Technical ReportPDF Available

Using price policies to promote healthier diets

Authors:
  • WHO - World Health Organization, Regional Office for Europe

Figures

Content may be subject to copyright.
A preview of the PDF is not available
Chapter
The objectives of this study are to analyze whether the fat tax stimulates a reduction in the consumption of taxed products and to assess whether the fat tax has led to an improvement in the population's health. The main conclusion of the study was that there was an increase in consumption of goods subject to the tax between 2016 and 2023. It also showed that the health of the Portuguese population in general has not improved with the implementation of the tax. The contributions of this article have made it possible to deepen our knowledge of fat tax consumption in the Portuguese population, and to study the perception of the level of health of the Portuguese after the implementation of the tax, something that previous studies had not addressed.
Article
Fat, sugar or sweetened beverage taxes are part of an overall public health nutrition approach to healthy eating. They are not approaches that on their own are likely to bring about change. Policy evidence from existing food tax implementation suggest that taxes need to be paralleled by subsidies and other interventions to encourage healthy eating. Such dual methods help not only contribute to nutrition outcomes but also ensure political support for food taxes. Politicians and policy makers are suspicious of taxes, using subsidies and revenue monies from taxes to support healthy eating are more likely to encourage both political and public support. Building support for policies is never just a matter of academic evidence. Public health advocates need to show more ambition by developing skills in implementing pricing policies to support healthy eating. Key opponents to taxes are the food industry who use a range of arguments to prevent taxation being implemented. Public health advocates are weak in tackling the issues of corporate power and providing evidence to maintain policy and political support. The public health movement needs to continue to develop the political will among politicians and the public for taxes on food. A new way of looking at policy formation is required and this includes addressing the power of corporate interests and the role of professionals in shaping or combating these influences. Copyright © 2015. Published by Elsevier Inc.
Article
Full-text available
Objective The aims of the review were to identify school-based randomised and non-randomised controlled trials to increase daily or lunchtime fruit and vegetable intake in children and to determine the impact of school-based interventions to change fruit and vegetable consumption at lunchtime and over the whole day. Design A systematic literature review was carried out to identify appropriate trials. This was followed by meta-analysis techniques to determine the pooled estimate of the difference in daily fruit and vegetable intake in the intervention group compared with the control group. Participants Trials carried out in schools where children were aged 5 to 11 years were included. All trials reported in English language journals were eligible. Results 28 randomised and non-randomised controlled trials were identified that reported daily fruit and/or vegetable intake. A median intake of 0.4 portions more fruit and vegetables was consumed in the intervention group compared to the control group. The qualitative review of 7 studies reporting lunchtime intake, either in addition to daily intake or independently in studies concentrating solely on lunchtime intake, revealed a median difference of 0.2 portions more fruit and vegetables in the intervention group at lunchtime. The meta-analysis of daily intake included 13 studies classified into one of two groups: behavioural change studies with a school and/or home component that relied on families improving eating behaviour; and free school fruit and vegetable scheme where fruit and vegetables are distributed to children. The short term impact of both type of programme was determined using the follow up data collected within 3 months of the end of the intervention. This was the longest follow-up period in most cases. The pooled estimates (95% CI) for behavioural change studies and free fruit and vegetable schemes were 0.43 (0.21 to 0.65) and 0.44 (0.20 to 0.67) portions respectively. The pooled estimate (95% CI) for all studies was 0.42 (95% CI 0.27 to 0.58) portions more in the intervention group. The majority of the difference was due to fruit not vegetables. Heterogeneity was high for the meta-analysis with lunchtime intake but reasonable for daily intake. Conclusion School-based interventions have the potential to moderately improve fruit and vegetable intake in children, with approximately half of the increase attributable to improvements in lunchtime intake.
Article
b>Objective : To examine the effects, by income group, of targeted food taxes and subsidies on nutrition, health and expenditure in the UK. Methods : A model based on consumption data and demand elasticity was constructed to predict the effects of four food taxation-subsidy regimens. Resulting changes in demand, expenditure, nutrition, cardiovascular disease (CVD) and cancer mortality were estimated. Data : Expenditure data were taken from the Expenditure and Food Survey; estimates of price elasticities of demand for food were taken from a report based on the National Food Survey 1988–2000. Estimates of effect on CVD and cancer mortality of changing fat, salt, fruit and vegetable intake were taken from previous meta-analyses. Results : (i) Taxing principal sources of dietary saturated fat is unlikely to reduce cardiovascular disease (CVD) or cancer mortality. (ii) Taxing ‘less healthy’ foods (defined by the WXYfm nutrient profiling model) could increase CVD and cancer deaths by 35–1300 yearly. (iii) Taxing ‘less healthy’ foods and subsidising fruits and vegetables by 17.5% could avert up to 2900 CVD and cancer deaths yearly. (iv) Taxing ‘less healthy’ foods and using all tax revenue to subsidize fruits and vegetables could avert up to 6400 CVD and cancer deaths yearly. Few obesity-related CVD deaths are averted by any of the regimens. All four regimens would be economically regressive and positive health effects will not necessarily be greater in lower-income groups where the need for dietary improvement is higher. Conclusions : A targeted food tax combined with the appropriate subsidy on fruits and vegetables could reduce deaths from CVD and cancer.<br /
Article
