TY - JOUR
T1 - The Navajo Nation Healthy Diné Nation Act
T2 - Community Support of a 2% Tax on Unhealthy Foods
AU - Curley, Caleigh
AU - Eddie, Regina
AU - Tallis, Kristen
AU - Lane, Taylor S.
AU - Yazzie, Del
AU - Sanderson, Priscilla R.
AU - Lorts, Cori
AU - Shin, Sonya
AU - Behrens, Timothy K.
AU - George, Carmen
AU - Antone-Nez, Ramona
AU - Ashley, Christine
AU - De Heer, Hendrik D.
N1 - Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023/9/1
Y1 - 2023/9/1
N2 - Context: The Healthy Diné Nation Act (HDNA) of 2014 included a 2% tax on foods of little-to-no-nutritious value ("junk foods") on the Navajo Nation. The law was the first ever in the United States and any Indigenous nation worldwide with a population at a high risk for common nutrition-related conditions. To date, research on community support for food tax legislation among Indigenous nations is entirely lacking. Objective: To assess the extent of support for the HDNA and factors associated with support including sociodemographic variables, knowledge of the HDNA, nutrition intake, and pricing preferences. Design: Cross-sectional survey. Setting: The Navajo Nation. Participants: A total of 234 Navajo Nation community members across 21 communities. Outcome Measures: The percentage of participants who were supportive of the HDNA. Results: Participants were 97% Navajo, on average middle-aged, 67% reported an income below $25 000 annually, and 69.7% were female. Half of the respondents said they "support" (37.4%) or "strongly support" (13.0%) the tax, while another 35% of people said they were neutral or somewhat supportive; 15% did not support the tax. Participants with higher income (P =.025) and education (P =.026) and understanding of the legislation (P <.001 for "very well" vs "not at all") had increased odds of greater support, as did people who believed that the HDNA would make Navajo people healthier (vs not, P <.001). Age, gender, language, and reported nutrition intake (healthy or unhealthy) were not associated with HDNA support, but participants willing to pay 5% or 12%-15% higher prices for fast food and soda had increased odds of greater support (P values range from.023 to <.001). Conclusions: The majority of Navajo community members surveyed were moderately supportive of the Navajo Nation tax on unhealthy foods. Higher income and education and understanding of the law were associated with greater support, but nutrition intake was not.
AB - Context: The Healthy Diné Nation Act (HDNA) of 2014 included a 2% tax on foods of little-to-no-nutritious value ("junk foods") on the Navajo Nation. The law was the first ever in the United States and any Indigenous nation worldwide with a population at a high risk for common nutrition-related conditions. To date, research on community support for food tax legislation among Indigenous nations is entirely lacking. Objective: To assess the extent of support for the HDNA and factors associated with support including sociodemographic variables, knowledge of the HDNA, nutrition intake, and pricing preferences. Design: Cross-sectional survey. Setting: The Navajo Nation. Participants: A total of 234 Navajo Nation community members across 21 communities. Outcome Measures: The percentage of participants who were supportive of the HDNA. Results: Participants were 97% Navajo, on average middle-aged, 67% reported an income below $25 000 annually, and 69.7% were female. Half of the respondents said they "support" (37.4%) or "strongly support" (13.0%) the tax, while another 35% of people said they were neutral or somewhat supportive; 15% did not support the tax. Participants with higher income (P =.025) and education (P =.026) and understanding of the legislation (P <.001 for "very well" vs "not at all") had increased odds of greater support, as did people who believed that the HDNA would make Navajo people healthier (vs not, P <.001). Age, gender, language, and reported nutrition intake (healthy or unhealthy) were not associated with HDNA support, but participants willing to pay 5% or 12%-15% higher prices for fast food and soda had increased odds of greater support (P values range from.023 to <.001). Conclusions: The majority of Navajo community members surveyed were moderately supportive of the Navajo Nation tax on unhealthy foods. Higher income and education and understanding of the law were associated with greater support, but nutrition intake was not.
KW - Chapter
KW - HDNA
KW - Navajo Nation
KW - junk food
KW - tax
UR - http://www.scopus.com/inward/record.url?scp=85165521680&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85165521680&partnerID=8YFLogxK
U2 - 10.1097/PHH.0000000000001753
DO - 10.1097/PHH.0000000000001753
M3 - Article
C2 - 37253351
AN - SCOPUS:85165521680
SN - 1078-4659
VL - 29
SP - 622
EP - 632
JO - Journal of Public Health Management and Practice
JF - Journal of Public Health Management and Practice
IS - 5
ER -