Economic Contextual Influences on Population Diet and Obesity

不良饮食和肥胖会增加患包括癌症在内的多种慢性病的风险。 和心血管疾病。这项拟议的研究将调查食物(糖果、 烘焙食品和薯条)、饮料(苏打)和餐馆的销售税和食品消费模式， 儿童、青少年和成人的饮食质量、身体质量指数(BMI)和肥胖率。这个 拟议的项目将在很大程度上建立在以前的文献的基础上，这些文献将食品价格而不是税收与 个人级别的人口数据。这些食品和饮料销售税针对的是通常价格较高的 糖和/或脂肪，鉴于这些税中的大多数已经在一些州存在(有大量的 各州之间的差异)，它们很可能是潜在政策变化的起点。因此，本研究 将为政策制定者提供证据，说明在多大程度上实施或增加这些 州级税收可能会影响食品消费行为、饮食质量以及相关的BMI和肥胖。全 分析将控制当地食品店和餐馆的可用性。我们还提出了具体的 对低收入次级样本的分析，特别是我们将审查低收入食品券接受者和 非领取者单独购买，因为当食品券领取者购买时，这类物品不受 税金。这个项目的具体目标有三个：1)检查苏打、糖果、烘焙 商品、薯片和餐馆销售税和饮食模式(已征税食品/饮料的摄入量和 膳食质量(总卡路里摄入量、膳食中脂肪和/或糖的百分比，以及总体健康 饮食指数)；2)检查苏打、糖果、烘焙食品、薯条和餐馆销售额之间的关系 税收、BMI和肥胖率；以及，3)分别检查低收入人群的拟议关系 并评估低收入食品券和非食品券之间的税收敏感性差异 收件人。为了实现这些目标，拟议的研究将进行二次数据分析，使用 四种数据的独特组合：1)州级食品、饮料和餐厅销售税税率；2)当地 食品店和餐馆的面积门店密度；3)当地的社会经济地位由 人口普查；以及，4)关于儿童饮食摄入量和测量的BMI的具有全国代表性的人口数据， 来自四个数据集的青少年和成年人，包括三个纵向调查。据我们所知， 提议的项目代表了迄今为止对背景关系最全面的探索 具体的食品、饮料和餐馆税与个人的饮食模式、饮食质量和BMI之间的关系。 鉴于不良饮食和肥胖流行带来的严重公共健康风险，这项研究可以提供 为政策制定者和公共卫生倡导者提供有关以下潜在有效性的重要信息 实施或提高苏打水、糖果、烘焙食品、薯条和餐馆的现行税率。

Poor diet and obesity have been linked to increased risks for a number of chronic diseases including cancer and cardiovascular diseases. The proposed research will investigate the relationship between food (candy, baked goods, and chips), beverage (soda) and restaurant state sales taxes and food consumption patterns, diet quality, body mass index (BMI) and obesity prevalence among children, adolescents, and adults. The proposed project will build substantially on the previous literature which has linked food prices but not taxes to individual-level population data. These food and beverage sales taxes are on items that are usually high in either sugar and/or fat and given that most of these taxes already exist in a number of states (with substantial variation across states) they are likely to be starting points for potential policy changes. Thus, this research would provide policy makers with evidence on the extent to which implementing or increasing any of these state-level taxes is likely to affect food consumption behavior, diet quality and related BMI and obesity. All analyses will control for the local area availability of food stores and restaurants. We also propose specific analyses of low-income sub-samples and, in particular, we will examine low-income food stamp recipients and non-recipients separately because when purchased by food stamp recipients, such items are exempt from the tax. The specific aims of this project are threefold: 1) Examine the relationship between soda, candy, baked goods, chips and restaurant sales taxes and dietary patterns (intake of taxed food/beverage items and consumption of FAFH) and diet quality (total caloric intake, % fat and/or % sugar in diet, and overall healthy eating index); 2) Examine the relationship between soda, candy, baked goods, chips and restaurant sales taxes and BMI and obesity prevalence; and, 3) Examine the proposed relationships separately for low-income populations and assess the differences in tax sensitivity between low-income food stamp and non-food stamp recipients. To accomplish these aims, the proposed research will conduct secondary data analyses, using a unique combination of four types of data: 1) state-level food, beverage and restaurant sales tax rates; 2) local area outlet density measures of food stores and restaurants; 3) local area socioeconomic status drawn from the Census; and, 4) nationally representative population data on dietary intake and measured BMI for children, adolescents and adults from four data sets including three longitudinal surveys. To our knowledge, the proposed project represents the most comprehensive exploration to date of the contextual relationship between specific food, beverage and restaurant taxes and individuals' dietary patterns, diet quality and BMI. Given the serious public health risk posed by poor diet and obesity prevalence, this research can provide important information for policymakers and public health advocates about the potential effectiveness of implementing or increasing existing tax rates on soda, candy, baked goods, chips and restaurants.