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Am J Prev Med. 2016 Apr;50(4):543-9. doi: 10.1016/j.amepre.2015.10.021. Epub 2015 Dec 18.

Obesity-Related Policy/Environmental Interventions: A Systematic Review of Economic Analyses.

Author information

  • 1Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland; Center for Food Safety and Applied Nutrition, Food and Drug Administration, College Park, Maryland. Electronic address:
  • 2Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.
  • 3Health Policy Center, Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, Illinois.
  • 4U.S. Department of Agriculture, Economic Research Service, Washington, District of Columbia;
  • 5Robert H. Smith School of Business, University of Maryland, College Park, Maryland.



Policy and environmental changes to support and encourage individual-level nutrition and physical activity behavior are underway in many parts of the U.S. and around the world at national, state, and local levels. Yet, to the authors' knowledge, no summary of the cost-benefit or cost-effectiveness studies of obesity-related policy/environmental interventions exists.


The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement guidelines were followed to identify, screen, and describe the protocols used in this systematic review. In 2014, a unique search was conducted of titles and abstracts in MEDLINE, EconLit, SCOPUS, and Web of Science databases that were published from January 2002 through January 2014 in English-language, peer-reviewed journals. The search terms described obesity, physical activity, and diet in combination with economic evaluation.


In 2014 and 2015, the results were analyzed. A total of 27 studies met the inclusion criteria, of which 26 described separate interventions. Of the 27 included studies, eight focused on the community and built environment, seven assessed nutrition-related changes, nine reported on the school environment, and three evaluated social marketing and media interventions. The vast majority of included studies reported beneficial economic outcomes of the interventions.


Given the large and growing literature on the health and behavioral outcomes of policy and environmental interventions, the relatively low number of located cost-beneft and cost-effectiveness economic assessments appears to indicate a prime opportunity for the research community to address.

Published by Elsevier Inc.

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