The effect of soda taxes beyond beverages in Philadelphia

Lozano‐Rojas, Felipe; Carlin, Patrick

doi:10.1002/hec.4586

Cited by 8 publications

(7 citation statements)

References 51 publications

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“…Our findings are also consistent with findings of net reductions of 22% of volume sold of taxed beverage and net reductions in added sugar purchased from beverages in Seattle and Philadelphia, which, if uncompensated, would be expected to result in improved BMI. 11,27,28 Our results are less consistent with findings from our previous longitudinal cohort study of taxed beverage consumption among lower-income children in Seattle and the nearby nontaxed comparison area. 29 In that study, we found no greater reduction in reported consumption for Seattle children vs those in the comparison area.…”

Section: Discussioncontrasting

confidence: 99%

“…Whereas these studies had repeated cross-sectional designs, our study used longitudinal data from the same children over time, used measured height and weight, and implemented methods to robustly control for pretax differences in trends; thus, our study builds on and adds rigor to the evidence. Our findings are also consistent with findings of net reductions of 22% of volume sold of taxed beverage and net reductions in added sugar purchased from beverages in Seattle and Philadelphia, which, if uncompensated, would be expected to result in improved BMI …”

Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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Sweetened Beverage Tax Implementation and Change in Body Mass Index Among Children in Seattle

Jones-Smith,

Knox,

Chakrabarti

et al. 2024

JAMA Netw Open

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ImportanceSweetened beverage taxes have been associated with reduced purchasing of taxed beverages. However, few studies have assessed the association between sweetened beverage taxes and health outcomes.ObjectiveTo evaluate the association between the Seattle sweetened beverage tax and change in body mass index (BMI) among children.Design, Setting, and ParticipantsIn this longitudinal cohort study, anthropometric data were obtained from electronic medical records of 2 health care systems (Kaiser Permanente Washington [KP] and Seattle Children’s Hospital Odessa Brown Children’s Clinic [OBCC]). Children were included in the study if they were aged 2 to 18 years (between January 1, 2014, and December 31, 2019); had at least 1 weight measurement every year between 2015 and 2019; lived in Seattle or in urban areas of 3 surrounding counties (King, Pierce, and Snohomish); had not moved between taxed (Seattle) and nontaxed areas; received primary health care from KP or OBCC; did not have a recent history of cancer, bariatric surgery, or pregnancy; and had biologically plausible height and BMI (calculated as weight in kilograms divided by height in meters squared). Data analysis was conducted between August 5, 2022, and March 4, 2024.ExposureSeattle sweetened beverage tax (1.75 cents per ounce on sweetened beverages), implemented on January 1, 2018.Main Outcomes and MeasuresThe primary outcome was BMIp95 (BMI expressed as a percentage of the 95th percentile; a newly recommended metric for assessing BMI change) of the reference population for age and sex, using the Centers for Disease Control and Prevention growth charts. In the primary (synthetic difference-in-differences [SDID]) model used, a comparison sample was created by reweighting the comparison sample to optimize on matching to pretax trends in outcome among 6313 children in Seattle. Secondary models were within-person change models using 1 pretax measurement and 1 posttax measurement in 22 779 children and fine stratification weights to balance baseline individual and neighborhood-level confounders.ResultsThe primary SDID analysis included 6313 children (3041 female [48%] and 3272 male [52%]). More than a third of children (2383 [38%]) were aged 2 to 5 years); their mean (SE) age was 7.7 (0.6) years. With regard to race and ethnicity, 789 children (13%) were Asian, 631 (10%) were Black, 649 (10%) were Hispanic, and 3158 (50%) were White. The primary model results suggested that the Seattle tax was associated with a larger decrease in BMIp95 for children living in Seattle compared with those living in the comparison area (SDID: −0.90 percentage points [95% CI, −1.20 to −0.60]; P &lt; .001). Results from secondary models were similar.Conclusions and RelevanceThe findings of this cohort study suggest that the Seattle sweetened beverage tax was associated with a modest decrease in BMIp95 among children living in Seattle compared with children living in nearby nontaxed areas who were receiving care within the same health care systems. Taken together with existing studies in the US, these results suggest that sweetened beverage taxes may be an effective policy for improving children’s BMI. Future research should test this association using longitudinal data in other US cities with sweetened beverage taxes.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 89%

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Sweetened Beverage Tax Implementation and Change in Body Mass Index Among Children in Seattle

Jones-Smith,

Knox,

Chakrabarti

et al. 2024

JAMA Netw Open

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“…At the population level, we estimate that a quarter of the caloric reduction from taxed beverages is compensated for by an increase in calories purchased from untaxed foods. This is close to the midpoint of Lozano‐Rojas and Carlin's (2022) quasi‐experimental estimates of between 19% and 37% of the reduction in beverage sugar in Philadelphia being offset by other sugary foods. At the subpopulation level, our simulation does indicate meaningful caloric compensations (63%–78%) among households without obese members, although substitution does not fully offset the direct effect of a sweetened beverage tax.…”

