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加工肉类征税对预防人群健康的潜在影响有哪些?德国定量健康影响评估。

What are the potential preventive population-health effects of a tax on processed meat? A quantitative health impact assessment for Germany.

机构信息

Institute for Public Health and Nursing Research, Health Sciences Bremen, University of Bremen, Bibliothekstraße 1, 28359 Bremen, Germany; Research Group for Evidence-Based Public Health, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359 Bremen, Germany.

ife Institute of Food Economics, Science Park Kiel, Fraunhoferstraße 13, 24118 Kiel, Germany.

出版信息

Prev Med. 2019 Jan;118:325-331. doi: 10.1016/j.ypmed.2018.11.011. Epub 2018 Nov 20.

Abstract

The International Agency for Research on Cancer considers processed meat to be carcinogenic. Further, processed meat is associated with diabetes, ischemic heart disease (IHD) and all-cause mortality. We aimed to assess health gains of four processed meat taxation scenarios in comparison to the reference and a minimum-risk-exposure-scenario. To estimate the shift in processed meat intake following respective taxes, we calculated price elasticities for processed meat. DYNAMO-HIA was used to dynamically project policy-attributable differences in the prevalence of diseases and deaths. In projection year 10, an extra 9300 males and 4500 females would be alive under the lowest tax scenario (4% tax), compared to the reference scenario. Prevalent IHD, diabetes and colorectal cancer cases in males would be 8400, 9500 and 500 lower, respectively, and there would be 4600, 7800 and 300 less cases in females. Of the respective death and disease reduction that would be achieved under the minimum-risk-exposure-scenario, the lowest tax reaches 2.84% (colorectal cancer in males) to 6.02% (diabetes in females). Under the highest tax scenario (33.3% tax), an extra 76,700 males and 37,100 females would be alive, compared to the reference scenario. Prevalent IHD, diabetes and colorectal cancer cases would be 70,800, 77,900 and 4900 lower in males and 29,900, 48,900 and 2300 lower in females, which represents 27.84% (colorectal cancer in males) to 37.76% (diabetes in females) of the maximal preventable death and disease burden. Further research needs to examine to what extent these health benefits are outweighed by a simultaneous tax-induced decrease in fish intake.

摘要

国际癌症研究机构认为加工肉类具有致癌性。此外,加工肉类还与糖尿病、缺血性心脏病(IHD)和全因死亡率有关。我们旨在评估与参照方案和最低风险暴露方案相比,对四种加工肉类征税方案的健康收益。为了估计各自税收后加工肉类摄入量的变化,我们计算了加工肉类的价格弹性。使用 DYNAMO-HIA 动态预测疾病和死亡的政策归因差异。在第 10 年预测期内,与参照方案相比,最低税收方案(4%的税收)下会多 9300 名男性和 4500 名女性存活。男性中常见的 IHD、糖尿病和结直肠癌病例将分别减少 8400、9500 和 500 例,而女性中则分别减少 4600、7800 和 300 例。在最低风险暴露方案下实现的相应死亡和疾病减少中,最低税收方案达到了 2.84%(男性结直肠癌)至 6.02%(女性糖尿病)。在最高税收方案(33.3%的税收)下,与参照方案相比,会多 76700 名男性和 37100 名女性存活。男性中常见的 IHD、糖尿病和结直肠癌病例将分别减少 70800、77900 和 4900 例,女性中则分别减少 29900、48900 和 2300 例,分别占男性最大可预防死亡和疾病负担的 27.84%(男性结直肠癌)和 37.76%(女性糖尿病)。还需要进一步研究,以确定这些健康益处在多大程度上被同时因税收而导致的鱼类摄入量减少所抵消。

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