The effect of food taxes and subsidies on population health and health costs: a modelling study

Abstract

Background One possible policy response to the burden of diet-related disease is food taxes and subsidies, but the net health gains of these approaches are uncertain because of substitution effects between foods. We estimated the health and cost impacts of various food taxes and subsidies in one high-income country, New Zealand. MethodsIn this modelling study, we compared the effects in New Zealand of a 20% fruit and vegetable subsidy, of saturated fat, sugar and salt taxes (each set at a level that increased the total food price by the same magnitude of decrease from the fruit and vegetable subsidy), and of an 8% so-called junk food tax (on non-essential, energy-dense food). We modelled the effect of price changes on food purchases, the consequent changes in fruit and vegetable and sugar-sweetened beverage purchasing, nutrient risk factors, and body-mass index, and how these changes affect health status and health expenditure. The pre-intervention intake for 340 food groups was taken from the New Zealand National Nutrition Survey and the post-intervention intake was estimated using price and expenditure elasticities. The resultant changes in dietary risk factors were then propagated through a proportional multistate lifetable (with 17 diet-related diseases) to estimate the changes in health-adjusted life years (HALYs) and health system expenditure over the 2011 New Zealand population's remaining lifespan. Findings Health gains (expressed inHALYs per 1000 people) ranged from 127 (95% uncertainty interval 96-167; undiscounted) for the 8% junk food tax and 212 (102-297) for the fruit and vegetable subsidy, up to 361 (275-474) for the saturated fat tax, 375 (272-508) for the salt tax, and 581 (429-792) for the sugar tax. Health expenditure savings across the remaining lifespan per capita (at a 3% discount rate) ranged from US$492 (334-694) for the junk food tax to $2164 (1472-3122) for the sugar tax.Interpretation The large magnitude of the health gains and cost savings of these modelled taxes and subsidies suggests that their use warrants serious policy consideration.

Creating Healthy Change in the Preconception Period for Women with Overweight or Obesity: A Qualitative Study Using the Information–Motivation–Behavioural Skills Model

“…A two-pronged approach is required—empowering women with the tools to change the way they respond to the environment, and also changing their environment, where possible, to make healthier choices easier to make. The sugar tax, intended to create shifts in consumer behaviour, has reduced sugar consumption in the United Kingdom and Mexico [ 62 ], with higher effects for lower-income households. While food taxes and subsidies have not yet been implemented in Australia [ 63 ], it stresses the importance of giving women evidence-informed guidance they can trust, but also individual support to counteract obesogenic environments [ 64 ].…”

Consumption of Foods Derived from Subsidized Crops Remains Associated with Cardiometabolic Risk: An Update on the Evidence Using the National Health and Nutrition Examination Survey 2009–2014

“…They found that the combined approach averted as many as 470,000 disability-adjusted life years, with cost-savings of AU$3.4 billion (~$2.3 billion) [52]. In a model examining the impact of a fruit and vegetable subsidy on the health-adjusted life years of New Zealand's population, 212 health-adjusted life years were gained through a 20% subsidy on fruits and vegetables [53]. These studies hint at the positive effect of redistributing agricultural subsidies to support the production of fruits and vegetables, in order to reduce cardiometabolic diseases.…”

Consumers' perceived value of healthier eating: A SEM analysis of the internalisation of dietary norms considering perceived usefulness, subjective norms, and intrinsic motivations in Singapore

“…The growth of civilisational ailments such as obesity or diabetes (WHO, 2020a(WHO, , 2020b and the increasing health-related costs (Blakely et al, 2020) are valid reasons to justify widespread dietary changes.…”