Effectiveness of implemented global dietary interventions: a scoping review of fiscal policies.

BACKGROUND: Although the World Health Organisation (WHO) has proposed the use of fiscal policies to mitigate consumption externalities such as overweight and obesity-related diseases, very little is known about the impacts of the different types and framing of national and/or regional fiscal policies that have been implemented over the years. There is the need to provide up-to-date evidence on the impact of fiscal policies that have been enacted and implemented across the globe. METHODS: We conducted a scoping review of all implemented government fiscal policies in the food and drinks sector to identify the different types of fiscal policies that exist and the scope of their impact on consumers as well as the food environment. Electronic databases such as the Web of Science and Google Scholar were used to search for appropriate literature on the topic. A total of 4,191 articles were retrieved and 127 were synthesized and charted for emerging themes. RESULTS: The results from this review were synthesized in MS Excel following Arksey & O'Malley (2005). Emerging themes were identified across different countries/settings for synthesis. The results confirms that fiscal policies improve consumers' health; increase the prices of foods that are high in fats, sugar, and salt; increase government revenue; and shift consumption and purchases towards healthier and untaxed foods. CONCLUSION: Governments already have the optimum tool required to effect changes in consumer behaviour and the food environment.

The carbon emission reduction effect of green fiscal policy: a quasi-natural experiment.

Carbon emission reduction is crucial for mitigating global climate change, and green fiscal policies, through providing economic incentives and reallocating resources, are key means to achieve carbon reduction targets. This paper uses data covering 248 cities from 2003 to 2019 and applies a multi-period difference-in-differences model (DID) to thoroughly assess the impact of energy conservation and emission reduction (ECER) fiscal policies on enhancing carbon emission (CE1) reduction and carbon efficiency (CE2). It further analyzes the mediating role of Green Innovation (GI), exploring how it strengthens the impact of ECER policies. We find that: (1) ECER policies significantly promote the improvement of carbon reduction and CE2, a conclusion that remains robust after excluding the impacts of concurrent policy influences, sample selection biases, outliers, and other random factors. (2) ECER policies enhance CE1 reduction and CE2 in pilot cities by promoting green innovation, and this conclusion is confirmed by Sobel Z tests. (3) The effects of ECER policies on CE1 reduction and the improvement of CE2 are more pronounced in higher-level cities, the eastern regions and non-resource cities. This research provides policy makers with suggestions, highlighting that incentivizing green innovation through green fiscal policies is an effective path to achieving carbon reduction goals.

Corrigendum: Systematic review on fiscal policy interventions in nutrition.

[This corrects the article DOI: 10.3389/fnut.2022.967494.].

A dataset of governments' economic responses to COVID-19.

We introduce a new dataset of ten economic measures in percentage of gross domestic product implemented by governments worldwide between January 2020 and June 2021 to fight COVID-19. The measures coded include fiscal measures (wage support, cash transfers, in-kind transfers, tax cuts, sectorial support and credit schemes), tax deferrals, off-budget measures, and main policy rate cuts. The data can be used to study the impact of economic measures on different outcomes, and to understand the diffusion of economic policies during crises.

Why has the taxing policy on sugar sweetened beverages not reduced their purchase in Iranian households?

Objective: This study aimed at analyzing the effectiveness of the policy of taxing Sugar-Sweetened Beverages (SSBs) on their purchases during the last decade in Iranian households. Methods: The present mixed method study was done in 2017 in four phases: (1) A meta-review of the fiscal policies during the last decade, (2) Collecting existing data on soft drinks' production, price, and household expenditure during the last decade, (3) Conducting 19 semi-structured interviews with key informants, and (4) Facilitating a national meeting to achieve a consensus on the recommendations and future implications. Results: Document reviews showed that based on the Permanent Provisions of National Development Plans of Iran, the Ministry of Health and Medical Education (MOHME) should announce the list of health threatening products to increase taxation for them. The government is allowed to impose taxes on domestically produced and imported SSBs. The average household expenditure on SSBs increased in the rural and urban households of Iran during 2006-2016 in spite of taxation. In the different key informants' opinion, only value-added tax (VAT) was implemented among different fiscal policies, and the other parts, including tax and tolls were debated. Conclusion: The present research findings further proposed some suggestions for increasing the effectiveness of financial policies in reducing the prevalence of NCDs in Iran.

Comparing taxes on alcoholic beverages in the Region of the Americas.

