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Fact SheetPublication 2024CHOICES: The Childhood Obesity Intervention Cost-Effectiveness Study
Adults and children in the U.S. consume more calories from foods and beverages than they …
Adults and children in the U.S. consume more calories from foods and beverages than they are expending. Over the past few decades, this trend has created an obesity epidemic. Identifying what works to prevent childhood obesity has become a priority for public health researchers, policymakers, and the general public. The Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) at the Harvard T.H. Chan School of Public Health is working to help reverse the U.S. obesity epidemic by…
Social Determinants | Cost-Effectiveness Analysis | Child/Nutrition | Chronic Disease/Risk | Health Systems | Clinical Care | Food/Agriculture | Government/Law | Health/Medicine | North America -
ArticlePublication 2017Cost-Effectiveness of Subsidizing Fruit and Vegetable through SNAP
A diet high in fruits and vegetables is associated with reduced risk of chronic disease …
A diet high in fruits and vegetables is associated with reduced risk of chronic disease - to incentivize consumption among low-income households one proposal is to make them more affordable through the Supplemental Nutrition Assistance Program (SNAP). This cost effectiveness analysis adopts a societal perspective to estimate the value of subsidizing fruit and vegetable (FV) purchases among the one in seven Americans who participate in SNAP. A stochastic microsimulation model of obesity, type 2 diabetes, myocardial infarction,…
Social Determinants | Mathematical Models | Microsimulation | Cost-Effectiveness Analysis | Child/Nutrition | Chronic Disease/Risk | Policy/Regulation | Economics/Finance | Food/Agriculture | Health/Medicine | North America -
ArticlePublication 2016New Strategies to Prioritize Nutrition, Physical Activity, and Obesity Interventions
Interventions for obesity have not often been based on considerations that could predict their effectiveness. …
Interventions for obesity have not often been based on considerations that could predict their effectiveness. However, advances in research provide several new approaches that can inform priorities for public health interventions directed at nutrition, physical activity, and obesity. These approaches include estimation of the effect size, comparison of the calorie gap with the caloric deficit induced by the intervention, population reach and impact, cost and cost effectiveness of the intervention, time required to evaluate the…
Social Determinants | Child/Nutrition | Chronic Disease/Risk | Health Systems | Policy/Regulation | Clinical Care | Food/Agriculture | Health/Medicine | North America | Europe -
ArticlePublication 2015BMI and Healthcare Cost Impact of Eliminating Tax Subsidy for Advertising Unhealthy Food to Youth
Children in the U.S. are exposed to thousands of food-related TV advertisements, most of which …
Children in the U.S. are exposed to thousands of food-related TV advertisements, most of which promote nutritionally poor foods and drinks. Food marketers spend millions of dollars on youth-directed television each year, and these advertising expenditures are currently treated by the U.S. government as ordinary business expenses, meaning they receive a tax subsidy of nearly $80 million. This study estimated the cost-effectiveness of eliminating this tax subsidy. Using a simulation model, the authors found that…
Social Determinants | Costing Methods | Health Outcomes | Microsimulation | Cost-Effectiveness Analysis | Child/Nutrition | Chronic Disease/Risk | Policy/Regulation | Culture/Society | Food/Agriculture | Government/Law | Health/Medicine | North America -
ArticlePublication 2015Cost Effectiveness of a SSB Excise Tax in the U.S.