Section: Comparisons With Previous Literaturesupporting

confidence: 78%

Do obese and nonobese consumers respond differently to price changes? Implications of preference heterogeneity for obesity‐oriented food taxes and subsidies

Zhen

Chen

Lin

et al. 2023

American J Agri Economics

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Preference heterogeneity in food demand has important health and equity implications for targeted and broad‐based taxes and subsidies intended to enhance diet quality and reduce obesity. We study the role of obesity in the purchases of food at home and food away from home using data from the nationally representative National Household Food Acquisition and Purchase Survey. We develop a method for incorporating the complex survey design and retail scanner data into the estimation of a 21‐good Exact Affine Stone Index demand system with endogenous prices and truncated purchases. We find significant preference heterogeneity associated with the obesity status of household members. Counterfactual simulations find that (1) a sweetened beverage tax is effective in increasing the healthfulness of purchases by lower income obese consumers; (2) the nutritional benefits of a fruit and vegetable subsidy are concentrated on nonobese consumers with little improvement in obese consumers' Healthy Eating Index and an increase in their total calories purchased; and (3) a fiscally neutral healthy food subsidy fully funded by an unhealthy food tax benefits nonobese consumers both financially and nutritionally more than it does obese consumers. These findings show that lowering healthy food prices without raising the cost of unhealthy foods is unlikely to reduce obesity. Policymakers in favor of a systems approach of simultaneously taxing unhealthy foods and subsidizing healthy foods should be mindful of the distributional effects of this policy on obese consumers and the lower income population.

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“…In Mexico – a national jurisdiction – much of the substitution effects from a diet-related tax came from individuals purchasing untaxed unhealthy foods within Mexico, 96 while in smaller subnational jurisdictions such as Philadelphia in the United States, cross-border shopping was an important source of substitution for a similar tax. 113 An important issue remains the specific economic context of the jurisdiction in which the FP is considered. Jurisdictions with greater reliance on the sugar industry may be more vulnerable to the impacts of a tax on sugar or sugar-added products and thus politically more sensitive to measures that target them.…”

Section: Discussionmentioning

confidence: 99%

An umbrella review of the acceptability of fiscal and pricing policies to reduce diet-related noncommunicable disease

et al. 2023

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Context Poor diet has been implicated in a range of noncommunicable diseases. Fiscal and pricing policies (FPs) may offer a means by which consumption of food and non-alcoholic beverages with links to such diseases can be influenced to improve public health. Objective To examine the acceptability of FPs to reduce diet-related noncommunicable disease, based on systematic review evidence. Data Sources MEDLINE, EMBASE, PsychInfo, SCI, SSCI, Web of Science, Scopus, EconLit, the Cochrane Library, Epistemonikos, and the Campbell Collaboration Library were searched for relevant studies published between January 1, 1990 and June 2021. Data Extraction The studies included systematic reviews of diet-related FPs and: used real-world evidence; examined real or perceived barriers/facilitators; targeted the price of food or non-alcoholic beverages; and applied to entire populations within a jurisdiction. A total of 9996 unique relevant records were identified, which were augmented by a search of bibliographies and recommendations from an external expert advisory panel. Following screening, 4 systematic reviews remained. Data Analysis Quality appraisal was conducted using the AMSTAR 2 tool. A narrative synthesis was undertaken, with outcomes grouped according to the WHO-INTEGRATE criteria. The findings indicated a paucity of high-quality systematic review evidence and limited public support for the use of FPs to change dietary habits. This lack of support was related to a number of factors that included: their perceived potential to be regressive; a lack of transparency, ie, there was mistrust around the use of revenues raised; a paucity of evidence around health benefits; the deliberate choice of rates that were lower than those considered necessary to affect diet; and concerns about the potential of such FPs to harm economic outcomes such as employment. Conclusion The findings underscore the need for high-quality systematic review evidence on this topic, and the importance of responding to public concerns and putting in place mechanisms to address these when implementing FPs. This study was funded by Safefood [02A-2020]. Systematic Review Registration PROSPERO registration no. CRD42021274454.

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The effect of soda taxes beyond beverages in Philadelphia

Cited by 8 publications

References 51 publications

Sweetened Beverage Tax Implementation and Change in Body Mass Index Among Children in Seattle

Sweetened Beverage Tax Implementation and Change in Body Mass Index Among Children in Seattle

Do obese and nonobese consumers respond differently to price changes? Implications of preference heterogeneity for obesity‐oriented food taxes and subsidies

An umbrella review of the acceptability of fiscal and pricing policies to reduce diet-related noncommunicable disease

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