Resource Type: Research Briefs & Reports

Brief: Sugar-Sweetened Beverage Excise Tax in the City of San José

Posted on January 12, 2026

Bottles of soda in a store

This material was developed at the Harvard T.H. Chan School of Public Health in collaboration with the County of Santa Clara Public Health Department through participation in the CalFresh Healthy Living-Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) Learning Collaborative Partnership. This material was funded by USDA’s Supplemental Nutrition Assistance Program, an equal opportunity provider. This material is intended for educational use only.  

This brief summarizes a CalFresh Healthy Living-CHOICES Project Learning Collaborative Partnership model, a cost-effectiveness analysis examining a sugar-sweetened beverage (SSB) excise tax in the City of San José. The model assessed the health impact and cost-effectiveness of a $0.02 per ounce excise tax in the City of San José. Read more in the full brief.

Contact choicesproject@hsph.harvard.edu with any accessibility questions.

Citation

Cholette V, Coxe N, Shir A, Gacutan-Galang J, Beccarelli M, Evans LW, Pugliese J, Gouck J, Barrett JL, McCulloch SM, Garrone ME, Cradock AL. Sugar-Sweetened Beverage Excise Tax in the City of San José {Issue Brief}. County of Santa Clara Public Health Department, San José, CA, and the CalFresh Healthy Living-Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) Learning Collaborative Partnership; December 2025.

The design for this brief and its graphics were developed by partners at Headlands Marketing.

Learn more about the CalFresh Healthy Living CHOICES Project.

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Brief: Safe Routes to School in San Mateo County

Posted on January 12, 2026

Crossing guards and children walking to school

This material was developed at the Harvard T.H. Chan School of Public Health in collaboration with San Mateo County Health through participation in the CalFresh Healthy Living-Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) Learning Collaborative Partnership. This material was funded by USDA’s Supplemental Nutrition Assistance Program, an equal opportunity provider. This material is intended for educational use only.  

This brief summarizes a CalFresh Healthy Living-CHOICES Project Learning Collaborative Partnership model examining Safe Routes to School (SRTS) and the School Travel Fellowship (STF) in San Mateo County. SRTS enables and encourages students to walk and bike to school, improving health, safety, and community well-being, while reducing traffic and emissions. Read more in the full brief.

Contact choicesproject@hsph.harvard.edu with any accessibility questions.

Citation

Watkins J, Vallez-Kelly T, Sanchez L, Ibarra M, Chan C, Gacutan-Galang J, Beccarelli M, Evans LW, Pugliese J, Gouck J, McCulloch SM, Barrett JL, Garrone ME, Cradock AL. Safe Routes to School in San Mateo County {Issue Brief}. San Mateo County Health, San Mateo, CA, and the CalFresh Healthy Living-Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) Learning Collaborative Partnership; December 2025.

The design for this brief and its graphics were developed by partners at Headlands Marketing.

Learn more about the CalFresh Healthy Living CHOICES Project.

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Brief: Safe Routes to School in Ravenswood City and South San Francisco Unified School Districts in San Mateo County

Posted on January 12, 2026

Kids biking to school

This material was developed at the Harvard T.H. Chan School of Public Health in collaboration with San Mateo County Health through participation in the CalFresh Healthy Living-Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) Learning Collaborative Partnership. This material was funded by USDA’s Supplemental Nutrition Assistance Program, an equal opportunity provider. This material is intended for educational use only.  

This brief summarizes a CalFresh Healthy Living-CHOICES Project Learning Collaborative Partnership model examining Safe Routes to School (SRTS) and the School Travel Fellowship (STF) in Ravenswood City and South San Francisco Unified school districts. SRTS promotes walking and biking by implementing projects that improve health, safety, and well-being while reducing traffic congestion and emissions. Read more in the full brief.

Contact choicesproject@hsph.harvard.edu with any accessibility questions.

Citation

Watkins J, Vallez-Kelly T, Sanchez L, Ibarra M, Chan C, Gacutan-Galang J, Beccarelli M, Evans LW, Pugliese J, Gouck J, McCulloch SM, Barrett JL, Garrone ME, Cradock AL. Safe Routes to School in Ravenswood City and South San Francisco Unified School Districts in San Mateo County {Issue Brief}. San Mateo County Health, San Mateo, CA, and the CalFresh Healthy Living-Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) Learning Collaborative Partnership; December 2025.

