A Sugar-Sweetened Beverage Excise Tax in California: Projected Benefits for Population Obesity and Health Equity.

INTRODUCTION: Amid the successes of local sugar-sweetened beverage (SSB) taxes, interest in state-wide policies has grown. This study evaluated the cost effectiveness of a hypothetical 2-cent-per-ounce excise tax in California and its implications for population health and health equity. METHODS: Using the Childhood Obesity Intervention Cost-Effectiveness Study microsimulation model, tax impacts on health, health equity, and cost effectiveness over 10 years in California were projected, both overall and stratified by race/ethnicity and income. Expanding on previous models, differences in the effect of intake of SSBs on weight by BMI category were incorporated. Costing was performed in 2020, and analyses were conducted in 2021-2022. RESULTS: The tax is projected to save $4.55 billion in healthcare costs, prevent 266,000 obesity cases in 2032, and gain 114,000 quality-adjusted life years. Cost-effectiveness metrics, including cost/quality-adjusted life year gained, were cost saving. Spending on SSBs was projected to decrease by $33 per adult and $26 per child overall in the first year. Reductions in obesity prevalence for Black and Hispanic Californians were 1.8 times larger than for White Californians, and reductions for adults with lowest incomes (<130% Federal Poverty Level) were 1.4 times the reduction among those with highest incomes (>350% Federal Poverty Level). The tax is projected to save $112 in obesity-related healthcare costs per $1 invested. CONCLUSIONS: A state-wide SSB tax in California would be cost saving, lead to reductions in obesity and improvement in SSB-related health equity, and lead to overall improvements in population health. The policy would generate more than $1.6 billion in state tax revenue annually that can also be used to improve health equity.

Promoting active commuting to school through environmental and policy supports in Buffalo, New York.

BACKGROUND: Children in Buffalo, New York, have limited opportunities for safe, enjoyable physical activity. The Healthy Kids, Healthy Communities-Buffalo partnership established in 2009 created environmental and policy supports to facilitate physical activity among youth. METHODS: This article uses a mixed-methods approach to document environment and policy changes in support of active commuting to school. Built environment data were collected using a pre-post research design with the Street Design Environmental Audit Tool. Supplementary sources of information include Geographic Information Systems, US Census data, and property parcel data. RESULTS: This exploratory study found modest improvements in the built environment during the period of assessment. Specifically, sidewalk conditions were improved. In addition, assessment of citywide policy indicates that systemic supports for active living have been put into place through the new (proposed) land use plan and the proposed zoning ordinance. CONCLUSIONS: Exploratory evaluation results suggest that Healthy Kids, Healthy Communities-Buffalo partnership was able to make some environmental and policy changes to promote active transportation. A long-term assessment is required to develop a fuller understanding of how environmental and policy changes impact active transportation.