The potential impact of food taxes and subsidies on cardiovascular disease and diabetes burden and disparities in the United States

BMC Medicine

Research Article

Laurie Whitsel¹  Martin O’Flaherty²  Simon Capewell²  Tom Gaziano³  José L. Peñalvo⁴  Renata Micha⁴  Dariush Mozaffarian⁴  Parke Wilde⁴  Frederick Cudhea⁴  Ashkan Afshin⁵  Colin D. Rehm⁶  Jonathan Pearson-Stuttard⁷ 

[1] American Heart Association (AHA), 20036, Washington, DC, USA;Department of Public Health and Policy, University of Liverpool, L69 3GL, Liverpool, UK;Divisions of Cardiovascular Medicine, Brigham and Women’s Hospital, 02115, Boston, MA, USA;Friedman School of Nutrition Science & Policy, Tufts University, 150 Harrison Ave, 02111, Boston, MA, USA;Institute for Health Metrics and Evaluation (IHME) at the University of Washington, 98121, Seattle, WA, USA;Montefiore Medical Center, 10467, New York, NY, USA;School of Public Health, Imperial College London, W2 1PG, London, UK;Department of Public Health and Policy, University of Liverpool, L69 3GL, Liverpool, UK;

关键词: Cardiovascular disease;    Diabetes;    Diet;    Taxes;    Subsidies;    Policy;    Cardiometabolic;    Disparities;   

DOI  :  10.1186/s12916-017-0971-9

 received in 2017-02-10, accepted in 2017-11-01,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundFiscal 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.MethodsUsing 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).ResultsEach 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.ConclusionsModest taxes and subsidies for key dietary factors could meaningfully reduce CMD and improve US disparities.

【 授权许可】

CC BY   
© The Author(s). 2017

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