The design for this brief and its graphics were developed by partners at Headlands Marketing.

Learn more about the CalFresh Healthy Living CHOICES Project.

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Brief: CalFresh Fruit & Vegetable EBT Program in Santa Clara County

Posted on January 12, 2026

Young father taking his two kids shopping at a local co-op grocery store. The oldest is pointing at organic beets.

This material was developed at the Harvard T.H. Chan School of Public Health in collaboration with the County of Santa Clara Public Health Department through participation in the CalFresh Healthy Living-Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) Learning Collaborative Partnership. This material was funded by USDA’s Supplemental Nutrition Assistance Program, an equal opportunity provider. This material is intended for educational use only.  

This brief summarizes a CalFresh Healthy Living-CHOICES Project Learning Collaborative Partnership model examining the CalFresh (federally, the Supplemental Nutrition Assistance Program, SNAP) Fruit & Vegetable EBT program in Santa Clara County. This model examined the health impacts of expanding the CalFresh Fruit & Vegetable EBT Program throughout Santa Clara County. Read more in the full brief.

Contact choicesproject@hsph.harvard.edu with any accessibility questions.

Citation

Cholette V, Coxe N, Shir A, Gacutan-Galang J, Beccarelli M, Evans LW, Pugliese J, Gouck J, Barrett JL, McCulloch SM, Garrone ME, Xiao Y, Cradock AL. CalFresh Fruit & Vegetable EBT Program in Santa Clara County {Issue Brief}. County of Santa Clara Public Health Department, San José, CA, and the CalFresh Healthy Living-Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) Learning Collaborative Partnership; December 2025.

The design for this brief and its graphics were developed by partners at Headlands Marketing.

Learn more about the CalFresh Healthy Living CHOICES Project.

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Brief: Sugar-Sweetened Beverage Excise Tax in the City of Los Angeles

Posted on January 12, 2026

Tops of soda cans in assorted colors

This material was developed at the Harvard T.H. Chan School of Public Health in collaboration with the Los Angeles County Department of Public Health through participation in the CalFresh Healthy Living-Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) Learning Collaborative Partnership. This material was funded by USDA’s Supplemental Nutrition Assistance Program, an equal opportunity provider. This material is intended for educational use only.  

This brief summarizes a CalFresh Healthy Living–CHOICES Project Learning Collaborative Partnership model of a $0.02-per-ounce volume excise tax on sugar-sweetened beverages (SSBs) in the City of Los Angeles. The SSB tax, which would be administered by the city, aims to reduce consumption of SSBs. Read more in the full brief.

Contact choicesproject@hsph.harvard.edu with any accessibility questions.

Citation

Vos K, Caldwell J, Sklyar L, Shah D, Kuo T, Gacutan-Galang J, Beccarelli M, Evans LW, Pugliese J, Gouck J, Barrett JL, McCulloch SM, Garrone ME, Cradock AL. Sugar-Sweetened Beverage Excise Tax in the City of Los Angeles {Issue Brief}. Los Angeles County Department of Public Health, Los Angeles, CA, and the CalFresh Healthy Living-Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) Learning Collaborative Partnership; December 2025.

The design for this brief and its graphics were developed by partners at Headlands Marketing.

Learn more about the CalFresh Healthy Living CHOICES Project.

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Brief: Sugar-Sweetened Beverage Excise Tax in Unincorporated Areas of Los Angeles County

Posted on January 8, 2026

Shopping for liter-sized bottles of soda in the grocery store

This material was developed at the Harvard T.H. Chan School of Public Health in collaboration with the Los Angeles County Department of Public Health through participation in the CalFresh Healthy Living-Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) Learning Collaborative Partnership. This material was funded by USDA’s Supplemental Nutrition Assistance Program, an equal opportunity provider. This material is intended for educational use only.  

This brief summarizes a CalFresh Healthy Living-CHOICES Project Learning Collaborative Partnership model of a $0.02-per-ounce volume excise tax on sugar-sweetened beverages (SSBs) in unincorporated Los Angeles County. The tax, which would be administered by the county, aims to reduce consumption of SSBs. Read more in the full brief.

Contact choicesproject@hsph.harvard.edu with any accessibility questions.

