Developing an integrated microsimulation model for the impact of fiscal policies on child health in Europe: the example of childhood obesity in Italy

Abstract Background We developed an integrated model called Microsimulation for Income and Child Health (MICH) that provides a tool for analysing the prospective effects of fiscal policies on childhood health in European countries. The aim of this first MICH study is to evaluate the impact of altern...

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Autores principales:	Davide Rasella, Lorenzo Richiardi, Nicolai Brachowicz, H. Xavier Jara, Mark Hanson, Delia Boccia, Matteo G. Richiardi, Costanza Pizzi
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Fiscal policies Poverty alleviation Microsimulation Child health Child overweight Child obesity Medicine R
Acceso en línea:	https://doaj.org/article/1ad4efb08338456a92e6401fa165663e
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spelling	oai:doaj.org-article:1ad4efb08338456a92e6401fa165663e2021-12-05T12:11:16ZDeveloping an integrated microsimulation model for the impact of fiscal policies on child health in Europe: the example of childhood obesity in Italy10.1186/s12916-021-02155-61741-7015https://doaj.org/article/1ad4efb08338456a92e6401fa165663e2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12916-021-02155-6https://doaj.org/toc/1741-7015Abstract Background We developed an integrated model called Microsimulation for Income and Child Health (MICH) that provides a tool for analysing the prospective effects of fiscal policies on childhood health in European countries. The aim of this first MICH study is to evaluate the impact of alternative fiscal policies on childhood overweight and obesity in Italy. Methods MICH model is composed of three integrated modules. Firstly, module 1 (M1) simulates the effects of fiscal policies on disposable household income using the tax-benefit microsimulation program EUROMOD fed with the Italian EU-SILC 2010 data. Secondly, module 2 (M2) exploits data provided by the Italian birth cohort called Nascita e Infanzia: gli Effetti dell’Ambiente (NINFEA), translated as Birth and Childhood: the Effects of the Environment study, and runs a series of concatenated regressions in order to estimate the prospective effects of income on child body mass index (BMI) at different ages. Finally, module 3 (M3) uses dynamic microsimulation techniques that combine the population structure and incomes obtained by M1, with regression model specifications and estimated effect sizes provided by M2, projecting BMI distributions according to the simulated policy scenarios. Results Both universal benefits, such as universal basic income (BI), and targeted interventions, such as child benefit (CB) for poorer households, have a significant effect on childhood overweight, with a prevalence ratio (PR) in 10-year-old children—in comparison with the baseline fiscal system—of 0.88 (95%CI 0.82–0.93) and 0.89 (95%CI 0.83–0.94), respectively. The impact of the fiscal reforms was even larger for child obesity, reaching a PR of 0.67 (95%CI 0·50–0.83) for the simulated BI and 0.64 (95%CI 0.44–0.84) for CB at the same age. While both types of policies show similar effects, the estimated costs for a 1% prevalence reduction in overweight and obesity with respect to the baseline scenario is much lower with a more focalised benefit policy than with universal ones. Conclusions Our results show that fiscal policies can have a strong impact on childhood health conditions. Focalised interventions that increase family income, especially in the most vulnerable populations, can help to prevent child overweight and obesity. Robust microsimulation models to forecast the effects of fiscal policies on health should be considered as one of the instruments to reach the Health in All Policies (HiAP) goals.Davide RasellaLorenzo RichiardiNicolai BrachowiczH. Xavier JaraMark HansonDelia BocciaMatteo G. RichiardiCostanza PizziBMCarticleFiscal policiesPoverty alleviationMicrosimulationChild healthChild overweightChild obesityMedicineRENBMC Medicine, Vol 19, Iss 1, Pp 1-12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Fiscal policies Poverty alleviation Microsimulation Child health Child overweight Child obesity Medicine R
