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What is the public appetite for healthy eating policies? Evidence from a cross-European survey

Published online by Cambridge University Press:  29 August 2014

Mario Mazzocchi*
Affiliation:
Associate Professor, Department of Statistical Sciences, University of Bologna, Bologna, Italy
Silvia Cagnone
Affiliation:
Assistant Professor, Department of Statistical Sciences, University of Bologna, Bologna, Italy
Tino Bech-Larsen
Affiliation:
Associate Professor, Department of Business Administration, Aarhus University, Aarhus, Denmark
Barbara Niedźwiedzka
Affiliation:
Head of Department, Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland
Anna Saba
Affiliation:
Senior Researcher, Istituto Nazionale di Ricerca per gli Alimenti e la Nutrizione, Rome, Italy
Bhavani Shankar
Affiliation:
Professor, Leverhulme Centre for Integrative Research on Agriculture and Health and School of Oriental and African Studies, London, UK
Wim Verbeke
Affiliation:
Professor, Department of Agricultural Economics, Ghent University, Ghent, Belgium
W Bruce Traill
Affiliation:
Professor, Department of Food Economics and Marketing, University of Reading, Reading, UK
*
*Correspondence to: Mario Mazzocchi, Associate Professor, Department of Statistical Sciences, University of Bologna, Bologna, Italy, Via Belle Arti 41, 40124 Bologna, Italy. Email: m.mazzocchi@unibo.it

Abstract

World Health Organization estimates that obesity accounts for 2–8% of health care costs in different parts of Europe, and highlights a key role for national policymaking in curbing the epidemic. A variety of healthy-eating policy instruments are available, ranging from more paternalistic policies to those less intrusive. Our aim is to measure and explain the level of public support for different types of healthy eating policy in Europe, based on data from a probabilistic sample of 3003 respondents in five European countries. We find that the main drivers of policy support are attitudinal factors, especially attribution of obesity to excessive availability of unhealthy foods, while socio-demographic characteristics and political preferences have little explanatory power. A high level of support for healthy eating policy does not translate into acceptance of higher taxes to fund them, however.

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Articles
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© Cambridge University Press 2014 