Citation

Vos K, Caldwell J, Sklyar L, Shah D, Kuo T, Gacutan-Galang J, Beccarelli M, Evans LW, Pugliese J, Gouck J, Barrett JL, McCulloch SM, Garrone ME, Cradock AL. Sugar-Sweetened Beverage Excise Tax in Unincorporated Areas of Los Angeles County {Issue Brief}. Los Angeles County Department of Public Health, Los Angeles, CA, and the CalFresh Healthy Living-Childhood Obesity Intervention Cost-Effectiveness Study (CHOICES) Learning Collaborative Partnership; December 2025.

The design for this brief and its graphics were developed by partners at Headlands Marketing.

Learn more about the CalFresh Healthy Living CHOICES Project.

← Back to Resources

Report: Sugary Drink Excise Tax in Boston, MA

Posted on September 25, 2024

Mom giving glass of water to young daughter

The information in this report is intended to provide educational information on the cost-effectiveness of sugary drink excise taxes.

Executive Summary

Sugary drink consumption has been linked to excess weight gain, obesity, incidence of type 2 diabetes, heart disease, and cancer. Federal, state, and local governments have considered implementing excise taxes on sugary drinks to reduce consumption, prevent obesity, and provide a new source of government revenue.1-3 In Massachusetts, legislative measures to introduce a tiered sugary drink excise tax have been proposed.4,5 The most recent proposed bills specify that tax revenue be dedicated to benefits, services, and programs, including universal free school meals and provision of healthy meals in Head Start and other high need early education settings, for communities most impacted by health inequity and burdened by chronic health outcomes related to sugary drink consumption.4,5

We modeled the impact of a statewide excise tax on sugary drinks on health outcomes among Boston residents. Consistent with current policy proposals, we assumed tiered tax rates depending on the sugar content of the beverage: $0.01/ounce for beverages with more than 7.5 but less than 30 grams of sugar per 12 fluid ounces and $0.02 for beverages with more than 30 grams of sugar per 12 fluid ounces. CHOICES cost-effectiveness analysis compared the costs and outcomes of implementing a tax with the costs and outcomes expected if the tax were not implemented over 10 years (2023-2032).

The sugary drink excise tax on distributors is projected to be cost-saving. This means that the tax would save more in future healthcare costs than it would cost to implement. This is without consideration of the potential revenue that would be generated, where a tiered $0.01-$0.02/ounce statewide excise tax on sugary drinks in Massachusetts could raise as much as $226 million to $322 million in annual revenue.6 Among Boston residents, the tax is projected to decrease sugary drink consumption, prevent more than 6,000 cases of obesity, and save $91.2 million in health care costs. People who consume sugary drinks are projected to spend less on these drinks with the excise tax in place. We also project that Black and Hispanic/Latinx Boston residents will experience a greater reduction in obesity rates compared with White, non-Hispanic/Latinx residents after the tax is implemented. These results are summarized below and in the complete report. Projected results for a $0.02/ounce state excise tax based on the volume of sugary drinks were similar.

Continue reading in the full report.

Contact choicesproject@hsph.harvard.edu for an accessible version of this report.

Citation

McCulloch SM, Barrett JL, Reiner JF, Cradock AL, Gortmaker SL. Boston: Sugary Drink Excise Tax. CHOICES Learning Collaborative Partnership at the Harvard T.H. Chan School of Public Health, Boston, MA; February 2024. For more information, please visit www.choicesproject.org.

The design for this brief and its graphics were developed by Molly Garrone, MA.

Funding

This work is supported by The JPB Foundation and the Centers for Disease Control and Prevention (U48DP006376), and the National Institutes for Health (R01HL146625). The findings and conclusions are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention or other funders.

For further information, contact choicesproject@hsph.harvard.edu

References

  1. American Public Health Association Taxes on Sugar-Sweetened Beverages. 2012.

  2. Falbe J, Rojas N, Grummon AH, Madsen KA. Higher Retail Prices of Sugar-Sweetened Beverages 3 Months After Implementation of an Excise Tax in Berkeley, California. American Journal of Public Health. 2015;105(11):2194-2201.

  3. World Health Organization. Global action plan for the prevention and control of noncommunicable diseases 2013–2020 [Internet]. Geneva: WHO. Updated appendix 3, “Best buys” and other recommended interventions for the prevention and control of noncommunicable diseases; [updated 2017; cited 2019 Sep 17]. Available from: https://iris.who.int/bitstream/handle/10665/94384/9789241506236_eng.pdf?sequence=1

  4. Massachusetts Senate Docket No. 959. An Act to promote healthy alternatives to sugary drinks. https://malegislature.gov/Bills/193/SD959. Filed January 18, 2023. Accessed March 9, 2023.