BACKGROUND AND AIMS: Excise taxes represent one of the most cost-effective policies to reduce the harmful use of alcohol. Existing information about their design is limited and no standardized metric has been used to compare tax levels in the Region of the Americas. This study aimed to compare alcohol excise tax policies throughout the Americas, compare tax levels and consider opportunities to improve the impact of excise taxes on alcohol consumption and health. DESIGN AND SETTING: Descriptive analysis using a method developed by the Pan American Health Organization and adapted from the World Health Organization's tobacco tax monitoring. Data were collected by surveying ministries of finance and reviewing tax legislation in effect as of November 2020 in the Region of the Americas. MEASUREMENTS: Tax policy design indicators, taxes as a percentage of the retail price of the most-sold brand of beer, wine and spirits, including a weighted average indicator across beverage types, and tax levels per standard drink (10 g ethanol) in international dollars at purchasing power parity. FINDINGS: Thirty-three countries in the Americas (94%) apply excise taxes on alcoholic beverages, with Argentina and Uruguay not applying them to wine. There is significant heterogeneity in excise tax design across countries and beverage types. Only a third of amount-specific excise taxes are regularly adjusted to avoid erosion. Regional median excise taxes represent the highest share of the price for spirits (21.4%) and the lowest for wine (11.0%). The regional median consumption-weighted average excise tax share across all beverage types is 12.0%. Excise tax shares are generally higher in Latin America than in the Caribbean and Canada. Excise tax levels per standard drink are generally lower for spirits than for other beverages. CONCLUSIONS: Alcohol excise tax policies vary significantly across the Americas, often reflecting national consumption patterns. To maximize their public health impact, tax rates could be increased and tax designs improved, particularly to ensure higher tax burdens on high-strength drinks.

Systematic review on fiscal policy interventions in nutrition.

Introduction: Both the World Health Organization and the Lancet Series on Adolescent nutrition recommend that governments adopt fiscal policies to combat diet-related non-communicable diseases (NCDs). However, rigorous, systematic evidence regarding the effects of these interventions is lacking. Methods: We synthesize the available evidence regarding the impacts of taxes and subsidies that directly affect consumer prices on availability and accessibility of foods and beverages, purchasing behavior, diet quality, health and well-being outcomes as well as considerations for implementation, sustainability and equity. Results: Our initial search returned 2,113 de-duplicated studies, and ultimately 24 impact evaluations and two systematic reviews met final eligibility criteria and represented unique evaluations. Our meta-analysis of these studies suggests that taxes may decrease purchases of taxed beverages (SMD = -0.14 [95% CI: -0.29 to -0.07], n = 15). Results should be interpreted cautiously due to considerable heterogeneity (Q(14) = 335.19, p = 0.01, τ ^ 2 = 0.03 , I 2 = 95.82%). Discussion: The evidence base is too limited to draw conclusions about the effects of taxes on beverages and calorie-dense foods on purchases, or on the effects of subsidies on purchasing or diet quality. Overall, the evidence base is inconclusive on whether fiscal policies can meaningfully influence the availability and accessibility of foods and beverages, diet quality, and health outcomes. Policymakers implementing fiscal policies should consider information campaigns on health benefits and health risks associated with certain food and beverage consumption. For taxes, exposure to health information may amplify signaling effects of taxes and reduce avoidance behaviors, such as cross-border shopping. Future evaluations should diversify data sources to better understand impacts on diet and health outcomes.

Comparing taxes as a percentage of sugar-sweetened beverage prices in Latin America and the Caribbean.

Background: Excise taxes can be used to reduce the consumption of sugar-sweetened beverages (SSBs), an important preventable risk factor for noncommunicable diseases. This study aimed to compare novel standardized indicators of the level of taxes applied on SSBs as a percentage of the price across beverage categories in Latin America and the Caribbean. Methods: We used a method developed by the Pan American Health Organization and adapted from the World Health Organization's tobacco tax share. The analysis focused on the most sold brand of five categories of non-alcoholic beverages. Data were collected by surveying ministries of finance and reviewing tax legislation in effect as of March 2019. Findings: Of the 27 countries analyzed, 17 applied excise taxes on SSBs. Of these, median excise taxes represented the highest share of the price for large sugar-sweetened carbonated drinks (6·5%) and the lowest for energy drinks (2·3%). In countries where excise taxes were applied on bottled waters, tax incidence exceeded the one applied on most SSBs. Overall, excise tax shares were higher in Latin America than in the Caribbean. Including all other indirect taxes (e.g., value added tax), median total tax shares were between 12·8% and 17·5%. At least two countries earmarked part of SSB excise tax revenues for health purposes. Interpretation: Excise tax levels are generally low in the region. From a public health perspective, tax rates could be increased, and tax designs improved (e.g., excluding bottled waters). The method describe here provides a feasible and informative way to monitor SSB taxation and could be replicated in other regions and over time. Funding: Bloomberg Philanthropies through the Global Health Advocacy Incubator.

