Economic & health impact evidence synthesis to inform policy and practice decisions

Work Package Researchers: Alan Brennan, Colin Angus, and Duncan Gillespie, University of Sheffield

Aim: To develop economic and health impact evidence, modelling and analysis, focussing on wider complex system effects of unhealthy commodities and prevention policies in the UK.

Objectives:

• Develop new evidence on the impacts of alcohol and tobacco, their associated diseases, and prevention policies on the wider economy – including: consumers’ work productivity, employment and early retirement; revenue to retailers; gains and losses in different sectors of the UK economy; direct and indirect tax revenues to government; and public sector costs from healthcare, social care and crime;
• Develop and extend the Sheffield Tobacco and Alcohol Policy Model (STAPM) for England to analyse the economic and health impacts of changes in use of alcohol and/or tobacco on a wide range of outcomes; and produce new versions for both Wales and Scotland, thus enabling between-country comparisons;
• Undertake translational work with collaborators in food systems to explore how economic methods in alcohol and tobacco could be of use in complex food systems modelling.

Methods and Data Sources:

The Sheffield Tobacco and Alcohol Policy Model (STAPM) for England was developed via UKCTAS, extending previously-developed methods to assess the effects of alcohol minimum unit pricing to model the impacts of tax policies on tobacco and alcohol. The model estimates the effects of such policies on consumer spending, morbidity and mortality from 57 diseases, and evaluates impacts on health inequalities, costs to the NHS, and government tax revenue. We will draw on existing datasets, results from systematic reviews, and new evidence to update this model for England and to develop new models for Scotland and Wales.

Novel evidence on the economic system will be produced following review, critical appraisal and categorisation of existing methods used to examine the wider economic impacts of policy interventions. These will be identified from both academic and grey literature - including industry funded reports, which make claims about the importance of tobacco and alcohol to the economy. Building on a research programme focused on health conditions related to workplace outcomes, we will undertake micro-econometric longitudinal analyses of datasets containing both health and work variables (HSE linked to Understanding Society, and Labour Force Survey) . This work will examine the relationship between changes in the prevalence of alcohol- and smoking-related conditions, and changes in workplace outcomes – including gross pay per week, hours worked, absences from work due to sickness, retirement and early retirement, unemployment and economic inactivity, and claiming income support. In parallel, we will develop ‘input-output modelling’ to understand interactions between different sectors of the economy in terms of the impact of changes in tobacco or alcohol consumption (e.g. sectors supplying goods/services to UCPs could experience reduced economic activity, while savings (e.g. healthcare) could divert to other sectors, which therefore experience growth). This approach has recently been applied in the alcohol sector, looking at the net redistribution effects of price increases – including on tax incomes and government expenditures, rather than just focussing on effects within a supply-related industries (which some industry funded studies have done). We propose to extend this approach to joint modelling of both alcohol and tobacco industry impacts.

We will integrate this modelling and economic analysis with evidence from the other WPs to undertake policy evaluation (retrospective), appraisal (prospective), and scenario analyses (modelling) from an economic perspective, with a focus on the impact of UCP activities intended to defeat or delay regulation or policy implementation. Finally, we will build on existing collaborations (including the NIHR School for Public Health Research), to undertake translational work linking these methods to complex systems modelling in food systems.