Powell Lisa M, Chaloupka Frank J
Institute for Health Research and Policy and Department of Economics, University of Illinois at Chicago, 1747 West Roosevelt, Chicago, IL 60608, USA.
Milbank Q. 2009 Mar;87(1):229-57. doi: 10.1111/j.1468-0009.2009.00554.x.
Pricing policies have been posited as potential policy instruments to address the increasing prevalence of obesity. This article examines whether altering the cost of unhealthy, energy-dense foods, compared with healthy, less-dense foods through the use of fiscal pricing (tax or subsidy) policy instruments would, in fact, change food consumption patterns and overall diet enough to significantly reduce individuals' weight outcomes.
This article examined empirical evidence regarding the food and restaurant price sensitivity of weight outcomes based on a literature search to identify peer-reviewed English-language articles published between 1990 and 2008. Studies were identified from the Medline, PubMed, Econlit, and PAIS databases. The fifteen search combinations used the terms obesity, body mass index, and BMI each in combination with the terms price, prices, tax, taxation, and subsidy.
The studies reviewed showed that when statistically significant associations were found between food and restaurant prices (taxes) and weight outcomes, the effects were generally small in magnitude, although in some cases they were larger for low-socioeconomic status (SES) populations and for those at risk for overweight or obesity.
The limited existing evidence suggests that small taxes or subsidies are not likely to produce significant changes in BMI or obesity prevalence but that nontrivial pricing interventions may have some measurable effects on Americans' weight outcomes, particularly for children and adolescents, low-SES populations, and those most at risk for overweight. Additional research is needed to be able to draw strong policy conclusions regarding the effectiveness of fiscal-pricing interventions aimed at reducing obesity.
定价政策已被视为应对肥胖率不断上升的潜在政策工具。本文探讨通过财政定价(税收或补贴)政策工具改变不健康、能量密集型食品与健康、低能量密度食品的成本,是否真的会改变食品消费模式和总体饮食,从而显著降低个人体重。
本文基于文献检索,研究了有关体重结果的食品和餐厅价格敏感性的实证证据,以识别1990年至2008年期间发表的经同行评审的英文文章。研究从医学文献数据库(Medline)、医学期刊数据库(PubMed)、经济文献数据库(Econlit)和公共事务信息服务数据库(PAIS)中获取。15种搜索组合分别将术语“肥胖”“体重指数”和“BMI”与“价格”“价格”“税收”“征税”和“补贴”相结合。
所审查的研究表明,当在食品和餐厅价格(税收)与体重结果之间发现具有统计学意义的关联时,其影响通常较小,尽管在某些情况下,对低社会经济地位(SES)人群以及超重或肥胖风险人群的影响较大。
现有的有限证据表明,小额税收或补贴不太可能使BMI或肥胖患病率产生显著变化,但重要的定价干预措施可能会对美国人的体重结果产生一些可衡量的影响,特别是对儿童和青少年、低SES人群以及超重风险最高的人群。需要进行更多研究,以便就旨在减少肥胖的财政定价干预措施的有效性得出有力的政策结论。