Click to edit Master title Sweetened Beverage Taxes? style Click - - PowerPoint PPT Presentation
What do we know about Sugar- Click to edit Master title Sweetened Beverage Taxes? style Click to edit Master subtitle style Kristine Madsen, MD, MPH Childhood Obesity Conference, 2019 Outline Strategic Research How sugar-sweetened
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Kristine Madsen, MD, MPH Childhood Obesity Conference, 2019
Strategic Research How sugar-sweetened beverage (SSB) taxes work Evidence to date on SSB taxes Revisit strategy
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0% 5% 10% 15% 20% 25% 30% 35% 40%
Adult Obesity and Diabetes in the U.S.
10 20 30 40 50 60 70 80 90 100
Economic inequity, 2010
OECD Wealth Distribution Database NHANES and CDC data
“… 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... ”
“Each morning in the open air, take exercise to help keep fit.”
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
Control of infectious diseases Widespread vaccination Reductions in smoking Motor-vehicle safety
Highly credible scientific evidence Laws and regulations
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
Passage of Sugared Beverage Taxes 2012 Pre-2009 2011 2012
Passage of Sugared Beverage Taxes 2013 Pre-2009 2011 2012 2013
Passage of Sugared Beverage Taxes 2014 Pre-2009 2011 2012 2013 2014
Passage of Sugared Beverage Taxes 2015 Pre-2009 2011 2012 2013 2014 2015
Passage of Sugared Beverage Taxes 2016 Pre-2009 2011 2012 2013 2014 2015 2016
Passage of Sugared Beverage Taxes 2017 Pre-2009 2011 2012 2013 2014 2015 2016 2017
Passage of Sugared Beverage Taxes 2018 Pre-2009 2011 2012 2013 2014 2015 2016 2017 2018
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Ret etaile ilers Sh Shelf elf P Price Dis istr tributors
$1.50 $1.62
TAX PASS-THROUGH
Consumer Beha havior
$1.62
Pay tax & raise price for retailers Raise prices for consumers Buy fewer SSBs Consume fewer SSBs
Ret etaile ilers Sh Shelf elf P Price Dis istr tributors
$1.50 $1.62
TAX PASS-THROUGH
Impr proved d public lic h health ealth
$1.62
Consumer Beha havior
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Ret etaile ilers Sh Shelf elf P Price Dis istr tributors
$1.50 $1.62
Impr proved d public lic h health ealth
$1.62
TAX PASS-THROUGH
Consumer Beha havior
0% 50% 100% 150% 200% 250% San Francisco Oakland Philadelphia Berkeley Mexico
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
Ret etaile ilers Sh Shelf elf P Price Dis istr tributors
$1.50 $1.62
Impr proved d public lic h health ealth
$1.62
TAX PASS-THROUGH
Consumer Beha havior
0% Oakland Philadelphia Berkeley Mexico
Colchero A et al. Health Affairs, 2017. Silver L et al. PLoS One, 2017. Roberto C et al. JAMA,
Ret etaile ilers Sh Shelf elf P Price Dis istr tributors
$1.50 $1.62
Impr proved d public lic h health ealth
$1.62
TAX PASS-THROUGH
Consumer Beha havior
32
Mean change in consumption in low-income neighborhoods
Total SSBs v b
4%
17% 5% 0% 29%
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
Silver L. PLoS One, 2017. Zhong Y et al. Am J Prev Med, 2018.
Ret etaile ilers Sh Shelf elf P Price Dis istr tributors
$1.50 $1.62
Impr proved d public lic h health ealth
$1.62
TAX PASS-THROUGH
Consumer Beha havior
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
Ret etaile ilers Sh Shelf elf P Price Dis istr tributors
$1.50 $1.62
Impr proved d public lic h health ealth
$1.62
Cross-border shopping Substitution
TAX PASS-THROUGH
Consumer Beha havior
Robust economic research: no overall loss of jobs due to tobacco taxes No effect on jobs or economy in Mexico after 2 years No effect on employment in Philadelphia Expected to save $ in health care
Guerrero-López CM et al. Prev Med, 2017. Lawman HG et al. PLoS One, 2019. Chaloupka F et al. Annu Rev Public Health, 2019.
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Distributors internalize societal costs of their products Tax is passed through to higher shelf prices People buy fewer sugar-sweetened beverages No overall loss of jobs Revenues can create greater health equity (up next!!)
California’s ban “Alternatives” to excise taxes
Ret etaile ilers Sh Shelf elf P Price Dis istr tributors
$1.50 $1.62
TAX PASS-THROUGH
Impr proved d public lic h health ealth Consumer er Beha havior
$1.62
Ret etaile ilers Sh Shelf elf P Price Dis istr tributors
$1.50 $1.62
TAX PASS-THROUGH
Impr proved d public lic h health ealth Consumer er Beha havior
$1.62
Important points about sales taxes:
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
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