COPPER: CO-designing for healthy People and Planet: food Economic policy Research

Background: The food that we eat in the UK impacts on our health and our wallets, with particularly large impacts for the poorer in our society. It also impacts on planetary health and the UK economy. One option to address these challenges is to introduce food taxes and subsidies to incentivise healthy, sustainable food and support low income groups. But taxes and subsidies are politicially difficult to introduce due to concerns over individual agency and stigmatisation. For such policies to be successful, it is vital that they are co-designed with the public and policymakers and their potential impact across multiple outcomes is established. Research questions: What impacts could food taxes and subsidies have on a) the incidence and prevalence of, inequalities in, and consequences for chronic non-communicable diseases? and b) household-level economics, national-level macroeconomics, greenhouse gas emissions, land use, water use and water pollution. Aims and objectives: We will co-design tax and subsidy scenarios with public and policymakers, develop a research infrastructure of linked datasets and integrated health, economic and environmental models, estimate the impact of six scenarios and communicate our results with public and policymakers. Methods: We will conduct a scoping review of the literature to identify a longlist of scenarios that improve health, reduce health inequalities and/or reduce environmental impact. We will assess public attitudes to the longlist via a survey and discrete choice experiment (DCE) with a representative sample and a low-income household boost. We will hold three deliberative forums with disadvantaged groups where we will present evidence from the survey and DCE alongside information about the health and environmental impact of the food system, the ethics of food taxes and subsidies, and their potential impact on the food industry. Forum participants will rank the longlist of scenarios and we will combine their findings to produce a shortlist of six, which will be refined and ratified at a meeting with public and policymaker representation. We will use household food purchasing data linked with environmental outcome measures to fit a consumer demand model. We will estimate the impact of the scenarios on nutritional quality, price of the diet and environmental outcomes for different income groups. The long-term impact on incidence and prevalence of obesity, diabetes and diet-related diseases, and NHS costs will be modelled using a validated proportional multistate life table model. Our results for health, healthcare costs, and changes in food sales will be used to estimate how the scenarios change GDP, jobs in the food industry and tax revenue using a computable general equilibrium macroeconomic model. Timelines of delivery: Deliberative forums will be held at the end of the first year; data linkage and model infrastucrure and early scenario results will be completed by the end of the second year; full results and dissemination will be completed in year 3. Anticipated impact and dissemination: We will work with public and policymaker representatives throughout to ensure our communication strategy is tailored to their needs. We will disseminate our findings through Food Foundation workshops, traditional media and social media. We will circulate policy briefs, and produce result summaries for lay audiences.