1Department of Health Management and Policy,Dornsife School of Public Health,Drexel University,Room 356 Nesbitt Hall,3215 Market Street,Philadelphia,PA 19104,USA.
2Department of Epidemiology and Biostatistics,Dornsife School of Public Health,Drexel University,Philadelphia,PA,USA.
Public Health Nutr. 2017 Sep;20(13):2450-2458. doi: 10.1017/S1368980017001756. Epub 2017 Aug 4.
Philadelphia passed a 1·5-cent-per-ounce sweetened beverage tax (SBT). Revenue will fund 10 000 quality pre-kindergarten slots for poor children. It is imperative to understand how revenue from SBT can be used to fund programmes to address education and other social determinants of health. The objective of the present study was to simulate quality pre-kindergarten attendance, educational achievement and sugar-sweetened beverage (SSB) consumption among Philadelphia children and adolescents under six intervention scenarios: (i) no intervention; (ii) 10 000 additional quality pre-kindergarten slots; (iii) a 1·5-cent-per-ounce SBT; (iv) expanded pre-kindergarten and 1·5-cent-per-ounce SBT; (v) a 3-cent-per-ounce SBT; and (vi) expanded pre-kindergarten and 3-cent-per-ounce SBT.
We used an agent-based model to estimate pre-kindergarten enrolment, educational achievement and SSB consumption under the six policy scenarios. We identified key parameters in the model from the published literature and secondary analyses of the Panel Study of Income Dynamics - Child Development Supplement.
Philadelphia, Pennsylvania, USA.
Philadelphia children and adolescents aged 4-18 years.
A 1·5-cents-per-ounce tax would reduce SSB consumption by 1·3 drinks/week among Philadelphia children and adolescents relative to no intervention, with larger effects among children below the poverty level. Quality pre-kindergarten expansion magnifies the effect of the SBT by 8 %, but has the largest effect on moderate-income children just above the poverty level. The SBT and quality pre-kindergarten programme each reduce SSB consumption, but primarily benefit different children and adolescents.
Pairing an excise tax with a complementary programme to improve a social determinant of health represents a progressive strategy to combat obesity, a disease regressive in its social patterning.
费城通过了一项每盎司 1.5 美分的含糖饮料税（SBT）。税收将为贫困儿童提供 10000 个优质学前教育名额。了解 SBT 的收入如何用于资助解决教育和其他健康社会决定因素的方案是当务之急。本研究的目的是模拟费城 6 岁以下儿童和青少年的优质学前教育出勤率、教育成就和含糖饮料（SSB）消费，共分为六种干预情景：（i）无干预；（ii）增加 10000 个优质学前教育名额；（iii）每盎司 1.5 美分的 SBT；（iv）扩大学前教育和每盎司 1.5 美分的 SBT；（v）每盎司 3 美分的 SBT；以及（vi）扩大学前教育和每盎司 3 美分的 SBT。
我们使用基于代理的模型来估计六种政策情景下的学前教育入学率、教育成就和 SSB 消费。我们从已发表的文献和收入动态儿童发展补充面板研究的二次分析中确定了模型中的关键参数。
美国宾夕法尼亚州费城。
4-18 岁的费城儿童和青少年。
与无干预相比，每盎司 1.5 美分的税收将使费城儿童和青少年的 SSB 消费减少 1.3 份/周，而贫困线下的儿童的影响更大。优质学前教育的扩大使 SBT 的效果增加了 8%，但对刚好高于贫困线的中等收入儿童的影响最大。SBT 和优质学前教育计划都减少了 SSB 的消费，但主要惠及不同的儿童和青少年。
将消费税与改善健康社会决定因素的补充方案相结合，代表了一种对抗肥胖这一疾病的倒退性社会模式的进步策略。
