Topic: Sugary Drinks

Coffee Chat: Investing in a Healthier Future: How a Sugary Drink Excise Tax Could Improve Health & Health Equity in Massachusetts

Posted on September 26, 2024

In this coffee chat hosted by the CHOICES Community of Practice, Sara Bleich, Professor of Public Health Policy at the Harvard T.H. Chan School of Public Health and inaugural Vice Provost for Special Projects at Harvard University and Steve Gortmaker, Professor of the Practice of Health Sociology, Director of the Prevention Research Center on Nutrition and Physical Activity, and Director and Co-Principal Investigator of the CHOICES Project at the Harvard T.H. Chan School of Public Health, discussed the progressive health and health equity impacts of a sugary drink excise tax, highlighting recent findings from modeling a statewide tax in Massachusetts.

View the resource round-up from this coffee chat

Download the September 2024 coffee chat presentation slides

Disclaimer: Our guest speakers share their own perspectives and do not speak for Harvard.

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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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Coffee Chat: Exploring the Health Equity Benefits of Sugary Drink Excise Taxes

Posted on January 25, 2024

In this coffee chat hosted by the CHOICES Community of Practice, Matthew Lee, PhD Candidate from the Harvard T.H. Chan School of Public Health and California native who has researched sugary drink trends and the impacts of sugary drink excise taxes in the San Francisco Bay Area, discusses insights from his recent study published in the American Journal of Preventive Medicine that he led along with other researchers from the CHOICES Team. Matt also focuses on the ways in which these taxes, and the potential revenue raised from them, can benefit communities by improving health equity.

View the resource round-up from this coffee chat

Download the January 2024 coffee chat presentation slides

Disclaimer: Our guest speakers share their own perspectives and do not speak for Harvard.

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A Sugar-Sweetened Beverage Excise Tax in California: Projected Benefits for Population Obesity and Health Equity

Posted on January 15, 2024

Sugary drinks

This study evaluates the cost-effectiveness of a hypothetical 2-cent-per-ounce excise tax in California (CA) and implications for population health and health equity.

Lee MM, Barrett JL, Kenney EL, Gouck J, Whetstone L, McCulloch SM, Cradock AL, Long MW, Ward ZJ, Rohrer B, Williams DR, Gortmaker SL. A Sugar-Sweetened Beverage Excise Tax in California: Projected Benefits for Population Obesity and Health Equity. Am J Prev Med. 2024 Jan;66(1):94-103. doi: 10.1016/j.amepre.2023.08.004. Epub 2023 Aug 6. PubMed PMID: 37553037;

Abstract

Introduction

Amid the successes of local sugar-sweetened beverage (SSB) taxes, interest in state-wide policies has grown. This study evaluated the cost-effectiveness of a hypothetical 2-cent-per-ounce excise tax in California (CA) and implications for population health and health equity.

Methods

Using the CHOICES microsimulation model, tax impacts on health, health equity, and cost-effectiveness over ten years in CA were projected, both overall and stratified by race/ethnicity and income. Expanding upon prior models, differences in the effect of SSB intake on weight by BMI category were incorporated. Costing was performed in 2020, and analyses were conducted in 2021-2022.

Results

The tax is projected to save $4.55b in healthcare costs, prevent 266,000 obesity cases in 2032, and gain 114,000 QALYs. Cost-effectiveness metrics, including the cost/QALY gained, were cost-saving. Spending on SSBs was projected to decrease by $33/adult and by $26/child in the first year overall. Reductions in obesity prevalence for Black and Hispanic Californians were 1.8 times larger compared to White Californians, and reductions for adults with lowest incomes (<130%FPL) were 1.4 times the reduction among those with highest incomes (>350%FPL). The tax is projected to save $112 in obesity-related healthcare costs per $1 invested.

Conclusions

A state-wide SSB tax in California would be cost saving and lead to reductions in obesity and improved SSB-related health equity, and lead to overall improvements in population health. The policy would generate more than $1.6 billion in state tax revenue annually that can also be used to improve health equity.

Funding

This work was supported by The JPB Foundation (Grant No. 1085), the National Institutes of Health (Grant No. R01HL146625), the Centers for Disease Control and Prevention (CDC) (Grant No. U48DP006376). This work is solely the responsibility of the authors and does not represent official views of the CDC or other agencies. The findings and conclusions in this article are those of the author(s) and do not necessarily represent the views or opinions of the California Department of Public Health or the California Health and Human Services Agency. The sponsors had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

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Strategy Report: Sugary Drink Excise Tax: 1 Cent per Ounce

Posted on December 5, 2023

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: 1 Cent per Ounce Strategy Report. CHOICES Project Team at the Harvard T.H. Chan School of Public Health, Boston, MA; December 2023.

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: Reducing Exposure to Unhealthy Food and Beverage Advertising

Posted on November 17, 2023

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

CHOICES National Action Kit: Reducing Exposure to Unhealthy Food and Beverage Advertising Strategy Report. CHOICES Project Team at the Harvard T.H. Chan School of Public Health, Boston, MA; November 2023.

Acknowledgments

We thank the following members of the CHOICES Project team for their contributions: Molly Garrone, Banapsha Rahman, Ya Xuan Sun, Shilpi Agarwal, Ana Paula Bonner Septien, 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: Creating Healthier Afterschool Environments

Posted on November 17, 2023

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

CHOICES National Action Kit: Creating Healthier Afterschool Environments Strategy Report. CHOICES Project Team at the Harvard T.H. Chan School of Public Health, Boston, MA; November 2023.

Acknowledgments

We thank the following members of the CHOICES Project team for their contributions: Molly Garrone, Dar Alon, Stella Zhu, Shilpi Agarwal, Ana Paula Bonner Septien, 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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Coffee Chat: An Action Kit for Prevention: Prioritizing Cost-Effective and Equitable Healthy Eating and Physical Activity Strategies

Posted on November 16, 2023

In this coffee chat hosted by the CHOICES Community of Practice, Dr. Steven Gortmaker, Principal Investigator of the CHOICES Project at the Harvard T.H. Chan School of Public Health, highlights the new features available in the Action Kit 2.0, including more detailed information on costs and health equity impacts. Dr. Gortmaker also discusses how this information can be helpful for planning and prioritization purposes to ensure responsible investments to improve child health, nutrition, physical activity, and health equity.

View the resource round-up from this coffee chat

Download the November 2023 coffee chat presentation slides

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