The rising prevalence of obesity is said to be threatening to drown the health care system under a wave of cardiovascular disease and diabetes. So some policymakers have suggested taxing foods high in saturated fats as a way to steer consumers clear of snacks that are bad for them and perhaps offset coming health care costs. Good idea? Not so fast, say some British public health scholars.

The researchers from the University of Oxford, Queen’s Medical Center, Nottingham, and the South East Public Health Observatory modeled the outcomes of three different approaches to extending Britain’s 17.5 percent value-added tax to a wider array of foods to discourage consumption of unhealthy food. They found that simply extending that tax to the main sources of dietary saturated fats–whole milk, butter, cakes and pastries, biscuits, puddings and ice creams, cheese and buns–actually could result in an increase in cardiovascular deaths of between 2,500 and 3,500 a year in the United Kingdom. Why? A tax on saturated fats alone would cause an increase in salt intake because of cross-price elasticities of demand, increasing deaths from ischemic heart disease and stroke.

A second approach, which involves taxing those foods that score poorly on a scale known as the SSCg3d–which balances calories, sugars, salt and fats against nutrients–would save between 2,100 and 2,500 lives. The authors call the third taxation design “best outcomes” to balance, through trial and error, the greatest dietary improvements with the least blow to the consumer pocketbook. That approach, while saving an estimated 2,600 to 3,200 lives, also would increase consumer costs by 4.6 percent, the most of the three modeled, and tax 44.5 percent of total food expenditure.

While the New York City ban on trans fats may be the most significant policy step to restrict food choice in the United States, Health Affairs has been documenting the projected costs of obesity for a number of years. Roland Sturm’s touchstone March/April 2002 paper estimated that the health care costs of obesity exceeded those of smoking or problem drinking [free access]. The coverage continues through the July/April 2007 issue, in which Jalpa Doshi and colleagues estimate that 3 million Medicare beneficiaries would be eligible for bariatric surgery under current Medicare policy. A fuller listing of Health Affairs articles of obesity issues can be found here.

It may be true that policymakers are not hungry for a fat tax just yet, and the research indicates that if it is to be done, governments need a deft touch. But it is also clear that obesity is a public health issue that needs to be addressed.

This entry was posted on Wednesday, July 18th, 2007 at 6:22 pm and is filed under All Categories, Europe, Medicare, Public Health. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.