Two cents per ounce tax - with funding dedicated to City and public school nutrition, health, and physical activity programs - will address diabetes and obesity epidemics by decreasing consumption and funding programs that improve health
SAN FRANCISCO--At tomorrow's Board of Supervisors meeting, Supervisor Scott Wiener will introduce legislation creating a tax of two cents per ounce on the distribution of soda and other sugar-sweetened beverages in San Francisco. The proceeds of the tax will be legally dedicated to fund active recreation and nutrition programs in schools, parks, and elsewhere, for example, physical education, school lunch, after-school programs, expansion of recreation center hours and physical activity offerings, and programs by community based organizations offering physical activity, health, and nutrition programs.
The tax is estimated to generate up to $31 million annually and to reduce consumption of sugary beverages significantly. Under the terms of the legislation, disadvantaged/low-income communities, including those most impacted by the diabetes and obesity epidemics, will be prioritized in funding decisions. The tax is proposed for the November 2014 election for consideration by the voters.
Because the tax proceeds will be legally restricted to nutrition, health, and physical activity programs, it will require a 2/3 affirmative vote. The measure is structured to require that funding be in addition to current funding levels and not utilized as replacement funding for existing programs.
Supervisor Wiener introduced the legislation after lengthy dialogue with health researchers and advocates, and community leaders about the health effects of soda and other sugary beverages on San Franciscans, as well as the success of local health education, nutrition, and exercise programs in
combating obesity and diabetes.
"We are experiencing an epidemic of health problems caused by sugary beverages - including diabetes and obesity afflicting adults, teenagers, and even young children - and we have a responsibility to act to confront this escalating public health challenge," said Supervisor Wiener. "While researchers, physicians, and community health advocates have made tremendous strides in educating the public on the negative health effects of sugary beverages, they agree that more must be done, and they are making urgent requests for intervention from policy leaders. More than 70% of San Francisco voters recently polled said they want the city to do more to combat childhood obesity, with over 85% recognizing that sugar-sweetened beverages are a direct cause of serious health problems like diabetes and obesity. As policy leaders, when we look at the impacts and the staggering costs in human livesand healthcare dollars, we have a moral imperative to act."
Researchers at UC San Francisco have been at the epicenter of the research linking sugary beverages with the diabetes epidemic and other health ailments, as well as the role of tax policy in reducing consumption. Research conducted by Dr. Kirsten Bibbins-Domingo, professor of medicine and of epidemiology and biostatistics at UCSF*, estimates that even a one-cent per ounce tax on sugar-sweetened beverages could cut sugary beverage consumption by up to 10%, with measurable reductions in cases of diabetes, obesity, and heart disease, as well as the costs associated with treating them.
"We used the best available evidence in the medical and economics literature to conduct a study on the impact of a national soda tax. We concluded that adding a penny-per-ounce tax on sweetened beverages could potentially prevent 240,000 cases of diabetes per year, and additionally avoid 100,000 cases of heart disease, 8,000 strokes, and 26,000 deaths over the next decade," said Bibbins-Domingo, who is also director of the Center for Vulnerable Populations at the UCSF-affiliated San Francisco General Hospital.
"I see firsthand the effects of sugar sweetened beverages in our centers across the city," stated Chuck Collins, president and CEO of the San Francisco YMCA, and the co-chair of the Shape Up San Francisco Coalition. "Obesity and diabetes rates are rising, and the health of our kids and families are at risk. We need to educate the public about how sugar-sweetened beverages are affecting all of us, and start making real changes to address these effects. Improving the health of our communities starts with reducing consumption of these beverages and improving our kids' access to and awareness of good diet and exercise."
The data supports the need for policy intervention:
-Since 1980, obesity among children and adolescents has tripled nationwide. Locally, as of 2010, nearly a third (31.7%) of children and adolescents in San Francisco were either obese or overweight. (SOURCE: UCLA Center for Health Policy Research and California Center for Public Health Advocacy.)
