■加糖饮料税与减少购买征税饮料有关。然而,很少有研究评估甜味饮料税与健康结果之间的关联.
■评估西雅图加糖饮料税与儿童体重指数(BMI)变化之间的关联。
■在这项纵向队列研究中,人体测量数据来自2个医疗保健系统(KaiserPermanenteWashington[KP]和西雅图儿童医院敖德萨布朗儿童医院[OBCC])的电子病历.如果儿童年龄在2至18岁(2014年1月1日至2019年12月31日),则将其纳入研究;在2015年至2019年之间,每年至少进行一次体重测量;居住在西雅图或周围3个县的城市地区(King,皮尔斯,和Snohomish);没有在征税地区(西雅图)和非征税地区之间移动;接受KP或OBCC的初级卫生保健;没有最近的癌症史,减肥手术,或怀孕;并且具有生物学上合理的身高和BMI(以千克为单位的体重除以以米为单位的身高的平方计算)。数据分析于2022年8月5日至2024年3月4日进行。
■西雅图加糖饮料税(加糖饮料每盎司1.75美分),于2018年1月1日实施。
■主要结果是年龄和性别参考人群的BMIp95(BMI表示为第95百分位数的百分比;评估BMI变化的新建议指标),使用疾病控制和预防中心的增长图表。在使用的主要(综合差异[SDID])模型中,在西雅图的6313名儿童中,通过对比较样本进行重新加权,以优化与税前结局趋势的匹配,从而创建比较样本.次要模型是人内变化模型,对22779名儿童使用1个税前测量和1个税后测量,并进行精细的分层权重以平衡基线个人和邻里水平的混杂因素。
■主要的SDID分析包括6313名儿童(3041名女性[48%]和3272名男性[52%])。超过三分之一的儿童(2383[38%])年龄在2至5岁之间);他们的平均(SE)年龄为7.7(0.6)岁。关于种族和族裔,789名儿童(13%)是亚洲人,631(10%)为黑色,649(10%)是西班牙裔,3158(50%)是白人。主要模型结果表明,与居住在比较地区的儿童相比,居住在西雅图的儿童的BMIp95下降幅度更大(SDID:-0.90个百分点[95%CI,-1.20至-0.60];P<.001)。二级模型的结果相似。
■这项队列研究的结果表明,与居住在西雅图的儿童相比,西雅图加糖饮料税与BMIp95的适度下降有关居住在附近的非税收地区的儿童在相同的医疗保健系统中接受护理。结合美国现有的研究,这些结果表明,加糖饮料税可能是改善儿童BMI的有效政策。未来的研究应该使用美国其他城市加糖饮料税的纵向数据来测试这种关联。
UNASSIGNED: Sweetened beverage
taxes have been associated with reduced purchasing of taxed beverages. However, few studies have assessed the association between sweetened beverage
taxes and health outcomes.
UNASSIGNED: To evaluate the association between the Seattle sweetened beverage tax and change in body mass index (BMI) among children.
UNASSIGNED: In this longitudinal cohort study, anthropometric data were obtained from electronic medical records of 2 health care systems (Kaiser Permanente Washington [KP] and Seattle Children\'s Hospital Odessa Brown Children\'s Clinic [OBCC]). Children were included in the study if they were aged 2 to 18 years (between January 1, 2014, and December 31, 2019); had at least 1 weight measurement every year between 2015 and 2019; lived in Seattle or in urban areas of 3 surrounding counties (King, Pierce, and Snohomish); had not moved between taxed (Seattle) and nontaxed areas; received primary health care from KP or OBCC; did not have a recent history of cancer, bariatric surgery, or pregnancy; and had biologically plausible height and BMI (calculated as weight in kilograms divided by height in meters squared). Data analysis was conducted between August 5, 2022, and March 4, 2024.
UNASSIGNED: Seattle sweetened beverage tax (1.75 cents per ounce on sweetened beverages), implemented on January 1, 2018.
UNASSIGNED: The primary outcome was BMIp95 (BMI expressed as a percentage of the 95th percentile; a newly recommended metric for assessing BMI change) of the reference population for age and sex, using the Centers for Disease Control and Prevention growth charts. In the primary (synthetic difference-in-differences [SDID]) model used, a comparison sample was created by reweighting the comparison sample to optimize on matching to pretax trends in outcome among 6313 children in Seattle. Secondary models were within-person change models using 1 pretax measurement and 1 posttax measurement in 22 779 children and fine stratification weights to balance baseline individual and neighborhood-level confounders.
UNASSIGNED: The primary SDID analysis included 6313 children (3041 female [48%] and 3272 male [52%]). More than a third of children (2383 [38%]) were aged 2 to 5 years); their mean (SE) age was 7.7 (0.6) years. With regard to race and ethnicity, 789 children (13%) were Asian, 631 (10%) were Black, 649 (10%) were Hispanic, and 3158 (50%) were White. The primary model results suggested that the Seattle tax was associated with a larger decrease in BMIp95 for children living in Seattle compared with those living in the comparison area (SDID: -0.90 percentage points [95% CI, -1.20 to -0.60]; P < .001). Results from secondary models were similar.
UNASSIGNED: The findings of this cohort study suggest that the Seattle sweetened beverage tax was associated with a modest decrease in BMIp95 among children living in Seattle compared with children living in nearby nontaxed areas who were receiving care within the same health care systems. Taken together with existing studies in the US, these results suggest that sweetened beverage
taxes may be an effective policy for improving children\'s BMI. Future research should test this association using longitudinal data in other US cities with sweetened beverage
taxes.