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The Health and Economic Impact of Using a Sugar Sweetened Beverage Tax to Fund Fruit and Vegetable Subsidies in New York City: A Modeling Study

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Abstract 

Low fruit and vegetable (FV) intake and high sugar-sweetened beverage (SSB) consumption are independently associated with an increased risk of developing cardiovascular disease (CVD). Many people in New York City (NYC) have low FV intake and high SSB consumption, partly due to high cost of fresh FVs and low cost of and easy access to SSBs. A potential implementation of an SSB tax and an FV subsidy program could result in substantial public health and economic benefits. We used a validated microsimulation model for predicting CVD events to estimate the health impact and cost-effectiveness of SSB taxes, FV subsidies, and funding FV subsidies with an SSB tax in NYC. Population demographics and health profiles were estimated using data from the NYC Health and Nutrition Examination Survey. Policy effects and price elasticity were derived from recent meta-analyses. We found that funding FV subsidies with an SSB tax was projected to be the most cost-effective policy from the healthcare sector perspective. From the societal perspective, the most cost-effective policy was SSB taxes. All policy scenarios could prevent more CVD events and save more healthcare costs among men compared to women, and among Black vs. White adults. Public health practitioners and policymakers may want to consider adopting this combination of policy actions, while weighing feasibility considerations and other unintended consequences.

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Acknowledgements

This research was supported by a grant from the National Heart, Lung, and Blood Institute (R01HL141427) of the National Institutes of Health. The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. School of Industrial Engineering, Purdue University, West Lafayette, IN, USA

    Zhouyang Lou

  2. Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA

    Stella S. Yi, Rachel Suss, Rienna Russo & Pasquale E. Rummo

  3. Department of Public Health Policy and Management, School of Global Public Health, New York University, New York, NY, USA

    Jennifer Pomeranz

  4. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA

    Rienna Russo

  5. Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Heesun Eom, Junxiu Liu & Yan Li

  6. Division of General Medicine, Columbia University Irving Medical Center, New York, NY, USA

    Yiyi Zhang, Andrew E. Moran & Brandon K. Bellows

  7. Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, USA

    Nan Kong

  8. School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Yan Li

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  1. Zhouyang Lou
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Correspondence to Brandon K. Bellows, Nan Kong or Yan Li.

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Lou, Z., Yi, S.S., Pomeranz, J. et al. The Health and Economic Impact of Using a Sugar Sweetened Beverage Tax to Fund Fruit and Vegetable Subsidies in New York City: A Modeling Study. J Urban Health 100, 51–62 (2023). https://doi.org/10.1007/s11524-022-00699-3

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