Assessing the impact on chronic disease of incorporating the societal cost of greenhouse gases into the price of food: an econometric and comparative risk assessment modelling study

Objectives To model the impact on chronic disease of a tax on UK food and drink that internalises the wider costs to society of greenhouse gas (GHG) emissions and to estimate the potential revenue. Design An econometric and comparative risk assessment modelling study. Setting The UK. Participants The UK adult population. Interventions Two tax scenarios are modelled: (A) a tax of £2.72/tonne carbon dioxide equivalents (tCO2e)/100 g product applied to all food and drink groups with above average GHG emissions. (B) As with scenario (A) but food groups with emissions below average are subsidised to create a tax neutral scenario. Outcome measures Primary outcomes are change in UK population mortality from chronic diseases following the implementation of each taxation strategy, the change in the UK GHG emissions and the predicted revenue. Secondary outcomes are the changes to the micronutrient composition of the UK diet. Results Scenario (A) results in 7770 (95% credible intervals 7150 to 8390) deaths averted and a reduction in GHG emissions of 18 683 (14 665to 22 889) ktCO2e/year. Estimated annual revenue is £2.02 (£1.98 to £2.06) billion. Scenario (B) results in 2685 (1966 to 3402) extra deaths and a reduction in GHG emissions of 15 228 (11 245to 19 492) ktCO2e/year. Conclusions Incorporating the societal cost of GHG into the price of foods could save 7770 lives in the UK each year, reduce food-related GHG emissions and generate substantial tax revenue. The revenue neutral scenario (B) demonstrates that sustainability and health goals are not always aligned. Future work should focus on investigating the health impact by population subgroup and on designing fiscal strategies to promote both sustainable and healthy diets

A health impact assessment of the UK soft drinks industry levy: a comparative risk assessment modelling study

Background In March, 2016, the UK government proposed a tiered levy on sugar-sweetened beverages (SSBs; high, moderate, and no tax for drinks with >8g, 5g to 8g, and <5g sugar per 100ml). We estimate the effect of possible industry responses to the levy on obesity, diabetes, and dental caries. Methods We modelled three possible industry responses: (1) reformulation to reduce sugar concentration, (2) increasing product price, and (3) changing the market share of high-, mid-, and low-sugar drinks. For each response, we defined a better and worse case health scenario. We developed a comparative risk assessment model to estimate the UK health impact of each scenario. Findings The best modelled scenario for health is SSB reformulation, resulting in 144,000 (95% uncertainty interval: 5,100 to 306,700) fewer adults and children with obesity in the UK, 19,000 (6,900 to 32,700) fewer incident cases of diabetes per year, and 269,000 (82,200 to 470,900) fewer decayed, missing, or filled teeth annually. Increasing the price of SSBs and changes to market share to increase the proportion of low-sugar drinks sold would also result in population health benefits, but to a lesser extent. The greatest benefit for obesity and oral health would be among individuals under 18 years, with people over 65 years experiencing the largest absolute decreases in diabetes incidence. Interpretation The health impact of the soft drink levy is dependent on its implementation by industry. There is uncertainty as to how industry will react and in the estimation of health outcomes. Health gains could be maximised by significant product reformulation with additional benefits possible if the levy is passed onto purchasers through raising the price of high- and mid-sugar drinks, and through activities to increase the market share of low-sugar products.RT and AK have previously done work on sugar-sweetened beverage taxes funded by the Union of European Soft Drinks Associations. MR is chair of Sustain and the Children's Food Campaign, which have campaigned for sugar drink taxes in the UK. MR is funded by the British Heart Foundation, grant number 006/PSS/CORE/2016/OXFORD. ADMB and OTM are members of the Faculty of Public Health, which has a position statement supporting sugary drink taxes. ADMB is funded by the Wellcome Trust, grant number 102730/Z/13/Z. OTM is a member of the UK Health Forum, which has also supported a UK sugar drinks tax. OTM is supported by a Wellcome Trust Clinical Doctoral Fellowship. SAJ was the independent Chair of the Department of Health Public Health Responsibility Deal Food Network from 2010 to 2015. SAJ is funded by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care Oxford. The views expressed are those of the authors and not necessarily those of the National Health Service, National Institute for Health Research, or the Department of Health. PS is funded by the British Heart Foundation, grant number FS/15/34/31656. TB is funded the Health Research Council of New Zealand (16/443). AE declares no competing interests

What are they thinking? Consumer attitudes to meat production in Australia

Meat production has come under increasing scrutiny from consumers and citizens who feel that certain practices are unethical and negatively affect farm-animal welfare. Animal welfare can be viewed as both a scientific and social concept, and purchasing products with animal welfare claims can be considered an act of ‘ethical consumption’. The present paper reviews research that examines consumer attitudes to animal welfare and highlights tensions between consumer and citizen attitudes and behaviours, and assumptions that are made within these studies. We present our own research into motivations to purchase free-range eggs as an example of research that attempts to unpack these assumptions, in particular, that such purchases are made out of concern for animal welfare. We present a further example of our own research that attempts to identify how attitudes to meat production are socially constructed. We conclude with recommended strategies to engage the broader community in discussions about animal production, so as to improve industry–community communication about farm-animal welfare in meat-production industries.H. J. Bray, E. A. Buddle and R. A. Anken

Simulating the impact on health of internalising the cost of carbon in food prices combined with a tax on sugar-sweetened beverages.

