Cardiovascular disease, including heart attacks, strokes, hypertension, and a wide range of other illnesses affecting the heart and blood vessels, is perhaps the biggest public health challenge in the United States. It causes about 800,000 deaths and 6 million hospital admissions every year, and it is a particularly urgent priority for policymakers because it disproportionately impacts lower income groups.
Dietary factors are one of the leading causes of heart disease, and a new study indicates that about 230,000 deaths could be prevented through 2030 in the U.S. with a combination of several specific food policy interventions. The international research team was led by Dr. Jonathan Pearson-Stuttard of Imperial College London’s School of Public Health, whose new online Global Masters in Public Health degree is making this kind of impact possible for students anywhere in the world.
Researchers used the US IMPACT Food Policy Model and probabilistic sensitivity analyses to evaluate several potential policy pathways to reduce U.S. cardiovascular disease (CVD) incidence through 2030. Options studied included:
- 10% tax to increase the costs of sugar-sweetened beverages (i.e. a soda tax)
- 10% subsidy to reduce the cost of fruits and vegetables
- 30% subsidy for fruits and vegetables for Supplemental Nutrition Assistance Program (SNAP) recipients
- A national mass media campaign aimed at increasing consumption of fruits and vegetables
In terms of overall benefits, the 10% nationwide subsidy on fruits and vegetables had the biggest modeled impact by far, with about 150,500 CVD deaths prevented or postponed by 2030. By comparison, the 30% subsidy for only SNAP recipients would save 35,100 lives, a 10% soda tax would save 31,000 lives, and a one-year mass media campaign would save 25,800 lives. Altogether, a combination of these policies could save 230,000 lives by 2030.
In addition to looking at overall CVD morality, the study also examined the extent to which these approaches reduced the socio-economic disparities in CVD impacts. While the media campaign and the national subsidy and tax policies had no impacts in this regard, the targeted 30% fruit and vegetable subsidy for SNAP recipients (who are, by definition, low-income households) could reduce the disparity of CVD mortality by about 6%.
Thus, while implementing all of these policies could have the best outcome, the study suggests that fiscal strategies to target the price of fruits and vegetables vs sugary beverages would have a much greater impact than public education and awareness strategies. Moreover, it should be possible to shrink the disproportionate burden low-income communities suffer from heart disease by targeting more aggressive subsidies towards these households.
While this research was focused on the U.S. context, it was conducted by a team spanning a number of institutions spread across multiple countries. Co-authors of the report hailing from the eastern side of the Atlantic include Dr. Pearson-Stuttard of Imperial College London as well as researchers from the University of Liverpool and the Medical University of Gdansk, Poland.
U.S. institutions were also very well represented, with researchers from Tufts University, the Montefiore Medical Center, Birgham and Women’s Hospital, and the American Heart Association. Collaboration between Imperial College and U.S. researchers is very common; U.S. researchers were the co-authors for nearly 8,000 papers published by Imperial researchers from 2015 to 2017, more than any other country! Additionally, the report drew on support from a grant from the National Institute of Health, part of the U.S. Department of Health and Human Services.
If you’re interested in making this kind of impact on public health and public policy in the US – or anywhere else in the world – the Global Master of Public Health degree from Imperial College gives you a chance to collaborate globally online and on your schedule from wherever you are.