The Role of Prices in Diet and Health of Older Adults

项目摘要 基于价格的政策干预，如含糖饮料或高热量食品税，有可能 改善人们的饮食，降低肥胖率。但在美国或其他地方，“罪恶税”在政治上很难实现。 实施，可能的健康益处很难预测。该项目调查了两个问题， 这对理解这些卫生政策的有效性具有重要意义。首先是要了解这种价格在多大程度上 干预措施改变了消费者食品价格。二是了解整体餐饮消费如何 对价格变化的反应，以及这种变化是否转化为健康的改善。我们将在本书中分别研究它们。 墨西哥的情况，对含糖饮料（约9%）和高能量饮料征收税， “垃圾”食品（每100克含有≥275卡路里的非基本食品占8%），2014年1月生效。 我们的具体目标是： (1)目标1：研究法律如何改变含糖饮料（SSB）和垃圾食品相对于其他食品的价格 使用详细的条形码价格数据的食品。 (2)目标2：研究食品价格随时间的变化与食品购买和健康变化的关系。 a）估计家庭对食物、卡路里和营养素（脂肪、蛋白质和蛋白质）需求的自身和交叉价格弹性， 碳水化合物，包括糖和纤维）。我们考虑了整个消费者篮子，并估计了所有消费者之间的替代模式。 使用家庭支出调查数据和条形码价格数据，对粮食和营养素购买情况进行了分析。 B）分析税收政策实施前后食品价格的变化如何影响自我报告， 客观测量老年人（1962年以前出生）的健康结果，如体重指数，臀腰比， 诊断糖尿病或高血压、血压测量以及葡萄糖和胆固醇水平。我们也来看看短- 2型糖尿病和高血压的药物治疗和费用的长期变化。这些分析依赖于 墨西哥健康和老龄化研究（MHAS）和条形码价格数据。 c）探讨目标（2b）中的关系如何因个人2012年的健康状况、社会经济地位、性别和 年龄;以及食物的饮食摄入量，如SSBs和高热量食物，按社会经济地位、性别和年龄在地方一级平均计算。 我们使用MHAS，2012年墨西哥营养和健康调查以及价格数据来做这件事。 (3)目标3：模拟替代税收政策，如更高的SSB或垃圾食品税，或卡路里和营养税，使用 关键参数：价格的税收弹性（目标1）、粮食采购和保健的价格弹性（目标2）。

PROJECT SUMMARY Price-based policy interventions, such as sugar-sweetened beverages (SSBs) or high-calorie food taxes, have the potential to improve people’s diets and reduce obesity rates. But “sin taxes” in the US or elsewhere have been politically difficult to implement, and the possible health benefits are hard to predict. This project investigates two issues that are of high significance for understanding the effectiveness of such health policies. The first is to understand to what extent such price interventions change consumer food prices. The second is to understand how overall food and beverage consumption responds to price changes, and whether such changes translate into improved health. We study them in separate aims in the context of Mexico, which imposed both a tax on sugar-sweetened beverages (approximately 9 percent) and energy-dense “junk” foods (8 percent on non-basic foods that contain ≥275 calories per 100 grams), effective January 2014. Our specific aims are to: (1) Aim 1: Study how the law changed prices for sugar-sweetened beverages (SSBs) and junk food relative to other foods using detailed barcoded price data. (2) Aim 2: Study how changes in food prices over time relate to changes in food purchases and health. a) Estimate own and cross-price elasticities of the household demand for food, calories and nutrients (fats, proteins, and carbohydrates, including sugar and fiber). We consider the full consumer basket and estimate substitution patterns between all food and nutrient purchases, using Household Expenditure Survey data (ENIGH) and barcoded price data. b) Analyze how changes in food prices before and after the tax policy was implemented affected self-reported and objectively-measured health outcomes for older adults (born prior 1962), such as body mass index, hip-to-waist ratio, diagnosed diabetes or hypertension, blood pressure measures, and glucose and cholesterol levels. ►We also look at the short- term changes in their medical therapy and expenses for type 2 diabetes and hypertension.◄ These analyses rely on the Mexican Health and Aging Study (MHAS) and barcoded price data. c) ►Explore how relationships in Aim (2b) vary by individual’s 2012 health condition, socio-economic status, their sex and age; and by the dietary intake of foods, such as SSBs and high-calorie foods averaged at the locality level by SES, sex and age. We do this using the MHAS, 2012 Mexican Nutritional and Health Survey, and price data.◄ (3) Aim 3: Simulate alternative tax policies, such as higher SSBs or junk food tax, or calorie and nutrient tax using key parameters: tax elasticities of prices (from Aim 1), price elasticities of food purchases and health (from Aim 2).