TY - JOUR
T1 - Reductions in national cardiometabolic mortality achievable by food price changes according to Supplemental Nutrition Assistance Program (SNAP) eligibility and participation
AU - Wilde, Parke Edward
AU - Conrad, Zach
AU - Rehm, Colin D.
AU - Pomeranz, Jennifer L.
AU - Penalvo, Jose L.
AU - Cudhea, Frederick
AU - Pearson-Stuttard, Jonathan
AU - O'Flaherty, Martin
AU - Micha, Renata
AU - Mozaffarian, Dariush
N1 - Funding Information:
Funding This research was supported by the NIH, NHLBI (R01 HL130735, PI Micha; R01 HL115189, PI Mozaffarian).
Funding Information:
Competing interests DM reports personal fees from Haas Avocado Board, Pollock Communications, Life Sciences Research Organization, Boston Heart Diagnostics, GOED, DSM, Unilever North American and UpToDate. RM reports research funding from Unilever and personal fees from the World Bank and Bunge, all outside the submitted work. JLPe now is employed by Merck KGaA. For all other authors: none declared.
Publisher Copyright:
© 2018 Article author(s).
PY - 2018/9/1
Y1 - 2018/9/1
N2 - Background Suboptimal diets are a major contributor to cardiometabolic disease (CMD) mortality, and substantial disparities exist for both dietary quality and mortality risk across income groups in the USA. Research is needed to quantify how food pricing policies to subsidise healthy foods and tax unhealthy foods could affect the US CMD mortality, overall and by Supplemental Nutrition Assistance Program (SNAP) eligibility and participation. Methods Comparative risk analysis based on national data on diet (National Health and Nutrition Examination Survey, 2003-2012) and mortality (mortality-linked National Health Interview Survey) and meta-analyses of policy-diet and diet-disease relationships. Results A national 10% price reduction on fruits, vegetables, nuts and whole grains was estimated to prevent 19 600 CMD deaths/year, including 2.6% (95% UI 2.4% to 2.8%) of all CMD deaths among SNAP participants, 2.7% (95% UI 2.4% to 3.0%) among SNAP-eligible non-participants and 2.6% (95% UI 2.4% to 2.8%) among SNAP-ineligible non-participants. Adding a national 10% tax on sugar-sweetened beverages (SSBs) and processed meats would prevent a total of 33 700 CMD deaths/year, including 5.9% (95% UI 5.4% to 7.4%) of all CMD deaths among SNAP participants, 4.8% (95% UI 4.4% to 5.2%) among SNAP-eligible non-participants and 4.1% (95% UI 3.8% to 4.5%) among SNAP-ineligible non-participants. Adding a SNAP-targeted 30% subsidy for the same healthy foods would offer the largest reductions in both CMD mortality and disparities. Conclusion National subsidies for healthy foods and taxes on SSBs and processed meats would each reduce CMD mortality; taxes would also reduce CMD mortality more steeply for SNAP participants than for non-participants.
AB - Background Suboptimal diets are a major contributor to cardiometabolic disease (CMD) mortality, and substantial disparities exist for both dietary quality and mortality risk across income groups in the USA. Research is needed to quantify how food pricing policies to subsidise healthy foods and tax unhealthy foods could affect the US CMD mortality, overall and by Supplemental Nutrition Assistance Program (SNAP) eligibility and participation. Methods Comparative risk analysis based on national data on diet (National Health and Nutrition Examination Survey, 2003-2012) and mortality (mortality-linked National Health Interview Survey) and meta-analyses of policy-diet and diet-disease relationships. Results A national 10% price reduction on fruits, vegetables, nuts and whole grains was estimated to prevent 19 600 CMD deaths/year, including 2.6% (95% UI 2.4% to 2.8%) of all CMD deaths among SNAP participants, 2.7% (95% UI 2.4% to 3.0%) among SNAP-eligible non-participants and 2.6% (95% UI 2.4% to 2.8%) among SNAP-ineligible non-participants. Adding a national 10% tax on sugar-sweetened beverages (SSBs) and processed meats would prevent a total of 33 700 CMD deaths/year, including 5.9% (95% UI 5.4% to 7.4%) of all CMD deaths among SNAP participants, 4.8% (95% UI 4.4% to 5.2%) among SNAP-eligible non-participants and 4.1% (95% UI 3.8% to 4.5%) among SNAP-ineligible non-participants. Adding a SNAP-targeted 30% subsidy for the same healthy foods would offer the largest reductions in both CMD mortality and disparities. Conclusion National subsidies for healthy foods and taxes on SSBs and processed meats would each reduce CMD mortality; taxes would also reduce CMD mortality more steeply for SNAP participants than for non-participants.
KW - cardiovascular disease
KW - cost effective
KW - modelling
KW - nutrition
KW - poverty
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U2 - 10.1136/jech-2017-210381
DO - 10.1136/jech-2017-210381
M3 - Article
C2 - 29748418
AN - SCOPUS:85047997222
SN - 0143-005X
VL - 72
SP - 817
EP - 824
JO - Journal of Epidemiology and Community Health
JF - Journal of Epidemiology and Community Health
IS - 9
ER -