title: Estimating the potential health impact and costs of implementing a local policy for food procurement to reduce the consumption of sodium in the county of Los Angeles.
abstract: OBJECTIVE
  We examined approaches to reduce sodium content of food served in settings operated or funded by the government of the County of Los Angeles, California.
  
  
  METHODS
  We adapted health impact assessment methods to mathematically simulate various levels of reduction in the sodium content of food served by the County of Los Angeles and to estimate the reductions' potential impacts on mean systolic blood pressure (SBP) among food-service customers. We used data provided by county government food-service vendors to generate these simulations.
  
  
  RESULTS
  Our analysis predicted that if the postulated sodium-reduction strategies were implemented, adults would consume, on average, 233 fewer milligrams of sodium each day. This would correspond to an average decrease of 0.71 millimeters of mercury in SBP among adult hypertensives, 388 fewer cases of uncontrolled hypertension in the study population, and an annual decrease of $629,724 in direct health care costs.
  
  
  CONCLUSIONS
  Our findings suggest that a food-procurement policy can contribute to positive health and economic effects at the local level. Our approach may serve as an example of sodium-reduction analysis for other jurisdictions to follow.
authors.affiliation: Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. lgase@cdc.gov
authors.forename: Lauren N
authors.initials: LN
authors.lastname: Gase
authors.forename: Tony
authors.initials: T
authors.lastname: Kuo
authors.forename: Diane
authors.initials: D
authors.lastname: Dunet
authors.forename: Steven M
authors.initials: SM
authors.lastname: Schmidt
authors.forename: Paul A
authors.initials: PA
authors.lastname: Simon
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Fielding
mesh_terms: D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D002648:Child; D002675:Child, Preschool; D003365:Costs and Cost Analysis; D005504:Food Analysis; D005522:Food Services / Q000191:economics; D006293:Health Promotion; D006801:Humans; D007223:Infant; D009111:Local Government; D015141:Los Angeles; D018673:Nutrition Policy; D012982:Sodium, Dietary / Q000008:administration & dosage / Q000032:analysis*
chemical_list: D012982:Sodium, Dietary