scholarly journals Equity impact of minimum unit pricing of alcohol on household health and finances among rich and poor drinkers in South Africa

2022 ◽  
Vol 7 (1) ◽  
pp. e007824
Author(s):  
Naomi Gibbs ◽  
Colin Angus ◽  
Simon Dixon ◽  
D H Charles ◽  
Petra S Meier ◽  
...  
Keyword(s):  
South Africa ◽  
Healthcare Cost ◽  
Cost Savings ◽  
Policy Appraisal ◽  
Catastrophic Health Expenditures ◽  
Health Related ◽  
Effective Policy ◽  
Unit Pricing ◽  
The Impact ◽  
Alcohol Related Harm

IntroductionSouth Africa experiences significant levels of alcohol-related harm. Recent research suggests minimum unit pricing (MUP) for alcohol would be an effective policy, but high levels of income inequality raise concerns about equity impacts. This paper quantifies the equity impact of MUP on household health and finances in rich and poor drinkers in South Africa.MethodsWe draw from extended cost-effectiveness analysis (ECEA) methods and an epidemiological policy appraisal model of MUP for South Africa to simulate the equity impact of a ZAR 10 MUP over a 20-year time horizon. We estimate the impact across wealth quintiles on: (i) alcohol consumption and expenditures; (ii) mortality; (iii) government healthcare cost savings; (iv) reductions in cases of catastrophic health expenditures (CHE) and household savings linked to reduced health-related workplace absence.ResultsWe estimate MUP would reduce consumption more among the poorest than the richest drinkers. Expenditure would increase by ZAR 353 000 million (1 US$=13.2 ZAR), the poorest contributing 13% and the richest 28% of the increase, although this remains regressive compared with mean income. Of the 22 600 deaths averted, 56% accrue to the bottom two quintiles; government healthcare cost savings would be substantial (ZAR 3.9 billion). Cases of CHE averted would be 564 700, 46% among the poorest two quintiles. Indirect cost savings amount to ZAR 51.1 billion.ConclusionsA MUP policy in South Africa has the potential to reduce harm and health inequality. Fiscal policies for population health require structured policy appraisal, accounting for the totality of effects using mathematical models in association with ECEA methodology.

scholarly journals The price of a drink: the potential of alcohol minimum unit pricing as a public health measure in the UK

2012 ◽  
Vol 201 (3) ◽  
pp. 169-171 ◽  
Author(s):  
Peter Rice ◽  
Colin Drummond
Keyword(s):  
Control Measures ◽  
The Past ◽  
Alcohol Control ◽  
Health Measure ◽  
Alcohol Taxation ◽  
Unit Pricing ◽  
The Uk ◽  
The Impact ◽  
Alcohol Related Harm ◽  
Related Harm

SummaryThe UK has seen a dramatic increase in alcohol consumption and alcohol-related harm over the past 30 years. Alcohol taxation has long been considered a key method of controlling alcohol-related harm but a combination of factors has recently led to consideration of methods which affect the price of the cheapest alcohol as a means of improved targeting of alcohol control measures to curb the consumption of the heaviest drinkers. Although much of the evidence in favour of setting a minimum price of a unit of alcohol is based on complex econometric models rather than empirical data, all jurisdictions within the UK now intend to make selling alcohol below a set price illegal, which will provide a naturalistic experiment allowing assessment of the impact of minimum pricing.

scholarly journals An Assessment of the Impact of the Tourism Sector on Regional Economic Development in Gauteng Province, South Africa

2021 ◽  
Author(s):  
Daniel F. Meyer
Keyword(s):  
Economic Growth ◽  
South Africa ◽  
Small Businesses ◽  
Growth And Development ◽  
Local Market ◽  
Gauteng Province ◽  
Economic Growth And Development ◽  
Tourism Sector ◽  
Effective Policy ◽  
The Impact

South Africa is facing three main developmental problems, including high levels of poverty, unemployment, and inequality. The tourism sector allows for a relatively easy entry into the local market for small businesses and entrepreneurs and has the potential to create jobs and subsequently, income. Tourism development could be utilised as a driver for economic growth and development. The main objective of this research was to assess the impact of the tourism sector on economic growth and development in South Africa, focusing on the Gauteng Province which, is the economic hub of the country and even Africa. The methodology utilised was based on a quantitative design, using secondary time series pooled panel data approach including, all the municipal entities in the region. Annual data from 2000 to 2019 were used to analyse the impact of tourism on economic growth and development. Tourism variables include measurements such as tourism spending and international tourism trips. Results confirm the tourism-growth nexus and the sector allows ease of market entry for small businesses, resulting in employment creation and income for the poor in developing regions if promoted via effective policy implementation, even in regions where tourism is not the leading sector.

scholarly journals Global Impacts and Trends of the COVID-19 Pandemic on the Cruise Sector: A Focus On South Africa

