Fiscal measures to improve health proven as essential

A new briefing from The King’s Fund has found that regulatory measures to improve health, such as the targeted use of taxation, have proven essential tools to reduce health inequalities.

Unhealthy behaviours such as smoking and poor diet contribute significantly to poor health and can deepen health inequalities. Currently, more than seven million people in the UK are smokers and children in the poorest parts of the country are now twice as likely to be obese as those in the richest areas.

The briefing highlights evidence that tax and regulatory measures can be used to reshape environments so that it is easier for people to live healthier lives, such as by limiting the promotion of unhealthy food and drink to children.  

The King’s Fund argues that using fiscal and regulatory measures to promote and protect public health is neither new nor novel. However, since 2010, government policy has tended to place more emphasis on the role of individual responsibility and voluntary regulation, although the introduction of the Soft Drinks Industry Levy is an example of a more robust approach.

Polling shows that policies to improve public health through taxation and regulation are more popular than politicians often assume, and that attitudes can change over time. For example, there is broad public support for the levy on soft drinks and for measures to make healthier foods cheaper than unhealthy ones, while a decade after the smoking ban was introduced, it was not only widely supported by non-smokers but also most smokers.

Helen McKenna, senior fellow at The King’s Fund, said: “Policy-makers can use tax and regulation to shape our environments, for example by changing prices to discourage people from purchasing unhealthy products. Dismissing these interventions as ‘nanny state’ unhelpfully polarises the debate when there is good evidence that well-designed fiscal and regulatory measures can play an important role in improving public health and reducing the economic and social costs of poor health. The government should follow this evidence and be bolder in using tax and regulation to improve public health. Surveys find broad public support for such measures, challenging the assumption that these interventions would be unpopular.”

Gary Howsam, vice chair of the Royal College of GPs, said: "The College has supported the use of so-called 'sin taxes' on items such as sugary drinks, alcohol and tobacco to tackle preventable chronic diseases for some time – and we agree with the King's Fund that dismissing these interventions as being too paternalistic is unhelpful as we strive for better public health across society.

"We have seen these interventions lead to significant improvements in public health, such as fewer people smoking, and the latest Public Health England progress report on the sugar reduction programme found that compulsory levies on soft drinks reduced sugar ten times faster than a request to companies to take sugar out of products. Lifestyle factors are the leading causes of non-communicable diseases, including cancer, diabetes and liver disease, which we know can be prevented or improved through addressing diet, physical inactivity, smoking and alcohol consumption – and we know that taxes can dissuade people from making lifestyle choices that can be detrimental for their health.

"What is essential is that any decisions made relating to public health are evidence-based – and that initiatives are regularly and rigorously evaluated in terms of their benefit - and current evidence shows that taxes have a more significant impact on public health than voluntary regulations."