Cost Effectiveness of a Sugar-Sweetened Beverage Excise Tax in the U.S.

INTRODUCTION: Reducing sugar-sweetened beverage consumption through taxation is a promising public health response to the obesity epidemic in the U.S. This study quantifies the expected health and economic benefits of a national sugar-sweetened beverage excise tax of $0.01/ounce over 10 years. METHODS: A cohort model was used to simulate the impact of the tax on BMI. Assuming ongoing implementation and effect maintenance, quality-adjusted life-years gained and disability-adjusted life-years and healthcare costs averted were estimated over the 2015-2025 period for the 2015 U.S. POPULATION: Costs and health gains were discounted at 3% annually. Data were analyzed in 2014. RESULTS: Implementing the tax nationally would cost $51 million in the first year. The tax would reduce sugar-sweetened beverage consumption by 20% and mean BMI by 0.16 (95% uncertainty interval [UI]=0.06, 0.37) units among youth and 0.08 (95% UI=0.03, 0.20) units among adults in the second year for a cost of $3.16 (95% UI=$1.24, $8.14) per BMI unit reduced. From 2015 to 2025, the policy would avert 101,000 disability-adjusted life-years (95% UI=34,800, 249,000); gain 871,000 quality-adjusted life-years (95% UI=342,000, 2,030,000); and result in $23.6 billion (95% UI=$9.33 billion, $54.9 billion) in healthcare cost savings. The tax would generate $12.5 billion in annual revenue (95% UI=$8.92, billion, $14.1 billion). CONCLUSIONS: The proposed tax could substantially reduce BMI and healthcare expenditures and increase healthy life expectancy. Concerns regarding the potentially regressive tax may be addressed by reduced obesity disparities and progressive earmarking of tax revenue for health promotion.

Trends and racial/ethnic disparities in severe obesity among US children and adolescents, 1976-2006.

Abstract Introduction. This study aims to describe the trends and racial/ethnic differences in prevalence of severe obesity among US children. Methods. We examined height and weight measurements from US children and adolescents aged 2 to 19 years using three National Health and Nutrition Examination Surveys (NHANES II: 1976-1980, N = 7 201, NHANES III: 1988-1994, N = 10 600, and NHANES 1999-2006, N = 15 980). We estimated the prevalence of severe obesity, defined as having a body mass index (BMI) above 35 kg/m(2) or 120% of the age- and sex-specific 95(th) percentile on the CDC reference standards, stratified by sex and age groups (aged 2-5 years, 6-11 years, and 12-19 years). We compared prevalence estimates among non-Hispanic white, non-Hispanic black, and Hispanic children. Results. The age-standardized prevalence of severe obesity increased from 1.1%/1.3% (boys/girls) in NHANES II, to 2.9%/3.1% in NHANES III and 5.1%/4.7% in NHANES 1999-2006 (p-values for trend <0.001). We observed some differences in prevalence by race/ethnicity. Hispanic boys 6-11 years of age (9.0%, 95% CI: [6.4, 11.5]) and non-Hispanic black girls 12-19 years of age (12.6%, 95% CI: [10.6, 14.6]) had the highest prevalence of severe obesity in the most recent NHANES data. On average, obese youth were 9.7 kg (95% CI: [9.2, 10.2]) above the obesity standard, and severely obese youth were 21.3 kg (95% CI: [20.5, 22.3]) above. Conclusions. The prevalence of severe obesity among US youth is increasing, especially among Hispanic boys and non-Hispanic black girls. Our findings suggest that the degree of pediatric obesity is substantial and will likely have profound impact on adult morbid obesity and other morbidities.