Evaluating the influence of a beverage tax on health outcomes

评估饮料税对健康结果的影响

• 批准号: 10121403
• 负责人: Laura Gibson
• 金额: $ 56.29万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-22 至 2023-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10121403
• 关键词: Accounting; Address; Adolescent; Adult; Baltimore; Behavioral; Beverages; Body mass index; Child; Chronic Disease; Cities; Consumption; Control Groups; County; Data; Dental; Dental Hygiene; Dental Records; Dental caries; Diet; Diet Habits; Dietary Intervention; Electronic Health Record; Evaluation; Food; Goals; Health; Heart Diseases; Individual; Intake; Intervention; Lead; Link; Liquid substance; Location; Long-Term Effects; Longitudinal cohort; Low income; Methods; Natural experiment; Needles; Non-Insulin-Dependent Diabetes Mellitus; Nutritional; Obesity; Oral health; Outcome; Philadelphia; Policies; Research; Risk; Risk Factors; Sales; Source; Study models; Subgroup; Surface; Taxes; Testing; Time; Translating; Weight Gain; Work; Youth; base; cost effective; design; effectiveness evaluation; health record; improved; interest; nutrition; population health; prevent; sugar; sweetened beverage; young adult

PROJECT SUMMARY There is considerable interest in policies to reduce sugar-sweetened beverage (SSB) intake. On January 1, 2017 Philadelphia became the second U.S. city and the largest to date to implement a sweetened beverage excise tax of 1.5 cents per fluid ounce on both SSBs and diet drinks. There is compelling evidence that beverage excise taxes can lead to large reductions in purchases of SSBs, but there is a critical need to understand whether this translates into improvements in health outcomes. Without this evidence, we will not know if SSB taxes are an effective method of preventing and reducing obesity, its associated chronic diseases, and dental caries. The overall objectives of this application are to determine the long-term influence of the Philadelphia beverage tax on adult and youth weight gain, type 2 diabetes status, and oral health. The rationale for this proposal is based on strong behavioral data that the Philadelphia sweetened beverage tax decreased SSB purchases and modeling studies that suggest such taxes will lead to improved health outcomes, including reductions in obesity, type 2 diabetes, and dental caries, especially for subgroups of at- risk children and adults. Therefore, our central hypothesis is that the Philadelphia tax on SSBs and diet drinks will be associated with less weight gain and fewer dental caries over time among adults and youth in Philadelphia compared to control locations. Our specific aims are to evaluate the effectiveness of an SSB tax on preventing weight gain among youth (Aim 1) and adults (Aim 2) by analyzing electronic health record data using a natural experiment design. To accomplish these aims, we will use electronic health record data to compare changes in BMI z- scores over time among a longitudinal cohort of 43,589 children and adolescents in Philadelphia and 117,850 youth in the untaxed neighboring counties (control group) 3-5 years after tax. We will also examine change in BMI for a longitudinal cohort of 108,862 adults in Philadelphia and 185,360 adults in the untaxed, surrounding counties (control group) 3-5 years post-tax. These aims address important unanswered questions about the impact of the beverage tax on BMI, a major predictor of lifelong chronic disease. Our third aim is to evaluate the effectiveness of an SSB tax on improving oral health among youth and adults in Philadelphia by analyzing electronic oral health records using a natural experiment design. To accomplish this aim, we will examine dental records on 5,189 adults and 1,462 youth in Philadelphia and 3,554 adults and 1,003 youth in untaxed, surrounding counties (control group). If there is a relationship between the tax and oral health improvements, this would be the first study finding an association between a dietary intervention and improved oral health. This study will deliver vitally important information on the effects of one of the most significant policies to address poor dietary habits. By evaluating the effectiveness of Philadelphia’s tax on improving population health, this work will offer key information to other places considering taxes to improve health.

项目概要 1 月 1 日，人们对减少含糖饮料 (SSB) 摄入量的政策非常感兴趣。 2017 年费城成为美国第二个、也是迄今为止最大的实施含糖饮料的城市 对 SSB 和减肥饮料征收每盎司 1.5 美分的消费税 有令人信服的证据表明。 饮料消费税可以导致 SSB 采购量大幅减少，但迫切需要 如果没有这些证据，这是否会转化为健康结果的改善。 了解 SSB 税是否是预防和减少肥胖及其相关慢性疾病的有效方法， 该应用的总体目标是确定牙齿的长期影响。 费城针对成人和青少年体重增加、2 型糖尿病状况和口腔健康征收饮料税。 该提案的理由基于费城加糖饮料税的强有力的行为数据 SSB 购买量减少，模型研究表明此类税收将改善健康状况 成果，包括减少肥胖、2 型糖尿病和龋齿，特别是对于以下亚组： 因此，我们的中心假设是费城对 SSB 和减肥饮料征税。 随着时间的推移，将与成年人和青少年的体重增加减少和龋齿减少有关 费城与控制地点的比较我们的具体目标是评估 SSB 税的有效性。 通过分析电子健康记录数据来预防青少年（目标 1）和成人（目标 2）体重增加 为了实现这些目标，我们将使用电子健康记录数据来实现。 比较 43,589 名儿童和青少年的纵向队列中 BMI z 分数随时间的变化 费城和邻近未纳税县的 117,850 名青少年（对照组）税后 3-5 年。 还将检查费城 108,862 名成年人和 185,360 名成年人的纵向队列的 BMI 变化 在未纳税的周边县（对照组），税后 3-5 年这些目标解决了重要问题。 关于饮料税对体重指数（终生慢性病的主要预测因素）影响的尚未解答的问题 我们的第三个目标是评估 SSB 税对改善青少年口腔健康的有效性。 费城的成年人通过使用自然实验设计分析电子口腔健康记录。 为了实现这一目标，我们将检查费城 5,189 名成年人和 1,462 名青少年以及 3,554 名青少年的牙科记录 周围未纳税县的成年人和 1,003 名青少年（对照组）。 税收和口腔健康改善之间的关系，这将是第一项发现饮食之间存在关联的研究 这项研究将提供有关其中一种影响的极其重要的信息。 通过评估费城的有效性，找出解决不良饮食习惯的最重要政策。 关于改善人口健康的税收，这项工作将为其他考虑税收的地方提供关键信息 改善健康。