The fiscal response to the Italian COVID-19 crisis: A counterfactual analysis.

The COVID-19 pandemic is an unprecedented worldwide event with a massive impact on the economic system. The first Western country that had to face the COVID-19 crisis was Italy, which therefore represents a natural "case study." By using the microdata and granular policy information available at the Italian Ministry of Economy and Finance, this paper provides a macroeconomic quantitative assessment of the initial emergency fiscal measures introduced in 2020 and an analysis of the impact of the COVID-19 shock during the lockdown. We find that emergency measures avoided an additional fall of GDP of about 4.4% in 2020. The impact of public interventions on the dynamics of investments is particularly significant.

Covid-19, Fiscal Policies, and Small-and-Medium-Sized Firm Survival: Evidence From the Cross-Country Matching Analysis.

OBJECTIVE: The present study examines the effect of fiscal policies on firm survival for small-and-medium-sized enterprises in the cross-country level firm-level data. RESEARCH DESIGN: A propensity score matching analysis is utilised for the post-COVID-19 period firms by using the World Bank Enterprise Follow-up Surveys for the pandemic period. Small-and-medium-sized enterprises are essential to the economy; firm failures can increase in a pandemic. RESULTS: The obtained findings show that the effect of fiscal policies has an essential effect on small-and-medium-sized enterprises survival in the COVID-19 pandemic period by using a cross-country heterogenous firm-level sample. CONCLUSIONS: In this context, the present study shed new light on the link between COVID-19-related fiscal policies and small-and-medium-sized firm survival in developing countries.

Strengthening Sugar-Sweetened Beverage Taxation for Non-Communicable Disease Prevention: A Comparative Political Economy Analysis Case Study of Fiji and Tonga.

Diet-related fiscal policy is an effective NCD prevention strategy. However, current sugar-sweetened beverage (SSB) taxes in Fiji and Tonga have not had the desired effect; SSB consumption in Fiji, for example, contributes to mortality more than double the global rates and is highest in the WHO Western Pacific Region. We therefore aimed to better understand the perceived underlying political economy drivers that have and continue to affect change in each country. Our study design utilised a comparative case study that triangulated documentary policy and stakeholder analysis with semi-structured stakeholder interviews in both countries and an in-depth corporate political activity analysis in Fiji. We drew on theoretical frameworks relevant to political economy to collect and analyse policy and stakeholder data, and utilised established corporate political activity frameworks to analyse industry activity. Common findings to both Fiji and Tonga suggested that the SSB tax impact could be increased through multisectoral engagement, embracing a whole-of-society approach, strengthened institutional structures and leveraging off competing priorities across sectors towards more common goals. These findings provide opportunities and lessons for Fiji and Tonga as well as other similar settings seeking to strengthen or upscale the impact of diet-related fiscal policy.

Assessing the impact of green fiscal policies and energy poverty on energy efficiency.

This article estimates the ties between green fiscal policies and energy efficiency in COVID-19 era. For this purpose, data envelopment analysis (DEA) approach is considered and applied. The study findings show that green fiscal policies, such as public supports and tax rebates, have significant role in reducing energy poverty of different international countries by advancing energy efficiency. Therefore, a panel data ranging from 2010 to 2020 is used. Our findings indicate that the aggregate degree of green fiscal policies help to decline energy poverty. Renewable energy companies had larger series of net fiscal competence and size efficiency, and their levels of energy efficiency were greater than 0.457%, with the 16% effect of current public supports and 11% effect of taxation rebates supported to diminish energy poverty with 29.7% in different international economies. This is a positive effect by green fiscal policies. The study also presented policy implications suggesting effectively implementing green fiscal policies for more efficient carbon reduction and making climate change supportive for peoples in post COVID-19 period.

Adhering to a Mediterranean diet in a Mediterranean country: an excess cost for families?

