PDF(Pubmed)
Abstract：
Low fruit and vegetable (FV) intake and high sugar-sweetened beverage (SSB) consumption are independently associated with an increased risk of developing cardiovascular disease (CVD). Many people in New York City (NYC) have low FV intake and high SSB consumption, partly due to high cost of fresh FVs and low cost of and easy access to SSBs. A potential implementation of an SSB tax and an FV subsidy program could result in substantial public health and economic benefits. We used a validated microsimulation model for predicting CVD events to estimate the health impact and cost-effectiveness of SSB taxes, FV subsidies, and funding FV subsidies with an SSB tax in NYC. Population demographics and health profiles were estimated using data from the NYC Health and Nutrition Examination Survey. Policy effects and price elasticity were derived from recent meta-analyses. We found that funding FV subsidies with an SSB tax was projected to be the most cost-effective policy from the healthcare sector perspective. From the societal perspective, the most cost-effective policy was SSB taxes. All policy scenarios could prevent more CVD events and save more healthcare costs among men compared to women, and among Black vs. White adults. Public health practitioners and policymakers may want to consider adopting this combination of policy actions, while weighing feasibility considerations and other unintended consequences.
摘要：
低水果和蔬菜（FV）摄入量和高糖饮料（SSB）消费与患心血管疾病（CVD）的风险增加独立相关。纽约市（NYC）的许多人FV摄入量低，SSB消费量高，部分原因是新鲜FV的成本高，SSB的成本低，易于使用。SSB税和FV补贴计划的潜在实施可能会带来巨大的公共卫生和经济利益。我们使用经过验证的微观模拟模型来预测CVD事件，以估计SSB税的健康影响和成本效益。FV补贴，并在纽约市征收SSB税，为FV补贴提供资金。使用纽约市健康与营养调查的数据估算了人口统计和健康状况。政策效应和价格弹性来自最近的荟萃分析。我们发现，从医疗保健行业的角度来看，用SSB税资助FV补贴预计是最具成本效益的政策。从社会的角度来看,最具成本效益的政策是SSB税。与女性相比，所有政策方案都可以预防更多的CVD事件，并节省更多的男性医疗费用。在黑色与白人成年人公共卫生从业者和政策制定者可能希望考虑采取这种政策行动的组合，同时权衡可行性考虑和其他意外后果。
