scholarly journals Implications of Brexit on the effectiveness of the UK soft drinks industry levy upon CHD in England: a modelling study

2018 ◽  
Vol 21 (18) ◽  
pp. 3431-3439
Author(s):  
Paraskevi Seferidi ◽  
Anthony A Laverty ◽  
Jonathan Pearson-Stuttard ◽  
Maria Guzman-Castillo ◽  
Brendan Collins ◽  
...  
Keyword(s):  
Food Policy ◽  
Uncertainty Interval ◽  
Sugar Price ◽  
Policy Model ◽  
Sweetened Beverages ◽  
Life Years ◽  
Economic Circumstance ◽  
One Year ◽  
The Uk ◽  
The Eu

AbstractObjectiveAn industry levy on sugar-sweetened beverages (SSB) was implemented in the UK in 2018. One year later, Brexit is likely to change the UK trade regime with potential implications for sugar price. We modelled the effect of potential changes in sugar price due to Brexit on SSB levy impacts upon CHD mortality and inequalities.DesignWe modelled a baseline SSB levy scenario; an SSB levy under ‘soft’ Brexit, where the UK establishes a free trading agreement with the EU; and an SSB levy under ‘hard’ Brexit, in which World Trade Organization tariffs are applied. We used the previously validated IMPACT Food Policy model and probabilistic sensitivity analysis to estimate the effect of each scenario on CHD deaths prevented or postponed and life-years gained, stratified by age, sex and socio-economic circumstance, in 2021.SettingEngland.SubjectsAdults aged 25 years or older.ResultsThe SSB levy was associated with approximately 370 (95 % uncertainty interval 220, 560) fewer CHD deaths and 4490 (2690, 6710) life-years gained in 2021. Associated reductions in CHD mortality were 4 and 8 % greater under ‘soft’ and ‘hard’ Brexit scenarios, respectively. The SSB levy was associated with approximately 110 (50, 190) fewer CHD deaths in the most deprived quintile compared with 60 (20, 100) in the most affluent, under ‘hard’ Brexit.ConclusionsOur study found the SSB levy resilient to potential effects of Brexit upon sugar price. Even under ‘hard’ Brexit, the SSB levy would yield benefits for CHD mortality and inequalities. Brexit negotiations should deliver a fiscal and regulatory environment which promotes population health.

scholarly journals Potential impacts of post-Brexit agricultural policy on fruit and vegetable intake and cardiovascular disease in England: a modelling study

2020 ◽  
Vol 3 (1) ◽  
pp. 3-10
Author(s):  
Paraskevi Seferidi ◽  
Anthony A Laverty ◽  
Brendan Collins ◽  
Piotr Bandosz ◽  
Simon Capewell ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Agricultural Policy ◽  
Fruits And Vegetables ◽  
Food Policy ◽  
Vegetable Intake ◽  
Uncertainty Interval ◽  
Domestic Production ◽  
Policy Model ◽  
Relative Risks ◽  
Cvd Mortality

BackgroundCurrent proposals for post-Brexit agricultural policy do not explicitly incorporate public health goals. The revised agricultural policy may be an opportunity to improve population health by supporting domestic production and consumption of fruits and vegetables (F&V). This study aims to quantify the potential impacts of a post-Brexit agricultural policy that increases land allocated to F&V on cardiovascular disease (CVD) mortality and inequalities in England, between 2021 to 2030.MethodsWe used the previously validated IMPACT Food Policy model and probabilistic sensitivity analysis to translate changes in land allocated to F&V into changes in F&V intake and associated CVD deaths, stratified by age, sex and Index of Multiple Deprivation. The model combined data on F&V agriculture, waste, purchases and intake, CVD mortality projections and appropriate relative risks. We modelled two scenarios, assuming that land allocated to F&V would gradually increase to 10% and 20% of land suitable for F&V production.ResultsWe found that increasing land use for F&V production to 10% and 20% of suitable land would increase fruit intake by approximately 3.7% (95% uncertainty interval: 1.6% to 8.6%) and 17.4% (9.1% to 36.9%), and vegetable intake by approximately 7.8% (4.2% to 13.7%) and 37% (24.3% to 55.7%), respectively, in 2030. This would prevent or postpone approximately 3890 (1950 to 7080) and 18 010 (9840 to 28 870) CVD deaths between 2021 and 2030, under the first and second scenario, respectively. Both scenarios would reduce inequalities, with 16% of prevented or postponed deaths occurring among the least deprived compared with 22% among the most deprived.ConclusionPost-Brexit agricultural policy presents an important opportunity to improve dietary intake and associated cardiovascular mortality by supporting domestic production of F&V as part of a comprehensive strategy that intervenes across the supply chain.

