265089 Health benefits, particularly in high risk populations, projected from an excise tax on sugar-sweetened beverages intake in California

Sunday, October 28, 2012

Tekeshe Mekonnen, MS , School of Medicine, University of California, San Francisco (UCSF), San Francisco, CA
Michelle Odden, PhD , School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University (OSU), Corvallis, OR
Pamela Coxson, PhD , School of Medicine, University of California, San Francisco, San Francisco, CA
David Guzman, MSPH , School of Medicine, University of California, San Francisco (UCSF), San Francisco, CA
James Lightwood, PhD, MA , Clinical Pharmacy, University of California, San Francisco, San Francisco, CA
Y. Claire Wang, MD, MSc, ScD , Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY
Kirsten Bibbins-Domingo, PhD, MD, MAS , School of Medicine, University of California, San Francisco, San Francisco, CA
Consumption of sugar-sweetened beverage (SSB) has risen over the past two decades, with over 10 million Californians now drinking one or more SSB per day. High consumption of SSB increases risk of obesity, diabetes, hypertension, and coronary heart disease (CHD). A penny-per-ounce excise tax has been proposed to reduce SSB intake in California, though the health and cost implications for this diverse state have not been quantified.

We projected the impact of an excise tax on health outcomes among Californians from 2011-2020. We used the CHD Policy Model – CA, an established computer simulation of diabetes and CHD adapted to California. Based on price elasticity estimates, we assumed the tax would reduce SSB intake by 10-20%. We projected avoided cases of diabetes and CHD, along with healthcare cost savings in 2010 US dollars in the total California population and in high-risk subgroups.

Over the next decade, a 10-20% SSB consumption reduction is projected to reduce diabetes incidence by 2.9-5.6% and CHD by 0.6-1.2%. The greatest reductions in diabetes are expected in Mexican American (4.1-8.0%), African Americans (3.9-7.7%), and those with limited income regardless of race/ethnicity (4.0-7.8%). A greater reduction in CHD is also projected in the high-risk subgroups: Mexican American (1.0-2.0%), African Americans (0.9-1.8%), and limited income (0.9-1.9%). We projected $0.5-$1 billion in savings associated with diabetes cases avoided and an additional savings of $65-$130 million from CHD.

A tax-induced reduction of SSB could yield substantial population health benefits and cost savings for California, with high-risk subgroups benefiting proportionately more.

Learning Areas:
Chronic disease management and prevention
Diversity and culture
Epidemiology
Public health or related public policy
Public health or related research

Learning Objectives:
1. To describe the health impact and cost impact of a penny-per-ounce proposed excise tax on sugar-sweetened beverages (SSB) in California. 2. To describe the health impact of this proposed tax on race/ethnic minority and low income subgroups in California.

Keywords: Vulnerable Populations, Diabetes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Since 2008, I work with Dr. Bibbins-Domingo on the Coronary Heart Disease (CHD) Policy Model projects, including evaluating the benefits of reducing dietary salt in today’s teenagers on future cardiovascular disease as they become adults, projecting the impact of the rise in California’s adolescent obesity and associated health outcomes and cost, modeling the impact of sodium reduction and taxation of sugar-sweetened beverages on diabetes in California. I helped create the subpopulation models for sensitivity analyses.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.