  5. Massachusetts House Docket No. 1813. An Act to promote healthy alternatives to sugary drinks. https://malegislature.gov/Bills/193/HD1813. Filed January 18, 2023. Accessed March 9, 2023.

  6. UCONN Rudd Center. Revenue Calculator for Sugary Drink Taxes. Release: April 13, 2021. http://www.uconnruddcenter.org/revenue-calculator-for-sugary-drink-taxes. Accessed December, 2023.

See the report for the full list of references.

See the sugary drink excise tax report for the impact on the Massachusetts population.

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Report: Sugary Drink Excise Tax in Massachusetts

Posted on September 25, 2024

Young girl drinking a glass of water

The information in this report is intended to provide educational information on the cost-effectiveness of sugary drink excise taxes.

Executive Summary

Sugary drink consumption has been linked to excess weight gain, obesity, incidence of type 2 diabetes, heart disease, and cancer. Federal, state, and local governments have considered implementing excise taxes on sugary drinks to reduce consumption, prevent obesity, and provide a new source of government revenue.1-3 In Massachusetts, legislative measures to introduce a tiered sugary drink excise tax have been proposed.4,5 The most recent proposed bills specify that tax revenue be dedicated to benefits, services, and programs, including universal free school meals and provision of healthy meals in Head Start and other high need early education settings, for communities most impacted by health inequity and burdened by chronic health outcomes related to sugary drink consumption.4,5

We modeled implementation of a state excise tax on sugary drinks in Massachusetts. Consistent with current policy proposals, we assumed tiered tax rates depending on the sugar content of the beverage: $0.01/ounce for beverages with more than 7.5 but less than 30 grams of sugar per 12 fluid ounces and $0.02 for beverages with more than 30 grams of sugar per 12 fluid ounces. CHOICES cost-effectiveness analysis compared the costs and outcomes of implementing a tax with the costs and outcomes expected if the tax were not implemented over 10 years (2023-2032).

The sugary drink excise tax on distributors is projected to be cost-saving. This means that the tax would save more in future health care costs than it costs to implement. This is without consideration of the potential revenue that would be generated, where a tiered $0.01-$0.02/ounce statewide excise tax on sugary drinks in Massachusetts could raise as much as $226 million to $322 million in annual revenue.6 Among Massachusetts residents, the tax is projected to decrease sugary drink consumption, prevent over 62,000 of cases of obesity, and save $937 million in health care costs. People who consume sugary drinks are projected to spend less on these drinks with the excise tax in place. We also project that Black and Hispanic/Latinx Massachusetts residents will experience a greater than average reduction in obesity levels after the tax is implemented, leading to improved health equity. These results are summarized below and in the complete report. Projected results for a $0.02/ounce state excise tax based on the volume of sugary drinks were similar.

Continue reading in the full report.

Contact choicesproject@hsph.harvard.edu for an accessible version of this report.

Citation

McCulloch SM, Barrett JL, Reiner JF, Cradock AL, Gortmaker SL. Massachusetts: Sugary Drink Excise Tax. The CHOICES Learning Collaborative Partnership at the Harvard T.H. Chan School of Public Health, Boston, MA; February 2024. For more information, please visit www.choicesproject.org.

The design for this brief and its graphics were developed by Molly Garrone, MA.

Funding

This work is supported by The JPB Foundation and the Centers for Disease Control and Prevention (U48DP006376), and the National Institutes for Health (R01HL146625). The findings and conclusions are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention or other funders.

For further information, contact choicesproject@hsph.harvard.edu

References

  1. American Public Health Association Taxes on Sugar-Sweetened Beverages. 2012.

  2. Falbe J, Rojas N, Grummon AH, Madsen KA. Higher Retail Prices of Sugar-Sweetened Beverages 3 Months After Implementation of an Excise Tax in Berkeley, California. American Journal of Public Health. 2015;105(11):2194-2201.

