MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK.
Global Food System and Policy Research, School of Global Health, Faculty of Health, York University, Toronto, Ontario, Canada.
Nat Food. 2023 Nov;4(11):986-995. doi: 10.1038/s43016-023-00856-0. Epub 2023 Oct 19.
Systems thinking can reveal surprising, counterintuitive or unintended reactions to population health interventions (PHIs), yet this lens has rarely been applied to sugar-sweetened beverage (SSB) taxation. Using a systematic scoping review approach, we identified 329 papers concerning SSB taxation, of which 45 considered influences and impacts of SSB taxation jointly, involving methodological approaches that may prove promising for operationalizing a systems informed approach to PHI evaluation. Influences and impacts concerning SSB taxation may be cyclically linked, and studies that consider both enable us to identify implications beyond a predicted linear effect. Only three studies explicitly used systems thinking informed methods. Finally, we developed an illustrative, feedback-oriented conceptual framework, emphasizing the processes that could result in an SSB tax being increased, maintained, eroded or repealed over time. Such a framework could be used to synthesize evidence from non-systems informed evaluations, leading to novel research questions and further policy development.
系统思维可以揭示出对人口健康干预（PHI）的出人意料、违反直觉或意料之外的反应，但这种视角很少被应用于含糖饮料（SSB）征税。我们采用系统范围审查方法，确定了 329 篇关于 SSB 征税的论文，其中 45 篇共同考虑了 SSB 征税的影响，涉及可能有助于将系统知情方法应用于 PHI 评估的有前途的方法。SSB 征税的影响可能是循环关联的，同时考虑这两者的研究使我们能够识别超出预期线性效应的影响。只有三项研究明确使用了受系统思维启发的方法。最后，我们开发了一个说明性的、面向反馈的概念框架，强调了随着时间的推移，SSB 税可能会增加、维持、侵蚀或废除的过程。这样的框架可以用于综合非系统知情评估的证据，从而提出新的研究问题和进一步的政策发展。