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References

Anderson, J. C. and Gerbing, D. W. (1988), ‘Structural equation modeling in practice – a review and recommended 2-step approach’, Psychological Bulletin, 103(3): 411423.CrossRefGoogle Scholar
Barry, C. L., Brescoll, V. L., Brownell, K. D., et al. (2009), ‘Obesity metaphors: how beliefs about the causes of obesity affect support for public policy’, Milbank Quarterly, 87(1): 747.CrossRefGoogle ScholarPubMed
Barry, C. L., Niederdeppe, J. and Gollust, S. E. (2013), ‘Taxes on sugar-sweetened beverages results from a 2011 National Public Opinion Survey’, American Journal of Preventive Medicine, 44(2): 158163.CrossRefGoogle ScholarPubMed
Beaglehole, R., Bonita, R., Horton, R., et al. (2011), ‘Priority actions for the non-communicable disease crisis’, Lancet, 377(9775): 14381447.CrossRefGoogle ScholarPubMed
Bos, C., Van der Lans, I., Van Rijnsoever, F. and Van Trijp, H. (2013), ‘Understanding consumer acceptance of intervention strategies for healthy food choices: a qualitative study’, BMC Public Health, 13(1): 1073.CrossRefGoogle ScholarPubMed
Botelho, A. and Pinto, L. C. (2002), ‘Hypothetical, real, and predicted real willingness to pay in open-ended surveys: experimental results’, Applied Economics Letters, 9(15): 993996.CrossRefGoogle Scholar
Brambila-Macias, J., Shankar, B., Capacci, S., Mazzocchi, M., Perez-Cueto, F. J. A., Verbeke, W. and Trail, W. B. (2011), ‘Policy interventions to promote healthy eating: a review of what works, what does not, and what is promising’, Food and Nutrition Bulletin, 32(4): 365375.CrossRefGoogle ScholarPubMed
Briggs, A. D. M., Mytton, O., Kehlbacher, A., et al. (2013), ‘Overall and income specific effect on prevalence of overweight and obesity of 20% sugar sweetened drink tax in UK: econometric and comparative risk assessment modelling study’, British Medical Journal, 347: f689.CrossRefGoogle ScholarPubMed
Brownell, K. D. (2005), ‘The chronicling of obesity: growing awareness of its social, economic, and political contexts’, Journal of Health Politics Policy and Law, 30(5): 955964.CrossRefGoogle ScholarPubMed
Brownell, K. D. and Frieden, T. R. (2009), ‘Ounces of prevention – the public policy case for taxes on sugared beverages’, New England Journal of Medicine, 360(18): 18051808.CrossRefGoogle ScholarPubMed
Camacho, C. J., Higgins, E. T. and Luger, L. (2003), ‘Moral value transfer from regulatory fit: what feels right is right and what feels wrong is wrong’, Journal of Personality and Social Psychology, 84(3): 498510.CrossRefGoogle ScholarPubMed
Capacci, S., Mazzocchi, M., Shankar, B., et al. (2012), ‘Policies to promote healthy eating in Europe: a structured review of policies and their effectiveness’, Nutrition Reviews, 70(3): 188200.CrossRefGoogle ScholarPubMed
Caraher, M. and Cowburn, G. (2005), ‘Taxing food: implications for public health nutrition’, Public Health Nutrition, 8(8): 12421249.CrossRefGoogle ScholarPubMed
Cattaneo, A., Monasta, L., Stamatakis, E., et al. (2010), ‘Overweight and obesity in infants and pre-school children in the European Union: a review of existing data’, Obesity Reviews, 11(5): 389398.CrossRefGoogle ScholarPubMed
Cawley, J. (2006), ‘Markets and childhood obesity policy’, Future of Children, 16(1): 6988.CrossRefGoogle ScholarPubMed
Cawley, J. (2008), ‘Contingent valuation analysis of willingness to pay to reduce childhood obesity’, Economics & Human Biology, 6(2): 281292.CrossRefGoogle ScholarPubMed
Cecchini, M., Sassi, F., Lauer, J. A., Lee, Y. Y., Guajardo-Barron, V. and Chisholm, D. (2010), ‘Chronic diseases: chronic diseases and development 3 tackling of unhealthy diets, physical inactivity, and obesity: health effects and cost-effectiveness’, Lancet, 376(9754): 17751784.CrossRefGoogle Scholar
Chouinard, H. H., Davis, D. E., LaFrance, J. T. and Perloff, J. M. (2007), ‘Fat taxes: big money for small change’, Forum for Health Economics & Policy, 10(2): 2.CrossRefGoogle Scholar
Crockett, S. J. and Kennedy, E. (2002), ‘Food industry’s role in national nutrition policy: working for the common good’, Journal of the American Dietetic Association, 102(4): 478479.CrossRefGoogle ScholarPubMed
Diepeveen, S., Ling, T., Suhrcke, M., Roland, M. and Marteau, T. M. (2013), ‘Public acceptability of government intervention to change health-related behaviours: a systematic review and narrative synthesis’, BMC Public Health, 13: 756.CrossRefGoogle ScholarPubMed
Drewnowski, A. and Specter, S. E. (2004), ‘Poverty and obesity: the role of energy density and energy costs’, American Journal of Clinical Nutrition, 79(1): 616.CrossRefGoogle ScholarPubMed
Drewnowski, A. and Darmon, N. (2005), ‘Food choices and diet costs: an economic analysis’, Journal of Nutrition, 135(4): 900904.CrossRefGoogle ScholarPubMed
