Erasmus School of Health Policy and Management, Erasmus University Rotterdam, P.O. Box 1738, 3000 DR, Rotterdam, The Netherlands.
Eur J Health Econ. 2023 Dec;24(9):1429-1440. doi: 10.1007/s10198-022-01554-7. Epub 2022 Nov 29.
Worldwide obesity rates have nearly tripled over the past five decades. So far, policies to promote a healthier diet have been less intrusive than those to reduce tobacco and alcohol consumption. Not much is known about public support for policies that aim to promote a healthy diet. In this study, a discrete choice experiment (DCE) was used to elicit stated preferences for policies varying in intrusiveness among a representative sample of the public of The Netherlands.
The choice tasks presented respondents a hypothetical scenario of two policy packages, each comprising a mix of seven potential policies that differed in level of intrusiveness. We estimated mixed logit models (MXL) to estimate respondents' preferences for these policies and performed latent class analyses to identify heterogeneity in preferences.
The MXL model showed that positive financial incentives like subsidies for vegetables and fruit yielded most utility. A tax of 50% on sugary drinks was associated with disutility while a tax of 20% was associated with positive utility compared to no tax at all. We identified three subgroups with distinct preferences for the seven policies to promote a healthy diet, which were characterized as being "against", "mixed" and "pro" policies to promote a healthy diet.
Preferences for policies promoting a healthy diet vary considerably in the Dutch population, particularly in relation to more intrusive policies. This makes selection and implementation of a policy package that has wide public support challenging.
在过去的五十年中，全球肥胖率几乎翻了三倍。到目前为止，促进健康饮食的政策的侵入性不如减少烟草和酒精消费的政策。对于旨在促进健康饮食的政策的公众支持，人们知之甚少。在这项研究中，使用离散选择实验（DCE）在荷兰公众的代表性样本中，根据侵入性的不同，对政策进行了选择，以得出公众对政策的偏好。
选择任务向受访者提出了两种政策方案的假设情景，每种方案都由七种不同侵入性水平的潜在政策组成。我们估计了混合对数模型（MXL）来估计受访者对这些政策的偏好，并进行了潜在类别分析，以确定偏好的异质性。
MXL 模型表明，像蔬菜和水果补贴这样的积极财政激励措施产生了最大的效用。与不征税相比，含糖饮料征收 50%的税与负效用相关，而征收 20%的税与正效用相关。我们确定了三个对促进健康饮食的七项政策有不同偏好的亚组，这些亚组的特点是“反对”、“混合”和“赞成”促进健康饮食的政策。
荷兰公众对促进健康饮食的政策的偏好差异很大，特别是对更具侵入性的政策。这使得选择和实施一个得到广泛公众支持的政策方案具有挑战性。
