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首页> 外文期刊>PLoS Medicine >Modelled health benefits of a sugar-sweetened beverage tax across different socioeconomic groups in Australia: A cost-effectiveness and equity analysis
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Modelled health benefits of a sugar-sweetened beverage tax across different socioeconomic groups in Australia: A cost-effectiveness and equity analysis

机译：澳大利亚不同社会经济群体的糖类饮料税的建模健康益处：成本效益和股权分析

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Background A sugar-sweetened beverage (SSB) tax in Mexico has been effective in reducing consumption of SSBs, with larger decreases for low-income households. The health and financial effects across socioeconomic groups are important considerations for policy-makers. From a societal perspective, we assessed the potential cost-effectiveness, health gains, and financial impacts by socioeconomic position (SEP) of a 20% SSB tax for Australia. Methods and findings Australia-specific price elasticities were used to predict decreases in SSB consumption for each Socio-Economic Indexes for Areas (SEIFA) quintile. Changes in body mass index (BMI) were based on SSB consumption, BMI from the Australian Health Survey 2011–12, and energy balance equations. Markov cohort models were used to estimate the health impact for the Australian population, taking into account obesity-related diseases. Health-adjusted life years (HALYs) gained, healthcare costs saved, and out-of-pocket costs were estimated for each SEIFA quintile. Loss of economic welfare was calculated as the amount of deadweight loss in excess of taxation revenue. A 20% SSB tax would lead to HALY gains of 175,300 (95% CI: 68,700; 277,800) and healthcare cost savings of AU$1,733 million (m) (95% CI: $650m; $2,744m) over the lifetime of the population, with 49.5% of the total health gains accruing to the 2 lowest quintiles. We estimated the increase in annual expenditure on SSBs to be AU$35.40/capita (0.54% of expenditure on food and non-alcoholic drinks) in the lowest SEIFA quintile, a difference of AU$3.80/capita (0.32%) compared to the highest quintile. Annual tax revenue was estimated at AU$642.9m (95% CI: $348.2m; $1,117.2m). The main limitations of this study, as with all simulation models, is that the results represent only the best estimate of a potential effect in the absence of stronger direct evidence. Conclusions This study demonstrates that from a 20% tax on SSBs, the most HALYs gained and healthcare costs saved would accrue to the most disadvantaged quintiles in Australia. Whilst those in more disadvantaged areas would pay more SSB tax, the difference between areas is small. The equity of the tax could be further improved if the tax revenue were used to fund initiatives benefiting those with greater disadvantage.
机译：背景技术墨西哥的糖甜味饮料（SSB）税收已经有效地减少了SSB的消费，低收入家庭减少了较大的减少。社会经济群体的健康和财务影响是政策制定者的重要考虑因素。从社会角度来看，我们评估了澳大利亚20％SSB税的社会经济地位（SEP）的潜在成本效益，健康收益和财务影响。方法和调查结果澳大利亚特定的价格弹性被用来预测SSB消费量减少，为各种社会经济指标（SEIFA）五分之一。体重指数（BMI）的变化是基于SSB消费，来自澳大利亚卫生调查2011-12的BMI和能量平衡方程。 Markov Cohort模型用于估计澳大利亚人口的健康影响，同时考虑到肥胖有关的疾病。每个SeiFa五分都估计，挽救了健康的生命年份（哈利人），保健费用，保健成本和拆销费用。经济福利损失计算为超额税收收入的重量亏损量。 20％的SSB税将导致175,300美元（95％CI：68,700; 277,800）和保健成本节约在人口的一生中，保健费用为1,733百万美元（M）（95％CI：$ 650米; $ 2,744M）， 49.5％的卫生总收益累计到2个最低码。我们估计，在最低的Seifa五分之度，SSBS的年度支出增加了35.40美元/人均（食品和非酒精饮料的0.54％），与最高季度相比，AU $ 3.80 / Cabita（0.32％）的差异。年度税收收入估计为6429万美元（95％CI：34820万美元; 1,117.2米）。与所有仿真模型一样，本研究的主要局限性是，结果仅代表在没有更强大的直接证据的情况下对潜在效果的最佳估计。结论本研究表明，从SSBS的20％税收，获得的最大哈利和医疗费用挽救了澳大利亚最不利多的昆虫。虽然那些更弱势地区的人会支付更多的SSB税，但区域之间的差异很小。如果税收收入用于资助受益于更大劣势的举措，税收的公平可以进一步提高。

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