scholarly journals Impacts of Brexit on fruit and vegetable intake and cardiovascular disease in England: a modelling study

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e026966 ◽  
Author(s):  
Paraskevi Seferidi ◽  
Anthony A Laverty ◽  
Jonathan Pearson-Stuttard ◽  
Piotr Bandosz ◽  
Brendan Collins ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Trade Policy ◽  
Food Systems ◽  
Fruits And Vegetables ◽  
Vegetable Intake ◽  
Uncertainty Interval ◽  
The Uk ◽  
The Eu ◽  
Cvd Mortality ◽  
Modelling Study

ObjectivesTo estimate the potential impacts of different Brexit trade policy scenarios on the price and intake of fruits and vegetables (F&V) and consequent cardiovascular disease (CVD) deaths in England between 2021 and 2030.DesignEconomic and epidemiological modelling study with probabilistic sensitivity analysis.SettingThe model combined publicly available data on F&V trade, published estimates of UK-specific price elasticities, national survey data on F&V intake, estimates on the relationship between F&V intake and CVD from published meta-analyses and CVD mortality projections for 2021–2030.ParticipantsEnglish adults aged 25 years and older.InterventionsWe modelled four potential post-Brexit trade scenarios: (1) free trading agreement with the EU and maintaining half of non-EU free trade partners; (2) free trading agreement with the EU but no trade deal with any non-EU countries; (3) no-deal Brexit; and (4) liberalised trade regime that eliminates all import tariffs.Outcome measuresCumulative coronary heart disease and stroke deaths attributed to the different Brexit scenarios modelled between 2021 and 2030.ResultsUnder all Brexit scenarios modelled, prices of F&V would increase, especially for those highly dependent on imports. This would decrease intake of F&V between 2.5% (95% uncertainty interval: 1.9% to 3.1%) and 11.4% (9.5% to 14.2%) under the different scenarios. Our model suggests that a no-deal Brexit scenario would be the most harmful, generating approximately 12 400 (6690 to 23 390) extra CVD deaths between 2021 and 2030, whereas establishing a free trading agreement with the EU would have a lower impact on mortality, contributing approximately 5740 (2860 to 11 910) extra CVD deaths.ConclusionsTrade policy under all modelled Brexit scenarios could increase price and decrease intake of F&V, generating substantial additional CVD mortality in England. The UK government should consider the population health implications of Brexit trade policy options, including changes to food systems.

scholarly journals Impacts of post-Brexit agricultural policy on fruit and vegetable intake and cardiovascular disease

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
P Seferidi ◽  
A A Laverty ◽  
J Pearson-Stuttard ◽  
B Collins ◽  
P Bandosz ◽  
...  
Keyword(s):  
Public Health ◽  
Cardiovascular Disease ◽  
Agricultural Policy ◽  
Agricultural Land ◽  
Vegetable Intake ◽  
Vegetable Production ◽  
Fruit And Vegetable ◽  
Uncertainty Interval ◽  
Policy Model ◽  
The Uk