Sugar-sweetened beverages (SSBs) have been closely linked with excess weight gain, diabetes, and cardiovascular disease, …
Sugar-sweetened beverages (SSBs) have been closely linked with excess weight gain, diabetes, and cardiovascular disease, which has led to public health recommendations for higher taxes on unhealthy drinks like soda and sports drinks. This study estimated the cost-effectiveness of implementing a 1-cent per ounce SSB excise tax in the U.S. The authors developed a simulation model and found that implementing the tax nationally would cost $51 million in the first year and would reduce SSB…
Social Determinants | Cost-Effectiveness Analysis | Child/Nutrition | Chronic Disease/Risk | Government/Law | Health/Medicine | North America -
ArticlePublication 2015Cost Effectiveness of Childhood Obesity Interventions: Evidence and Methods for CHOICES
As the childhood obesity epidemic continues in the U.S., fiscal crises are leading policymakers to …
As the childhood obesity epidemic continues in the U.S., fiscal crises are leading policymakers to ask not only whether an intervention works, but also whether it offers good value for money spent. This paper discussed the methods used to evaluate the cost-effectiveness of four strategies to address the obesity epidemic: (1) a sugar-sweetened beverage excise tax; (2) eliminating the tax subsidy of TV advertising of unhealthy food to children; (3) early care and education policy…
Social Determinants | Health Outcomes | Evidence Synthesis | Cost-Effectiveness Analysis | Child/Nutrition | Chronic Disease/Risk | Culture/Society | Government/Law | Health/Medicine | North America -
ReviewPublication 2016Strengthening Cost-Effectiveness Analysis for Public Health Policy
Many important opportunities to improve health lie outside the health sector and involve improving the …
Many important opportunities to improve health lie outside the health sector and involve improving the conditions in which we live and work: safe design and maintenance of roads, bridges, train tracks, and airports; control of environmental pollutants; occupational safety; healthy buildings; a safe and healthy food supply; safe manufacture of consumer products; a healthy social environment; and others. Faced with the overwhelming array of possibilities, U.S. decision makers need help identifying those that can contribute the…
Social Determinants | Preferences/Values | Priority Setting/Ethics | Costing Methods | Cost-Effectiveness Analysis | Environmental Health | Health Systems | Policy/Regulation | Climate/Environment | Economics/Finance | Food/Agriculture | Health/Medicine | North America -
ArticlePublication 2015Child and Adolescent Obesity: Part of a Bigger Picture
This series paper stresses a need for the governance of food supply and food markets …
This series paper stresses a need for the governance of food supply and food markets to be improved and commercial activities subordinated to protect and promote children's health. The prevalence of childhood overweight and obesity has risen substantially worldwide in less than one generation. In the U.S., the average weight of a child has risen by more than 5 kg within three decades, to a point where a third of the country's children are overweight…
Social Determinants | Child/Nutrition | Chronic Disease/Risk | Health Systems | Policy/Regulation | Culture/Society | Food/Agriculture | Government/Law | Health/Medicine | Global -
ArticlePublication 2019Projected U.S. State-Level Prevalence of Adult Obesity and Severe Obesity
This analysis estimates state-specific and demographic subgroup-specific trends and projections of the prevalence of categories …
This analysis estimates state-specific and demographic subgroup-specific trends and projections of the prevalence of categories of body-mass index (BMI) in the United States. Self-reported BMI from the Behavioral Risk Factor Surveillance System Survey (1993-1994 and 1999-2016) were obtained and corrected for quantile-specific self-reporting bias. Multinomial regressions were then fitted for each state and subgroup to estimate the prevalence of four BMI categories from 1990 through 2030: underweight or normal weight (BMI <25), overweight (25 to…
Social Determinants | Health Outcomes | Mathematical Models | Calibration/Validation | Chronic Disease/Risk | North America -
ArticlePublication 2022Excess Mortality and Elevated Body Weight in the U.S.
This analysis estimates excess mortality associated with elevated body weight in the United States by …
This analysis estimates excess mortality associated with elevated body weight in the United States by state and demographic subgroup. The authors developed a nationally-representative microsimulation (individual-level) model of US adults between 1999 and 2016, based on risk factor data from the Behavioral Risk Factor Surveillance System and body-mass index (BMI) mortality hazard ratios from a global pooling dataset. The model was calibrated to empirical all-cause mortality rates from CDC WONDER by state and subgroup, and…
Social Determinants | Health Outcomes | Microsimulation | Calibration/Validation | Chronic Disease/Risk | North America
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