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

Penalvo, Jose L, Cudhea, Frederick, Micha, Renata, Rehm, Colin D, Afshin, Ashkan, Whitsel, Laurie, Wilde, Parke, Gaziano, Tom, Pearson-Stuttard, Jonathan, O'Flaherty, Martin ORCID: 0000-0001-8944-4131
et al (show 2 more authors) (2017) The potential impact of food taxes and subsidies on cardiovascular disease and diabetes burden and disparities in the United States. BMC MEDICINE, 15 (1). 208-.

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<h4>Background</h4>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.<h4>Methods</h4>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).<h4>Results</h4>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.<h4>Conclusions</h4>Modest taxes and subsidies for key dietary factors could meaningfully reduce CMD and improve US disparities.

Item Type: Article
Uncontrolled Keywords: Cardiovascular disease, Diabetes, Diet, Taxes, Subsidies, Policy, Cardiometabolic, Disparities
Depositing User: Symplectic Admin
Date Deposited: 17 Jan 2018 14:03
Last Modified: 19 Jan 2023 06:43
DOI: 10.1186/s12916-017-0971-9
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