2021 ◽  
Vol 10(1) (10(1)) ◽  
pp. 22-39
Author(s):  
Reshma Sucheran
Keyword(s):  
South Africa ◽  
Secondary Data ◽  
Global Scale ◽  
Tourism Industry ◽  
Cruise Industry ◽  
News Reports ◽  
Cruise Tourism ◽  
Health Related ◽  
Global Impacts ◽  
The Impact

Cruise tourism is one of the major growth areas of international tourism, and the impact of cruise tourists on a national economy is similar to that of other foreign visitors. The cruise industry has, however, continuously faced exposure to various types of health risks, which can develop into health-related crises, to which both passengers and crew members are vulnerable The coronavirus 2019 (COVID-19 pandemic has reached a critical situation on a global scale and is severely impacting on the global cruise tourism industry. This papers seeks to examine the impacts of the COVID-19 pandemic on the cruise tourism industry globally and in South Africa specifically. Desktop research was undertaken to gather data and insights on the unfolding global pandemic and its effect on the cruise sector. Secondary data from various national and international organisations was analysed, as well as current news reports and academic literature. The data indicates that the cruise sector is one of the hardest hit sectors of the tourism industry, and the economic impacts of the COVID-19 pandemic on this sector is devastating. The data further implies that the future of the cruise industry looks bleak, especially due to the reputational damage the sector is currently faced with.

scholarly journals 448 Association between Positive Airway Pressure Adherence and Healthcare Costs

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A177-A177
Author(s):  
Jaejin An ◽  
Henry Glick ◽  
Jiaxiao Shi ◽  
Aiyu Chen ◽  
Jessica Arguelles ◽  
...  
Keyword(s):  
Healthcare Cost ◽  
Airway Pressure ◽  
Healthcare Costs ◽  
Positive Airway Pressure ◽  
Cost Savings ◽  
Study Cohort ◽  
Obstructive Sleep ◽  
High Adherence ◽  
The Impact

Abstract Introduction The impact of positive airway pressure (PAP) therapy for obstructive sleep apnea (OSA) on healthcare costs is uncertain. We explored the relationship between 3-year PAP adherence and direct healthcare cost utilizing the Tele-OSA study cohort. Methods The Tele-OSA randomized clinical trial demonstrated improved PAP adherence in patients receiving automated feedback messaging regarding their PAP use versus usual care. The study enrolled patients at Kaiser Permanente Southern California, a large integrated healthcare system, from 2014–2015. Patients with moderate-severe OSA (Apnea Hypopnea Index [AHI] ≥15) from all study arms were consolidated, then stratified into PAP adherence groups based on mean PAP hours and PAP use patterns over 3-year follow-up period: (a) high adherence (consistent ≥4 hours/night); (b) moderate adherence (2–3.9 hours/night or inconsistent ≥4 hours/night); (c) low adherence (<2 hours/night). Healthcare costs (2020 US dollars) were derived by assigning costs from Federal fee schedules to healthcare utilization extracted from electronic health records. The 6-month mean healthcare costs during follow-up were estimated using generalized linear models adjusting for patient demographics, comorbidities, Medicaid coverage, prior healthcare cost, and AHI. Results Of 374 patients (mean age 50 years, 63% male), 22% were categorized into high adherence, 18% moderate adherence, and 60% low adherence to PAP therapy. Mean (SD) hours of PAP use were 6.5 (1.1) hours, 3.7 (1.3) hours, and 0.3 (0.5) hours for high, moderate, and low adherence groups, respectively. The high adherence group had the lowest average (SE) adjusted 6-month healthcare costs compared with other groups (High: $2,991 [$234]; Moderate: $3,604 [$412]; Low: $3,854 [$300]). Cost savings of high vs low adherence were $862 (95% CI $1540, $185). Cost savings of moderate vs low adherence were $250 (95% CI -$694, $1,193). Conclusion Better PAP adherence was associated with significantly lower healthcare costs over 3 years in patients with moderate-severe OSA. Findings support the importance of care strategies to enhance long-term PAP adherence for OSA therapy. Support (if any) The Tele-OSA Study was supported by AASM Foundation SRA Grant #: 104-SR-13

scholarly journals Effects of minimum unit pricing for alcohol in South Africa across different drinker groups and wealth quintiles: a modelling study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e052879
Author(s):  
Naomi Gibbs ◽  
Colin Angus ◽  
Simon Dixon ◽  
Charles Parry ◽  
Petra Meier
Keyword(s):  
South Africa ◽  
Alcohol Consumption ◽  
South African ◽  
Model Development ◽  
Wealth Quintile ◽  
Annual Number ◽  
Tax Revenue ◽  
Policy Appraisal ◽  
Heavy Drinkers ◽  
Unit Pricing

