IntroductionBoth the World Health Organization and the Lancet Series on Adolescent nutrition recommend that governments adopt fiscal policies to combat diet-related non-communicable diseases (NCDs). However, rigorous, systematic evidence regarding the effects of these interventions is lacking.MethodsWe synthesize the available evidence regarding the impacts of taxes and subsidies that directly affect consumer prices on availability and accessibility of foods and beverages, purchasing behavior, diet quality, health and well-being outcomes as well as considerations for implementation, sustainability and equity.ResultsOur initial search returned 2,113 de-duplicated studies, and ultimately 24 impact evaluations and two systematic reviews met final eligibility criteria and represented unique evaluations. Our meta-analysis of these studies suggests that taxes may decrease purchases of taxed beverages (SMD = −0.14 [95% CI: −0.29 to −0.07], n = 15). Results should be interpreted cautiously due to considerable heterogeneity (Q(14) = 335.19, p = 0.01, τ^2=0.03, I2 = 95.82%).DiscussionThe evidence base is too limited to draw conclusions about the effects of taxes on beverages and calorie-dense foods on purchases, or on the effects of subsidies on purchasing or diet quality. Overall, the evidence base is inconclusive on whether fiscal policies can meaningfully influence the availability and accessibility of foods and beverages, diet quality, and health outcomes. Policymakers implementing fiscal policies should consider information campaigns on health benefits and health risks associated with certain food and beverage consumption. For taxes, exposure to health information may amplify signaling effects of taxes and reduce avoidance behaviors, such as cross-border shopping. Future evaluations should diversify data sources to better understand impacts on diet and health outcomes.
also lent their subject expertise to the framework development process and provided valuable guidance throughout. We wish to thank Sarah Young for helpful contributions to designing and executing the search strategy, and Paul Winters and Paul Fenton Villar for useful comments on a draft of this report.We are grateful to Maryia Ivanina and Volha Skidan for their work on the automation tools that greatly accelerated this work.Finally, we wish to thank the following research assistants who supported this EGM through literature screening and data extraction:
The authors of this paper, Use of performance-based contracts for road maintenance projects: a rapid evidence assessment, synthesize evidence from evaluations on the impact of performance-based contracts for road maintenance projects on cost savings, road quality, collaboration and direct user benefits. They also provide insights into the implementation, sustainability, and evaluation of these interventions, as well as a risk of bias assessment for each study. This work can help policymakers and practitioners determine the expected outcomes of their interventions and identify key barriers and facilitators of impact.
also lent their subject expertise to the framework development process and provided valuable guidance throughout. We wish to thank Sarah Young for helpful contributions to designing and executing the search strategy, and Paul Winters and Paul Fenton Villar for useful comments on a draft of this report.We are grateful to Maryia Ivanina and Volha Skidan for their work on the automation tools that greatly accelerated this work.Finally, we wish to thank the following research assistants who supported this EGM through literature screening and data extraction:
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