Reducing Childhood Obesity through U.S. Federal Policy

Abstract

Background Childhood obesity prevalence remains high in the U.S., especially among racial/ethnic minorities and low-income populations. Federal policy is important in improving public health given its broad reach. Information is needed about federal policies that could reduce childhood obesity rates and by how much. Purpose To estimate the impact of three federal policies on childhood obesity prevalence in 2032, after 20 years of implementation. Methods Criteria were used to select the three following policies to reduce childhood obesity from 26 recommended policies: afterschool physical activity programs, a $0.01/ounce sugar-sweetened beverage (SSB) excise tax, and a ban on child-directed fast food TV advertising. For each policy, the literature was reviewed from January 2000 through July 2012 to find evidence of effectiveness and create average effect sizes. In 2012, a Markov microsimulation model estimated each policy’s impact on diet or physical activity, and then BMI, in a simulated school-aged population in 2032. Results The microsimulation predicted that afterschool physical activity programs would reduce obesity the most among children aged 6–12 years (1.8 percentage points) and the advertising ban would reduce obesity the least (0.9 percentage points). The SSB excise tax would reduce obesity the most among adolescents aged 13–18 years (2.4 percentage points). All three policies would reduce obesity more among blacks and Hispanics than whites, with the SSB excise tax reducing obesity disparities the most. Conclusions All three policies would reduce childhood obesity prevalence by 2032. However, a national $0.01/ounce SSB excise tax is the best option.

Cost Effectiveness of a Sugar-Sweetened Beverage Excise Tax in the U.S.

“…18,20 Conversely, another simulation study assumed that tax-induced reductions in SSB intake will not result in any caloric compensation. 65 The empirical association between SSB prices (included tax-driven price changes) and BMI supporting this argument is inconsistent. One repeated cross-sectional study estimated a significant 0.003 BMI unit reduction per 1% increase in soft drink tax rates, which would lead to an estimated reduction of 0.05 BMI units from a 16% tax, near the lower bound of the uncertainty interval in this study.…”

Ethnic Disparities in Trends in High BMI Among California Adolescents, 2003–2012

“…Although many policy approaches have been recommended to reduce obesity disparities, 31 more recently, researchers have begun to quantify and rank these approaches on potential impact and cost effectiveness. In a simulation study, Kristensen et al 32 found that a nationwide excise tax on sugar-sweetened beverages (SSBs) would reduce adolescent obesity the most, while expanded afterschool physical activity would reduce obesity in younger children (aged 6–12 years) the most. These policies would both reduce racial/ethnicity disparities in childhood obesity, with SSB taxes reducing disparities the most.…”

Simulating Strategies for Improving Control of Hypertension Among Patients with Usual Source of Care in the United States: The Blood Pressure Control Model

“…Computer simulation modeling has been instrumental in developing clinical guidelines and policy in general, 14,[23][24][25][26] and for hypertension in particular. 27 Farley and colleagues 27 used mathematical modeling to project the potential mortality benefits of increasing hypertension control, while Turner and Schalkwyk 28 used computer simulation of BP variability to examine spurious identification of hypertension in clinical studies.…”