Center for Research on Nutrition and Health, Instituto Nacional de Salud Pública, Cuernavaca, Mexico.
Center for Health Systems Research, Instituto Nacional de Salud Pública, Cuernavaca, Mexico.
Caries Res. 2021;55(3):183-192. doi: 10.1159/000515223. Epub 2021 Apr 14.
In January 2014, taxes on sugar-sweetened beverages and nonessential energy-dense food were implemented in Mexico to discourage the consumption of these products. Published evaluations have shown reductions in purchases of taxed food and beverages associated with the implementation of this fiscal policy. Although there are some studies on the impact on health based on simulation studies, no evaluations with empirical data on changes in oral health have been published. We used administrative records and data from an epidemiological surveillance system to estimate changes in (1) outpatient visits related to dental caries; (2) having experienced dental caries: Decayed, Missing and Filled Teeth (DMFT) >0 for permanent dentition or dmft >0 for primary dentition (dmft); (3) number of teeth with caries experience (DMFT and dmft), (4) cases with DMFT >0 or dmft >0, and (5) the series of mean DMFT or dmft, associated with the taxes. We estimated probit and negative binomial models for outcomes at individual level, and interrupted time series analysis for population-level outcomes. The implementation of the taxes was associated with negative changes in the trends of outpatient visits, as well as for cases with DMFT >0, dmft >0 and mean DMFT. Taxes were also associated with a lower probability of having experienced dental caries and with a lower number of teeth with caries experience in the samples studied. Our results suggest positive impacts of the implementation of taxes on unhealthy food and beverages in the oral health of Mexicans, which are the first health benefits observed, and add to the health benefits predicted by modeling studies.
2014 年 1 月，墨西哥开始对含糖饮料和非必需的高能量食品征收税款，以抑制这些产品的消费。已发表的评估结果表明，与实施这项财政政策相关的，被征税的食品和饮料的购买量有所减少。尽管基于模拟研究有一些关于对健康影响的研究，但没有发表关于口腔健康变化的基于实证数据的评估。我们使用行政记录和流行病学监测系统的数据来估计以下方面的变化：（1）与龋齿有关的门诊就诊次数；（2）出现龋齿的情况：恒牙的龋齿、缺失和补牙（DMFT）>0 或乳牙的 dmft>0；（3）有龋齿经历的牙齿数量（DMFT 和 dmft）；（4）DMFT>0 或 dmft>0 的病例数；以及（5）与税收相关的 DMFT 或 dmft 的平均值系列。我们在个体水平上估计了概率单位和负二项式模型，在人群水平上估计了中断时间序列分析。税收的实施与门诊就诊趋势的负面变化以及 DMFT>0、dmft>0 和平均 DMFT 的病例数相关。税收还与龋齿经历的可能性降低和研究样本中龋齿经历的牙齿数量减少相关。我们的结果表明，对不健康食品和饮料征税对墨西哥人的口腔健康产生了积极影响，这是观察到的第一批健康益处，并增加了模型研究预测的健康益处。
