Funding quality pre-kindergarten slots with Philadelphia's new "sugary drink tax': simulating effects of using an excise tax to address a social determinant of health
Funding quality pre-kindergarten slots with Philadelphia's new "sugary drink tax': simulating effects of using an excise tax to address a social determinant of health
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DOI：
10.1017/s1368980017001756
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发表时间：
2017-09-01
影响因子：
3.2
通讯作者：
Purtle, Jonathan
中科院分区：
文献类型：
--
作者：
Langellier, Brent A.;Le-Scherban, Felice;Purtle, Jonathan
目的：费城通过了每盎司1.5美分的加糖饮料税（SBT）。收入将为贫困儿童提供10000个优质幼儿园名额。必须了解SBT的收入如何用于资助解决教育和其他健康社会决定因素的方案。本研究的目的是模拟费城儿童和青少年在六种干预情景下的优质幼儿园前出勤率、教育成就和含糖饮料（SSB）消费：（i）不干预;（ii）10 000个额外的优质幼儿园前名额;（iii）每盎司1.5美分的SBT;（iv）扩大幼儿园前和每盎司1.5美分的SBT;设计：我们使用基于代理人的模型来估计六个政策情景下的学前入学率，教育成就和SSB消费。我们从已发表的文献和收入动态小组研究-儿童发展补充的二次分析中确定了模型中的关键参数。背景：美国宾夕法尼亚州费城。受试者：费城4-18岁的儿童和青少年。结果：每盎司1.5美分的税收将使费城儿童和青少年每周的SSB消费量减少1.3杯，对贫困线以下儿童的影响更大。优质学前教育的扩大将SBT的效果放大了8%，但对中等收入家庭的儿童的影响最大。SBT和优质的学前教育计划，每个减少SSB消费，但主要受益于不同的儿童和青少年.Conclusions：配对的消费税与补充计划，以提高健康的社会决定因素是一个渐进的战略，以打击肥胖症，疾病的社会模式倒退。
Objective: Philadelphia passed a 1.5-cent-per-ounce sweetened beverage tax (SBT). Revenue will fund 10 000 quality pre-kindergarten slots for poor children. It is imperative to understand how revenue from SBT can be used to fund programmes to address education and other social determinants of health. The objective of the present study was to simulate quality pre-kindergarten attendance, educational achievement and sugar-sweetened beverage (SSB) consumption among Philadelphia children and adolescents under six intervention scenarios: (i) no intervention; (ii) 10 000 additional quality pre-kindergarten slots; (iii) a 1 .5-cent-per-ounce SBT; (iv) expanded pre-kindergarten and 1 .5-cent-per-ounce SBT; (v) a 3-cent-per-ounce SBT; and (vi) expanded pre-kindergarten and 3-cent-per-ounce SBT.Design: We used an agent-based model to estimate pre-kindergarten enrolment, educational achievement and SSB consumption under the six policy scenarios. We identified key parameters in the model from the published literature and secondary analyses of the Panel Study of Income Dynamics -Child Development Supplement.Setting: Philadelphia, Pennsylvania, USA.Subjects: Philadelphia children and adolescents aged 4-18 years.Results: A 1.5-cents-per-ounce tax would reduce SSB consumption by 1.3drinks/week among Philadelphia children and adolescents relative to no intervention, with larger effects among children below the poverty level. Quality pre-kindergarten expansion magnifies the effect of the SBT by 8%, but has the largest effect on moderate-income children just above the poverty level. The SBT and quality pre-kindergarten programme each reduce SSB consumption, but primarily benefit different children and adolescents.Conclusions: Pairing an excise tax with a complementary programme to improve a social determinant of health represents a progressive strategy to combat obesity, a disease regressive in its social patterning.