The economics of obesity, nutrition and physical activity
Franco's research team has made important contributions to the understanding of the economics of obesity and of the health-related behaviours that contribute to it. This work has focused on analyzing global trends in the obesity epidemic; their components (including age-period-cohort effects) and determinants; as well as disparities across and within countries in obesity rates and their growth over time. A key contribution has been in the assessment of the health and economic impacts of alternative policy approaches to prevent obesity and address the associated behavioural risk factors. This work has been based on the use of microsimulation modelling to estimate the effects of policies over time at the population level and in specific sub-groups. Further modelling work, carried out in collaboration with OECD’s Agriculture Directorate, has provided an assessment of the potential impacts of obesity prevention policies on agricultural commodity markets. A selection of relevant publications includes the following:
Hawkes C, Sassi F. Tackling Unhealthy Diets. In: McDaid D, Sassi F, and Merkur S (Eds.) Promoting Health, Preventing Disease: The Economic Case. Maidenhead, UK, Open University Press 2015.
Sassi F. Obesity and the economics of prevention. Fit not Fat. Paris, OECD Publishing, 2010. Also published by Edward Elgar, 2010. http://www.oecd.org/health/fitnotfat
Cecchini M, Sassi F, Lauer JA, Lee YY, Guajardo-Barron V, Chisholm D. Tackling of unhealthy diets, physical inactivity, and obesity: health effects and cost-effectiveness. The Lancet. 2010 Nov 20; 376(9754):1775-84. PMID: 21074255
Herforth A, Frongillo EA, Sassi F, Mclean MS, Arabi M, Tirado C, Remans R, Mantilla G, Thomson M, Pingali P. Toward an integrated approach to nutritional quality, environmental sustainability, and economic viability: research and measurement gaps. Annals of the New York Academy of Science 2014;1332:1-21. doi: 10.1111/nyas.12552. PMID: 25351044
Deavaux M, Sassi F. Social inequalities in obesity and overweight in eleven OECD countries. European Journal of Public Health 2013;23(3):464-9. doi: 10.1093/eurpub/ckr058. Epub 2011 Jun 6. PMID: 21646363
The economics of health promotion and chronic disease prevention
The main long-term theme of Franco Sassi's research has been the economic evaluation of health interventions. He has contributed to this field through a number of applied evaluations, often based on mathematical and decision models, and through methodological work, e.g. on conjoint analysis and discrete choice techniques, measures of health outcomes, and simulation modelling approaches. Much of his work has been focused on health promotion and chronic disease prevention (including screening). A significant component of this work involves the development of cost-effectiveness modelling approaches for the evaluation of prevention programmes. This work has benefited from a close collaboration with the World Health Organization. Selected publications:
McDaid D, Sassi F, and Merkur S (Eds.) Promoting Health, Preventing Disease: The Economic Case. Maidenhead, UK, Open University Press 2015.
Beaglehole R, Bonita R, Horton R, Adams C, Alleyne G, Asaria P, Baugh V, Bekedam H, Billo N, Casswell S, Cecchini M, Colagiuri R, Colagiuri S, Collins T, Ebrahim S, Engelgau M, Galea G, Gaziano T, Geneau R, Haines A, Hospedales J, Jha P, Keeling A, Leeder S, Lincoln P, McKee M, Mackay J, Magnusson R, Moodie R, Mwatsama M, Nishtar S, Norrving B, Patterson D, Piot P, Ralston J, Rani M, Reddy KS, Sassi F, Sheron N, Stuckler D, Suh I, Torode J, Varghese C, Watt J; for The Lancet NCD Action Group. Priority actions for the non-communicable disease crisis. The Lancet. 2011 Apr 23; 377(9775):1438-47. PMID: 21474174.
Sassi F, Hurst J. The prevention of lifestyle-related chronic diseases: an economic framework. OECD Health Working Paper 32. Paris, OECD, 2008. http://dx.doi.org/10.1787/243180781313
McDaid D, Sassi F. Equity, efficiency and research synthesis. In: Shemilt I. et al. (Eds.). Evidence-based Decisions and Economics: Health care, social welfare, education and criminal justice. 2nd Edition. Chichester, UK: Wiley-Blackwell, 2010.