-Sugary beverages constitute, on average, 11% of daily caloric intake by children in the U.S. Nearly half of caloric intake from sugar in the U.S. is from sugary beverages. (SOURCE: Columbia Mailman School of Public Health Study)
-Every additional sugary beverage consumed daily increases a child's risk for obesity by 60%, (SOURCE: California Center for Public Health Advocacy citing a study from Children's Hospital, Boston) and one or two sugary beverages per day increases the risk of Type 2 diabetes by 26%. (SOURCE: American Diabetes Association)
-One in three children born today will develop Type 2 diabetes in their lifetime, if sugary beverage consumption does not decline. Currently, nearly 10% of Americans are estimated to have diagnosed or undiagnosed Type 2 diabetes, and more than a third are pre-diabetic -- meaning they have higher than normal blood sugar that is not classified as diabetes, but high enough to lead to an increased risk of developing Type 2 diabetes, heart disease, and stroke. San Francisco's incidence is similar to these national numbers. As of 2007, the annual direct and indirect health care costs of diabetes in the U.S. was $174 billion. (SOURCE: Centers for Disease Control and Prevention)
-Carbonated soft drinks are the single biggest source of calories in the American diet. A 12 ounce can of soda contains around 10 teaspoons of sugar, which is higher than the American Heart Association's daily recommendation for men (no more than 9 teaspoons) and women (no more than 6 teaspoons.). (SOURCE: American Heart Association)
-Research shows that diseases connected to sugary beverages disproportionately impact minorities and low-income communities. For example, 18% of 3-4 year olds enrolled in Head Start in San Francisco - which serves children of low-income families - were obese. (SOURCE: San Francisco Head Start Program) From 2009-2011, the Bayview-Hunters Point neighborhood, which has one of the highest African-American populations in San Francisco, had more diabetes-related emergency room visits than any other neighborhood in San Francisco.(SOURCE: SFHIP website - data from the California Office of Statewide Health Planning and Development)
Sugar-sweetened beverages are different - and more extreme - than other sugary foods in terms of their negative health effects. Extensive data on how the body processes sugar-sweetened beverages demonstrate that these are more than empty calories. These drinks do not satiate hunger, unlike foods that eventually create a feeling of fullness. Sugar in these beverages can be consumed in large quantities in a very short period of time, effectively rushing the liver - which processes the drinks as toxins - with large amounts of sugar and leading to fat deposits (Non-Alcoholic Fatty Liver Disease or NAFLD) that give rise to diabetes, cardiovascular disease, and other diseases. The consumption of sugar-sweetened-beverages has also been shown to raise triglycerides, leading to increased risk of heart attacks and stroke. (Source: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2880768 )
The measure will apply to non-alcoholic beverages with added sugar where the beverage has at least 25 calories per 12 ounces. For these beverages, the tax will be 2 cents for each ounce of beverage. For example, for a 12-ounce can of sugary soda, the tax will be 24 cents. The tax does not apply to diet soda, natural juices, milk, infant formula, or medical drinks. The tax will be imposed at the point of the first distribution within San Francisco and will be paid by the distributor.
The idea of a sugary beverage tax has been endorsed by many organizations, for example, the American Heart Association, American Diabetes Association, Trust for Public Land, Hospital Council of Northern California, the San Francisco medical Society and California Center for Public Health Advocacy.
*for identification purposes only
For more information:
How Many Lives Could a Soda Tax Save?
Credit Suisse Research Institute: Sugar with a Bitter Aftertaste
The American Heart Association: 180,000 deaths worldwide may be associated with sugary soft drinks
Health Affairs: A Penny-Per-Ounce Tax On Sugar-Sweetened Beverages Would Cut Health And Cost Burdens Of Diabetes
Obesity Reviews: Pro v Con Debate: Role of sugar sweetened beverages in obesity
Lena Brook, San Francisco Unified School District Food and Fitness Committee
Harold Goldstein, Executive Director, California Center for Public Health Advocacy
(530) 297-6000 x 201
GL Hodge, Administrator, Providence Baptist Church, Bayview-Hunters Point
Ron Smith, Senior Vice President, Hospital Council of Northern and Central California
Rachel Dinno Taylor, Director, Government Relations, The Trust for Public Land