Update: Taxing Sugar Starts at Home

By Corby Kummer

In the way of modern couples, I had no idea when writing my post on the virtues of water over soda--mentioning the possibility of taxing soda as a way to combat childhood obesity--that my spouse, John Auerbach, was preparing testimony to give this morning before the state legislature in Massachusetts, where he is the state's commissioner of public health. (Or, as the Boston Herald called him in a January editorial criticizing his efforts to mandate calorie labeling on fast-food menus--an idea that has taken hold in New York, Philadelphia, and now England--"the state's irrepressible Nanny-in-Chief"). Also in the way of modern couples, I'm in Washington, at mag HQ, as he addresses legislators on Beacon Hill.

Excerpts of his testimony below. It draws a linkage between sugary foods and diabetes and obesity, as you would expect, and also brings in childrens' oral health, costs and access of which are big issues in Massachusetts as in other states. And it gives hard numbers of estimated revenues, and the tens of millions that could go to health care and, even more important, prevention programs in a year of fearsome cuts:

Historically, items are exempted from sales tax if they are considered to be essential or necessities for survival. We can understand such a policy for milk, bread, vegetables and chicken. But candy and soda are optional, discretionary purchases without any nutritional value. And worse than that, they contribute to some of the most serious health problems in the state.

A substantial body of research in both public health and medicine demonstrates the linkage between obesity and overweight and the consumption of empty calories in items like soda and candy. Even stronger research shows the correlation between obesity and chronic diseases like high blood pressure, cardiovascular disease, type 2 diabetes, and cancer.

What effect is this having on chronic disease in the state? One example is Type 2 diabetes - which is caused by poor diet and lack of exercise. The percentage of the adult population in Massachusetts with diabetes has doubled in the last 10 years. Doubled! And diabetes is the leading cause of blindness, kidney failure, and amputation.

Sweetened, empty calorie foods like soda and candy are also linked to serious oral health problems. Adolescents have increasingly decreased their calcium and vitamin C intake in recent years in favor of soft drinks. This decrease has been linked with periodontal disease. We know that in 2008, about 19,000 MA students have evidence of dental decay with nearly 10,000 of those being untreated. Nationally, kids miss 51 million hours of school due to oral diseases. Kids with oral health problems often have difficulty focusing and learning in school; issues that will have repercussions throughout their lives.

We need to contain health care costs if our health care reform effort is to continue to succeed. One way to do that is through prevention. Chronic diseases--many of them caused or made worse by a poor diet--are responsible for 75 percent of our current health care costs. And we need new revenue sources as we look for ways to support health reform and preserve the core public health services that the Commonwealth relies on, such services as school nurses, homicide and suicide prevention efforts, and health screening programs.

We cannot afford to continue to give candy and soda consumption privileged protection by exempting it from state revenue collection. It's unjustifiable in terms of public health, and unnecessary in terms of state revenue collections. Seventeen other states and the District of Columbia already tax such unhealthy foods. The list of those states includes Arkansas, California, Texas, Virginia, Maine, New Jersey and Tennessee.

We estimate that the revenue stream from the removal of subsidies for candy, soda and alcohol purchases will generate $121.5 million in FY10, with $45.6 million going to the health promotion and wellness efforts.

I respectfully request that you report out House Bill 101 favorably, and in particular, that you support the Governor's effort to protect public health and reduce health care costs through the wellness fund and the removal of tax subsidies on junk food and alcohol.

This article available online at:

http://www.theatlantic.com/health/archive/2009/04/update-taxing-sugar-starts-at-home/7285/