Fiscal policies for health promotion
An important part of Franco Sassi's research in recent years has been devoted to the analysis of the potential for fiscal policies to contribute to the pursuit of health promotion goals. This has become a major area of debate in health economics and health policy at the global level, as an increasing number of governments have been considering tax hikes, or new taxes, to curb potentially unhealthy consumption, seen as a major determinant of the rise in chronic noncommunicable diseases. Franco Sassi's contributions have been mainly focused on assessing the economic justification for the use of fiscal measures for health promotion, on the health impacts to be expected from the use of fiscal policies targeting potentially unhealthy commodities; and on the distributional effects of fiscal policies. Selected publications:
Sassi F, Belloni A. Fiscal incentives, behavior change and health promotion: what place in the health-in-all-policies toolkit? Health Promotion International 2014;29(1):i103-i112. PMID: 25217345
Sassi F, Belloni A, Capobianco C. The Role of Fiscal Policies in Health Promotion. OECD Health Working Paper 66. Paris, OECD Publishing, 2013.
Sassi F, Belloni A, Capobianco C, Alemanno A. Taxation and Economic Incentives. In: Alemanno A and Garde A. (Eds.) Regulating Lifestyle Risks – The EU, Alcohol, Tobacco and Unhealthy Diets. Cambridge, Cambridge University Press, 2014.
The economics of tackling harmful alcohol use
An important component of Franco Sassi's work during the past 5 years has been on the economics of tackling harmful alcohol use, and on the impacts of alternative alcohol policy approaches. The work of his team has focused on analyzing global trends in alcohol use and harmful use; their components and determinants; as well as disparities across and within countries in harmful alcohol use and their changes over time. The team's assessment of the health and economic impacts of alternative policy approaches to prevent the health and social consequences of harmful alcohol use has been an important contribution to existing knowledge in the field. As in the case of his work on obesity, Franco Sassi's alcohol policy analyses have been based on the use of microsimulation modelling to estimate the effects of policies over time at the population level. Selected publications:
Sassi F (Ed.) Tackling harmful alcohol use: Economics and public health policy. Paris, OECD Publishing, 2015.
Devaux M, Sassi F. Alcohol consumption and harmful drinking: Trends and social disparities across OECD Countries. OECD Health Working Paper 79. Paris, OECD Publishing, 2015.
Cecchini M, Devaux M, Sassi F. Assessing the impacts of alcohol policies: A microsimulation approach. OECD Health Working Paper 80. Paris, OECD Publishing, 2015.
McKracken K, Sassi F. Alcohol arrest-referral. In: McMurran, M. (Ed.). Alcohol-Related Violence: Prevention and Treatment. Chichester, UK: Wiley-Blackwell, 2012.
Health disparities and social determinants of health
Franco Sassi's research has contributed to knowledge about how health interventions and policies may affect health disparities, through an improved understanding of the individual and social determinants of disparities. A large part of his work in this area has been focused in the cancer area, through the study the distributional impact of preventive health care measures. Based on US data, he demonstrated that policies based on the pursuit of equity of access to health care may fail to deliver equity of health outcomes. This work was based on a novel approach combining multiple sources of data. In the United Kingdom, Franco Sassi extended this work to cover a broader range of social determinants of health, including area-level socio-economic conditions, income distribution, ethnic and economic segregation. He worked with collaborators at UC Berkeley to include in his analyses concepts of trust and social capital. Selected publications:
Sassi F, Luft HS, Guadagnoli E. Addressing racial and ethnic disparities in breast cancer. Relationship between population screening rates and stage at diagnosis. American Journal of Public Health 2006;96:2165-72. PMID: 17077392.
Sassi F. Health Inequalities, a persisting problem. In: Hills J, Stewart K, Sefton T (Eds.). A more equal Society? 2nd Edition. Bristol, The Policy Press, 2009.
Lejeune C, Sassi F, Ellis L, Godward S, Mak V, Day M, Rachet B. Socioeconomic disparities in access to treatment and their impact on colorectal cancer survival. International Journal of Epidemiology 2010; 39(3):710-7. PMID: 20378687
Damiani G, Federico B, Bianchi CBNA, Ronconi A, Basso D, Fiorenza S, Sassi F. Socioeconomic status and prevention of cardiovascular disease in Italy: evidence from a national health survey. European Journal of Public Health 2011 Oct; 21(5):591-6. PMID: 20534691
Devaux M, Sassi F, Church J, Cecchini M, Borgonovi F. Exploring the relationship between education and obesity. Economic Studies 2011; 121-59.