Taxes, Prices and Health Behaviors—8:15 am-9:00 am
|Saturday, March 26, 2011|
|8:15 AM–12:15 PM |
|Area: SCI; Domain: Experimental Analysis|
|Instruction Level: Intermediate|
|CE Instructor: Steven Hursh, Ph.D.|
|Chair: Steven R. Hursh (Institutes for Behavior Resources, Inc.)|
|FRANK CHALOUPKA (University of Illinois at Chicago)|
|Dr. Chaloupka is distinguished professor of economics at the University of Illinois at Chicago and the university's Institute for Health Research and Policy. He is also a research associate at the National Bureau of Economic Research's Health Economics Program and Program on Children. Since 1997, Dr. Chaloupka has co-directed, with Lloyd Johnston of the University of Michigan, Bridging the Gap, an interdisciplinary research collaborative funded by the Robert Wood Johnson Foundation to improve understanding of the influences of policy, programs, and environment on youth health behavior. Dr. Chaloupka received his doctorate in economics from the City University of New York Graduate School in 1988. Dr. Chaloupka's research interests include the impact of economic, policy, and other environmental influences on health behaviors, including tobacco, alcohol, and illicit drug use, physical activity, diet, and related outcomes, as well as the economics of tobacco and tobacco control, particularly in developing countries.|
Over the past few decades, economic and other research has clearly demonstrated the role of price in influencing a variety of health-related behaviors. These include several unhealthy behaviors that, at least in part, arise from imperfect information, time-inconsistent preferences, and addiction that impose costs on those not engaged in the behavior. Together, these suggest that government intervention to manipulate prices through taxes and subsidies can significantly affect these health behaviors and help correct the market failures associated with them. This presentation will review the effectiveness of taxation and other pricing policies in promoting healthy behaviors. The extensive research documenting the impact of tobacco and alcoholic beverage excise taxes on tobacco use, drinking, and their consequences will be reviewed, along with the more limited evidence on the impact of other policies that influence the price of tobacco products and alcoholic beverages. Drawing on these experiences, the potential for using pricing policies to promote healthier eating, physical activity, and to curb obesity will be discussed. Recent trends in food/beverage prices and weight outcomes will be described and findings from the emerging research on price and obesity will be reviewed.
|Leonard H. Epstein, Ph.D., is State University of New York distinguished professor in both the Departments of Pediatrics and Social and Preventive Medicine at the University of Buffalo, and the chief of the Division of Behavioral Medicine. Dr. Epstein’s research interests focus on health behavior change and determinants of eating, physical activity, and drug self-administration. Dr. Epstein is an internationally recognized authority in the fields of childhood obesity, physical activity, weight control, and family intervention. For the past 25 years, Dr. Epstein has conducted research relevant to the prevention and treatment of childhood obesity, including mechanisms that regulate intake and energy expenditure in children. He is a fellow in numerous scientific organizations, and has been the president of the American Psychological Association’s (APA) Division of Health Psychology and was a recipient of the APA Award for Outstanding Contributions to Health Psychology. Dr. Epstein chaired the National Institute of Health’s (NIH) Behavioral Medicine Study Section and served on the NIH Advisory Board for Center for Scientific Research. Dr. Epstein has published over 300 scientific papers and three books.|
Losing weight requires a series of choices to eat healthier and be more active. Behavioral economics is a theoretical approach to understanding how people make decisions about how to allocate their time among alternatives and how to set priorities. Behavioral choice theory incorporates multiple levels of analysis, ranging from basic neuroscience and genetic research, field and clinical studies, and environmental analyses. Basic research will be reviewed that demonstrates the central role of choice in determining motivation to engage in behaviors, and these basic paradigms will be applied to human eating and physical activity. The interaction of genetic factors that may influence the motivation to eat, and how these genetic polymorphisms interact with behavioral phenotypes to influence the choice to eat are presented. These basic principles are extended to clinical research on weight loss in children, and prevention research to assess the role of reducing television on weight change in young children. The potential role of environmental changes that favor healthier eating and greater access to physical activity, such as pricing, are noted. These studies highlight the importance of integrating basic and clinical research, and the potential for multidisciplinary approaches to improve healthy behaviors.
