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BMC Medicine
Published in: BMC Medicine 1/2017

Open Access 01-12-2017 | Research article

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

Authors: José L. Peñalvo, Frederick Cudhea, Renata Micha, Colin D. Rehm, Ashkan Afshin, Laurie Whitsel, Parke Wilde, Tom Gaziano, Jonathan Pearson-Stuttard, Martin O’Flaherty, Simon Capewell, Dariush Mozaffarian

Published in: BMC Medicine | Issue 1/2017

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Abstract

Background

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.

Methods

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).

Results

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.

Conclusions

Modest taxes and subsidies for key dietary factors could meaningfully reduce CMD and improve US disparities.
Appendix
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Metadata
Title
The potential impact of food taxes and subsidies on cardiovascular disease and diabetes burden and disparities in the United States
Authors
José L. Peñalvo
Frederick Cudhea
Renata Micha
Colin D. Rehm
Ashkan Afshin
Laurie Whitsel
Parke Wilde
Tom Gaziano
Jonathan Pearson-Stuttard
Martin O’Flaherty
Simon Capewell
Dariush Mozaffarian
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2017
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-017-0971-9

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