Emm, L. G., Gillison, F. B. and Juszczyk, D. (2013), ‘Support for obesity-related policy and its association with motivation for weight control’, Psychology Public Policy and Law, 19(3): 321330.CrossRefGoogle Scholar
Evans, W. D., Finkelstein, E. A., Kamerow, D. B. and Renaud, J. M. (2005), ‘Public perceptions of childhood obesity’, American Journal of Preventive Medicine, 28(1): 2632.CrossRefGoogle ScholarPubMed
Fletcher, J. M., Frisvold, D. E. and Tefft, N. (2010), ‘The effects of soft drink taxes on child and adolescent consumption and weight outcomes’, Journal of Public Economics, 94(11–12): 967974.CrossRefGoogle Scholar
Gortmaker, S. L., Swinbum, B. A., Levy, D., Carter, R., Mabry, P. L., Finegood, D. T., Huang, T., Marsh, T. and Moodie, M. L. (2011), ‘Obesity 4 changing the future of obesity: science, policy, and action’, Lancet, 378(9793): 838847.CrossRefGoogle Scholar
Gray, B. H. (2009), ‘In this issue’, Milbank Quarterly, 87(1): 15.CrossRefGoogle Scholar
Grier, S. and Bryant, C. A. (2005), ‘Social marketing in public health’, Annual Review of Public Health, 26: 319339.CrossRefGoogle ScholarPubMed
Grunert, K. G. and Wills, J. M. (2007), ‘A review of European research on consumer response to nutrition information on food labels’, Journal of Public Health, 15(5): 385399.CrossRefGoogle Scholar
Hardus, P. M., van Vuuren, C. L., Crawford, D. and Worsley, A. (2003), ‘Public perceptions of the causes and prevention of obesity among primary school children’, International Journal of Obesity, 27(12): 14651471.CrossRefGoogle ScholarPubMed
Harvard School of Public Health. (2003), Obesity as a public health issue: a look at solutions, http://www.phsi.harvard.edu/health_reform/poll_results.pdf [10 August 2014].Google Scholar
Higgins, E. T., Friedman, R. S., Harlow, R. E., Idson, L. C., Ayduk, O. N. and Taylor, A. (2001), ‘Achievement orientations from subjective histories of success: promotion pride vs prevention pride’, European Journal of Social Psychology, 31(1): 323.CrossRefGoogle Scholar
Hilbert, A., Rief, W. and Braehler, E. (2007), ‘What determines public support of obesity prevention?’, Journal of Epidemiology and Community Health, 61(7): 585590.CrossRefGoogle ScholarPubMed
Iacobucci, D. (2010), ‘Structural equations modeling: fit Indices, sample size, and advanced topics’, Journal of Consumer Psychology, 20(1): 9098.CrossRefGoogle Scholar
Jacobson, M. F. and Brownell, K. D. (2000), ‘Small taxes on soft drinks and snack foods to promote health’, American Journal of Public Health, 90(6): 854857.Google ScholarPubMed
Jensen, J. D. and Smed, S. (2013), ‘The Danish tax on saturated fat – short run effects on consumption, substitution patterns and consumer prices of fats’, Food Policy, 42: 1831.CrossRefGoogle Scholar
Jöreskog, K. G. and Moustaki, I. (2006), Factor analysis of ordinal variables with full information maximum likelihood, SSI Scientific Software International, http://www.ssicentral.com/lisrel/techdocs/orfiml.pdf [10 August 2014].Google Scholar
Jöreskog, K. G., Sörbom, D., Du Toit, S. and Du Toit, M. (2001), LISREL 8: New Statistical Features, Lincolnwood, IL: Scientific Software International.Google Scholar
Jost, J. T., Glaser, J., Kruglanski, A. W. and Sulloway, F. J. (2003), ‘Political conservatism as motivated social cognition’, Psychological Bulletin, 129(3): 339375.CrossRefGoogle ScholarPubMed
Kersh, R. (2009), ‘The politics of obesity: a current assessment and look ahead’, Milbank Quarterly, 87(1): 295316.CrossRefGoogle ScholarPubMed
Kim, D. and Kawachi, I. (2006), ‘Food taxation and pricing strategies to “thin out” the obesity epidemic’, American Journal of Preventive Medicine, 30(5): 430437.CrossRefGoogle Scholar
Lang, T. and Rayner, G. (2007), ‘Overcoming policy cacophony on obesity: an ecological public health framework for policymakers’, Obesity Reviews, 8: 165181.CrossRefGoogle ScholarPubMed
Lang, T. and Rayner, G. (2010), ‘Corporate responsibility in public health’, British Medical Journal, 341: 110111.CrossRefGoogle ScholarPubMed
Legifrance.gouv.fr (2012), Code général des impôts, Article 1613 ter: contribution perçue sur les boissons et préparations liquides pour boissons destinées à la consommation humaine, http://www.legifrance.gouv.fr/affichCodeArticle.do?idArticle=LEGIARTI000025051331&cidTexte=LEGITEXT000006069577 [10 August 2014].Google Scholar
Leicester, A. and Windmeijer, F. (2004), ‘The ‘fat tax’: economic incentives to reduce obesity’, IFS Briefing Notes, 49: 19pp.Google Scholar
Ludwig, D. S. and Nestle, M. (2008), ‘Can the food industry play a constructive role in the obesity epidemic?’, Journal of the American Medical Association, 300(15): 18081811.CrossRefGoogle ScholarPubMed
Mazzocchi, M., Brasili, C. and Sandri, E. (2008), ‘Trends in dietary patterns and compliance with World Health Organization recommendations: a cross-country analysis’, Public Health Nutrition, 11(5): 535540.CrossRefGoogle ScholarPubMed
