The Not-So-Empty Calories We Drink

1. TheNot-So-Empty CaloriesWe Drink Kerry O’Rourke HPA 430 2.12.13

2. Policy Action Plan Overview • Position: Illinois should impose an excise tax on sugar-sweetened beverages • Why? Research shows that making soda and other drinks with added sugar more expensive can reduce consumption • End Goal: Reduce rates of obesity in children and adults

3. It’s Not Just Soda…Gulp! • It’s SSBs (sugar-sweetened beverages) • Sports drinks • Fruit drinks • Teas • Flavored/enhanced waters • Energy drinks • Soda (or pop, as we say in Illinois)

4. Why Pick on Soda? • Since late 1970s, adult consumption of SSBs has more than doubled. SSBs provide the largest source of daily calories in the diets of U.S. children ages 2-18. SSB consumption is highest among the groups that are at greatest risk of obesity and type 2 diabetes. • Source: Friedman RR, Brownell, K. (October 2012). Rudd Report on Sugar-Sweetened Beverage Taxes: An Updated Policy Brief. Yale Rudd Center for Food Policy & Obesity.

5. The Skinny on Sugar One 12-oz can of soda has about 10 tsp of sugar -- about as much added sugar as the USDA recommends we have each day

6. Why Impose a Tax? • Research shows making these drinks more expensive could reduce consumption • Taxing tobacco has worked to reduce consumption • Revenue can pay for nutrition programs and obesity prevention efforts

7. Obesity and Taxes Two complicated topics!

8. Excise vs. Sales Taxes • What’s the difference? • Excise taxes are reflected in the shelf price of an item • Sales taxes are added at the register • Excise taxes can be more effective • Consumers notice the higher price when they reach for the beverage on the shelf

9. Research is Pouring In • One systematic review reported that a 10% price increase could reduce soft drink consumption by ~8%. • The evidence suggests that a tax of 1 cent or 2 cents per ounce would raise prices enough to reduce consumption.

10. But More Research Is Needed • Experts aren’t yet sure what the impact of taxes will be on actual weight loss. • So, we won’t stop other efforts.

11. The Situation in Illinois

12. Obesity among Adults in Illinois

13. Obesity Among Youth in Illinois

14. Research in Illinois • Ongoing at the Health Policy Center at UIC’s Institute for Health Research and Policy • NIH funding for a longitudinal study • Testing the hypotheses that higher SSB state and local taxes will lead to: • Lower household SSB purchasing • Lower BMIs and obesity rates

15. Research in Illinois • The IHRP team is looking at numerous outcomes: • Beverage consumption • Tax revenues • Frequency of SSB consumption • Diabetes incidence • Health care costs of diabetes • Obesity prevalence • Obesity-related health care costs

16. Alternative Tax Scenarios

17. The “Win-Win” for Illinois SSB tax increase ↓ New revenues ↓ Reduce SSB consumption ↓ Reduce obesity and related diseases ↓ Lower health care costs and healthier residents

18. Increasing Tax in Illinois • Illinois has a sales tax of 6.25% now on many beverages • Chicago has an additional 3% tax on bottled and canned soda and an additional 9% tax on fountain soda syrup • A resolution was introduced last spring in the Chicago City Council designed to “start a dialogue” on the subject • The Illinois legislature has enacted a soda tax cap for Chicago

19. Increasing Tax in Illinois • The path to a tax increase goes through the General Assembly • SB396 was introduced in 2011 • 1-cent per ounce excise tax on SSBs to be paid by beverage distributors • Creation of Illinois Health Promotion Fund

20. Possible Next Steps • Senator John G. Mulroe (D)10th District in Chicago • Chair of the Public Health Committee

21. Public Health Committee • Chair: John G. Mulroe-D • Vice-Chair: Mattie Hunter-D • Members: Napoleon Harris III-D • Kwame Raoul-D • Heather A. Steans-D • Patricia Van Pelt-D • Minority Spokesperson: Dave Syverson-R • Members: Darin M. LaHood-R • Jim Oberweis-R

22. Possible Next Steps • Revisit SB 396 • Strategy • Additional supporters • Amount of tax • Group paying the tax

23. From a Public Health Perspective • Emphasize the benefits to children • Highlight recent research • Position it as a population health measure • Success of tobacco taxes

24. Stakeholders Likely to Support Tax PRO • Government-Related • Illinois Department of Public Health • Chicago Department of Public Health • Cook County Department of Public Health • National Conference on Mayors • Institute of Medicine • United Nations • White House Task Force on Childhood Obesity

25. Stakeholders Likely to Support Tax PRO • Community-Based Organizations/Non-Profits • CLOCC (Consortium to Lower Obesity in Chicago Children) • Illinois Alliance to Prevent Obesity

26. Stakeholders Likely to Support Tax PRO • Professional Groups • American Medical Association • American Academy of Pediatrics • American Public Health Association • American Cancer Society • American Heart Association

27. Stakeholders Likely to Support Tax PRO • Universities • Institute on Health Research and Policy at UIC • Yale Rudd Center for Food Policy & Obesity • UC Berkeley’s Center for Health and Public Policy Studies • Think Tanks • Bipartisan Policy Center • Brookings Institution • Urban Institute • Foundations • Robert Wood Johnson Foundation

28. Stakeholders Likely to Oppose Tax CON • Business and Industry/Trade Groups • Illinois Restaurant Association • Illinois Beverage Association (includes distributors) • Illinois Food Retailers Association • Advocacy Groups • Chicago Coalition Against Beverage Taxes • Americans for Tax Reform • Unions • Teamsters

29. References • Amendment to Senate Bill 396. (2011, April 1). Springfield, IL: Illinois General Assembly. • Chaloupka, F. J., Wang, Y. C., Powell, L. M., Andreyeva, T., Chriqui, J. F., & Rimkus, L. M. (October 2011). Estimating the Potential Impact of Sugar-Sweetened and Other Beverage Excise Taxes in Illinois. Cook County Department of Public Health. • Chicago Department of Public Health. (July 2010). Can Taxes on Sugar-Sweetened Beverages Reduce Obesity? • Choucair, B. (May 2012). The Relationship between obesity and sugar-sweetened beverages; testimony from Dr. Bechara Choucair. • Eng, M. (2012, April 30). City set to hear testimony on soda taxes. Chicago Tribune. • Friedman RR Brownell, K. (October 2012). Rudd Report on Sugar-Sweetened Beverage Taxes: An Updated Policy Brief. Yale Rudd Center for Food Policy & Obesity. • Lustig, R. H., Schmidt, L. A., & Brindis, C. D. (2012). The toxic truth about sugar. Nature, 27-29. • The Urban Institute. (2009, July 24). Reducing Obesity: Policy Strategies from the Tobacco Warsr. Retrieved from http://www.urban.org/publications/411926.html • U.S. Centers for Disease Control and Prevention. (2010, 2011). Behavioral Risk Factor Surveillance System. Retrieved from http://www.cdc.gov/brfss/index.htm • UIC Institute for Health Research and Policy. (n.d.). Association Between Local and State Sugar-Sweetened Beverage Taxes, Beverage Purchasing Patterns and Weight. Retrieved from http://www.ihrp.uic.edu/study/association-between-local-and-state-sugar-sweetened-beverage-taxes-beverage-purchasing-pattern • Yale Rudd Center for Food Policy & Obesity. (November 2012). Sugar-Sweetened Beverage Taxes and Sugar Intake: Policy Statements, Endorsements, and Recommendations.

30. Questions? Thank you