spellingShingle	Fiscal policies Poverty alleviation Microsimulation Child health Child overweight Child obesity Medicine R Davide Rasella Lorenzo Richiardi Nicolai Brachowicz H. Xavier Jara Mark Hanson Delia Boccia Matteo G. Richiardi Costanza Pizzi Developing an integrated microsimulation model for the impact of fiscal policies on child health in Europe: the example of childhood obesity in Italy
description	Abstract Background We developed an integrated model called Microsimulation for Income and Child Health (MICH) that provides a tool for analysing the prospective effects of fiscal policies on childhood health in European countries. The aim of this first MICH study is to evaluate the impact of alternative fiscal policies on childhood overweight and obesity in Italy. Methods MICH model is composed of three integrated modules. Firstly, module 1 (M1) simulates the effects of fiscal policies on disposable household income using the tax-benefit microsimulation program EUROMOD fed with the Italian EU-SILC 2010 data. Secondly, module 2 (M2) exploits data provided by the Italian birth cohort called Nascita e Infanzia: gli Effetti dell’Ambiente (NINFEA), translated as Birth and Childhood: the Effects of the Environment study, and runs a series of concatenated regressions in order to estimate the prospective effects of income on child body mass index (BMI) at different ages. Finally, module 3 (M3) uses dynamic microsimulation techniques that combine the population structure and incomes obtained by M1, with regression model specifications and estimated effect sizes provided by M2, projecting BMI distributions according to the simulated policy scenarios. Results Both universal benefits, such as universal basic income (BI), and targeted interventions, such as child benefit (CB) for poorer households, have a significant effect on childhood overweight, with a prevalence ratio (PR) in 10-year-old children—in comparison with the baseline fiscal system—of 0.88 (95%CI 0.82–0.93) and 0.89 (95%CI 0.83–0.94), respectively. The impact of the fiscal reforms was even larger for child obesity, reaching a PR of 0.67 (95%CI 0·50–0.83) for the simulated BI and 0.64 (95%CI 0.44–0.84) for CB at the same age. While both types of policies show similar effects, the estimated costs for a 1% prevalence reduction in overweight and obesity with respect to the baseline scenario is much lower with a more focalised benefit policy than with universal ones. Conclusions Our results show that fiscal policies can have a strong impact on childhood health conditions. Focalised interventions that increase family income, especially in the most vulnerable populations, can help to prevent child overweight and obesity. Robust microsimulation models to forecast the effects of fiscal policies on health should be considered as one of the instruments to reach the Health in All Policies (HiAP) goals.
format	article
author	Davide Rasella Lorenzo Richiardi Nicolai Brachowicz H. Xavier Jara Mark Hanson Delia Boccia Matteo G. Richiardi Costanza Pizzi
author_facet	Davide Rasella Lorenzo Richiardi Nicolai Brachowicz H. Xavier Jara Mark Hanson Delia Boccia Matteo G. Richiardi Costanza Pizzi
author_sort	Davide Rasella
title	Developing an integrated microsimulation model for the impact of fiscal policies on child health in Europe: the example of childhood obesity in Italy
title_short	Developing an integrated microsimulation model for the impact of fiscal policies on child health in Europe: the example of childhood obesity in Italy
title_full	Developing an integrated microsimulation model for the impact of fiscal policies on child health in Europe: the example of childhood obesity in Italy
title_fullStr	Developing an integrated microsimulation model for the impact of fiscal policies on child health in Europe: the example of childhood obesity in Italy
title_full_unstemmed	Developing an integrated microsimulation model for the impact of fiscal policies on child health in Europe: the example of childhood obesity in Italy
title_sort	developing an integrated microsimulation model for the impact of fiscal policies on child health in europe: the example of childhood obesity in italy
publisher	BMC
publishDate	2021
url	https://doaj.org/article/1ad4efb08338456a92e6401fa165663e
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Developing an integrated microsimulation model for the impact of fiscal policies on child health in Europe: the example of childhood obesity in Italy

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