nuts/seeds and taxes (10%, 30%) on processed meat, unprocessed red meats, and sugar-sweetened beverages. We modeled two gradients of price-responsiveness by education, an indicator of socioeconomic status (SES), based on global price elasticities (18% greater price-responsiveness in low vs. high SES) and recent national experiences with taxes on sugar-sweetened beverages (65% greater price-responsiveness in low vs. high SES).RESULTS: Each price intervention would reduce CMD deaths. Overall, the largest proportional reductions were seen in stroke, followed by diabetes and coronary heart disease. Jointly altering prices of all seven dietary factors (10% each, with 18% greater price-responsiveness by SES) would prevent 23,174 (95% UI 22,024-24,595) CMD deaths/year, corresponding to 3.1% (95% UI 2.9-3.4) of CMD deaths among Americans with a lower than high school education, 3.6% (95% UI 3.3-3.8) among high school graduates/some college, and 2.9% (95% UI 2.7-3.5) among college graduates. Applying a 30% price change and larger price-responsiveness (65%) in low SES, the corresponding reductions were 10.9% (95% UI 9.2-10.8), 9.8% (95% UI 9.1-10.4), and 6.7% (95% UI 6.2-7.6). The latter scenario would reduce disparities in CMD between Americans with lower than high school versus a college education by 3.5 (95% UI 2.3-4.5) percentage points.CONCLUSIONS: Modest taxes and subsidies for key dietary factors could meaningfully reduce CMD and improve US disparities.
KW - Cardiovascular disease
KW - Diabetes
KW - Diet
KW - Taxes
KW - Subsidies
KW - Policy
KW - Cardiometabolic
KW - Disparities
KW - COMPARATIVE RISK-ASSESSMENT
KW - AMERICAN-HEART-ASSOCIATION
KW - PUBLIC-HEALTH
KW - SATURATED FAT
KW - BEVERAGE TAX
KW - EXCISE TAX
KW - NUTRITION
KW - PRICES
KW - US
KW - MORTALITY
U2 - 10.1186/s12916-017-0971-9
DO - 10.1186/s12916-017-0971-9
M3 - A1: Web of Science-article
C2 - 29178869
VL - 15
JO - BMC Medicine
JF - BMC Medicine
SN - 1741-7015
IS - 1
M1 - 208
ER -