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Articles February 2018 Issue

How Changing Food Prices Could Save Lives

Tufts study predicts that subsidies and taxes could prevent deaths from major chronic diseases and narrow health gaps.

Image © Tero Vesalainen |

A mix of taxes and subsidies on food prices could, hypothetically, prevent deaths from heart disease and diabetes.

Subsidies and taxes to adjust the prices of seven foods—both healthy and unhealthy—is predicted to prevent tens of thousands of deaths each year from cardiometabolic diseases such as heart disease, stroke and diabetes, according to a study led by researchers from Tufts University.

The study, published in BMC Medicine, used a mathematical model and nationally representative health data spanning the years 2012–2014 to predict the effects of taxes on unhealthy foods and subsidies for healthy foods on the risk of death from cardiometabolic diseases in people with varying socioeconomic status. (Socioeconomic status is a way to measure a person’s social and economic position based on income, education, and occupation.)

For example, people with lower socioeconomic status—who have relatively less education and income—suffer from cardiometabolic diseases at higher rates than people with higher socioeconomic status. But the model showed that taxes and subsidies can both help lower disease rates overall and narrow gaps associated with socioeconomic status.

“These results suggest that financial incentives to purchase healthy food and disincentives to purchase unhealthy foods can successfully and meaningfully reduce cardiometabolic disease disparities,” says Dariush Mozaffarian, MD, DrPH, senior author of the report and dean of the Friedman School.

Building the Model: The researchers focused on seven types of foods based on evidence of their associations with cardiometabolic diseases. Fruits, vegetables, whole grains and nuts and seeds are associated with lower risk for cardiometabolic disease. In contrast, processed meats, unprocessed red meats and sugar-sweetened beverages are associated with higher cardiometabolic risk.

The model estimates how consumption of these foods goes up or down by age, gender and socioeconomic status in response to price changes. For example, when unhealthy foods are taxed, people tend to buy less of them. Subsidies to reduce prices of healthy foods create an incentive to buy more of them. Together, the relative amounts of healthy or unhealthy foods people eat—in other words, their overall dietary pattern—influence their risk of dying from cardiometabolic diseases.

Health Benefits: The model predicted that changing the prices by 10% on all seven food items might prevent an estimated 23,000 deaths per year, or 3.4% of all deaths from cardiometabolic diseases in the US. Alternatively, the model predicted that a 30% price change could prevent 63,000 deaths per year, or 9.2% of all deaths from cardiometabolic diseases. The largest proportional reductions were seen in stroke, followed by diabetes and coronary heart disease.

“The largest changes resulted from reducing the prices of fruits and vegetables and increasing the price of sugary drinks,” explains the BMC Medicine report’s lead author, José L. Peñalvo, PhD, adjunct assistant professor at the Friedman School of Nutrition Science and Policy at Tufts.

Diabetes deaths was predicted to be most reduced by taxes on sugar-sweetened beverages, while stroke deaths was predicted to be most reduced by subsidies for fruits and vegetables.

Reducing Disparities: The model also predicted that taxes and subsidies could reduce disparities in death rates from cardiometabolic diseases associated with socioeconomic status. In part, that’s because people with less wealth respond more strongly to price changes than more affluent people, a phenomenon called “price responsiveness.”

In the model, taxes create a greater incentive among cash-strapped shoppers to buy fewer unhealthy foods, such as processed meats or sugar-sweetened beverages. Subsidies, by contrast, lower the price of healthy foods and encourage people to buy relatively larger amounts of them.

The model predicted that subsidies and taxes could reduce disparities in death rates from all types of cardiometabolic diseases, and especially in scenarios where people were assumed to be very responsive to the price changes

“Even modest price changes on healthy and unhealthy foods would help decrease overall cardiometabolic deaths and also reduce health disparities,” Peñalvo notes.

What Can You Do? The study findings are consistent with the principle that “every choice counts” in following a healthy eating pattern. It also points to the role that socioeconomic and other factors that often seem beyond our direct control—like taxes and subsidies on certain foods—play in determining what we eat. Taxing unhealthy food is expected to lead more people to consume less of it, which would in turn lead to an overall healthier dietary pattern. Another possible way to improve America’s diets would be by subsidizing healthier food.

Either way, attending to both the “debits” and “credits” in your own food choices can pay off in the long run in greater health and longevity.

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