by Marion Nestle
Dec 2 2012

The defeat of California’s soda tax initiatives: lessons learned

My monthly (first Sunday) Food Matters column for the San Francisco Chronicle deals with the aftermath of the defeat of two California soda tax ballot initiatives.

Q: As one who campaigned for the soda tax in Richmond, I’m so discouraged by the millions spent by the soda industry to defeat it there and in El Monte (Los Angeles County). I don’t see how anyone without that kind of money can do anything to reverse obesity and diabetes.

A: Patience. These things take time.

Losing the soda tax campaigns taught health advocates some important lessons, not least that money buys votes. But it also taught that appeals to voter concerns about higher prices, job losses and personal autonomy are more effective than appeals based solely on health considerations.

Nobody likes taxes, and soda taxes are regressive, meaning that they impose a greater burden on the poor. Although the poor drink more sodas and have higher rates of obesity, and are likely to derive the most benefit from drinking less soda, taxes are still a hard sell.

Because dietary choices seem so personal, the influence of the food marketing environment on personal choices is not intuitively obvious. Everyone “knows” that larger food portions have more calories, but that doesn’t stop anyone from eating more calories when confronted with supersize foods or drinks.

The public health route

That’s why public health approaches work better than just telling people to eat less or eat better. The most effective measures change the environment of food choice by encouraging better options with price subsidies or portion-size caps and discouraging unhealthier choices, which is where taxes, bans on toys, and restrictions on marketing come in.

Such measures aim to make healthy choices the default. Most people are happy to live with the default option.

Food companies want their products to be the default. They will always oppose measures that might reduce sales, and they have no lack of resources to do so.

How might public health advocates counter such opposition?

Community approach

The Richmond example suggests the need for public health approaches that are community-based. This means going into communities and asking residents how they view the causes and consequences of their own health problems, and what they think should be done to fix those problems.

Communities set the goals. Advocates help communities achieve them.

This approach is fine in theory, but difficult in practice. Nobody makes food choices in a vacuum. Soda and fast food companies market their products to low-income and minority groups, and make sure their products are inexpensive, readily available and ubiquitously advertised.

To gain traction, food and beverage companies support the activities of community groups, sponsor playgrounds, and place their brand logos on everything they can. My favorite recent example is Coca-Cola’s $3 million gift to Chicago to fund an educational campaign to counter obesity and diabetes (no, I did not make this up).

Community-based campaigns not only can focus on the health consequences of poor diets but also can demonstrate to residents just how food companies put corporate health above public health and engage low-income communities in achieving corporate goals.

Teaching how the food marketing environment works should stimulate plenty of questions about why healthier foods aren’t more widely available in communities – and at affordable prices. It should raise questions about why school lunches aren’t better, and why soda advertising pervades athletic facilities. It should get people thinking about what food and beverage companies are actually doing in low-income communities.

Community-based public health should encourage residents to want to change their food environment.

It should get them thinking about wanting stores to provide healthier foods. Or they might want a farmers’ market, community gardens, better school food, and cooking lessons for their kids.

A method that works

These things really can help change eating behavior. The American Heart Association recently published a massive review – with rankings – of environmental interventions aimed at improving personal diets, physical activity levels, and smoking habits (See Circulation 2012; 126:1514-1563).

The review cites evidence for strategies to improve diets such as media campaigns, price subsidies, school meals and gardens, and restrictions on marketing, as well as taxes as portion caps. Some of these interventions are expensive, but others are not.

A review like this gives advocates plenty to work with.

Soda tax initiatives will not be going away. Neither will other such measures. Community leaders across the country will be continuing to introduce them as a means to reduce health care costs and to generate needed revenue for health-promoting activities.

It’s worth starting now to engage communities in efforts to improve their own health. Next time, engaged communities may be ready to vote for health over corporate interests.

Grassroots efforts take time. It’s too soon to be discouraged.

Marion Nestle is the author of “Why Calories Count: From Science to Politics,” as well as “Food Politics” and “What to Eat,” among other books. She is a professor in the nutrition, food studies and public health department at New York University, and blogs at foodpolitics.com. E-mail: food@sfchronicle.com. 

  • http://www.muchmorethanfood.com Bonnie Modugno, MS, RD

    I’m not so sure typical public health efforts are all that effective, either. Right now buses and billboards throughout LA are plastered with messages telling people to eat smaller portions and count calories. http://muchmorethanfood.com/blog/choose-less-weigh-less/

    Most of my clients struggling with their weight and metabolic health already know that. Knowledge is not the same as behavior. Critical factors that influence behavior point to motivation — that critical mix of ability, readiness and willingness to change. Unless we are willing to address the capacity for self efficacy, all the messaging is not likely to be effective.

    Critical efforts need to focus on adjusting our expectations. We need to be willing to spend much more for whole food and wean ourselves off of subsidized highly processed food. We need to spend serious money counseling every woman pregnant, lactating and thinking about getting pregnant because early metabolic programming is significant. We need to get serious about the chemical environment. While everyone is railing at personal choice and counting calories, there is very little said about the influence of endocrine disruptors and other persistent organic pollutants that influence the very nature of metabolism.

  • http://hopefulgeranium.blogspot.co.nz/ George @ the High Fat hep C Diet

    The alcohol industry in NZ are the masters of this indirection. they have set themselves up at the authority on responsible alcohol use (drunkeness is the user’s fault and alcoholism would never happen if people listened to the liquor industry).
    The food industry – like the liquor industry – can afford to promote calorie restriction IN PRINCIPLE while supplying excess, because trying to “eat less move more” isn’t going to change much as long as people eat the same trash as before.
    Some people will even pay extra for calorie-restricted food, then buy more of it to compensate – win-win.

  • Ron

    I think efforts to change the way cheap food is subsidized would be more effective than a tax on the end user. Instead of subsidizing sugar, refined flour, and corn why not subsidize fresh fruits and vegetables? The result would still be higher cost of the less healthy foods – which might make healthier alternatives more attractive.

  • http://hopefulgeranium.blogspot.co.nz/ George @ the High Fat hep C Diet

    New Zealand removed all farming subsidies (except a small fund for experimental crops) in the 1980s. Our farming economy is doing better than ever. Removing subsidies, rather than increasing taxes on subsidised goods, which hits the taxpayer twice, is the best way to go.

  • Priya

    Marion,

    I couldn’t agree more with you. These efforts take time.

    I’m a sociology doctoral student at Stanford, and colleague and I wrote a piece for the Chronicle on Thanksgiving where we respond to the failure of prop 37 by talking about how long social movements take – and how long the food movement will take. Perhaps you’d find it interesting.

    http://www.sfgate.com/opinion/openforum/article/Prop-37-Food-movement-has-just-begun-4058131.php

  • joe

    It is sad that so many intelligent individuals miss the fact that virtually no one in the United States suffers true hunger. Rather they spend their time trying to convince people how bad, corrupt, unfair and immoral our food system is? Moreover they seek the strong arm of government to regulate and restrict personal choice when it comes to food. Why seek government control? Because they know that no one will by choice go along with their ideas unless forced to by law.

  • http://hopefulgeranium.blogspot.co.nz/ George @ the High Fat hep C Diet

    Hey Joe, the same argument applies to pharmaceuticals too doesn’t it?