“Holding the City's Feet to the Fire”: Lessons Learned From Oakland's Implementation of Measure HH Sugar-Sweetened Beverage Tax

Abstract

Context: Sugar-sweetened beverage (SSB) taxes offer a promising public health strategy to decrease consumption of sugary beverages. To date, 7 US cities have successfully implemented SSB taxes; however, only a few studies have examined adoption and implementation processes. Objectives: To describe public health and policy lessons learned during the first 2.5 years of implementation of the Oakland, California, penny-per-ounce SSB tax, Measure HH. Design: A mixed-methods, longitudinal, qualitative case study was conducted using a combination of key informant interviews with implementation stakeholders as well as analyses of archival documents and media documents from 2016 to 2019. Interviews were digitally recorded and professionally transcribed. Interview transcripts, archival documents, and media documents were analyzed by 3 coders using Atlas.ti v8. Analyses employed principles of constant comparative analysis to identify themes related to lessons learned. Setting: Oakland, California. Participants: Key informants (n = 15), archival documents (n = 43), and media documents (n = 90). Intervention: Oakland, California's SSB tax (Measure HH). Results: Implementation lessons included both success stories and challenges. Successes included contracting a thirdparty tax administrator to support tax collection and education; leveraging a pro-tax coalition to counteract industry attacks and to protect tax revenue; and offering "quick win" funding to support local needs. Challenges were associated with implementing a "general" tax versus a "special" tax; the lack of explicit revenue allocation in the ordinance to support city-level implementation and oversight; and, the original ordinance language for tax application to distributors. Conclusions:The study offers a range of recommendations-derived from lessons learned over several years of implementation-to policy makers and advocates engaged in SSB tax adoption and implementation efforts in their jurisdictions. SSB tax implementation requires sufficient agency administrative capacity and a strong pro-tax coalition that engages local community organizations to respond to public health needs.

Evaluation of Seattle’s sweetened beverage tax on tax support and perceived economic and health impacts

“…Seattle news organizations mostly focused on the potential negative impacts on small businesses and in the Summer of 2018, there was a large anti-beverage tax campaign in Seattle that accompanied a Washington State preemption bill; estimates suggest that the beverage industry spent approximately $20 million on the “Yes to Affordable Groceries” anti-tax campaign ( Crosbie et al, 2021 ). These findings are generally consistent with studies focused on SBT implementation, which suggest messaging is important for the passage and long-term success of these taxes ( Asada et al, 2022 , Falbe et al, 2020 ). Findings from Berkeley suggested that early and robust outreach to the public about the tax and programs funded may promote public support and pro-tax campaigns may be important in mitigating well-funded repeal efforts or post-enactment lawsuits ( Falbe et al, 2020 ).…”

“…The increase in tax support among lower-income individuals and overall perceptions becoming more negative among higher-income individuals may stem from the messaging environment in Seattle, which is generally supported by prior literature ( Julia et al, 2015 , Donaldson et al, 2015 , Curry et al, 2018 , Barry et al, 2013 , Gollust et al, 2017 , Chriqui et al, 2020 , Bosire et al, 2020 , Jou et al, 2014 , Asada et al, 2022 , Falbe et al, 2020 ). There was no city-government supported pro-tax or educational campaign in Seattle, after tax implementation.…”

“…Consistent with the increased support among lower-income individuals in Seattle, there were several grassroots organizations that conducted outreach in lower-income communities to provide information about the rationale for the SBT. Leveraging and strengthening existing community partnerships for campaigns to raise awareness and counter misinformation has been found to be an important component of SBT implementation ( Asada et al, 2022 ). Additionally, by ordinance mandate, a Community Advisory Board advised the City of Seattle regarding revenue distribution, to ensure revenues were used to fund programs that would benefit lower-income populations (e.g., the Fresh Bucks program) ( Moss et al, 2019 ).…”

“…Findings from Berkeley suggested that early and robust outreach to the public about the tax and programs funded may promote public support and pro-tax campaigns may be important in mitigating well-funded repeal efforts or post-enactment lawsuits ( Falbe et al, 2020 ). Likewise, in Oakland, a pro-tax coalition and campaign were important for counteracting industry attacks ( Asada et al, 2022 ). In combination with evidence from Illinois, Berkeley, and Oakland, our findings suggest that if officials want to sustain broad public support for these taxes, they should invest in ongoing campaigns that explain the benefits of SBTs and provide information about how tax revenues are being used ( Chriqui et al, 2020 , Altman et al, 2021 , Asada et al, 2022 , Falbe et al, 2020 ).…”

“…Likewise, in Oakland, a pro-tax coalition and campaign were important for counteracting industry attacks ( Asada et al, 2022 ). In combination with evidence from Illinois, Berkeley, and Oakland, our findings suggest that if officials want to sustain broad public support for these taxes, they should invest in ongoing campaigns that explain the benefits of SBTs and provide information about how tax revenues are being used ( Chriqui et al, 2020 , Altman et al, 2021 , Asada et al, 2022 , Falbe et al, 2020 ).…”