Hawaii legislators missed an opportunity to address an important issue with regards to taxing sugar-sweetened beverages (SSB) this year. The bill proposed a 2-cents-per-ounce tax on soda and other SSB, which include sweetened juice and tea.
The negative effect of excess sugar consumption on health is well-known and provides an important basis for such a measure. The most recent release of the Dietary Guidelines for Americans states that a healthy dietary pattern limits added sugars to less than 10% of calories per day; however, many Americans exceed this limit.
SSB are a significant source of added sugar in the American diet. SSB provide empty calories, which means that they are a source of energy without providing nutrients the body needs, such as vitamins and minerals. Sugar in liquid form also does not provide a sense of satiety to keep caloric intake at a recommended level.
While consumption of SSB has declined in recent years, it remains high in children and adolescents. Research links a high intake of sugar to obesity, and high intake of SSB in particular to increased risk of Type 2 diabetes. In Hawaii, the prevalence of self-reported obesity in 2019 was 25%. Low-income and minority groups are particularly at risk, with higher rates of obesity and associated chronic diseases in these groups.
The benefit of the tax for low-income communities is clear. Rather than punishing low-income people with this additional cost when purchasing SSB, it would help to de-incentivize the purchase in the first place, as previous studies in other groups have shown.
A study conducted in Mexico, for example, showed a decline in purchasing of taxed beverages, with households at the lowest socioeconomic level showing the largest decreases in purchases of taxed beverages. As low-income communities in Hawaii generally have ample access to calorie-rich, nutrient-poor food and drink, but insufficient access to nutrient-rich items, increasing the cost of SSB would not do them a disservice nutritionally.
The high rates of obesity in low-income communities results in part from this easy access to cheap, high-calorie items, and the tax is one way to discourage the purchase of such options.
In addition, while some may consider this strategy to constitute the government dictating what people should eat and drink, it’s important to consider the way in which companies producing SSB have already dictated the diet through clever marketing.
Fit, attractive celebrities are often featured in ads for these products, sending the message that consumption of SSB is associated with success and beauty.
Low-income communities are heavily targeted.
The revenue from the tax was to be invested in health and nutrition programs designed to prevent chronic disease, with all of the funds to be deposited into the “Healthy Ohana Fund.”
There is a great need to shift toward prevention of chronic disease, rather than treatment after it develops. Our current model places a burden on the health-care system due to the lifestyle-related illnesses it promotes.
While there has been pushback from some business owners with regards to a possible loss in profits from SSB, this potential loss — due to a shift to less consumption of these items — needs to be viewed in terms of the dire need in the U.S. to make changes in diet to improve the health of the nation.
Focusing on diet and physical activity by funding initiatives in this area is a step in the right direction.
Jinan Banna, Ph.D., R.D., is an associate professor in the University of Hawaii’s Department of Human Nutrition, Food and Animal Sciences.