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This book uses an economic framework to examine the consequences of U.S. farm and food policies for obesity, its social costs, and the implications for government policy. Drawing on evidence from economics, public health, nutrition, and medicine, the authors evaluate past and potential future roles of policies such as farm subsidies, public agricultural R&D, food assistance programs, taxes on particular foods (such as sodas) or nutrients (such as fat), food labeling laws, and advertising controls. The findings are mostly negative—it is generally not economic to use farm and food policies as obesity policy—but some food policies that combine incentives and information have potential to make a worthwhile impact. This book is accessible to advanced undergraduate and graduate students across the sciences and social sciences, as well as to decision-makers in the public, private, and not-for-profit sectors.


Inhaltsverzeichnis

Frontmatter

1. Introduction

Abstract
The obesity epidemic is a global phenomenon, but it is worse in the United States than in most places. Obesity imposes significant individual and social costs and has become a focus of policy discussions. Many policy proposals relate to food and farms. What part have farm and food policies played as contributors to the problem? What part should they play in the government’s strategy to reduce obesity and its social costs? This book explores these questions, taking an economics perspective and using the tools of economics to analyze and evaluate the alternatives. The book is written for a broad general audience, including policymakers and the general public, and advanced undergraduate and graduate students across a range of disciplines.
Julian M. Alston, Abigail M. Okrent

2. Obesity in America

Abstract
Obesity was first identified as an issue of significant public policy concern in the late 1990s, after which US obesity rates continued to grow. Now, more than one-third of adult Americans are obese or extremely obese while a further one-third or more are overweight; in addition, one-third of American children are at least overweight, and about one-sixth are obese. In this chapter we document the obesity status of the nation and its genesis over the past 50 years. We review various concepts and measures of obesity, including the conventional BMI and alternatives. Then, using the BMI, we review the patterns of US obesity for adults and children over time, disaggregated spatially and among various sociodemographic groups.
Julian M. Alston, Abigail M. Okrent

3. Consequences of Obesity

Abstract
Obesity has serious consequences both for individuals and for society as a whole. At the individual level, obesity is associated with a host of diseases resulting in reduced life expectancy, lower productivity and wages, and increased health-care expenditure. Obesity also entails significant private expenditures on preventative measures such as gymnasium memberships and weight-loss programs. At the level of the broader society, the individual consequences are reflected in social costs through lost productivity, reduced income tax receipts for the government, greater public health-care expenditure, and expenditure on public policies for reducing obesity. In this chapter, we describe and document the individual consequences and present and interpret measures of the social costs.
Julian M. Alston, Abigail M. Okrent

4. Causes of Obesity: Individual Physiology and Consumption Choices

Abstract
The recent upward trend in the adult obesity rate is attributable to an energy imbalance, where people consume more calories than they expend. Between 1970 and 2004, Americans increased their daily consumption by an average of 300–500 calories, and the quality of diets changed. The typical American diet today consists of foods and beverages with a greater degree of processing, including more calories consumed from restaurants, sugar-sweetened beverages (SSBs), and ready-to-eat and ready-to-heat foods. Meanwhile, although physical activity in leisure has increased slightly, physical activity in work, housework, and travel has declined steadily. The complex interaction between diet composition, eating and physical activity behaviors, and human physiology makes it difficult to pinpoint the exact mechanism through which prevalence of obesity has increased.
Julian M. Alston, Abigail M. Okrent

5. Causes of Obesity: External Influences

Abstract
Individuals have heterogeneous preferences for food consumption, physical activity, and body weight, which may be shaped by environmental and market factors. These factors have also contributed to changes in household budget and time constraints in ways that have encouraged consumers to make choices consistent with gaining weight. In particular, changes in income, prices, the opportunity cost of time, and the quantity of time required to prepare and consume certain types of food have affected choices of physical activity and food consumption. In this chapter we examine the roles of these external factors, including environmental factors such as public transportation and food access, and market factors, such as food marketing, and the prices and availability of different options for food and exercise.
Julian M. Alston, Abigail M. Okrent

