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Health and Economic Impacts of Healthier Lifestyles

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Economics".

Deadline for manuscript submissions: closed (31 August 2021) | Viewed by 17748

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Special Issue Editors

Dr. Ce Shang

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Guest Editor

Department of Internal Medicine, Division of Medical Oncology, The Ohio State University Wexner Medical Center, Columbus, OH 43017, USA
Interests: health economics; experimental economics; tobacco and alcohol control policies
Special Issues, Collections and Topics in MDPI journals

Dr. Nigar Nargis

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Guest Editor

American Cancer Society, Economic and Health Policy Research, Atlanta, United States
Interests: health economics; labor economics; development economics; tobacco control; fiscal policies for controlling unhealthy behavior
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Frank J. Chaloupka

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Guest Editor

University of Illinois at Chicago, Health Policy Center, Institute for Health Research and Policy Chicago, United States
Interests: the impact of economic; policy and other environmental influences on health behaviors; the economics of tobacco and tobacco control; particularly in developing countries
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Healthier lifestyles, such as increased physical activity, healthy diets, and reduced health-compromising behaviors including tobacco, alcohol, and drug use, have a significant impact on society. Risk factors that contribute to unhealthy behaviors and regulatory policies that promote healthy lifestyles will impact a broad array of health and economic outcomes, such as employment, tax revenue, and disability-adjusted-life year (DALY). It is critical to enhance the knowledge of how to comprehensively model factors related to healthier lifestyles and their societal impacts. This Special Issue welcomes studies and reviews belonging to each or the interface of the following broad areas of modeling healthier lifestyles:

Innovation in measurements and methodologies to comprehensively model the impacts of healthier lifestyles and related regulatory policies on a variety of outcomes. (e.g., simulation models, industrial organization and computable general equilibrium models, conjoint analysis, agent-based model, and complex system approaches);
Reviews and assessments of existing methodologies to model healthy lifestyles (e.g., tax and affordability approaches, SimSmoke model, etc.);
The impact of healthy lifestyles and related regulatory policies on economic outcomes (e.g., employment, wages, productivity, sin tax revenues, and medical care costs);
The impact of healthier lifestyles and their regulatory policies on health outcomes (e.g., mortality and morbidity, diseases, DALY, and broadly cost-effectiveness of interventions or policies);

This Special Issue aims to encourage the development of methodologies and approaches to evaluate and project the potential impact of healthier lifestyles on the society and pave the way forward for scientific research and action to promote healthier lifestyles.

Dr. Ce Shang
Dr. Nigar Nargis
Prof. Dr. Frank J. Chaloupka
Guest Editors

Manuscript Submission Information

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Keywords

modeling healthy lifestyles
methodology innovation
economic outcome
public health outcome
mortality and morbidity
DALY
impact analysis
regulatory science
cost-effectiveness
complex systems
conjoint analysis
simulation model
agent-based model
IO/CGE

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Published Papers (5 papers)

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Research

13 pages, 973 KiB

Open AccessArticle

Impact of Little Cigars and Cigarillos Packaging Features on Product Preference

by Ce Shang, James Nonnemaker, Kymberle Sterling, Jessica Sobolewski and Scott R. Weaver

Int. J. Environ. Res. Public Health 2021, 18(21), 11443; https://doi.org/10.3390/ijerph182111443 - 30 Oct 2021

Cited by 3 | Viewed by 2345

Abstract

Background: We conducted a discrete choice experiment (DCE) among young adult cigarette smokers in the period July–August 2018 to examine their preference for cigarillos in response to various packaging-related attributes, including flavor, flavor description, quality descriptors, pack size, and prices. Methods: A convenience sample of 566 US young adult cigarette smokers aged 18–34, among whom 296 were current little cigar and cigarillo (LCC) smokers, were recruited using Facebook ads and invited to participate in an online (Qualtrics) tobacco survey containing DCE and tobacco use questions. In the experiment, participants chose among two cigarillo products or “neither” (opt-out). Results: We analyzed preferences for LCCs using multinomial, nested, random parameter logit models. Results showed that young adult cigarette smokers preferred grape over menthol, tobacco/regular, and wine flavors; “color only” and “color and text” flavor depictions over text only; “smooth” and “sweet” quality descriptors over “satisfying”; and larger pack sizes and lower prices. Conclusions: Regulating packaging-related features will impact LCC choices among US young adult smokers. FDA regulation over these packaging-related features may impact LCC use among young adult smokers. Full article