Adherence to the Mediterranean diet (MD) has been decreasing in southern Europe, which could be linked to several cultural or educational factors. Our aim is to evaluate the extent to which economic aspects may also play a role, exploring the relationship between food prices in Portugal and adherence to the MD. We evaluated data from the Portuguese National Food, Nutrition, and Physical Activity Survey (IAN-AF 2015-2016) (n 3591). Diet expenditures were estimated by attributing a retail price to each food group, and the diet was transposed into the Mediterranean Diet Score used in the literature. Prices were gathered from five supermarket chains (65 % of the Portuguese market share). Linear regression models were used to assess the association between different adherence levels to the MD levels and dietary costs. Greater adherence to the MD was associated with a 21·2 % (P < 0·05) rise in total dietary cost, which accounts for more 0·59€ in mean daily costs when compared with low adherence. High adherence individuals (v. low adherence) had higher absolute mean daily costs with fish (0·62€/+285·8 %; P < 0·05), fruits (0·26€/+115·8 %; P < 0·05) and vegetables (0·10€/+100·9 %; P < 0·05). The analysis stratified by education and income level showed significantly higher mean daily diet cost only amongst higher income groups. Our findings suggest that greater adherence to the MD was positively and significantly associated with higher total dietary cost. Policies to improve population's diet should take into consideration the cost of healthy foods, especially for large low- and middle-income families.

Revisiting Keynes in the Light of the Transition to Circular Economy.

The study briefly recalls the evolution and crisis of the theory and thought of John Maynard Keynes with the rise and progressive dominance of the neoliberalism paradigm. The exercise has been made for evaluating the effects of such process for the sustainability of the global economy and society. In this view, we explored how Keynes' contribution could be useful for the global economy in building a new paradigm of socio-economic development underpinning the transition to circular economy (CE). We also evaluated the adoption of the Global Green New Deal including a case study of Italy for the purpose of suggesting how that topical political programme can be key in the CE transition. Given the urgency of environmental problems, we underline the importance of the adoption of Keynesian expansionary "green mission oriented" fiscal policies with the purpose of allowing the triggering of a virtuous circle of sustainable welfare involving the Green New deal and the transition to CE. At the basis of such virtuous circle, we propose a new paradigm based on a revisited Keynesian paradigm and models of economy within the framework of Genovesi's "civil economy" that entails an active role and responsibility of all the societal actors (consumers, companies and institutions). In this view, the "spirit" of Keynes in the economy, policy and society could be appreciated once more and be extremely useful along with other scholars' contributions in accelerating the CE transition and a more sustainable development.

Developing an integrated microsimulation model for the impact of fiscal policies on child health in Europe: the example of childhood obesity in Italy.

BACKGROUND: We developed an integrated model called Microsimulation for Income and Child Health (MICH) that provides a tool for analysing the prospective effects of fiscal policies on childhood health in European countries. The aim of this first MICH study is to evaluate the impact of alternative fiscal policies on childhood overweight and obesity in Italy. METHODS: MICH model is composed of three integrated modules. Firstly, module 1 (M1) simulates the effects of fiscal policies on disposable household income using the tax-benefit microsimulation program EUROMOD fed with the Italian EU-SILC 2010 data. Secondly, module 2 (M2) exploits data provided by the Italian birth cohort called Nascita e Infanzia: gli Effetti dell'Ambiente (NINFEA), translated as Birth and Childhood: the Effects of the Environment study, and runs a series of concatenated regressions in order to estimate the prospective effects of income on child body mass index (BMI) at different ages. Finally, module 3 (M3) uses dynamic microsimulation techniques that combine the population structure and incomes obtained by M1, with regression model specifications and estimated effect sizes provided by M2, projecting BMI distributions according to the simulated policy scenarios. RESULTS: Both universal benefits, such as universal basic income (BI), and targeted interventions, such as child benefit (CB) for poorer households, have a significant effect on childhood overweight, with a prevalence ratio (PR) in 10-year-old children-in comparison with the baseline fiscal system-of 0.88 (95%CI 0.82-0.93) and 0.89 (95%CI 0.83-0.94), respectively. The impact of the fiscal reforms was even larger for child obesity, reaching a PR of 0.67 (95%CI 0·50-0.83) for the simulated BI and 0.64 (95%CI 0.44-0.84) for CB at the same age. While both types of policies show similar effects, the estimated costs for a 1% prevalence reduction in overweight and obesity with respect to the baseline scenario is much lower with a more focalised benefit policy than with universal ones. CONCLUSIONS: Our results show that fiscal policies can have a strong impact on childhood health conditions. Focalised interventions that increase family income, especially in the most vulnerable populations, can help to prevent child overweight and obesity. Robust microsimulation models to forecast the effects of fiscal policies on health should be considered as one of the instruments to reach the Health in All Policies (HiAP) goals.