Several jurisdictions are now imposing taxes on food and beverages to prevent obesity (and related conditions). Existing evidence concerning their effects comes largely from simulation studies and trials in closed settings, both of which have limitations. Rigorous evaluation of actual taxes may provide richer evidence with greater external validity to support policy making. This article describes existing evaluation studies and outlines an implicit underlying theoretical framework for how taxes are expected to affect health. It then explores three important issues for future studies: selection of an appropriate evaluative perspective (comparing realist and biomedical experimental paradigms); approaches to causal inference; and the challenge of a low signal-to-noise ratio. We argue that evaluation should be informed by a realist perspective as well as making appropriate use of established empirical quasi-experimental approaches to testing causal effects. This should be underpinned by a theoretical framework that acknowledges complexity and the potential diversity of impacts.
Article
Summary Once dispatched to the bottom draw of policy options to address unhealthy eating, food taxes now seem back in the out tray of European policy makers. Even David Cameron made an offhand quip recently suggesting that this is something the British Government might explore. While the purpose of developing food taxes is likely their potential to raise money for national treasuries, governments have justified them on health grounds. But, what evidence is available that can inform policy development in this area from a health perspective? Most obvious are the studies that model different scenarios for taxes. Yet these studies form a relatively small part of the potential evidence-base. The largest proportion of existing research on food prices has simply measured food prices in the marketplace and drawn hypotheses about the dietary implications. Other studies have estimated the costs of actually consumed diets. Another set of studies have quantified an association between price of specific foods and diet from real world data. Others have likewise taken a quantitative approach, but in experimental settings. A particularly large group of studies are qualitative – those asking consumers if and/or how their food choices are influenced by prices. The final type of study combines qualitative and quantitative methods. This paper examines the relevance of these different types of evidence as information for policy development in this area.
Article
This paper summarises the recently introduced fat tax in Denmark, which came into force on 1 October 2012, and discusses some of the consequences of introducing the tax. Furthermore, this paper discusses the theoretical background and reasoning for imposing a fat tax as well as some of the problems and concerns stated, especially by the food industry. The fat tax is a tax paid per kilogram of saturated fat in the following foods if the content of saturated fat exceeds 2.3 g/100 g. These include meat, dairy products and animal fats that are rendered or are extracted in other ways, edible oils and fats, margarine and spreadable blended spreads. The declared aim of the tax is to reduce the consumption of saturated fat among the Danish population in order to decrease the prevalence of diet-related illnesses. The tax is part of a larger reform of the Danish tax system with the general aim of decreasing the income taxation pressure and financing it by, among other things, increased environmental and energy taxes, as well as increased ‘health’ taxes. Pre-tax simulations predict that the health tax on saturated fat will give rise to a reduction in the consumption of saturated fat of approximately 8%.
Article
There has been significant growth in political, public, media, and academic interest in taxes and subsidies to encourage healthy food consumption over the past 3 years. The present systematic review, including an assessment of study quality, was conducted on new evidence published between January 2009 and March 2012 for the effect of food taxes and subsidies on consumption. Forty-three reports representing 38 studies met the inclusion criteria. Two of these were prospective randomized controlled trials that showed price changes were effective in both grocery store purchasing (subsidy) and away-from-home food purchasing (tax) contexts. The most robust modeled studies (considering substitution) showed larger effects for taxes on noncore foods or beverages for which there are close untaxed substitutes (such as soft drinks or “unhealthy” foods, based on nutrient profiling). Taxes and subsidies are likely to be an effective intervention to improve consumption patterns associated with obesity and chronic disease, with evidence showing a consistent effect on consumption across a range of tax rates emerging. Future research should use prospective study methods to determine the effect of taxes on diets and focus on the effect of taxation in conjunction with other interventions as part of a multisectoral strategy to improve diets and health.
Article
This paper investigates the impact of sugar-sweetened beverages (SSB) taxes on consumption, bodyweight and tax burden for low-income, middle-income and high-income groups using an Almost Ideal Demand System and 2011 Household level scanner data. A significant contribution of our paper is that we compare two types of SSB taxes recently advocated by policy makers: A 20% flat rate sales (valoric) tax and a 20 cent/L volumetric tax. Censored demand is accounted for using a two-step procedure. We find that the volumetric tax would result in a greater per capita weight loss than the valoric tax (0.41 kg vs. 0.29 kg). The difference between the change in weight is substantial for the target group of heavy purchasers of SSBs in low-income households, with a weight reduction of up to 3.20 kg for the volumetric and 2.06 kg for the valoric tax. The average yearly per capita tax burden on low-income households is 17.87(0.2117.87 (0.21% of income) compared with 15.17 for high-income households (0.07% of income) for the valoric tax, and 13.80(0.1513.80 (0.15%) and 10.10 (0.04%) for the volumetric tax. Thus, the tax burden is lower, and weight reduction is higher under a volumetric tax. Copyright © 2014 John Wiley & Sons, Ltd.
Article
Increasing prevalence of overweight and obesity has led policy-makers to consider health-related taxes to limit the consumption of unhealthy foods and beverages. Such taxes are currently already in place in countries in Europe (e.g. Hungary, France and Finland) and in various states in the USA. Although these taxes are possibly efficient in reducing by a small amount the consumption of targeted products if the tax is fully transmitted to the consumer, there is too little available evidence on what will be consumed instead and whether these food substitutions undermine the hoped-for health benefits of the tax. We also know very little on how the food supply side will respond and what overall impact this will have. Without a proper appreciation of the potential indirect impacts we do not know the overall impact of taxes foods on unhealthy foods and beverages and further that there is a very real possibility that they may not be beneficial for health after all.