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BLOG: Review of summer sweetness
Last summer, we took a look at the sweet beverage tax in my home town of Philadelphia. At the time of publication of that blog, I thought that once the new law was passed the controversy would die down. The public health logic that fueled my interest in the project seemed so obvious, I assumed that once the shock value of this type of law was digested, the issue would fade from the limelight.
Just the opposite has occurred.
The beverage industry, with a fervor that reminds me of the big tobacco industry, has launched a full-scale battle with ads on public buses, TV and radio in addition to a website to appeal to the public to repeal this legislation. The money that is generated from this tax is used for education for the children of Philadelphia.
I find it fascinating that the battle on both sides seems to center on where the money that is generated from the tax is spent rather than the purpose behind the tax. The opponents say that the city has other sources of money for the children, and the proponents talk about all the children that have been helped by the new funds. I have yet to hear anyone talk about the danger of sugary beverages and the obesity epidemic in America and in the big cities, in particular.
The opponents talk about discrimination against the poor, as they are less able to afford the tax and also less able to travel outside of the city to buy sugary drinks. Oddly, as pointed out in my blog last year, the obesity epidemic is more prevalent in the disadvantaged population by a two-to-one margin. I would argue with the opponents of this program that the law is helping exactly the right population.
In an article published in The Hill, by Lynn Silver, MD, MPH, titled, “Soda taxes are a sweetener for public health efforts,” the author makes the point that we no longer need to speculate on the public health value of these types of laws. Based on a study published in PLOS Medicine, it is clear that taxes on sweetened beverages shift the buying public to heather alternatives. The study showed a 20% reduction in the daily calorie intake from sugary drinks. The study also showed a shift to other beverages including bottled water and milk so that there was no significant increase in the grocery bill from the tax and no notable decrease in the dollars spent at the retail level.
There are a couple of considerations in the review of this study. First, it was based on Berkeley, Calif., where the first of this type of tax was instituted in 2014. As a lifelong Pennsylvanian, I am the first that admit that Philly is not Berkeley. Second, the Philadelphia tax is not pure. In passing any type of legislation in Philadelphia there are crazy compromises, and our tax encompasses other beverages including fruit juice and diet soda. In spite of these wrinkles, I am confident that tax will change the habits of the citizens of our fair city and that this is a positive step in the direction of better health.
As primary care health providers, optometrists need to become more involved with wellness education and programs to promote public health issues. Obesity is a growing problem in America. Our population is more overweight today than 5 years ago and we are overweight at a younger age. This health crisis is leading to more type 2 diabetes and hypertension that will result in eye and vision changes that become our problems to manage.
We need to support the sweet beverage tax and other legislative programs that promote public health. We need to be active members of the American Public Health Association, read the research, and use the information to educate and counsel our patients on health and wellness issues. We see patients at the critical age in their lives where lifestyle and health habits are developed. We, perhaps more than any other health care provider, can have an impact on the long-term health and wellness of our nation.
Reference:
Silver LD, et al. PLOS Medicine. 2016;doi.org/10.1371/journal.pmed.1002283.