Click to edit Master title What do we know about Sugar ......Click to edit Master subtitle style...

Click to edit Master subtitle style

Click to edit Master title styleKristine Madsen, MD, MPHChildhood Obesity Conference, 2019

What do we know about Sugar-Sweetened Beverage Taxes?

Strategic ResearchHow sugar-sweetened beverage (SSB) taxes work Evidence to date on SSB taxesRevisit strategy

Outline


Click to edit Master title style

Strategic research

0%

5%

10%

15%

20%

25%

30%

35%

40%Adult Obesity and Diabetes in the U.S.

0102030405060708090

100Economic inequity, 2010

The need for a strategy around obesity

OECD Wealth Distribution DatabaseNHANES and CDC data

Industry is far more strategic

“… Instead of imposing regressive taxes, government should work together with industry to help educate people about how to moderate their calories and achieve a balanced lifestyle... ”

Some educational messages from Coca-Cola

“Each morning in the open air, take exercise to help keep fit.” - 1938

Coke’s Chief Health and Science Officer: “Akin to a political

campaign, we will develop, deploy and evolve a powerful and multi-

faceted strategy to counter radical organizations and their

proponents.” 2015

Center for Science in the Public Interest.

Big Soda Lobbying and Ballot Spending, 2009-2016

What’s our long game?

Control of infectious diseasesWidespread vaccinationReductions in smokingMotor-vehicle safety

Learning from public health successes in the U.S.

Highly credible scientific evidence Laws and regulations

Ingredients of success for public health programs

Isaacs SL & Schroeder SA. The American Prospect, 2001.

World map by www.freeworldmaps.net

Passage of Sugared Beverage Taxes Pre-2009

Pre-2009

Passage of Sugared Beverage Taxes 2011

Pre-2009 2011


Pre-2009 2011 2012


Pre-2009 2011 2012 2013


Pre-2009 2011 2012 2013 2014


Pre-2009 2011 2012 2013 2014 2015


Pre-2009 2011 2012 2013 2014 2015 2016


Pre-2009 2011 2012 2013 2014 2015 2016 2017


Pre-2009 2011 2012 2013 2014 2015 2016 2017 2018

Berkeley – First city to pass a tax in the U.S.



How SSB excise taxes work

Presumed mechanism of SSB excise taxes

Retailers Shelf PriceDistributors

$1.50$1.62

TAX PASS-THROUGHConsumer Behaviors

$1.62

Pay tax & raise price for retailers

Raise prices for

consumers

Buy fewer SSBs

Consume fewer SSBs

Presumed mechanism of SSB excise tax


$1.50$1.62

TAX PASS-THROUGH

Improved public health

$1.62

Consumer Behaviors



Evidence on SSB taxes



$1.50$1.62


$1.62


0% 50% 100% 150% 200% 250%

San Francisco

Oakland

Philadelphia

Berkeley

Mexico

Range of tax pass through

Colchero A et al. PLoS One, 2015. Silver L et al. PLoS One, 2017. Cawley J et al. JAMA, 2018. Roberto C et al. JAMA, 2019. Falbe et al. Forthcoming



$1.50$1.62


$1.62


-60% -50% -40% -30% -20% -10% 0%

Oakland

Philadelphia

Berkeley

Mexico

Relative reduction in sales of SSBs

Colchero A et al. Health Affairs, 2017. Silver L et al. PLoS One, 2017. Roberto C et al. JAMA, 2019. White J et al. Forthcoming.



$1.50$1.62


$1.62


32

Mean change in consumption in low-income neighborhoods over first 3 years of Berkeley’s tax

Total SSBs

v b

4%

-13%

-9%

-18%

17%

5%

0%

29%

-70%

-36%

-51%

-60%

-54%

-52%

Berkeley Oakland/San Francisco

Regular soda

Sports drinks

Energy drinks

Fruit drinks

Sweetened coffee/tea

Water

p < 0.001

p = 0.001

p = 0.001

p = 0.001

p = 0.003

Lee et al. AJPH, 2019.

1-year results from Berkeley showed no decline in consumption

2-month results from Philadelphia suggest 26% decline in consumption

SSB consumption

Silver L. PLoS One, 2017. Zhong Y et al. Am J Prev Med, 2018.



$1.50$1.62


$1.62


Cross-border shopping

Within Philadelphia, -1.261 billion ounces

In bordering zip codes, +0.308 billion ounces

Estimate 25% of SSB reduction in Philly offset by cross-border shopping


Roberto C et al. JAMA, 2019.


Interviews with over 100 randomly selected retailers in San Francisco, Oakland and Berkeley

53% support a statewide tax Population health benefits Equity for businesses

Geography of taxes and equity



$1.50$1.62


$1.62

Cross-border shopping Substitution


Robust economic research: no overall loss of jobs due to tobacco taxes

No effect on jobs or economy in Mexico after 2 yearsNo effect on employment in Philadelphia Expected to save $ in health care

Expected overall economic impacts

Guerrero-López CM et al. Prev Med, 2017. Lawman HG et al. PLoS One, 2019. Chaloupka F et al. Annu Rev Public Health, 2019.



Revisiting strategy

Distributors internalize societal costs of their products Tax is passed through to higher shelf prices People buy fewer sugar-sweetened beveragesNo overall loss of jobsRevenues can create greater health equity (up next!!)

What we know about SSB excise taxes

California’s ban “Alternatives” to excise taxes Education Sales taxes…

Preemption – the next fight



$1.50$1.62

TAX PASS-THROUGH


ConsumerBehaviors

$1.62



$1.50$1.62

TAX PASS-THROUGH


ConsumerBehaviors

$1.62

sales

?Important points about sales taxes: 1. Generally smaller than excise taxes2. Small to no impact on behaviors3. Paid directly by consumers

?

Be willing to take action!!

Ana Ibarra-Castro Ben King Christina Becker Hannah Thompson Jen Falbe Jenny Linchey Julián Ponce Karen Sokal-Gutierrez Matt Lee Nadia Rojas Natalya Goode Somanette Rivas Tara Benesch

Thank you

All of our wonderful students and volunteers!

San Francisco Department of Public Health

City of Berkeley Johns Hopkins Global Obesity

Prevention Center The California Endowment NIH/NHLBI

46

Date post:	23-May-2020
Category:	Documents
Upload:	others
View:	3 times
Download:	0 times

Click to edit Master title What do we know about Sugar ......Click to edit Master subtitle style...

Documents