Estimating the potential health impact and costs of implementing a local policy for food procurement to reduce the consumption of sodium in the county of Los Angeles

Abstract

Objectives: We examined approaches to reduce sodium content of food served in settings operated or funded by the government of the County of Los Angeles, California.

Methods: We adapted health impact assessment methods to mathematically simulate various levels of reduction in the sodium content of food served by the County of Los Angeles and to estimate the reductions' potential impacts on mean systolic blood pressure (SBP) among food-service customers. We used data provided by county government food-service vendors to generate these simulations.

Results: Our analysis predicted that if the postulated sodium-reduction strategies were implemented, adults would consume, on average, 233 fewer milligrams of sodium each day. This would correspond to an average decrease of 0.71 millimeters of mercury in SBP among adult hypertensives, 388 fewer cases of uncontrolled hypertension in the study population, and an annual decrease of $629,724 in direct health care costs.

Conclusions: Our findings suggest that a food-procurement policy can contribute to positive health and economic effects at the local level. Our approach may serve as an example of sodium-reduction analysis for other jurisdictions to follow.

FIGURE 1

Logic framework for estimating the impacts on health of a proposed food-procurement policy to reduce sodium consumption among customers of food-service venues operated or funded by the County of Los Angeles, California, 2010. Note. Although these 2 policy approaches are not mutually exclusive, we assumed that each food-service setting would implement only the more feasible approach (and not both approaches). Approach 1 assumed that the food-service setting would reduce the sodium content in all foods served. Approach 2 assumed that the food-service setting would label, promote, subsidize, and provide low-sodium food options.

FIGURE 2

Equations for estimating reduction in average daily sodium consumption, reduction in systolic blood pressure, and number of individuals potentially affected by a proposed food-procurement policy to reduce sodium consumption among customers of food-service venues operated or funded by the County of Los Angeles, California, 2010. Note. The conversion factor was derived from 2 studies by He and MacGregor.^, We used different conversion factors for adults with and without hypertension and for children.