Economics of Prevention and Lifestyles. From Evidence to Policies Summary

The focus of this project is the economic analysis of the efficiency and equity of policies against obesity and smoking, their design and implementation to Spain in the context of economic crisis. The situation is diagnosed by measuring the social gradient of obesity and smoking and its evolution in recent years, and the expected effects of different interventions and is valued, deepening theoretical and empirical knowledge of individual behavior and social interactions. From the evidence obtained we propose cost-effective interventions for reducing obesity and smoking prevalence in Spain.

The prevalence of smoking and obesity reflects social inequalities in health. With the economic crisis, they are possibly expanding. Social policies focusing on smoking and obesity are ultimately pro-equity policy policies. This project contributes to the design of such policies from different perspectives, covering a wide spectrum. In short, the project measures, estimates, experiments and proposes.

We will measure the social gradient of health inequality related to obesity, physical activity and diet, as well as its dynamics after the economic crisis aftermath. We will also measure the social gradient in smoking cessation. The inequalities are considered in their interpersonal aspect (analysis of microdata from surveys ) and spatial (geostatistics, small area analysis for the study of obesity, proxied with one of its consequences, diabetes). We use a conceptual theoretical basis of behavioral economics and social interactions.

We will use models based on microdata to estimate attributable causes of given effects: obesity, labor productivity, income and education, smoking cessation and its determinants. With the results of the models and using simulation methods, we determine the likely effects of various interventions on the factors amenable to intervention with pubic policy change.

We will experiment with adults, to determine whether group incentives to engage in regular physical exercise are more effective than individual incenctives. We will also perform an experiment with school children in Catalonia, in order to better understand the potential levers of change of eating habits in childhood. These childhood habits will derive to adulthood behaviours.

We will propose cost-effective and equitable strategies to address smoking cessation, and we will propose some changes in the regulation of taxes and rights to bid obesogenic components.

1. Systematic review of the international literature on the social gradient of obesity and on the effectiveness and equity of the policies , targeted to individuals and to communities, aiming to reduce the gradient. Particular focus on OECD cntries
   
   • Responsible: Beatriz G Lopez-Valcarcel
   • Participant: Patricia Barber, Laura Vallejo, Steve Morris
2. To measure the social gradient of obesity and sedentarism in Spain and its dynamics since 2006
   
   • Responsible: Beatriz G Lopez-Valcarcel
   • Participant: Patricia Barber, Laura Vallejo, Steve Morris
3. Microeconometric model of obesity and productivity
   
   • Responsible: Laura Vallejo
   • Participant: Stephen Morris, Beatriz G Lopez-Valcarcel, Patricia Barber, Alejandro Rodriguez
4. To measure the social multiplier of th obesity in Sapin (infection through social interactions) and the processes of territorial clusterization of obesity
   
   • Responsible: Jeffrey Harris
   • Participant: Patricia Barber, Rafael Suarez Vega, Beatriz G Lopez-Valcarcel, Alejandro Rodriguez
5. To evaluate experimentally the impact of different informations and interventions on the impact of consumption of sugared sodas by teenagers
   
   • Responsible: Toni Mora
   • Participant: Beatriz G Lopez-Valcarcel
6. Economics crisis and changes in nutrition patterns
   
   • Responsible: Almudena Sanchez Villegas.
   • Participant: Patricia Barber, Beatriz G Lopez-Valcarcel, Jaime Pinilla
7. To design a proposal of tax on sugared sodas, neutral to the income of the households in order to change unhealthy habits. The tax will have a measurable target in terms of reduction of obesity. To propose regulatory changes in the use of obesogenic/unhealthy ingredients (salt, saturated fats) with quantified objectives in terms of population health. To prospectivelly evaluate its medium and long term economic effects
   
   • Responsible: Vicente Ortún
   • Participant: Jaume Puig-Junoy, Beatriz G Lopez-Valcarcel, Alejandro Rodriguez
8. To identify interventions and smoking cessation programs at regional and local level in Spain
   
   • Responsible: Ángel López Nicolás,
   • Participant: Marta Trapero Bertrán, José María Ramos Parreño, Lourdes Badillo Amador, Belén Cobacho Tornel, Jeffrey Harris
9. To estimate the effectiveness of cessation programs . Comparison with results in the international literature
   
   • Responsible: Ángel López Nicolás,
   • Participant: Marta Trapero Bertrán, José María Ramos Parreño, Lourdes Badillo Amador, Belén Cobacho Tornel, Jeffrey Harris
10. Economic evaluation
    
    • Responsible: Ángel López Nicolás,
    • Participant: Marta Trapero Bertrán, José María Ramos Parreño, Lourdes Badillo Amador, Belén Cobacho Tornel, Jeffrey Harris
11. To propose measures to promote cessation
    
    • Responsible: Ángel López Nicolás,
    • Participant: Marta Trapero Bertrán, José María Ramos Parreño, Lourdes Badillo Amador, Belén Cobacho Tornel, Jeffrey Harris