6. Role for Government: In Principle

Abstract
The primary economic rationale for government intervention to reduce obesity relates to externalities. An in-principle case can be made for government intervention on these grounds. Various interventions are feasible, including government incentives related to food consumption such as taxes or subsidies on “unhealthy” and “healthy” foods; government incentives related to healthy behavior and health outcomes; government provision of education or information about nutrition, including regulation of food labeling; government regulation of the food industry and its marketing practices, such as advertising to children; or rules and regulations pertaining to the provision of public and private health insurance. This chapter reviews these options and their relative merits in principle, paying attention to the issue of matching policy instruments to targets.
Julian M. Alston, Abigail M. Okrent

7. US Farm Subsidies and Obesity

Abstract
The idea that farm subsidies contribute significantly to obesity and that reducing these subsidies would go a long way toward solving the problem has been popular among the mainstream media and in policy circles. However, economists who have evaluated the issue have consistently found that farm subsidies have had negligible impacts on US obesity patterns. If anything, farm income support policies, including various subsidies and price supports, have made fattening food more expensive and reduced US obesity. New evidence from our updated economic simulation model reinforces that view and the conclusion that reformulation of farm subsidies would be ineffective and even counterproductive as a way of fighting US obesity.
Julian M. Alston, Abigail M. Okrent

8. Agricultural R&D, Technology, and Obesity

Abstract
Agricultural R&D has contributed to obesity by making food more abundant and cheaper, and some commentators have proposed that the agricultural research portfolio could be tilted more in favor of healthy foods, and away from less-healthy foods. We review these ideas in principle, and present a review of prior work and new evidence on the effects of past research investments and on the likely costs of changing the R&D portfolio as a way of fighting obesity in the United States. Our analysis suggests that redirecting agricultural research priorities would be a generally ineffective and highly expensive way of fighting obesity.
Julian M. Alston, Abigail M. Okrent

9. Fat Taxes and Thin Subsidies as Obesity Policy

Abstract
Many obesity policy proponents have speculated about taxing foods with high fat or high sugar content or subsidizing healthier foods, such as fresh fruit and vegetables, and governments have tried some of these possibilities. While much remains unresolved, the available evidence does not favor subsidies on fresh fruit and vegetables or taxes on sugar-sweetened beverages (SSBs) as obesity policy. Taxes on specific nutrients are generally found to be more effective in reducing calorie consumption and body weight as well as economically more efficient. However, any food tax will be regressive and could have other undesirable unintended consequences, and it is not clear that it would be politically feasible to set any such tax at a high enough rate to have a worthwhile effect on reducing obesity.
Julian M. Alston, Abigail M. Okrent

10. Other Food Policies as Obesity Policy

Abstract
Other food policies have also been implicated in the obesity epidemic. Our findings are generally negative regarding both the contributions of USDA’s food and nutrition programs (FANPs) to obesity and the potential for modifying them effectively and economically to reduce obesity. Some say strengthening the role of the US government in regulation of food labeling (the nutrition facts panel, other requirements for specific types of labels on the front or back of packages, and calorie postings at restaurants) and marketing to children will help fight obesity. Changes to current food labeling practices that are underway in the United States have potential to help some consumers to make more healthful food choices, but it is left to the food industry to self-regulate food marketing to children, and changes here have been largely ineffective. “Nudges” have been shown to complement the effectiveness of some existing policies.
Julian M. Alston, Abigail M. Okrent

11. Summary and Synthesis

Abstract
Many farm and food policies that have been proposed to reduce obesity will not be effective, economic, or politically acceptable. Farm subsidies and the Supplemental Nutrition Assistance Program (SNAP) have not contributed to obesity, and although public agricultural R&D has contributed to obesity, it would be inefficient to use agricultural R&D policy to curb obesity. Taxing calories, sugar, or fat might be an economically efficient way of reducing obesity; however, food taxes are regressive and might not be politically acceptable. Policies that induce the food industry to redesign foods may be more effective at reducing obesity than policies that rely entirely on inducing response by consumers. Policies that combine the push of market incentives with the pull of public education and nudging interventions may be the best of all.
Julian M. Alston, Abigail M. Okrent

Backmatter

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