Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, 3215 Market St, Office 356, Philadelphia, PA19104, USA.
Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
Public Health Nutr. 2022 Jun;25(6):1711-1719. doi: 10.1017/S1368980021004833. Epub 2021 Dec 13.
To develop a simulation framework for assessing how combinations of taxes, nutrition warning labels and advertising levels could affect purchasing of ultra-processed foods (UPF) in Latin American countries and to understand whether policies reinforce or reduce pre-existing social disparities in UPF consumption.
We developed an agent-based simulation model using international evidence regarding the effect of price, nutrition warning labels and advertising on UPF purchasing.
We estimated policy effects in scenarios representing two stages of the 'social transition' in UPF purchasing: (1) a pre-transition scenario, where UPF purchasing is higher among high-income households, similar to patterns in Mexico; and (2) a post-transition scenario where UPF purchasing is highest among low-income households, similar to patterns in Chile.
A population of 1000 individual agents with levels of age, income, educational attainment and UPF purchasing similar to adult women in Mexico.
A 20 % tax would decrease purchasing by 24 % relative to baseline in both the pre- and post-transition scenarios, an effect that is similar in magnitude to that of a nutrition warning label policy. A 50 % advertising increase or decrease had a comparatively small effect. Nutrition warning labels were most effective among those with higher levels of educational attainment. Labelling reduced inequities in the pre-transition scenario (i.e. highest UPF purchasing among the highest socio-economic group) but widened inequities in the post-transition scenario.
Effective policy levers are available to reduce UPF purchasing, but policymakers should anticipate that equity impacts will differ depending on existing social patterns in UPF purchasing.
开发一个模拟框架，以评估税收、营养警示标签和广告水平的组合如何影响拉丁美洲国家超加工食品（UPF）的购买情况，并了解政策是否会加剧或减少 UPF 消费方面已存在的社会差距。
我们使用国际上关于价格、营养警示标签和广告对 UPF 购买影响的证据，开发了一个基于代理的模拟模型。
我们在代表 UPF 购买“社会转型”两个阶段的情景中估计政策效果：（1）预转型情景，高收入家庭的 UPF 购买量较高，类似于墨西哥的模式；（2）后转型情景，低收入家庭的 UPF 购买量最高，类似于智利的模式。
一个由 1000 个个体代理组成的群体，其年龄、收入、教育程度和 UPF 购买水平与墨西哥成年女性相似。
与基线相比，20%的税收会使预转型和后转型情景下的购买量分别减少 24%，其效果与营养警示标签政策的效果相当。50%的广告增减幅度相对较小。营养警示标签在受教育程度较高的人群中最有效。在预转型情景下（即最高社会经济群体的 UPF 购买量最高），标签减少了不平等，但在后转型情景下，不平等程度扩大了。
有有效的政策手段可以减少 UPF 的购买，但政策制定者应预计到，公平影响将根据 UPF 购买方面已存在的社会模式而有所不同。