|Dr. Higgins is a professor of psychiatry and psychology at the University of Vermont where he serves as vice chair of the Department of Psychiatry and director of the Department of Psychiatry's Center on Substance Abuse Research and Treatment, and co-director of their Human Behavioral Pharmacology Laboratory. He completed postdoctoral training in behavioral pharmacology at The Johns Hopkins University School of Medicine from 1983-85, obtained his doctorate degree in child psychology and human development from the University of Kansas in 1983, a master's in counseling in 1977, and a bachelorï¿½s degree in psychology in 1975 from Shippensburg University. He has been the recipient of many national research awards, including a National Institutes of Health (NIH) MERIT Award for his development of an efficacious outpatient treatment for cocaine dependence. More recently, an incentive-based intervention that Dr. Higgins developed for smoking cessation among pregnant women has gained considerable national and international attention for its efficacy in producing high antepartum cessation rates and significant improvements in birth outcomes. Dr. Higgins has published approximately 250 articles, book chapters, and books; has served as president of two national scientific organizations and in other leadership positions in the areas of psychopharmacology and substance abuse; is on the editorial board of four peer-reviewed journals, including the well regarded international specialty journal Addiction; has served as the editor for behavioral pharmacology for the Journal of the Experimental Analysis of Behaviorï¿½a well-respected outlet for basic research on operant conditioning; and has served as a guest editor for special issues of different peer-reviewed specialty journals on selected topics in behavioral pharmacology and behavioral economics (e.g., Drug and Alcohol Dependence, Experimental and Clinical Psychopharmacology, Journal of Applied Behavior Analysis). He has served on various NIH study sections, including a 3-year term on the Training and Career Development Review Committee of the National Institute on Drug Abuse.|
There is growing recognition and concern that many individuals persist in behavior patterns (substance abuse, physical inactivity, unhealthy food choices, medication non-adherence) that are strikingly harmful to their long-term health and a staggering financial burden on the U.S. health care system. Indeed, unhealthy personal behavior patterns are estimated to contribute to 40% of all premature deaths in the U.S. annually, with cigarette smoking alone being responsible for approximately 435,000 deaths/year and physical inactivity and obesity contributing to another 365,000 deaths/year. These behavior patterns increase risk for numerous chronic diseases, including cardiovascular disease, stroke, site-specific cancers, and type-2 diabetes. Our group has been investigating the systematic use of financial incentives to promote behavior change among addicted individuals. In this presentation I will review a program of research we have conducted with pregnant women who are still smoking cigarettes upon entry into prenatal care. I will review results from studies demonstrating that providing these women with vouchers exchangeable for retail items in the community contingent on objectively verified abstinence from recent smoking can significantly increase abstinence levels and improve birth outcomes. These positive results are congruent with a larger body of evidence demonstrating that financial incentives can be effective in promoting health-related behavior change and improving health outcomes.
|Dr. Steven R. Hursh received his B.A. from Wake Forest University in 1968 and his Ph.D. from the University of California, San Diego in 1972. He is the president of the Institutes for Behavior Resources and adjunct professor of Behavioral Biology at Johns Hopkins University School of Medicine. Dr. Hursh has over 40 years experience as a researcher and is author of over 80 articles, book chapters, and books. He is a former associate editor of the Journal of the Experimental Analysis of Behavior. His seminal article on economic concepts for the analysis of behavior is considered one of the most significant articles in the history of the journal. Dr. Hursh has been a key figure in the establishment of behavioral economics as a major conceptual area. His research papers have introduced into the behavioral vocabulary a number of "household terms" in behavioral psychology: open and closed economies, demand curves and demand elasticity, unit price, substitution and complementarity, Pmax, Omax, and recently essential value based on exponential demand that has broad generality across species and reinforcers. His extensions to drug abuse and the framing of drug abuse policy have had a major impact on the direction of research on substance use disorders.|
A fundamental tenant of behavior analysis is that operant behavior is strengthened by its consequences and that the strength of a reinforcer determines the strength of the behavior it supports. Behavioral economics provides a framework for understanding and measuring reinforcer strength, and by implication, the strength of the behavior it supports. At the same time, government policy is often directed toward creating conditions that encourage changes in the strength of certain behaviors, such as substance abuse, unhealthy dietary habits, cigarette smoking, wasteful use of energy resources, and excessive use of hydrocarbon products. Behavior analysis provides empirical tools for measuring behavioral strength and demand for reinforcers. An empirical model of demand defines how reinforcer consumption varies as a function of the requirements to obtain the reinforcer (price) and a number of recent studies have verified the feasibility of measuring empirical demand functions in human volunteers. Behavioral economics provides a conceptual link between empirical studies of behavioral strength and how government policy might alter that strength. Effective government policy can apply this knowledge to alter community behavior by arranging various conditions that affect the costs and benefits of selected behaviors, through penalties, taxes, refunds, tax deductions, or opportunity costs. Taken together, behavior analysis provides the empirical tools and behavioral economics provides the bridge between behavioral data and the economic implications for regulatory initiatives.
Frank Chaloupka, Leonard Epstein, Stephen Higgins, and Steven Hursh will participate in a panel discussion and answer questions on the topics presented in Cluster 1.
Session Moderator: Steven Hursh
|Target Audience: |
Certified behavior analysts, behavioral consultants, behavioral therapists, psychologists, and university faculty.
|Learning Objectives: available onsite|