Cost-effectiveness of strategies to reduce CVD

Cardiovascular disease (CVD) is the leading cause of death in the US, with direct and indirect costs exceeding $500,000,000/year.

We and others have shown that suboptimal diet is a leading cause of CVD. Thus, improving diet must be a major priority for reducing CVD burden. From previous projects, we have identified key policy strategies (link to overview page with nutrition strategies) that are promising in improving the public's diet. Yet evidence on the efficacy of these strategies is often insufficient to change policy without information on the cost, cost-effectiveness, and feasibility of these strategies.

No prior study has comprehensively evaluated the cost, cost-effectiveness, or effects on disparities of specific dietary policies in the US. Moreover, implementation, scale-up, and sustainability of such strategies are important to the political and legal process. Our work seeks to provide such information by asking the following questions:

We will estimate the net costs of implementing each of the selected nutrition policies at the national level. We will use a micro-costing approach to determine and collect detailed data on the quantities and costs of resources used in each stage of the policy implementation.

We use two models to estimate the cost-effectiveness of each strategy: A microsimulation CVD Policy Model that projects the lifetime cost and CVD mortality benefits, as well as an IMPACT Food Policy Model that estimates the cost and potential decline in CVD mortality over 5, 10, 15 and 20 years.

In-depth qualitative research and analysis will reconstruct the dynamics of past and ongoing political efforts to adopt specific policies at the federal, state, and local levels, helping to establish political feasibility. Legal feasibility will assessed by conducting qualitative legal research into each proposed policy using Lexis-Nexis and Bloomberg Law, and government sites to determine constitutional authorization as well as barriers to implementation at each policy making level.

Our innovative research will provide high impact findings on the cost, cost-effectiveness, influence on disparities, and political and legal feasibility of promising dietary policies to reduce CVD in the US. The findings will be critical to inform the planning, implementation and evaluation of evidence-based dietary strategies to achieve optimal cardiovascular health and reduce inequities for all Americans.

Project leader: Dr. Renata Micha