Abstract Background The post-Brexit agricultural regime represents an opportunity to positively influence food systems and improve public health. Health-improving measures could include expanding the UK production of fruits and vegetables (F&V), thus increasing F&V availability. Currently, only 1.4% of total agricultural land in England is allocated to F&V. This study aims to estimate the potential impacts of allocating additional land to F&V production on cardiovascular disease (CVD) and inequalities in England between 2021 and 2030. Methods We used the previously validated IMPACT Food Policy model to translate changes in land allocated to F&V into changes in F&V intake and associated CVD mortality, expressed in number of deaths prevented or postponed (DPPs) by age, sex, and Index of Multiple Deprivation (IMD) quintile. We modelled two scenarios that assumed a linear increase in agricultural land allocated to F&V until it covers a) 10% and b) 20% of all land suitable for production of horticultural crops in England. We assumed that F&V prices would drop to a new equilibrium. We used Monte Carlo simulations to produce uncertainty intervals. Results Our model suggested that by 2030, F&V intake might increase by approximately 4% (95% Uncertainty Interval: 2%-7%) and 8% (4%-13%) respectively, under the first scenario. Under the second scenario, F&V intake could increase by approximately 17% (10%-29%) and 37% (26%-51%) respectively. These increases in F&V intake were associated with 3360 (1760-5920) CVD DPPs under the first scenario and 15700 (9000-24310) under the second scenario in 2021-2030. Our modelled scenarios could also reduce inequalities, with some 16% of DPPs occurring in the least deprived group compared with 22% in the most deprived. Conclusions Policymakers should consider the public health impacts of the post-Brexit agricultural regime in England. Increasing the land allocated to F&V production could substantially reduce the burden of CVD and associated inequalities. Key messages The post-Brexit agricultural policy can be an opportunity to improve diet and public health in the UK. Increasing the agricultural land allocated to fruit and vegetable production in England could reduce the burden of cardiovascular disease and associated inequalities.

scholarly journals The potential global gains in health and revenue from increased taxation of tobacco, alcohol and sugar-sweetened beverages: a modelling analysis

2020 ◽  
Vol 5 (3) ◽  
pp. e002143
Author(s):  
Amit Summan ◽  
Nicholas Stacey ◽  
Johanna Birckmayer ◽  
Evan Blecher ◽  
Frank J Chaloupka ◽  
...  
Keyword(s):  
Low Income ◽  
National Level ◽  
Economic Effects ◽  
Data Availability ◽  
Alcoholic Beverages ◽  
Sugar Sweetened Beverages ◽  
Uncertainty Interval ◽  
Sweetened Beverages ◽  
Life Years ◽  
Global Population

IntroductionGlobally, a growing burden of morbidity and mortality is attributable to lifestyle behaviours, and in particular to the consumption of tobacco, alcohol and sugar-sweetened beverages (SSB). In low-income and middle-income countries, this increased disease burden falls on already encumbered and resource-constrained healthcare systems. Fiscal policies, specifically taxation, can lower consumption of tobacco, alcohol and SSB while raising government revenues.MethodsWe simulated the health and economic effects of taxing cigarettes, alcohol and SSB over 50 years for 30–79 years old populations using separate mathematical models for each commodity that incorporated country-level epidemiological, demographic and consumption data. Based on data availability, national-level health effects of higher tobacco, alcohol and SSB taxes were simulated in 141, 166 and 176 countries, respectively, which represented 92%, 97% and 95% of the global population, respectively. Economic effects for tobacco, alcohol and SSB were estimated for countries representing 91%, 43% and 83% of the global population, respectively. These estimates were extrapolated to the global level by matching countries according to income level.ResultsOver 50 years, taxes that raise the retail price of tobacco, alcoholic beverages and SSB by 20% could result in a global gain of 160.7 million (95% uncertainty interval (UI): 96.3 to 225.2 million), 227.4 million (UI: 161.2 to 293.6 million) and 24.3 million (UI: 15.7 to 35.4 million) additional life years, respectively.ConclusionExcise tax increases on tobacco, alcohol and SSB can produce substantial health gains by reducing premature mortality while raising government revenues, which could be used to increase public health funding.

