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IJE Advance Access published online on May 29, 2009

International Journal of Epidemiology, doi:10.1093/ije/dyp214
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Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2009; all rights reserved.

Modelling income group differences in the health and economic impacts of targeted food taxes and subsidies

Kelechi E Nnoaham1,*, Gary Sacks2, Mike Rayner1, Oliver Mytton1 and Alastair Gray3

1British Heart Foundation Health Promotion Research Group, Department of Public Health, University of Oxford, Oxford, UK.
2School of Exercise and Nutrition Sciences, Deakin University, Burwood, Australia.
3Health Economics Research Centre, University of Oxford, Oxford, UK.

* Corresponding author. Specialist Registrar and Research Associate, Department of Public Health, University of Oxford, Old Road Campus, Headington, Oxford OX3 7LF, UK. E-mail: kcnnoaham{at}yahoo.com


   Abstract

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.

Keywords Junk-food tax, chronic disease prevention, fiscal policy

Accepted 21 April 2009


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