Developing an integrated microsimulation model for the impact of fiscal policies on child health in Europe: the example of childhood obesity in Italy.

BACKGROUND: We developed an integrated model called Microsimulation for Income and Child Health (MICH) that provides a tool for analysing the prospective effects of fiscal policies on childhood health in European countries. The aim of this first MICH study is to evaluate the impact of alternative fiscal policies on childhood overweight and obesity in Italy. METHODS: MICH model is composed of three integrated modules. Firstly, module 1 (M1) simulates the effects of fiscal policies on disposable household income using the tax-benefit microsimulation program EUROMOD fed with the Italian EU-SILC 2010 data. Secondly, module 2 (M2) exploits data provided by the Italian birth cohort called Nascita e Infanzia: gli Effetti dell'Ambiente (NINFEA), translated as Birth and Childhood: the Effects of the Environment study, and runs a series of concatenated regressions in order to estimate the prospective effects of income on child body mass index (BMI) at different ages. Finally, module 3 (M3) uses dynamic microsimulation techniques that combine the population structure and incomes obtained by M1, with regression model specifications and estimated effect sizes provided by M2, projecting BMI distributions according to the simulated policy scenarios. RESULTS: Both universal benefits, such as universal basic income (BI), and targeted interventions, such as child benefit (CB) for poorer households, have a significant effect on childhood overweight, with a prevalence ratio (PR) in 10-year-old children-in comparison with the baseline fiscal system-of 0.88 (95%CI 0.82-0.93) and 0.89 (95%CI 0.83-0.94), respectively. The impact of the fiscal reforms was even larger for child obesity, reaching a PR of 0.67 (95%CI 0·50-0.83) for the simulated BI and 0.64 (95%CI 0.44-0.84) for CB at the same age. While both types of policies show similar effects, the estimated costs for a 1% prevalence reduction in overweight and obesity with respect to the baseline scenario is much lower with a more focalised benefit policy than with universal ones. CONCLUSIONS: Our results show that fiscal policies can have a strong impact on childhood health conditions. Focalised interventions that increase family income, especially in the most vulnerable populations, can help to prevent child overweight and obesity. Robust microsimulation models to forecast the effects of fiscal policies on health should be considered as one of the instruments to reach the Health in All Policies (HiAP) goals.

The Role of Automatic Stabilizers and Emergency Tax-Benefit Policies During the COVID-19 Pandemic: Evidence from Ecuador.

By combining household survey data before and during the COVID-19 pandemic with detailed tax-benefit simulations, this paper quantifies the distributional effects of COVID-19 in Ecuador and the role of tax-benefit policies in mitigating the immediate impact of the economic shocks. Our results show a dramatic increase in income poverty and inequality between December 2019 and June 2020, the period when the economy was hit the hardest. The national poverty headcount increases from 25.7 to 58.2%, the extreme poverty headcount from 9.2 to 38.6%, and the Gini coefficient from 0.461 to 0.592. On average, household disposable income drops by 41%. The new Family Protection Grant provides income protection for the poorest income decile. However, overall tax-benefit policies do little to mitigate the losses in household incomes due to the pandemic. Informal workers, in particular, are left unprotected due to the lack of income support in the event of unemployment. Supplementary Information: The online version contains supplementary material available at 10.1057/s41287-021-00490-1.

En combinant les données d'enquêtes auprès des ménages avant et pendant la pandémie de COVID-19 avec des simulations détaillées d'impôts et de prestations, cet article quantifie les effets distributifs de la COVID-19 en Équateur et le rôle que jouent les politiques d'impôts et des prestations pour atténuer l'impact immédiat des chocs économiques. Nos résultats montrent une hausse spectaculaire de la pauvreté monétaire et des inégalités entre décembre 2019 et juin 2020, période durant laquelle l'économie a été le plus durement touchée. Le taux national de pauvreté passe de 25,7% à 58,2%, le taux d'extrême pauvreté de 9,2% à 38,6% et le coefficient de Gini de 0,461 à 0,592. En moyenne, le revenu disponible des ménages baisse de 41%. La nouvelle allocation de protection familiale offre une assurance de protection des revenus aux 10% des ménages les plus pauvres. Cependant, de façon générale, les politiques d'impôts et des prestations en font peu pour atténuer les pertes de revenus des ménages en raison de la pandémie. Les travailleurs et travailleuses informel·le·s, en particulier, sont laissé·e·s sans protection en raison de l'absence d'allocation de revenu en cas de chômage.