# Cost-Effectiveness of Health System and State-Level Strategies to Improve Diet and Reduce Cardiometabolic Diseases

> **NIH NIH R01** · TUFTS UNIVERSITY BOSTON · 2021 · $768,881

## Abstract

Project Summary
While considerable evidence supports and informs the likely benefits of policy innovations within and outside
health systems to improve diet and reduce cardiometabolic diseases (CMD), their impacts on health,
disparities, costs, and cost-effectiveness are not well established. Because major diet-related disparities
persist, assessing effects of such strategies in at-risk subgroups is crucial. Administrative and legal challenges
can strongly influence implementation, scale-up, and sustainability of such strategies, but such considerations
have not yet been rigorously assessed. Our specific aims extend our prior analyses of national policies to
address crucial questions for health system strategies and state-specific actions and to disseminate this
evidence. The aims are 1) to estimate the health impacts, costs, cost-effectiveness, and effects on disparities
of specific health system strategies to improve diet and reduce CMD in the US; 2) to estimate the health
impacts, costs, cost-effectiveness, and effects on disparities of specific state-level policies to improve diet and
reduce CMD in the US; 3) to assess the administrative and legal challenges and feasibility of specific health
system and state strategies to improve diet and reduce CMD in the US; and 4) to disseminate our top findings
from the prior period, related grants, and this new work to relevant stakeholders in key legislative, agency, and
advocacy positions. Building on our prior experience, we will evaluate health system interventions, state
interventions, and administrative/legal feasibility. We will define plausible policy effect sizes and their
uncertainty based on reviews of literature and expert contacts; and adopt a micro-costing approach using
established methods to assess policy costs including by sectors. We will project costs and CMD benefits of
each policy, using established modeling approaches, and quantify comparative efficiency measured by ICER
comparing each intervention to a base case. Effects on disparities will be evaluated comparing differences in
CMD disparities (difference in difference approach) for each action in key population subgroups. We will
conduct in-depth administrative and legal analysis to identify the likely conditions for success and the
authorities and obstacles for implementation.

## Key facts

- **NIH application ID:** 10224315
- **Project number:** 5R01HL115189-07
- **Recipient organization:** TUFTS UNIVERSITY BOSTON
- **Principal Investigator:** DARIUSH MOZAFFARIAN
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $768,881
- **Award type:** 5
- **Project period:** 2013-08-15 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10224315

## Citation

> US National Institutes of Health, RePORTER application 10224315, Cost-Effectiveness of Health System and State-Level Strategies to Improve Diet and Reduce Cardiometabolic Diseases (5R01HL115189-07). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10224315. Licensed CC0.

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