(This article belongs to the Special Issue Health and Economic Impacts of Healthier Lifestyles)

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12 pages, 681 KiB

Open AccessArticle

Assessing the Effects of a Tobacco Tax Reform on the Industry Price-Setting Strategy

by Jose Angelo Divino, Philipp Ehrl, Osvaldo Candido and Marcos Aurelio Pereira Valadao

Int. J. Environ. Res. Public Health 2021, 18(19), 10376; https://doi.org/10.3390/ijerph181910376 - 2 Oct 2021

Viewed by 2494

Abstract

In July 2020, the Executive Power submitted Bill no. 3887-2020 as the first step towards a wide reform of the Brazilian tax system. It will replace the current PIS/COFINS (charged on turnover of companies) by the CBS (a tax on goods and services), which includes a special regime for cigarettes. The novelty is that the specific cigarette tax will be charged on the highest retail price per cigarette brand across the country. This research simulates three scenarios that differ according to the price-setting strategy of the tobacco industry in reaction to the proposed tax reform. In all simulations, the tax reform would result in considerably higher cigarette prices, lower cigarette consumption, higher tax collection, and an implicit minimum price that is far above the current official price floor. Furthermore, the price dispersion and cross-border shopping across states would be reduced because prices and tax burden per brand would tend to be the same across the country due to the dominant price-setting strategy in the cigarette industry. Full article

(This article belongs to the Special Issue Health and Economic Impacts of Healthier Lifestyles)

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19 pages, 692 KiB

Open AccessArticle

Inequality-Reducing Effects of Tobacco Tax Increase: Accounting for Behavioral Response of Low-, Middle-, and High-Income Households in Serbia

by Marko Vladisavljević, Jovan Zubović, Mihajlo Đukić and Olivera Jovanović

Int. J. Environ. Res. Public Health 2021, 18(18), 9494; https://doi.org/10.3390/ijerph18189494 - 9 Sep 2021

Cited by 3 | Viewed by 3012

Abstract

While previous research has indicated that increasing tobacco excises is a crucial instrument for lowering tobacco demand, this policy has been criticized for its alleged regressive impact on the poor. However, this critique does not take into account the behavioral response, i.e., decrease in consumption that occurs after excises and prices increase. In this paper, we examine the effect of cigarettes’ price increase on tobacco consumption, household expenditures, and tax burdens in three income groups and provide empirical arguments on the regressivity/progressivity effects of tobacco tax increase. Estimated elasticities indicate that all groups decrease their cigarettes demand with increasing prices, with demand decrease stronger for low- than for middle- and high-income households. Results further suggest that increasing tobacco excises (1) decreases tobacco expenditure of low-income households, which increases their productive consumption, such as on food, clothes, etc., and (2) redistributes the tobacco tax burden from low- to high-income households. Therefore, excise increase policies do not have an adverse effect on the position of the low-income households; on the contrary, they lower their cigarettes expenditure and their tax burden, while lower cigarettes consumption has an additional, positive effect on their health, which attenuates future inequalities. Full article

(This article belongs to the Special Issue Health and Economic Impacts of Healthier Lifestyles)

