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

The Lancet Public Health Volume 5, ISSUE 7, e404-e413, July 01, 2020

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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.
Methods
In 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 in HALYs 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.

Population-based estimates of healthy working life expectancy in England at age 50 years: analysis of data from the English Longitudinal Study of Ageing

The Lancet Public Health Volume 5, ISSUE 7, e395-e403, July 01, 2020

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Background
Retirement ages are rising in many countries to offset the challenges of population ageing, but people’s capacity to work for more years in their later working life (>50 years) is unclear. We aimed to estimate healthy working life expectancy in England.
Methods
This analysis included adults aged 50 years and older from six waves (2002–13) of the English Longitudinal Study of Ageing (ELSA), with linked mortality data. Healthy working life expectancy was defined as the average number of years expected to be spent healthy (no limiting long-standing illness) and in paid work (employment or self-employment) from age 50 years. Healthy working life expectancy was estimated for England overall and stratified by sex, educational attainment, deprivation level, occupation type, and region by use of interpolated Markov chain multi-state modelling.
Findings
There were 15 284 respondents (7025 men and 8259 women) with survey and mortality data for the study period. Healthy working life expectancy at age 50 years was on average 9·42 years (10·94 years [95% CI 10·65–11·23] for men and 8·25 years [7·92–8·58] for women) and life expectancy was 31·76 years (30·05 years for men and 33·49 years for women). The number of years expected to be spent unhealthy and in work from age 50 years was 1·84 years (95% CI 1·74–1·94) in England overall. Population subgroups with the longest healthy working life expectancy were the self-employed (11·76 years [95% CI 10·76–12·76]) or those with non-manual occupations (10·32 years [9·95–10·69]), those with a tertiary education (11·27 years [10·74–11·80]), those living in southern England (10·73 years [10·16–11·30] in the South East and 10·51 years [9·80–11·22] in the South West), and those living in the least deprived areas (10·53 years [10·06–10·99]).
Interpretation
Healthy working life expectancy at age 50 years in England is below the remaining years to State Pension age. Older workers of lower socioeconomic status and in particular regions in England might benefit from proactive approaches to improve health, workplace environments, and job opportunities to improve their healthy working life expectancy. Continued monitoring of healthy working life expectancy would provide further examination of the success of such approaches and that of policies to extend working lives.

Database of public health guidance on COVID-19

By Health Information and Quality Authority (2020)

To inform the ongoing response to the COVID-19 pandemic, specifically, to inform the development of public health guidance to prevent the spread of COVID-19, we have created a database of COVID-19 public health guidance produced by international organisations.

This database is updated daily, and is primarily for the use of relevant stakeholders in the Health Protection Surveillance Centre, the National Public Health Emergency Team, the Department of Health, and Health Service Executive.

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Finding the evidence: Coronavirus

By Public Health England (2020)

We are delighted to announce the launch of the COVID-19 Register of PHE led studies. It includes Public Health England led studies relating to COVID-19, that have taken place since February 2020. The register will be updated every two months, and can be accessed via our re-vamped Finding the evidence: Coronavirus page – 4th heading down

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Covid-19 and the nation’s mental health Forecasting needs and risks in the UK: May 2020

By The Centre for Mental Health (2020)

This briefing seeks to use evidence from existing research about the likely impact of the Covid-19 pandemic on the mental health of the UK population. It draws on published evidence to make projections about the potential impacts and which groups within the population face the highest risks to their mental health as a result of the crisis.

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COVID-19 & Mindfulness: Resources for health and care staff

By The Mindfulness Initiative (2020)

A curated list of free mindfulness resources for health and care workers to support them through a time of crisis.

Click here to view these resources

Global research on coronavirus disease (COVID-19)

By WHO

WHO is gathering the latest international multilingual scientific findings and knowledge on COVID-19. The global literature cited in the WHO COVID-19 database is updated daily (Monday through Friday) from searches of bibliographic databases, hand searching, and the addition of other expert-referred scientific articles. This database represents a comprehensive multilingual source of current literature on the topic. While it may not be exhaustive, new research is added regularly.

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COVID-19 Current Awareness

By Knowledge for Healthcare (2020)

COVID-19 Current Awareness

Epidemiology for Practitioners – free e-learning

By Public Health Action Support Team (2020)

Welcome to our course on epidemiology for practitioners. You will learn about basic concepts of measures of disease burden, of association and causation, and of bias and confounding, and will be introduced to epidemiological study designs, along with their application, strengths, and limitations.

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Finding the evidence: Coronavirus

The PHE Knowledge and Library Services Team (KLS) has produced this page to help those, working on the current coronavirus outbreak, embed evidence-informed decision-making in their daily practice.
The page signposts to a range of open access resources that have been promoted by different groups including National Library of Medicine Disaster Information Management Research Center, Erasmus MC, Cambridge University, Bedford Veterans Affairs Medical Center, Evidence Aid, Icahn School of Medicine at Mount Sinai.

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