taxes

What is the association between local legal infrastructure and population health?

State and local governments make important decisions about how resources and services—including public health services--are provided to citizens.  Examples of these decisions include how much decision-making autonomy local governments are given by the state, or the powers of local boards of health to impose public health taxes, and whether the public health delivery system provides basic or comprehensive services to the community. This study will examine how these decisions impact population health.  Based on the findings, this study will make recommendations for state legislation that will position local public health systems for optimal impact on population health.

Grant Number: 68395

Funding Date: Mon, 11/15/2010

Researching Institution: University of Kentucky College of Public Health

Researcher: Julia Costich, M.P.A., J.D., Ph.D.; Dana Patton

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Do hospital community benefit requirements help public health activities?

To maintain their tax-exempt status, federal and state governments require non-profit hospitals to provide benefits to the communities in which they reside. The Internal Revenue Service (IRS) is developing regulations that require these hospitals to provide more extensive information than previously required about the benefits they are providing to the community. Using data from hospital responses to the new preliminary IRS reporting requirements, this study aims to document which community benefit activities are undertaken and which of these are considered public health activities. The study will also identify those activities that are collaborative efforts between hospitals and public health entities.

Grant Number: 68393

Funding Date: Mon, 11/15/2010

Researching Institution: Saint Louis University

Researcher: Connie Evashwick, Sc.D.; Jesse Goldner, M.A., J.D., Jason S. Turner, Ph.D., M.A.E

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Cigarette Excise Taxes and Tobacco Cessation

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ORIGIN: Community Guide systematic review

Publication Date: 12/07/2009

Author(s): NPO Staff

The Problem:

Tobacco use is a source of chronic and fatal illnesses for users and persons with secondary exposure. In the United States, cigarette smoking contributes to one in five deaths and costs more than $193 billion in annual lost productivity and healthcare expenditures. CDC: Smoking-Attributable Mortality, Years of Potential Life Lost, and Productivity Losses—United States, 2000–2004.

The Law:

All states have laws that tax cigarettes to discourage continued use. Tobacco Free Kids: Fact Sheet. For example, under California Proposition 99, Cal Rev & Tax Code § 30122-3 (2008), adopted in 1988, cigarette distributors are taxed $0.0125 per cigarette or $0.25 per pack. For other examples of cigarette excise tax laws, see ALM GL ch. 64C, § 6 (Massachusetts) and ORS § 323.030(1) (Oregon).

The Evidence:

In a systematic review, a Community Guide expert panel reviewed 17 studies that assessed the effectiveness of California Proposition 99 and similar cigarette excise tax laws as public health interventions aimed at reducing tobacco use and its associated harms. Community Guide Task Force: Changing Risk Behaviors and Addressing Environmental Change - Tobacco, 27-29. The underlying studies used time-series analyses of aggregate data collected by state authorities to measure price elasticity related to sales or overall consumption trends. According to the reviewers, the findings across the studies suggest that increasing cigarette prices reduces cigarette sales and or consumption. For example, the seven underlying studies focusing on California found that the $0.25 per pack tax instituted by Proposition 99 reduced per capita cigarette consumption by 4 – 16 percent in the short term. 

The Bottom Line:

In the judgment of a Community Guide expert panel, excise taxes are an effective public health intervention aimed at decreasing the amount of cigarettes purchased and the prevalence of smoking. The effects are generally proportional to the size of the tax increase.  

Additional Information:

Tobacco Free Kids provides online access to a number of resources including informative briefs and fact sheets.

The National Conference on State Legislatures (NCSL) provides online access to a map illustrating state cigarette excise taxes and tracks cigarette excise tax legislation.

An interactive map from the Robert Wood Johnson Foundation gives policy-makers and advocates a nationwide picture of continuing state efforts on key tobacco control policies.

Additional Resources: Tobacco Free Kids, National Conference on State Legislatures, Cigarette Tax Laws by State

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