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The Impact of Healthy Diet Promotion Policies on Maternal and Infant Health in the Navajo Nation
Thursday, November 13, 8:30 to 10:00am, Property: Hyatt Regency Seattle, Floor: 6th Floor, Room: 601 - HohAbstract
In light of widespread increases in diet-related chronic disease, numerous intergovernmental and public health organizations have advocated for fiscal policies to improve diets. One of the most comprehensive such policies in the world was adopted by the Navajo Nation, which has a high prevalence of food insecurity and gestational diabetes. Their Healthy Diné Nation Act (HDNA) of 2014-15 consists of two parts: 1) an exemption from sales tax for healthy foods and beverages; and 2) a tax increase on unhealthy foods and beverages.
This study estimates the impact of the HDNA on birth outcomes. We examine CDC birth certificate data for the U.S. for 2010-2018; i.e. for more than 3 years before to 3 years after the HDNA. We estimate difference-in-difference models and event studies that estimate the effect of the HDNA on a variety of outcomes concerning the health of newborns (e.g. birth weight, premature births) and mothers (e.g. gestational diabetes, gestational hypertension, weight gain during pregnancy, and pre-pregnancy weight). The treatment group consists of mothers whose self-reported race is American Indian and Alaskan Native (AIAN) and who live in the counties of the Navajo Nation. The comparison group consists of mothers whose self-reported race is also AIAN but who live outside the three states that include the Navajo Nation (AZ, NM, UT).
We hypothesize that the HDNA, given that it was designed to promote healthy diets, improved health outcomes for newborns and mothers. However, we find no beneficial impacts of the HDNA on these outcomes. The comprehensive nature of the HDNA, as well as the prevalence of diet-related chronic disease and maternal and infant health conditions among the Navajo Nation population, make this an important contribution to the evidence base.