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Table 1 Summary of included reviews reporting studies of fiscal policy intervention

From: The effects of public health policies on health inequalities in high-income countries: an umbrella review

Study No. of relevant studies (total studies) Context (setting, country, search timeframe) Intervention(s) Summary of results AMSTAR quality appraisal (derived from R-AMSTAR)
Brown et al. 2014 [20] 12 (117) Studies based in a country at stage 4 of the tobacco epidemic or in the WHO European Region, 1995–2013 Tobacco/cigarette (including excise) tax increase, cigarette price increase; population-level cessation support initiatives. Higher quality evidence suggests a neutral effect of prices increases. Some evidence to suggest that lower SES groups are most likely to change to price-minimising strategies. 28 (medium)
Jackson et al. 2010 [44] 1 (103) Adults 15 and above, Finland, searches up to 2008 Large reduction in price of alcohol (average 33% decrease). Alcohol-related deaths increased overall by 16% (95% CI 12.1–19.4). Amongst the 30–59 age group, mortality was highest for those individuals with lower levels of education, social class, or income. 26 (medium)
Alagiyawanna et al. 2015 [21] 2 (17) No country restrictions, start date to 2013 USA Food Stamp Programme (effects in pregnant women).
Includes 1 study also identified in Black et al. (2012).
Food stamp programs can have positive impacts on low-income populations (decreased probability of gaining insufficient weight during pregnancy) but only small increased infant survival rates in white, low-income women only. 29 (medium)
Black et al. 2012 [22] 9 (14) High income countries, 1980–2010 USA food subsidy programmes (Special Supplementary Nutrition Program [SNAP] for Women, Infants and Children [WIC]; and Food Stamp Programme).
Includes 1 study also identified in Alagiyawanna et al. (2015).
Authors found limited high quality evidence of the impacts of food subsidy programs on the health and nutrition of adults and children. Improvements in perinatal outcomes was generally limited and most evident in women who smoked during pregnancy. 27 (medium)
de Sa and Lock 2008 [23] 1 (30) School children aged 4–6 years, UK; start date to August 2007 National School Fruit scheme. Short-term and long-term increases in fruit and vegetable consumption resulted from the National School Fruit scheme pilot in low SES schools in the UK. 22 (low)
Hillier-Brown et al. 2014 [24] 2 (20) Deprived homes/population; USA; start date to 2012 USA Food Stamp Programme. No significant effect on weight change or BMI from Food Stamp intervention overall. Although evidence from the very poorest indicates, there is a significant increase in weight. 31 (medium)
Olsted et al. 2016 [25] 10 (36) Hungary, Norway, UK, US, and the Netherlands; January 2004–August 2015 Taxes on unhealthy food and drink, free fruit and breakfast school schemes. Some evidence of taxes on unhealthy food and drink having a positive equity effect on diet outcomes. Free fruit or breakfast schemes in schools had no effect on health inequalities. 29 (medium)
National Collaborating Centre for Women’s and Children’s Health 2009 [26] 2 (142) Context limited to application to a UK setting; searches to March 2008, articles published before 1988 were excluded. English language only. National-level approaches to increasing vaccination rates including parent and practitioner incentives. There is evidence of positive effects on inequalities in vaccination rates for fiscal type interventions. 28 (medium)
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