Brexit and the EU Area of Freedom, Security, and Justice

2017 ◽  
Author(s):  
Deirdre Curtin
Keyword(s):  
Member State ◽  
Data Retention ◽  
Free Zone ◽  
The Uk ◽  
The Eu

UK involvement in the EU Area of Freedom, Security, and Justice (AFSJ) has been patchy. It never joined the Schengen border-free zone, and when in 2014 it exercised a block exit from all AFSJ measures, it selectively rejoined a substantial number. Even if partially outside, the UK has been a leader inside. Advanced intelligence capabilities meant it provided important support to the functioning of agencies such as Europol and UK laws inspired EU laws, for example, on data retention. The need to preserve some pragmatic forms of cooperation between the UK and the EU is obvious and shared by the UK security establishment. There is a partial institutional precedent . When Denmark rejected participation in Europol in a popular referendum, the Danish government obtained a deal from the EU institutions which allows it to remain associated to Europol as a ‘third country’ (and a Member State). The bespoke Brexit reality may prove even more complex.

The Law & Politics of Brexit: Volume II

2020 ◽  
Keyword(s):  
Decision Making ◽  
European Union ◽  
Legal Framework ◽  
Comprehensive Analysis ◽  
The European Union ◽  
Trade Relations ◽  
The United Kingdom ◽  
The Uk ◽  
Financial Settlement ◽  
The Eu

This book provides the first comprehensive analysis of the withdrawal agreement concluded between the United Kingdom and the European Union to create the legal framework for Brexit. Building on a prior volume, it overviews the process of Brexit negotiations that took place between the UK and the EU from 2017 to 2019. It also examines the key provisions of the Brexit deal, including the protection of citizens’ rights, the Irish border, and the financial settlement. Moreover, the book assesses the governance provisions on transition, decision-making and adjudication, and the prospects for future EU–UK trade relations. Finally, it reflects on the longer-term challenges that the implementation of the 2016 Brexit referendum poses for the UK territorial system, for British–Irish relations, as well as for the future of the EU beyond Brexit.

Medical Device Regulation: Requirements for Dental Professionals Who Prescribe and Manufacture Custom-Made Devices

2021 ◽  
Vol 10 (1) ◽  
pp. 64-88
Author(s):  
James I. J. Green
Keyword(s):  
Medical Device ◽  
Medical Devices ◽  
Transition Period ◽  
Eu Directive ◽  
Custom Made ◽  
Dental Setting ◽  
The Uk ◽  
Dental Professionals ◽  
The Eu ◽  
Medical Device Regulation

A custom-made device (CMD) is a medical device intended for the sole use of a particular patient. In a dental setting, CMDs include prosthodontic devices, orthodontic appliances, bruxism splints, speech prostheses and devices for the treatment of obstructive sleep apnoea, trauma prevention and orthognathic surgery facilitation (arch bars and interocclusal wafers). Since 1993, the production and provision of CMDs have been subject to European Union (EU) Directive 93/42/EEC (Medical Device Directive, MDD) given effect in the UK by The Medical Devices Regulations 2002 (Statutory Instrument 2002/618), and its subsequent amendments. Regulation (EU) 2017/745 (Medical Device Regulation, EU MDR) replaces the MDD and the other EU Directive pertaining to Medical Devices, Council Directive 90/385/EEC (Active Implantable Medical Device Directive, AIMDD). The EU MDR was published on 5 April 2017, came into force on 25 May 2017 and, following a three-year transition period was due to be fully implemented and repeal the MDD on 26 May 2020, but was deferred until 26 May 2021 due to the coronavirus disease 2019 (COVID-19) pandemic. In the UK, in preparation for the country’s planned departure from the EU, the EU MDR, with necessary amendments, was transposed into UK law (Medical Devices (Amendment etc.) (EU Exit) Regulations 2019, UK MDR). The UK left the Union on 31 January 2020 and entered a transition period that ended on 31 December 2020, meaning that, from 1 January 2021, dental professionals in Great Britain who prescribe and manufacture CMDs are mandated to do so in accordance with the new legislation while Northern Ireland remains in line with the EU legislation and implementation date. This paper sets out the requirements that relate to the production and provision of CMDs in a UK dental setting.

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