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      Framing the tax and health nexus: a neglected aspect of public health concern.

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          Abstract

          Previous studies have described various associations between tax policy and health. Here we propose a unifying conceptual framework of 'Five R's' to stimulate awareness about the importance of tax to health improvement. First, tax can improve representation and democratic accountability, and help make governments more responsive to the needs of its citizens. Second, tax can create a revenue stream for a universal pool of public finance for health care and other public services. Third, progressive taxation when combined with appropriate public spending can help redistribute wealth and income and mitigate social and health inequalities. Fourth, the re-pricing of harmful products (e.g. tobacco, alcohol and unhealthy food) can help reduce their consumption. Fifth, taxation provides a route by which certain harmful industries can be regulated. The paper also discusses the barriers that hinder the full potential for taxation to be used to improve health, including: weak tax administrations, large 'shadow economies', international trade liberalisation, tax avoidance, transfer pricing by transnational corporations and banking secrecy. We suggest that a greater awareness of the manifold associations between tax and health will encourage health practitioners to actively promote fairer and better taxation, thereby helping to improve health and reduce health inequalities.

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          Author and article information

          Journal
          Health Econ Policy Law
          Health economics, policy, and law
          Cambridge University Press (CUP)
          1744-134X
          1744-1331
          Apr 2017
          : 12
          : 2
          Affiliations
          [1 ] 1Centre for Primary Care and Public Health,Queen Mary University of London,London,UK.
          [2 ] 2Oxford Department of International Development,University of Oxford,Oxford,UK.
          [3 ] 3Department of Epidemiology and Public Health,University College London,London,UK.
          Article
          S174413311600044X
          10.1017/S174413311600044X
          28332460
          722b374d-a8ab-4a07-85c2-d5efa8a6df56

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