A new hybrid metaheuristic method based on biogeography-based optimization and particle swarm optimization algorithm to estimate money demand in Iran.

Money demand is one of the most important economic variables which are a critical component in appointing and choosing appropriate monetary policy, because it determines the transmission of policy-driven change in monetary aggregates to the real sector. In this paper, the data of economic indicators in Iran are presented for estimating the money demand using biogeography-based optimization (BBO) algorithm, particle swarm optimization (PSO) algorithm, and a new hybrid metaheuristic method based on biogeography-based optimization and particle swarm optimization algorithm (BBPSO). The data are used in two forms (i.e. linear and exponential) to estimate money demand values based on true liquidity, Consumer price index, GDP, lending interest rate, Inflation, and official exchange rate. The available data are partly used for finding optimal or near-optimal values of weighting parameters (1974-2013) and partly for testing the models (2014-2018). The performance of methods is evaluated using mean squared error (MSE), root mean squared error (RMSE), and mean absolute error (MAE). According to the simulation results, the proposed method (i.e. BBPSO) outperformed the other models. The findings proved that the recommended method was an appropriate tool for effective money demand prediction in Iran. These data were the result of a comprehensive look at the most influential factors for money market demand. With this method, the demand side of this market was clearly defined. Along with other markets, the consequences of economic policy could be analyzed and predicted. • The article provides a method for observing the effect of economic scenarios on the money market and the analysis obtained by this proposed method allows experts, public sector economics, and monetary economist to see a clearer explanation of the country's liquidity plan. • The method presented in this article can be beneficial for the policy makers and monetary authorities during their decision-making process.

Strengthening prevention of nutrition-related non-communicable diseases through sugar-sweetened beverages tax in Rwanda: a policy landscape analysis.

Background: Food and beverages high in sugar are recognized to be among the major risk factors for nutrition-related non-communicable diseases. The growing presence of ultra-processed food producers has resulted in shifts to diets that are associated with non-communicable diseases and which include sugar-sweetened beverages. Sugar-sweetened beverage taxation presents an opportunity to prevent non-communicable diseases but it comes with challenges.Objectives: To describe the policy landscape, identify and analyse the facilitators of and barriers to strengthening taxation on sugar-sweetened beverages in Rwanda.Methods: We conducted a desk-based policy analysis to assess the facilitators of and barriers to strengthening sugary beverage taxation policy. We consulted eight stakeholders to validate the findings of the desk review.Results: Non-communicable diseases are recognized as a public health challenge in Government health and non-health policy documents. However, sugar intake is not explicitly identified as a risk factor for non-communicable diseases and existing policies do not clearly aim to reduce sugar consumption. The Rwandan Government's commitment to growing the local sugar industry and the substantial economic contribution of Rwandan beverage producers are potential barriers to fiscal policies aimed at reducing sugar consumption. However, the current 39% excise tax levied on all soft drinks could support the adoption of future sugar-sweetened beverage policies.Conclusions: The landscape for strengthening a sugar-sweetened beverage tax in Rwanda is complex. The policy environment provides both facilitators of and impediments to strengthening the existing tax. A differential tax could be introduced by leveraging on the existing excise tax and linking it to the sugar content of beverages.

Nutrition related non-communicable diseases and sugar sweetened beverage policies: a landscape analysis in Zambia.