Rising greenhouse gas emissions (GHGEs) have implications for health and up to 30 % of emissions globally are thought to arise from agriculture. Synergies exist between diets low in GHGEs and health however some foods have the opposite relationship, such as sugar production being a relatively low source of GHGEs. In order to address this and to further characterise a healthy sustainable diet, we model the effect on UK non-communicable disease mortality and GHGEs of internalising the social cost of carbon into the price of food alongside a 20 % tax on sugar sweetened beverages (SSBs).Developing previously published work, we simulate four tax scenarios: (A) a GHGEs tax of £2.86/tonne of CO2 equivalents (tCO2e)/100 g product on all products with emissions greater than the mean across all food groups (0.36 kgCO2e/100 g); (B) scenario A but with subsidies on foods with emissions lower than 0.36 kgCO2e/100 g such that the effect is revenue neutral; (C) scenario A but with a 20 % sales tax on SSBs; (D) scenario B but with a 20 % sales tax on SSBs. An almost ideal demand system is used to estimate price elasticities and a comparative risk assessment model is used to estimate changes to non-communicable disease mortality.We estimate that scenario A would lead to 300 deaths delayed or averted, 18,900 ktCO2e fewer GHGEs, and £3.0 billion tax revenue; scenario B, 90 deaths delayed or averted and 17,100 ktCO2e fewer GHGEs; scenario C, 1,200 deaths delayed or averted, 18,500 ktCO2e fewer GHGEs, and £3.4 billion revenue; and scenario D, 2,000 deaths delayed or averted and 16,500 ktCO2e fewer GHGEs. Deaths averted are mainly due to increased fibre and reduced fat consumption; a SSB tax reduces SSB and sugar consumption.Incorporating the social cost of carbon into the price of food has the potential to improve health, reduce GHGEs, and raise revenue. The simple addition of a tax on SSBs can mitigate negative health consequences arising from sugar being low in GHGEs. Further conflicts remain, including increased consumption of unhealthy foods such as cakes and nutrients such as salt

Incorporating the societal cost of greenhouse gases into the price of foods could save lives from cardiovascular disease and cancer in England: a comparative risk assessment modelling study

Background Climate change has been described as ‘the biggest global health threat of the 21st century’. Taxation based on greenhouse gas (GHG) emissions is a potential mechanism for internalising the wider costs of climate change to society. We ask whether such a tax on UK food and drink would have a positive impact on climate change and UK population health, and what revenue it would raise. Methods and Findings The Living Costs and Food Survey (LCF) is used to derive baseline UK consumption data and food prices. Food specific GHG emissions are taken from a World Wildlife Fund report; cross- and own-price elasticities derived from LCF data are used to model changes in consumption following application of taxes. Health outcomes are modelled by a comparative risk assessment model. Two tax scenarios are modelled, where taxation levels are based on a UK governmental agriculture marginal abatement cost curve: (a) a tax of £2.72/tonne carbon dioxide equivalents (tCO2e)/100g product applied to all food and drink groups with above average emissions. (b) as with scenario (a) but food groups with emissions below average are subsidised to create a tax neutral scenario. Scenario (a) results in 6,750 (95% credible intervals: 6,150 to 7,350) deaths averted and a reduction in GHG emissions of 18,800 (14,700 to 23,000) ktCO2e per year. Annual revenue generated from this tax scenario is £2.03 (1.98 to 2.07) billion. Scenario (b) results in 3,720 (2,980 to 4,460) extra deaths and a reduction in GHG emissions of 16,100 (12,000 to 20,400) ktCO2¬e per year. Conclusions Incorporating the societal cost of greenhouse gases into the price of foods could save nearly 7,000 lives in the UK each year, reduce food-related GHG emissions, and generate substantial tax revenue. The revenue neutral scenario (b) demonstrates that sustainability and health goals are not always aligned

A health impact assessment of the UK soft drinks industry levy: a comparative risk assessment modelling study

Background In March, 2016, the UK government proposed a tiered levy on sugar-sweetened beverages (SSBs; high, moderate, and no tax for drinks with &gt;8g, 5g to 8g, and &lt;5g sugar per 100ml). We estimate the effect of possible industry responses to the levy on obesity, diabetes, and dental caries. Methods We modelled three possible industry responses: (1) reformulation to reduce sugar concentration, (2) increasing product price, and (3) changing the market share of high-, mid-, and low-sugar drinks. For each response, we defined a better and worse case health scenario. We developed a comparative risk assessment model to estimate the UK health impact of each scenario. Findings The best modelled scenario for health is SSB reformulation, resulting in 144,000 (95% uncertainty interval: 5,100 to 306,700) fewer adults and children with obesity in the UK, 19,000 (6,900 to 32,700) fewer incident cases of diabetes per year, and 269,000 (82,200 to 470,900) fewer decayed, missing, or filled teeth annually. Increasing the price of SSBs and changes to market share to increase the proportion of low-sugar drinks sold would also result in population health benefits, but to a lesser extent. The greatest benefit for obesity and oral health would be among individuals under 18 years, with people over 65 years experiencing the largest absolute decreases in diabetes incidence. Interpretation The health impact of the soft drink levy is dependent on its implementation by industry. There is uncertainty as to how industry will react and in the estimation of health outcomes. Health gains could be maximised by significant product reformulation with additional benefits possible if the levy is passed onto purchasers through raising the price of high- and mid-sugar drinks, and through activities to increase the market share of low-sugar products