  3. World Health Organization. Global action plan for the prevention and control of noncommunicable diseases 2013–2020 [Internet]. Geneva: WHO. Updated appendix 3, “Best buys” and other recommended interventions for the prevention and control of noncommunicable diseases; [updated 2017; cited 2019 Sep 17]. Available from: https://iris.who.int/bitstream/handle/10665/94384/9789241506236_eng.pdf?sequence=1

  4. Massachusetts Senate Docket No. 959. An Act to promote healthy alternatives to sugary drinks. https://malegislature.gov/Bills/193/SD959. Filed January 18, 2023. Accessed March 9, 2023.

  5. Massachusetts House Docket No. 1813. An Act to promote healthy alternatives to sugary drinks. https://malegislature.gov/Bills/193/HD1813. Filed January 18, 2023. Accessed March 9, 2023.

  6. UCONN Rudd Center. Revenue Calculator for Sugary Drink Taxes. Release: April 13, 2021. http://www.uconnruddcenter.org/revenue-calculator-for-sugary-drink-taxes. Accessed December, 2023.

See the report for the full list of references.

See the sugary drink excise tax report for the impact on the Boston, MA population.

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Strategy Report: Sugary Drink Excise Tax: 2 Cents per Ounce

Posted on June 6, 2024

Mom and young daughter drinking glasses of water

The information provided here is intended to be used for educational purposes. Links to other resources and websites are intended to provide additional information aligned with this educational purpose.

Overview

CHOICES uses cost-effectiveness analysis to compare the costs and outcomes of different policies and programs promoting improved nutrition or increased physical activity in schools, early care and education and out-of-school settings, communities, and clinics. This strategy report describes the projected national population reach, impact on health and health equity, implementation costs, and cost-effectiveness for an effective strategy to improve child health. This information can help inform decision-making around promoting healthy weight. To explore and compare additional strategies, visit the CHOICES National Action Kit 2.0.

Continue reading in the full report.

Contact choicesproject@hsph.harvard.edu with any accessibility questions.

Suggested Citation

Barrett JL, McCulloch SM, Cradock AL, Gortmaker SL. CHOICES National Action Kit: Sugary Drink Excise Tax: 2 Cents per Ounce Strategy Report. CHOICES Project Team at the Harvard T.H. Chan School of Public Health, Boston, MA; May 2024.

Acknowledgments

We thank the following members of the CHOICES Project team for their contributions: Molly Garrone, Dar Alon, Banapsha Rahman, Ya Xuan Sun, Amy Bolton, Jenny Reiner, Matt Lee, Zach Ward.

Funding

This work is supported by the National Institutes of Health (R01HL146625), The JPB Foundation, and the Centers for Disease Control and Prevention (U48DP006376). The findings and conclusions are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention or other funders. The information provided here is intended to be used for educational purposes. Links to other resources and websites are intended to provide additional information aligned with this educational purpose

For further information, contact choicesproject@hsph.harvard.edu

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Strategy Report: Improved WIC Food Package for 1-4-Year-Olds (2009)

Posted on May 20, 2024

The information provided here is intended to be used for educational purposes. Links to other resources and websites are intended to provide additional information aligned with this educational purpose.

Overview

CHOICES uses cost-effectiveness analysis to compare the costs and outcomes of different policies and programs promoting improved nutrition or increased physical activity in schools, early care and education and out-of-school settings, communities, and clinics. This strategy report describes the projected national population reach, impact on health and health equity, implementation costs, and cost-effectiveness for an effective strategy to improve child health. This information can help inform decision-making around promoting healthy weight. To explore and compare additional strategies, visit the CHOICES National Action Kit 2.0.

Continue reading in the full report.

Contact choicesproject@hsph.harvard.edu with any accessibility questions.

Suggested Citation

Barrett JL, Kenney EL, Cradock AL, Gortmaker SL. CHOICES National Action Kit: Improved WIC Food Package for 1-4-Year-Olds (2009) Strategy Report. CHOICES Project Team at the Harvard T.H. Chan School of Public Health, Boston, MA; May 2024.

Acknowledgments

We thank the following members of the CHOICES Project team for their contributions: Molly Garrone, Matt Lee, Zach Ward, Stephanie McCulloch.

Funding

This work is supported by the National Institutes of Health (R01HL146625), The JPB Foundation, and the Centers for Disease Control and Prevention (U48DP006376). The findings and conclusions are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention or other funders. The information provided here is intended to be used for educational purposes. Links to other resources and websites are intended to provide additional information aligned with this educational purpose

For further information, contact choicesproject@hsph.harvard.edu

← Back to Resources