Two weeks ago, in an effort to curb rising rates of obesity, the New York City’s board of health banned the sale of “sugary drinks”, i.e soft drinks, in servings larger than 16 ounces. Predictably the cries of undue government infringement, a nanny state, and anything else you can imagine have dominated the media coverage. I think the NYC health board and health advocates can expect to spend the foreseeable future embroiled in lawsuits and targeted campaigns attacking the new law. NYC has a history as a trendsetter for public health initiatives. They were one of the first cities to ban indoor smoking and, in 2006, were the first to ban trans fats. Both are great initiatives but the soda ban misses the mark. So before anyone gets excited about the new pop ban, or thinks about following suit, a second look at the ban is due.
The pop ban is about winning the “war on obesity”, an issue that that we’re not doing very well on. After a few decades of attempting to educate people about the perils of obesity, 30 percent of North American’s are now overweight or obese, a rate that has essentially doubled in 20 years. We are starting to conclude that continuing to teach people on the harmful impact of being overweight is more effective at creating a culture of blame than actually helping people be healthy.
Adds like these fail to address why people consume unhealthy food, but make it their fault if they continue to do so. Shame by education has been a massive historic misfire of public health, and we have our track record of a bulging waistline to prove it.
Advocates are looking for new ways to make North American’s slimmer, and topping the list is altering consumer choices by changing social and economic factors. The goal is to make consumers move towards healthier products because they have become more accessible or affordable.
However, with a closer look, it seems as though the designers of the soda ban were determined to ignore all research on the topic, along with experiences and evidence from previous attempts.
Forget that many skeptics believe the ban will not be effective: people will exploit the numerous loopholes to get their soda elsewhere, or switch to other non-banned sugary drinks and products. The real issue is that the ban works on a superficial of level in that the BEST-case scenario people will drink fewer large servings of pop, less often. This will bring about a less-than-impressive impact. The ban does not effect a change in the factors that lead people to consume sugary beverages it just infantilizes them by limiting their choices to certain arbitrary products.
If I am right, the ban is not just bad for progressive politics but is, frankly, bad policy.
The economics of body weight are actually well understood. Studies in the US and Canada have shown that there is a consistent relation between the price of food, weight and health. The lower the cost of fruits and vegetables, the healthier people are. The lower the cost of fast food and high-energy dense foods, such as soft drinks and processed carbohydrates, the heavier and less healthy people are. Further, modest changes in the price of foods cause corresponding changes in their consumption. Other factors, such as accessibility to food are key but less amendable to federal regulation.
The situation is not overly complicated and is quite intuitive. But, our governments continue to financially support the production of the ingredients used to make unhealthy foods, such as corn and soy, with commodity subsidies, as well as research and development grants. At the same time, farmers of a diverse array of fruits and vegetables are not supported with subsidies and R&D grants. In short choosing to grow non-subsided healthy food is riskier, and less lucrative.
Looking at examples of the subsidies is almost comical. Each year the US government gives farmers the equivalent of 29 cents per taxpayer to subsidize all fruit and vegetable production. When I say fruits and vegetables, I mean apples. Just apples. Compare that to the 8 dollars spent per taxpayer on just the production of high fructose corn syrup – a big component of sugary drinks. We are eating a lot of unhealthy food because partly because our government, with some generous pressure from interest groups, make that food more accessible and affordable. http://uspirg.org/issues/usp/stop-subsidizing-obesity
Working on changing agricultural subsidies is the best approach we have right now to combat obesity. This directly addresses the economic suprastructure in which people make decisions about the food they can and want to eat. The NYC soda ban is a local issue; agricultural subsidies are a national issue, but the resources that have and will continue to go into advocating for the ban could have gone towards changing agricultural subsidies.
The costs associated with obesity are dire, and local action should be part of the solution. Then why is the soda ban so weak? Smoking indoors and trans fats were flatly banned in NYC. Is “big soda” more powerful than “big tobacco”, forcing the board of health tiptoe around with partial bans? More importantly why did NYC not opt for a soft drink tax, or an even more ambitious fast food tax? By throwing an almost unenforceable ban into the fray of food politics in NYC, another layer of bureaucracy has been added; it will distract from real issues like subsidies and have a limited impact.
It sounds like I am complaining that NYC is trying to ban the sale of pop rather than impose a tax. But it is not my point, what I am frustrated with is that designing health interventions to tell people what to do or actively limiting their choices is bad policy. It annoys consumers, galvanizes the right wing, and creates new problems. Changing the price of food through taxes or subsidies avoids the paternalism of directly denying people products but still achieves the end goal of decreased consumption, and hopefully healthier people.
I think the soda ban might have a modest impact on soft drink consumption but it will not be worth it, dollar for dollar. The ban passed unanimously with one absentee vote, a good indicator that more ambitious policy could have been pursued. I hope this is a stepping-stone in NYC to more aggressive policies. Instead of playing around with piecemeal local bans health advocates need to think more upstream and start changing consumption of all unhealthy foods by altering food subsidies.