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Obesity-related health impacts of fuel excise taxation- an evidence review and cost-effectiveness study

Brown, V., Moodie, M., Cobiac, L., Mantilla Herrera, A. M. and Carter, R. 2017, Obesity-related health impacts of fuel excise taxation- an evidence review and cost-effectiveness study, BMC public health, vol. 17, pp. 1-23, doi: 10.1186/s12889-017-4271-2.

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Title Obesity-related health impacts of fuel excise taxation- an evidence review and cost-effectiveness study
Author(s) Brown, V.ORCID iD for Brown, V. orcid.org/0000-0003-2891-9476
Moodie, M.ORCID iD for Moodie, M. orcid.org/0000-0001-6890-5250
Cobiac, L.
Mantilla Herrera, A. M.
Carter, R.ORCID iD for Carter, R. orcid.org/0000-0002-1586-5619
Journal name BMC public health
Volume number 17
Article ID 359
Start page 1
End page 23
Total pages 23
Publisher BioMed Central
Place of publication London, Eng.
Publication date 2017-05
ISSN 1471-2458
Keyword(s) Active transport
Cost-effectiveness
Obesity
Physical activity
Science & Technology
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
PUBLIC TRANSPORT USE
PHYSICAL-ACTIVITY
ACTIVE-TRANSPORT
TRAVEL BEHAVIOR
NATURAL EXPERIMENTS
GASOLINE PRICES
UNITED-STATES
BENEFITS
INTERVENTIONS
WALKING
Summary Background
Reducing automobile dependence and improving rates of active transport may reduce the impact of obesogenic environments, thereby decreasing population prevalence of obesity and other diseases where physical inactivity is a risk factor. Increasing the relative cost of driving by an increase in fuel taxation may therefore be a promising public health intervention for obesity prevention.

Methods
A scoping review of the evidence for obesity or physical activity effect of changes in fuel price or taxation was undertaken. Potential health benefits of an increase in fuel excise taxation in Australia were quantified using Markov modelling to simulate obesity, injury and physical activity related health impacts of a fuel excise taxation intervention for the 2010 Australian population. Health adjusted life years (HALYs) gained and healthcare cost savings from diseases averted were estimated. Incremental cost-effectiveness ratios (ICERs) were reported and results were tested through sensitivity analysis.

Results
Limited evidence on the effect of policies such as fuel taxation on health-related behaviours currently exists. Only three studies were identified reporting associations between fuel price or taxation and obesity, whilst nine studies reported associations specifically with physical activity, walking or cycling. Estimates of the cross price elasticity of demand for public transport with respect to fuel price vary, with limited consensus within the literature on a probable range for the Australian context. Cost-effectiveness modelling of a AUD0.10 per litre increase in fuel excise taxation using a conservative estimate of cross price elasticity for public transport suggests that the intervention would be cost-effective from a limited societal perspective (237 HALYs gained, AUD2.6 M in healthcare cost savings), measured against a comparator of no additional increase in fuel excise. Under “best case” assumptions, the intervention would be more cost-effective (3181 HALYs gained, AUD34.2 M in healthcare cost savings).

Conclusions
Exploratory analysis suggests that an intervention to increase fuel excise taxation may deliver obesity and physical activity related benefits. Whilst such an intervention has significant potential for cost-effectiveness, potential equity and acceptability impacts would need to be minimised. A better understanding of the effectiveness and cost-effectiveness of a range of transport interventions is required in order to achieve more physically active transport environments.
Language eng
DOI 10.1186/s12889-017-4271-2
Field of Research 1117 Public Health And Health Services
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2017, The Authors
Free to Read? Yes
Use Rights Creative Commons Attribution licence
Persistent URL http://hdl.handle.net/10536/DRO/DU:30096195

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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.