A Philadelphia Anabaptist Immersion during a Storm

Philly Is Taking the Fizz Out of Obesity and Diabetes

Yep. We’re just about done here. Soda taxes are highly effective, and Philly has proved it. Classic economic price-demand curves work, especially in a city with a lot of poverty. If you tax soda and raise the price, sales go down. Philly obesity and diabetes rates will follow. A hot new publication in JAMA proves it. The headlines are screaming about it:

Soda taxes are a “no-brainer” for public health,
says author of a new study on them

Open and Shut Case

This could hardly be simpler to understand. That’s why the lead author, Christina Roberto, calls it a no-brainer. Just don’t think about it too hard. She and her colleagues found that after Philly put a tax of 1.5 cents per ounce on drinks sweetened with sugar and artificial sweeteners, the price went up. Sales went down by a whopping 51 percent.

Sure, people who could afford it found ways around the tax. Some of them just left the city and bought their soda elsewhere. That brought down the net impact of the tax to a still-impressive 38 percent.

Some people are whining about a supermarket closing in a low-income neighborhood. But making good policies is sometimes messy. Get over it.

Starbucks Doing Great

Besides, Starbucks is doing great in Philly. Even after an ugly incident where an employee called the cops on two black men for being in the coffee shop, sales are up. It probably helps that those big, expensive lattes with 64 grams of sugar were totally untouched by soda tax.

Remember, this soda tax will be especially helpful to poor people who can’t afford to pay it. Since they suffer more from obesity and diabetes, they’ll get an extra benefit from being unable to afford expensive sugary drinks. Dr. Roberto explains why she sees no ethical problem with a so-called “regressive” tax:

The flip side of the ethical concern is that we have a system right now where diseases like type 2 diabetes and chronic diseases are disproportionately impacting those with the lowest resources and the greatest need. Part of what this is trying to do is to help people make healthy choices that are going to help them lead a long life.

In fact, she says she’d like to tax the other bad foods that those people buy. “That would also do more to help public health.”

Nattering Nabobs of Negativity

The only dissenting voices come from folks like Lisa Powell and Matthew Maciejewski who try to distract us with irrelevant facts like this:

The fact that intake of SSBs has declined over the past decade and the obesity epidemic has continued unabated suggests that reducing SSBs alone is not the sole solution.

Staying Positive

Sure, we’ve seen no impact on Philly obesity yet. But collecting real data on health outcomes is a waste of time that we can’t afford. So instead, let’s focus on the more positive outlook that Kristine Masden, James Krieger, and Xavier Morales offer up in an editorial alongside the new study. Obesity and diabetes are complex problems, they say. Communities are doing many other things about this problem, so “it will likely be difficult to demonstrate the specific contribution of sugar-sweetened beverage taxes to changes in health outcomes.”

But that doesn’t really matter. “Current evidence is already sufficient to move forward with adoption of taxes while continuing to monitor outcomes.” The Philly obesity and diabetes tax strategy can be a model for the nation.

The evangelists of soda taxes believe all of this and more.

But Seriously

Assumptions about health outcomes are not good enough. People may well compensate by buying other stuff that’s not good for them. Trying to tax all of that, too, will go over like a lead balloon.

Taxes on stuff that erudite people think “the others” in their midst shouldn’t be eating or drinking will never be popular. No amount of rationalization will transform regressive taxes into a progressive policy. We certainly hope that obesity in Philly goes down. But it’s hardly inevitable.

Click here for the study and here for the Masden editorial. For the viewpoint of Powell and Maciejewski, click here. And finally, for some perspective from people who are paying the tax, click here.

A Philadelphia Anabaptist Immersion during a Storm; watercolor, pen, and ink by Pavel Svinyin / WikiArt

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May 16, 2019

One Response to “Philly Is Taking the Fizz Out of Obesity and Diabetes”

  1. May 16, 2019 at 7:16 am, Joe Gitchell said:

    Thank you, Ted, for this summary.

    The parallels to tobacco and nicotine policy are substantial (you might imagine that Dr. Whigham and I had engaging discussions on more than one thread yesterday–and you’d be right!) though with many important differences (particularly about the health consequences of available substitutes).

    If folk are interested in some insight in to the caliber of the discourse on tax policy for nicotine products, I would, self-promotionally but humbly (is that a thing?) encourage people to read the Jawad et al article at the first link below, or at least the Discussion, and then read the two Rapid Responses (to which the authors have yet to reply, over a year later…).

    And for even more perspective in this vein, the UCSF blog link should be revealing.

    My relevant disclosures can be found in all of the links.