Modelling the potential impact of a sugar-sweetened beverage tax on stroke mortality, costs and health-adjusted life years in South Africa

Abstract Background Stroke poses a growing human and economic burden in South Africa. Excess sugar consumption, especially from sugar-sweetened beverages (SSBs), has been associated with increased obesity and stroke risk. Research shows that price increases for SSBs can influence consumption and mod...

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Main Authors: Mercy Manyema, Lennert J. Veerman, Aviva Tugendhaft, Demetre Labadarios, Karen J. Hofman
Format: Article
Language:English
Published: BMC 2016-05-01
Series:BMC Public Health
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12889-016-3085-y
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author Mercy Manyema
Lennert J. Veerman
Aviva Tugendhaft
Demetre Labadarios
Karen J. Hofman
author_facet Mercy Manyema
Lennert J. Veerman
Aviva Tugendhaft
Demetre Labadarios
Karen J. Hofman
author_sort Mercy Manyema
collection DOAJ
description Abstract Background Stroke poses a growing human and economic burden in South Africa. Excess sugar consumption, especially from sugar-sweetened beverages (SSBs), has been associated with increased obesity and stroke risk. Research shows that price increases for SSBs can influence consumption and modelling evidence suggests that taxing SSBs has the potential to reduce obesity and related diseases. This study estimates the potential impact of an SSB tax on stroke-related mortality, costs and health-adjusted life years in South Africa. Methods A proportional multi-state life table-based model was constructed in Microsoft Excel (2010). We used consumption data from the 2012 South African National Health and Nutrition Examination Survey, previously published own and cross price elasticities of SSBs and energy balance equations to estimate changes in daily energy intake and BMI arising from increased SSB prices. Stroke relative risk, and prevalent years lived with disability estimates from the Global Burden of Disease Study and modelled disease epidemiology estimates from a previous study, were used to estimate the effect of the BMI changes on the burden of stroke. Results Our model predicts that an SSB tax may avert approximately 72 000 deaths, 550 000 stroke-related health-adjusted life years and over ZAR5 billion, (USD400 million) in health care costs over 20 years (USD296-576 million). Over 20 years, the number of incident stroke cases may be reduced by approximately 85 000 and prevalent cases by about 13 000. Conclusions Fiscal policy has the potential, as part of a multi-faceted approach, to mitigate the growing burden of stroke in South Africa and contribute to the achievement of the target set by the Department of Health to reduce relative premature mortality (less than 60 years) from non-communicable diseases by the year 2020.
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spelling doaj.art-43e5c71b6953465cb5c9a02bcfd759662022-12-22T01:36:41ZengBMCBMC Public Health1471-24582016-05-0116111010.1186/s12889-016-3085-yModelling the potential impact of a sugar-sweetened beverage tax on stroke mortality, costs and health-adjusted life years in South AfricaMercy Manyema0Lennert J. Veerman1Aviva Tugendhaft2Demetre Labadarios3Karen J. Hofman4PRICELESS-SA, MRC/Wits Rural Public, Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the WitwatersrandSchool of Public Health, University of QueenslandPRICELESS-SA, MRC/Wits Rural Public, Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the WitwatersrandPopulation Health, Health Systems and Innovation (PHHSI), Human Sciences Research CouncilPRICELESS-SA, MRC/Wits Rural Public, Health and Health Transitions Research Unit, School of Public Health, Faculty of Health Sciences, University of the WitwatersrandAbstract Background Stroke poses a growing human and economic burden in South Africa. Excess sugar consumption, especially from sugar-sweetened beverages (SSBs), has been associated with increased obesity and stroke risk. Research shows that price increases for SSBs can influence consumption and modelling evidence suggests that taxing SSBs has the potential to reduce obesity and related diseases. This study estimates the potential impact of an SSB tax on stroke-related mortality, costs and health-adjusted life years in South Africa. Methods A proportional multi-state life table-based model was constructed in Microsoft Excel (2010). We used consumption data from the 2012 South African National Health and Nutrition Examination Survey, previously published own and cross price elasticities of SSBs and energy balance equations to estimate changes in daily energy intake and BMI arising from increased SSB prices. Stroke relative risk, and prevalent years lived with disability estimates from the Global Burden of Disease Study and modelled disease epidemiology estimates from a previous study, were used to estimate the effect of the BMI changes on the burden of stroke. Results Our model predicts that an SSB tax may avert approximately 72 000 deaths, 550 000 stroke-related health-adjusted life years and over ZAR5 billion, (USD400 million) in health care costs over 20 years (USD296-576 million). Over 20 years, the number of incident stroke cases may be reduced by approximately 85 000 and prevalent cases by about 13 000. Conclusions Fiscal policy has the potential, as part of a multi-faceted approach, to mitigate the growing burden of stroke in South Africa and contribute to the achievement of the target set by the Department of Health to reduce relative premature mortality (less than 60 years) from non-communicable diseases by the year 2020.http://link.springer.com/article/10.1186/s12889-016-3085-ySugar-sweetened beveragesStrokeModellingMortalityHealth care costs
spellingShingle Mercy Manyema
Lennert J. Veerman
Aviva Tugendhaft
Demetre Labadarios
Karen J. Hofman
Modelling the potential impact of a sugar-sweetened beverage tax on stroke mortality, costs and health-adjusted life years in South Africa
BMC Public Health
Sugar-sweetened beverages
Stroke
Modelling
Mortality
Health care costs
title Modelling the potential impact of a sugar-sweetened beverage tax on stroke mortality, costs and health-adjusted life years in South Africa
title_full Modelling the potential impact of a sugar-sweetened beverage tax on stroke mortality, costs and health-adjusted life years in South Africa
title_fullStr Modelling the potential impact of a sugar-sweetened beverage tax on stroke mortality, costs and health-adjusted life years in South Africa
title_full_unstemmed Modelling the potential impact of a sugar-sweetened beverage tax on stroke mortality, costs and health-adjusted life years in South Africa
title_short Modelling the potential impact of a sugar-sweetened beverage tax on stroke mortality, costs and health-adjusted life years in South Africa
title_sort modelling the potential impact of a sugar sweetened beverage tax on stroke mortality costs and health adjusted life years in south africa
topic Sugar-sweetened beverages
Stroke
Modelling
Mortality
Health care costs
url http://link.springer.com/article/10.1186/s12889-016-3085-y
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