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  • Effects of public policies in the prevention of cardiovascular diseases_OA

    Rights statement: This is the author’s version of a work that was accepted for publication in Public Health. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Public Health, 207, 2022 DOI: 10.1016/j.puhe.2022.03.021

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    Embargo ends: 11/05/23

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Effects of public policies in the prevention of cardiovascular diseases: A systematic review of global literature

Research output: Contribution to Journal/MagazineJournal articlepeer-review

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<mark>Journal publication date</mark>30/06/2022
<mark>Journal</mark>Public Health
Volume207
Number of pages9
Pages (from-to)73-81
Publication StatusPublished
Early online date11/05/22
<mark>Original language</mark>English

Abstract

Objectives
Given the growing interest worldwide in applying public policies to improve human health, we undertook a systematic review of studies investigating whether public policies targeting unhealthy products could reduce cardiovascular diseases.

Study design
This study was a systematic review of the literature.

Methods
We searched research studies published in 2000–2020 from major databases, including MEDLINE and Embase. We followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and narratively synthesized the studies based on vote counting and direction of the intervention effect.

Results
Ninety-eight studies, mostly from high-income countries, met the inclusion criteria. Most studies were on public policies targeting sugar-sweetened beverages and tobacco, followed by alcohol, sugar, salt, and junk foods. Overall, many reported that several fiscal, regulatory, and educational policies generated beneficial effects of reducing the diseases. Those studies that reported no or limited effects highlighted several sociodemographic and health risk characteristics and design and implementation aspects of the policy interventions as factors limiting the policy effects; most of these are modifiable with appropriate policy interventions. For instance, low magnitude of tax, substitution with other unhealthy products, firms’ competitive response strategies, pre-existence of smoking bans, incremental enactment of smoking regulations, degree of enforcement, and various sociocultural factors minimized the effects of the policies.

Conclusion
The literature supports a growing consensus on the beneficial effects of public policy for improving human health. The design and implementation of public policies must address various impeding factors and incorporate appropriate remedial measures. Further research is needed from low- and middle-income countries and on whether and how multiple policy instruments work in tandem.

Bibliographic note

This is the author’s version of a work that was accepted for publication in Public Health. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Public Health, 207, 2022 DOI: 10.1016/j.puhe.2022.03.021