Background: Taxation on unhealthy products is recommended as a cost-effective intervention to address the global burden of non-communicable diseases. Taxation of sugar-sweetened beverages dis-incentivize consumption of unhealthy products. Implementation of such policies is difficult in Sub-Saharan African countries, which are targets for global corporate expansion by the sugar-sweetened beverages industry.Objective: To identify opportunities to strengthen policies relating to sugar-sweetened beverage taxation in Zambia, through: (1) understanding the policy landscape and political context in which policies for nutrition-related non-communicable diseases are being developed, particularly sugar-sweetened beverage taxation, and exploring the potential use of revenue arising from sugar-sweetened beverage taxation to support improved nutrition.Methods: We conducted a retrospective qualitative policy analysis with a review of nutrition-related non-communicable diseases policies and key informant interviews (n = 10) with policy actors. Data were coded and analyzed data using pre-constructed matrices based on the Kingdon's Policy Agenda Framework.Results: Government responses to nutrition-related non-communicable diseases were developed in an incoherent policy environment. The health sector's commitment to regulate sugar-sweetened beverages conflicted with the manufacturing sector's priorities for economic growth. Increased regulation of sugar-sweetened beverages was a priority for the health sector. Economic interests sought to grow the manufacturing sector, including the food and beverage industries. Consequently, incoherent policy objectives might have contributed to the adoption of a weakened excise tax. The general public were poorly informed about nutrition-related non-communicable diseases.Conclusions: The tension between the Government's economic and public health priorities is a barrier for strengthening fiscal measures to address nutrition-related non-communicable diseases. However, this did not prevent the introduction of a differential sugar tax on sugar-sweetened beverages. Opportunities exist to strengthen the existing taxation of sugar-sweetened beverages in Zambia. These include a more inclusive consultation process for policy formulation and comprehensive monitoring of risk factors.

Barriers to, and facilitators of, the adoption of a sugar sweetened beverage tax to prevent non-communicable diseases in Uganda: a policy landscape analysis.

BACKGROUND: Uganda is experiencing an increase in nutrition-related non-communicable diseases. Risk factors include overconsumption of sugar-sweetened beverages. Fiscal and taxation policies aim to make the consumption of healthier foods easier. However, the adoption and implementation of fiscal policies by countries are constrained by political and economic challenges. OBJECTIVE: We investigated the policy and political landscape related to the prevention of nutrition-related non-communicable diseases in Uganda to identify barriers to and facilitators of the adoption of sugar-sweetened beverage taxation in Uganda. METHODS: A desk-based policy analysis of policies related to nutrition-related non-communicable diseases and sugar-sweetened beverage taxation was conducted. Four key informant consultations (n = 4) were conducted to verify the policy review and to gain further insight into the policy and stakeholder contexts. Analysis was framed by Kingdon's theory of agenda setting and policy change. RESULTS: Nutrition-related non-communicable diseases were recognised as an emerging problem in Uganda. The Government has adopted a comprehensive approach to improve diets, but implementation is slow. There is limited recognition of the consumption of sugar and sugar-sweetened beverages as a contributor to the nutrition-related non-communicable disease burden in policy documents. Existing taxes on soft drinks are lower than the World Health Organization's recommended rate of 20% and do not target sugar content. The soft drink industry has been influential in framing the taxation debate, and the Ministry of Finance previously reduced taxation of sugar-sweetened beverages. Maintaining competitiveness in a regional market is an important business strategy. However, the Ministry of Health and other public health actors in civil society have been successful (albeit marginally) in countering reductions in taxation, which are supported by industry. CONCLUSIONS: An established platform for sugar-sweetened beverage taxation advocacy exists in Uganda. Compelling local research that explicitly links soft drink taxes to health goals is essential to advance sugar-sweetened beverage taxation.

Measuring the Efficiency of Fiscal Policies for Environmental Pollution Control and the Spatial Effect of Fiscal Decentralization in China.

This paper uses both fiscal expenditure policy and fiscal revenue policy as input indicators and selects environmental pollution control results reflecting different forms and sources of pollution as output indicators. The efficiency of fiscal policies for environmental pollution control (EFPE) of 30 provincial-level administrative divisions in China from 2007 to 2017 is measured by adopting the data envelopment analysis (DEA) method. Then, the spatial effect of fiscal decentralization on EFPE is empirically analyzed by using the spatial lag model (SLM). The results show that EFPE values in China have been greatly improved overall since 2014. The change in technical efficiency (TE) is caused mainly by the change in pure technical efficiency (PTE). EFPE values have regional heterogeneity and convergence. The eastern region has clearly higher EFPE values than other regions. The growth rate of the low efficient region is greater than that of the high efficient region. Fiscal expenditure decentralization has a direct negative effect and spatial spillover effect on EFPE values, while fiscal revenue decentralization has a non-significant effect. Based on these results, this paper proposes the following policy implications: increasing the level of fiscal expenditure of environmental pollution control and improving the central transfer payment system for environmental protection; reforming the government performance assessment system and innovating the conditions of government expenditure on environmental pollution control; and promoting horizontal fiscal cooperation in cross-regional environmental governance.