Mazzocchi, M., Traill, B. and Shogren, J. F. (2009), Fat Economics: Nutrition, Health, and Economic Policy, New York: Oxford University Press.CrossRefGoogle Scholar
McColl, K. (2009), ‘“Fat taxes” and the financial crisis’, Lancet, 373(9666): 797798.CrossRefGoogle ScholarPubMed
Millstone, E. and Lobstein, T. (2007), ‘The PorGrow project: overall cross-national results, comparisons and implications’, Obesity Reviews, 8: 2936.CrossRefGoogle ScholarPubMed
Morain, S. and Mello, M. M. (2013), ‘Survey finds public support for legal interventions directed at health behavior to fight noncommunicable disease’, Health Affairs, 32(3): 486496.CrossRefGoogle ScholarPubMed
Mytton, O., Gray, A., Rayner, M. and Rutter, H. (2007), ‘Could targeted food taxes improve health?Journal of Epidemiology and Community Health, 61(8): 689694.CrossRefGoogle ScholarPubMed
Mytton, O., Clarke, D. and Rayner, M. (2012), ‘Taxing unhealthy food and drinks to improve health’, British Medical Journal, 344: e2931.CrossRefGoogle ScholarPubMed
Nnoaham, K. E., Sacks, G., Rayner, M., Mytton, O. and Gray, A. (2009), ‘Modelling income group differences in the health and economic impacts of targeted food taxes and subsidies’, International Journal of Epidemiology, 38(5): 13241333.CrossRefGoogle ScholarPubMed
Nordstrom, J. and Thunstrom, L. (2009), ‘The impact of tax reforms designed to encourage healthier grain consumption’, Journal of Health Economics, 28(3): 622634.CrossRefGoogle ScholarPubMed
Oliver, J. E. and Lee, T. (2005), ‘Public opinion and the politics of obesity in America’, Journal of Health Politics Policy and Law, 30(5): 923954.CrossRefGoogle ScholarPubMed
Parkinson, B. and Goodall, S. (2011), ‘Considering consumer choice in the economic evaluation of mandatory health programmes: a review’, Health Policy, 101(3): 236244.CrossRefGoogle ScholarPubMed
Pickett, K. E., Kelly, S., Brunner, E., Lobstein, T. and Wilkinson, R. G. (2005), ‘Wider income gaps, wider waistbands? An ecological study of obesity and income inequality’, Journal of Epidemiology and Community Health, 59(8): 670674.CrossRefGoogle ScholarPubMed
Powell, L. M. and Chaloupka, F. J. (2009), ‘Food prices and obesity: evidence and policy implications for taxes and subsidies’, Milbank Quarterly, 87(1): 229257.CrossRefGoogle ScholarPubMed
Sikorski, C., Luppa, M., Schomerus, G., Werner, P., Konig, H. H. and Riedel-Heller, S. G. (2012), ‘Public attitudes towards prevention of obesity’, PLoS One, 7(6).CrossRefGoogle ScholarPubMed
Smed, S. (2012), ‘Financial penalties on foods: the fat tax in Denmark’, Nutrition Bulletin, 37(2): 142147.CrossRefGoogle Scholar
Stirling, A., Lobstein, T. and Millstone, E. (2007), ‘Methodology for obtaining stakeholder assessments of obesity policy options in the PorGrow project’, Obesity Reviews, 8: 1727.CrossRefGoogle ScholarPubMed
Story, M. (1999), ‘School-based approaches for preventing and treating obesity’, International Journal of Obesity, 23: S43S51.CrossRefGoogle ScholarPubMed
Suggs, L. S. and McIntyre, C. (2011), ‘European Union public opinion on policy measures to address childhood overweight and obesity’, Journal of Public Health Policy, 32(1): 91103.CrossRefGoogle ScholarPubMed
Tiffin, R. and Arnoult, M. (2011), ‘The public health impacts of a fat tax’, European Journal of Clinical Nutrition, 65(4): 427433.CrossRefGoogle ScholarPubMed
Variyam, J. N. (2008), ‘Do nutrition labels improve dietary outcomes?Health Economics, 17(6): 695708.CrossRefGoogle ScholarPubMed
Veerman, J. L., Van Beeck, E. F., Barendregt, J. J. and Mackenbach, J. P. (2009), ‘By how much would limiting TV food advertising reduce childhood obesity?European Journal of Public Health, 19(4): 365369.CrossRefGoogle ScholarPubMed
Wilde, P. (2009), ‘Self-regulation and the response to concerns about food and beverage marketing to children in the United States’, Nutrition Reviews, 67(3): 155166.CrossRefGoogle ScholarPubMed
Wilkinson, R. G. and Pickett, K. E. (2006), ‘Income inequality and population health: a review and explanation of the evidence’, Social Science & Medicine, 62(7): 17681784.CrossRefGoogle Scholar
World Health Organization. (2000), ‘Obesity: preventing and managing the global epidemic’, WHO Technical Report Series, Report number 894, 252pp.Google Scholar
Zhen, C., Finkelstein, E. A., Nonnemaker, J. M., Karns, S. A. and Todd, J. E. (2014), ‘Predicting the effects of sugar-sweetened beverage taxes on food and beverage demand in a large demand system’, American Journal of Agricultural Economics, 96(1): 125.CrossRefGoogle Scholar
Zywicki, T. J., Holt, D. and Ohlhausen, M. K. (2004), ‘Obesity and advertising policy’, George Mason Law Review, 12(4): 9791011.Google Scholar
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