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Obesity-related health impacts of fuel excise taxation- an evidence review and cost-effectiveness study

BACKGROUND: Reducing automobile dependence and improving rates of active transport may reduce the impact of obesogenic environments, thereby decreasing population prevalence of obesity and other diseases where physical inactivity is a risk factor. Increasing the relative cost of driving by an increa...

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Autores principales: Brown, V., Moodie, M., Cobiac, L., Mantilla Herrera, A. M., Carter, R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5415832/
https://www.ncbi.nlm.nih.gov/pubmed/28468618
http://dx.doi.org/10.1186/s12889-017-4271-2
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author Brown, V.
Moodie, M.
Cobiac, L.
Mantilla Herrera, A. M.
Carter, R.
author_facet Brown, V.
Moodie, M.
Cobiac, L.
Mantilla Herrera, A. M.
Carter, R.
author_sort Brown, V.
collection PubMed
description BACKGROUND: Reducing automobile dependence and improving rates of active transport may reduce the impact of obesogenic environments, thereby decreasing population prevalence of obesity and other diseases where physical inactivity is a risk factor. Increasing the relative cost of driving by an increase in fuel taxation may therefore be a promising public health intervention for obesity prevention. METHODS: A scoping review of the evidence for obesity or physical activity effect of changes in fuel price or taxation was undertaken. Potential health benefits of an increase in fuel excise taxation in Australia were quantified using Markov modelling to simulate obesity, injury and physical activity related health impacts of a fuel excise taxation intervention for the 2010 Australian population. Health adjusted life years (HALYs) gained and healthcare cost savings from diseases averted were estimated. Incremental cost-effectiveness ratios (ICERs) were reported and results were tested through sensitivity analysis. RESULTS: Limited evidence on the effect of policies such as fuel taxation on health-related behaviours currently exists. Only three studies were identified reporting associations between fuel price or taxation and obesity, whilst nine studies reported associations specifically with physical activity, walking or cycling. Estimates of the cross price elasticity of demand for public transport with respect to fuel price vary, with limited consensus within the literature on a probable range for the Australian context. Cost-effectiveness modelling of a AUD0.10 per litre increase in fuel excise taxation using a conservative estimate of cross price elasticity for public transport suggests that the intervention would be cost-effective from a limited societal perspective (237 HALYs gained, AUD2.6 M in healthcare cost savings), measured against a comparator of no additional increase in fuel excise. Under “best case” assumptions, the intervention would be more cost-effective (3181 HALYs gained, AUD34.2 M in healthcare cost savings). CONCLUSIONS: Exploratory analysis suggests that an intervention to increase fuel excise taxation may deliver obesity and physical activity related benefits. Whilst such an intervention has significant potential for cost-effectiveness, potential equity and acceptability impacts would need to be minimised. A better understanding of the effectiveness and cost-effectiveness of a range of transport interventions is required in order to achieve more physically active transport environments.
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spelling pubmed-54158322017-05-04 Obesity-related health impacts of fuel excise taxation- an evidence review and cost-effectiveness study Brown, V. Moodie, M. Cobiac, L. Mantilla Herrera, A. M. Carter, R. BMC Public Health Research Article BACKGROUND: Reducing automobile dependence and improving rates of active transport may reduce the impact of obesogenic environments, thereby decreasing population prevalence of obesity and other diseases where physical inactivity is a risk factor. Increasing the relative cost of driving by an increase in fuel taxation may therefore be a promising public health intervention for obesity prevention. METHODS: A scoping review of the evidence for obesity or physical activity effect of changes in fuel price or taxation was undertaken. Potential health benefits of an increase in fuel excise taxation in Australia were quantified using Markov modelling to simulate obesity, injury and physical activity related health impacts of a fuel excise taxation intervention for the 2010 Australian population. Health adjusted life years (HALYs) gained and healthcare cost savings from diseases averted were estimated. Incremental cost-effectiveness ratios (ICERs) were reported and results were tested through sensitivity analysis. RESULTS: Limited evidence on the effect of policies such as fuel taxation on health-related behaviours currently exists. Only three studies were identified reporting associations between fuel price or taxation and obesity, whilst nine studies reported associations specifically with physical activity, walking or cycling. Estimates of the cross price elasticity of demand for public transport with respect to fuel price vary, with limited consensus within the literature on a probable range for the Australian context. Cost-effectiveness modelling of a AUD0.10 per litre increase in fuel excise taxation using a conservative estimate of cross price elasticity for public transport suggests that the intervention would be cost-effective from a limited societal perspective (237 HALYs gained, AUD2.6 M in healthcare cost savings), measured against a comparator of no additional increase in fuel excise. Under “best case” assumptions, the intervention would be more cost-effective (3181 HALYs gained, AUD34.2 M in healthcare cost savings). CONCLUSIONS: Exploratory analysis suggests that an intervention to increase fuel excise taxation may deliver obesity and physical activity related benefits. Whilst such an intervention has significant potential for cost-effectiveness, potential equity and acceptability impacts would need to be minimised. A better understanding of the effectiveness and cost-effectiveness of a range of transport interventions is required in order to achieve more physically active transport environments. BioMed Central 2017-05-04 /pmc/articles/PMC5415832/ /pubmed/28468618 http://dx.doi.org/10.1186/s12889-017-4271-2 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Brown, V.
Moodie, M.
Cobiac, L.
Mantilla Herrera, A. M.
Carter, R.
Obesity-related health impacts of fuel excise taxation- an evidence review and cost-effectiveness study
title Obesity-related health impacts of fuel excise taxation- an evidence review and cost-effectiveness study
title_full Obesity-related health impacts of fuel excise taxation- an evidence review and cost-effectiveness study
title_fullStr Obesity-related health impacts of fuel excise taxation- an evidence review and cost-effectiveness study
title_full_unstemmed Obesity-related health impacts of fuel excise taxation- an evidence review and cost-effectiveness study
title_short Obesity-related health impacts of fuel excise taxation- an evidence review and cost-effectiveness study
title_sort obesity-related health impacts of fuel excise taxation- an evidence review and cost-effectiveness study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5415832/
https://www.ncbi.nlm.nih.gov/pubmed/28468618
http://dx.doi.org/10.1186/s12889-017-4271-2
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