ObjectivesTo quantify the potential impact of minimum unit pricing (MUP) for alcohol on alcohol consumption, spending and health in South Africa. We provide these estimates disaggregated by different drinker groups and wealth quintiles.DesignWe developed an epidemiological policy appraisal model to estimate the effects of MUP across sex, drinker groups (moderate, occasional binge, heavy) and wealth quintiles. Stakeholder interviews and workshops informed model development and ensured policy relevance.SettingSouth African drinking population aged 15+.ParticipantsThe population (aged 15+) of South Africa in 2018 stratified by drinking group and wealth quintiles, with a model time horizon of 20 years.Main outcome measuresChange in standard drinks (SDs) (12 g of ethanol) consumed, weekly spend on alcohol, annual number of cases and deaths for five alcohol-related health conditions (HIV, intentional injury, road injury, liver cirrhosis and breast cancer), reported by drinker groups and wealth quintile.ResultsWe estimate an MUP of R10 per SD would lead to an immediate reduction in consumption of 4.40% (−0.93 SD/week) and an increase in spend of 18.09%. The absolute reduction is greatest for heavy drinkers (−1.48 SD/week), followed by occasional binge drinkers (−0.41 SD/week) and moderate drinkers (−0.40 SD/week). Over 20 years, we estimate 20 585 fewer deaths and 9 00 332 cases averted across the five health-modelled harms.Poorer drinkers would see greater impacts from the policy (consumption: −7.75% in the poorest quintile, −3.19% in richest quintile). Among the heavy drinkers, 85% of the cases averted and 86% of the lives saved accrue to the bottom three wealth quintiles.ConclusionsWe estimate that MUP would reduce alcohol consumption in South Africa, improving health outcomes while raising retail and tax revenue. Consumption and harm reductions would be greater in poorer groups.

Alcohol-related harm and health inequalities

2017 ◽  
Author(s):  
Katherine Smith ◽  
Jon Foster ◽  
Katherine Brown
Keyword(s):  
Health Inequalities ◽  
Welfare Spending ◽  
Younger Women ◽  
Disadvantaged Groups ◽  
Unit Pricing ◽  
The Impact ◽  
Alcohol Related Harm ◽  
The Relationship ◽  
Related Harm

This chapter examines the relationship between alcohol use and health inequalities. It first reviews the evidence and theories concerning health inequalities in morbidity and mortality as well as evidence and theories that specifically relate to the role of alcohol within these broader inequalities. The available evidence suggests that alcohol-related harms follow the expected social gradient; greater harms are suffered by more disadvantaged groups, at least for men and for younger women. However, some statistics indicate that people living in deprived communities consume less alcohol than more advantaged communities. The chapter analyses potential explanations for this apparent tension, often referred to as the alcohol harm paradox, along with evidence concerning the impact of alcohol-related interventions, such as minimum unit pricing (MUP), Reducing the Strength (RTS) schemes and welfare spending, on inequalities. It concludes with a range of relevant research and policy recommendations.

scholarly journals The Modelled Population Obesity-Related Health Benefits of Reducing Consumption of Discretionary Foods in Australia

Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 649 ◽  
Author(s):  
Anita Lal ◽  
Anna Peeters ◽  
Vicki Brown ◽  
Phuong Nguyen ◽  
Huong Ngoc Quynh Tran ◽  
...  
Keyword(s):  
Body Weight ◽  
Healthcare Cost ◽  
Weight Reduction ◽  
Disease Incidence ◽  
Health Benefits ◽  
Cost Savings ◽  
Life Years ◽  
Different Types ◽  
Potential Impact ◽  
The Impact

Over one third of Australians’ daily energy intake is from discretionary foods and drinks. While many health promotion efforts seek to limit discretionary food intake, the population health impact of reductions in the consumption of different types of discretionary foods (e.g., sugar-sweetened beverages (SSBs), confectionery, sweet biscuits) has not been quantified. This study estimated the potential reductions in body weight, obesity-related disease incidence, and healthcare cost savings associated with consumption of one less serving per week of different discretionary foods. Reductions in the different types of discretionary food were modelled individually to estimate the impact on energy consumption and population body weight by 5-year age and sex groups. It was assumed that one serving of discretionary food each week was replaced with either a serving of fruit or popcorn, and a serving (375 mL) of SSBs was replaced with coffee, tea, or milk. Proportional multi-state multiple-cohort Markov modelling estimated likely resultant health adjusted life years (HALYs) gained and healthcare costs saved over the lifetime of the 2010 Australian population. A reduction of one serving of SSBs (375 mL) had the greatest potential impact in terms of weight reduction, particularly in ages 19–24 years (mean 0.31 kg, 95% UI: 0.23 kg to 0.37 kg) and overall healthcare cost savings of AUD 793.4 million (95% UI: 589.1 M to 976.1 M). A decrease of one serving of sweet biscuits had the second largest potential impact on weight change overall, with healthcare cost savings of $640.7 M (95% CI: $402.6 M to $885.8 M) and the largest potential weight reduction amongst those aged 75 years and over (mean 0.21 kg, 95% UI: 0.14 kg to 0.27 kg). The results demonstrate that small reductions in discretionary food consumption are likely to have substantial health benefits at the population level. Moreover, the study highlights that policy responses to improve population diets may need to be tailored to target different types of foods for different population groups.

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