Evidence on the effectiveness and equity of population-based policies to reduce the burden of type 2 diabetes: a narrative review.
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| Titel: | Evidence on the effectiveness and equity of population-based policies to reduce the burden of type 2 diabetes: a narrative review. |
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| Autoren: | Mackenbach JD; Amsterdam UMC location Vrije Universiteit, Epidemiology and Data Science, Amsterdam, the Netherlands. j.mackenbach@amsterdamumc.nl.; Amsterdam Public Health Research Institute, Amsterdam, the Netherlands. j.mackenbach@amsterdamumc.nl.; Upstream Team, Amsterdam, the Netherlands. j.mackenbach@amsterdamumc.nl., Stuber JM; Amsterdam UMC location Vrije Universiteit, Epidemiology and Data Science, Amsterdam, the Netherlands.; Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.; Upstream Team, Amsterdam, the Netherlands., Beulens JWJ; Amsterdam UMC location Vrije Universiteit, Epidemiology and Data Science, Amsterdam, the Netherlands.; Amsterdam Public Health Research Institute, Amsterdam, the Netherlands.; Upstream Team, Amsterdam, the Netherlands. |
| Quelle: | Diabetologia [Diabetologia] 2025 Feb; Vol. 68 (2), pp. 281-294. Date of Electronic Publication: 2024 Dec 02. |
| Publikationsart: | Journal Article; Review |
| Sprache: | English |
| Info zur Zeitschrift: | Publisher: Springer Verlag Country of Publication: Germany NLM ID: 0006777 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-0428 (Electronic) Linking ISSN: 0012186X NLM ISO Abbreviation: Diabetologia Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Berlin Springer Verlag |
| MeSH-Schlagworte: | Health Equity*/economics , Health Equity*/legislation & jurisprudence , Diabetes Mellitus, Type 2*/prevention & control , Diabetes Mellitus, Type 2*/psychology , Community Health Planning*/economics , Community Health Planning*/legislation & jurisprudence , Sense of Agency* , Health Promotion*/economics , Health Promotion*/legislation & jurisprudence , Health Promotion*/methods , Health Policy*/economics, Cost of Illness ; Humans ; Cost-Effectiveness Analysis |
| Abstract: | Competing Interests: Funding: This work is part of EXPOSOME-NL which is funded through the Gravitation programme of the Dutch Ministry of Education, Culture, and Science and the Netherlands Organisation for Scientific Research (NWO grant number 024.004.017). This work is also part of the EXPANSE project which is funded by the European Union’s Horizon 2020 research and innovation programme under grant agreement number 874627. The funders were not involved in the design of the study; the collection, analysis, and interpretation of data; writing the report; and did not impose any restrictions regarding the publication of the report. Authors’ relationships and activities: The authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work. Contribution statement: JDM and JWJB contributed to the conceptualisation of the article. All authors contributed to the formal analysis of findings. JDM and JMS wrote the original draft. All authors reviewed and edited the article and approved the final version to be published. There is increasing evidence for the effectiveness of population-based policies to reduce the burden of type 2 diabetes. Yet, there are concerns about the equity effects of some policies, whereby socioeconomically disadvantaged populations are not reached or are adversely affected. There is a lack of knowledge on the effectiveness and equity of policies that are both population based (i.e. targeting both at-risk and low-risk populations) and low agency (i.e. not requiring personal resources to benefit from the policy). In this narrative review, we selected 16 policies that were both population based and low agency and reviewed the evidence on their effectiveness and equity. Substantial evidence suggests that fruit and vegetable subsidies, unhealthy food taxes, mass media campaigns, and school nutrition and physical activity education are effective in promoting healthier lifestyle behaviours. Less evidence was available for mandatory food reformulation, reduced portion sizes, marketing restrictions and restriction of availability and promotion of unhealthy products, although the available evidence suggested that these policies were effective in reducing unhealthy food choices. Effects could rarely be quantified across different studies due to substantial heterogeneity. There is an overall lack of evidence on equity effects of population-based policies, although available studies mostly concluded that the policies had favourable equity effects, with the exception of food-labelling policies. Each of the policies is likely to have a relatively modest effect on population-level diabetes risks, which emphasises the importance of combining different policy measures. Future research should consider the type of evidence needed to demonstrate the real-world effectiveness and equity of population-based diabetes prevention policies. (© 2024. The Author(s).) |
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| Grant Information: | 024.004.017 Dutch Ministry of Education, Culture, and Science and the Netherlands Organization for Scientific Research; 874627 Horizon 2020 Framework Programme |
| Contributed Indexing: | Keywords: Agency; Obesity; Population-level approaches; Prevention; Review; WHO Best Buys |
| Entry Date(s): | Date Created: 20241202 Date Completed: 20250609 Latest Revision: 20250609 |
| Update Code: | 20250611 |
| PubMed Central ID: | PMC11732888 |
| DOI: | 10.1007/s00125-024-06330-1 |
| PMID: | 39621105 |
| Datenbank: | MEDLINE |
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Nájsť tento článok vo Web of Science | Abstract: | Competing Interests: Funding: This work is part of EXPOSOME-NL which is funded through the Gravitation programme of the Dutch Ministry of Education, Culture, and Science and the Netherlands Organisation for Scientific Research (NWO grant number 024.004.017). This work is also part of the EXPANSE project which is funded by the European Union’s Horizon 2020 research and innovation programme under grant agreement number 874627. The funders were not involved in the design of the study; the collection, analysis, and interpretation of data; writing the report; and did not impose any restrictions regarding the publication of the report. Authors’ relationships and activities: The authors declare that there are no relationships or activities that might bias, or be perceived to bias, their work. Contribution statement: JDM and JWJB contributed to the conceptualisation of the article. All authors contributed to the formal analysis of findings. JDM and JMS wrote the original draft. All authors reviewed and edited the article and approved the final version to be published.<br />There is increasing evidence for the effectiveness of population-based policies to reduce the burden of type 2 diabetes. Yet, there are concerns about the equity effects of some policies, whereby socioeconomically disadvantaged populations are not reached or are adversely affected. There is a lack of knowledge on the effectiveness and equity of policies that are both population based (i.e. targeting both at-risk and low-risk populations) and low agency (i.e. not requiring personal resources to benefit from the policy). In this narrative review, we selected 16 policies that were both population based and low agency and reviewed the evidence on their effectiveness and equity. Substantial evidence suggests that fruit and vegetable subsidies, unhealthy food taxes, mass media campaigns, and school nutrition and physical activity education are effective in promoting healthier lifestyle behaviours. Less evidence was available for mandatory food reformulation, reduced portion sizes, marketing restrictions and restriction of availability and promotion of unhealthy products, although the available evidence suggested that these policies were effective in reducing unhealthy food choices. Effects could rarely be quantified across different studies due to substantial heterogeneity. There is an overall lack of evidence on equity effects of population-based policies, although available studies mostly concluded that the policies had favourable equity effects, with the exception of food-labelling policies. Each of the policies is likely to have a relatively modest effect on population-level diabetes risks, which emphasises the importance of combining different policy measures. Future research should consider the type of evidence needed to demonstrate the real-world effectiveness and equity of population-based diabetes prevention policies.<br /> (© 2024. The Author(s).) |
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| ISSN: | 1432-0428 |
| DOI: | 10.1007/s00125-024-06330-1 |