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22 pages, 1402 KiB

Open AccessArticle

Nutrient Dense, Low-Cost Foods Can Improve the Affordability and Quality of the New Zealand Diet—A Substitution Modeling Study

by Carlene S. Starck, Michelle Blumfield, Tim Keighley, Skye Marshall, Peter Petocz, Elif Inan-Eroglu, Kylie Abbott, Tim Cassettari, Ajmol Ali, Carol Wham, Rozanne Kruger, Geoff Kira and Flavia Fayet-Moore

Int. J. Environ. Res. Public Health 2021, 18(15), 7950; https://doi.org/10.3390/ijerph18157950 - 27 Jul 2021

Cited by 6 | Viewed by 4506

Abstract

The high prevalence of non-communicable disease in New Zealand (NZ) is driven in part by unhealthy diet selections, with food costs contributing to an increased risk for vulnerable population groups. This study aimed to: (i) identify the nutrient density-to-cost ratio of NZ foods; (ii) model the impact of substituting foods with a lower nutrient density-to-cost ratio with those with a higher nutrient density-to-cost ratio on diet quality and affordability in representative NZ population samples for low and medium socioeconomic status (SES) households by ethnicity; and (iii) evaluate food processing level. Foods were categorized, coded for processing level and discretionary status, analyzed for nutrient density and cost, and ranked by nutrient density-to-cost ratio. The top quartile of nutrient dense, low-cost foods were 56% unprocessed (vegetables, fruit, porridge, pasta, rice, nuts/seeds), 31% ultra-processed (vegetable dishes, fortified bread, breakfast cereals unfortified <15 g sugars/100 g and fortified 15–30 g sugars/100 g), 6% processed (fruit juice), and 6% culinary processed (oils). Using substitution modeling, diet quality improved by 59% and 71% for adults and children, respectively, and affordability increased by 20–24%, depending on ethnicity and SES. The NZ diet can be made healthier and more affordable when nutritious, low-cost foods are selected. Processing levels in the healthier, modeled diet suggest that some non-discretionary ultra-processed foods may provide a valuable source of low-cost nutrition for food insecure populations. Full article

(This article belongs to the Special Issue Health and Economic Impacts of Healthier Lifestyles)

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18 pages, 1766 KiB

Open AccessArticle

Diet and Economic Modelling to Improve the Quality and Affordability of the Australian Diet for Low and Medium Socioeconomic Households

by Michelle Blumfield, Carlene Starck, Tim Keighley, Peter Petocz, Anna Roesler, Kylie Abbott, Tim Cassettari, Skye Marshall and Flavia Fayet-Moore

Int. J. Environ. Res. Public Health 2021, 18(11), 5771; https://doi.org/10.3390/ijerph18115771 - 27 May 2021

Cited by 6 | Viewed by 4178

Abstract

Food costs are a barrier to healthier diet selections, particularly for low socioeconomic households who regularly choose processed foods containing refined grains, added sugars, and added fats. In this study, the objectives were to: (i) identify the nutrient density-to-cost ratio of Australian foods; (ii) model the impact of substituting foods with lower nutrient density-to-cost ratio with those with the highest nutrient density-to-cost ratio for diet quality and affordability in low and medium socioeconomic households; and (iii) evaluate food processing levels. Foods were categorized, coded for processing level, analysed for nutrient density and cost, and ranked by nutrient density-to-cost ratio. The top quartile of nutrient dense, low-cost foods included 54% unprocessed (vegetables and reduced fat dairy), 33% ultra-processed (fortified wholegrain bread and breakfast cereals <20 g sugars/100 g), and 13% processed (fruit juice and canned legumes). Using substitution modelling, diet quality improved by 52% for adults and 71% for children across all households, while diet affordability improved by 25% and 27% for low and medium socioeconomic households, respectively. The results indicate that the quality and affordability of the Australian diet can be improved when nutritious, low-cost foods are selected. Processing levels in the healthier modelled diets suggest that some ultra-processed foods may provide a beneficial source of nutrition when consumed within national food group recommendations. Full article

(This article belongs to the Special Issue Health and Economic Impacts of Healthier Lifestyles)

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