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INNOVATORS Q&A

How a tax on sugary drinks could help address public health and hunger in R.I.

Dr. Amy Nunn, a Brown University professor and executive director of the Rhode Island Public Health Institute, says beverage companies are targeting low-income communities in the state.

Dr. Amy Nunn is a professor at Brown University and executive director of the Rhode Island Public Health Institute.
Dr. Amy Nunn is a professor at Brown University and executive director of the Rhode Island Public Health Institute.Dr. Amy Nunn

The Boston Globe’s weekly Ocean State Innovators column features a Q&A with Rhode Island innovators who are starting new businesses and nonprofits, conducting groundbreaking research, and reshaping the state’s economy. Send tips and suggestions to reporter Alexa Gagosz at alexa.gagosz@globe.com.

In Rhode Island, a new bill sponsored by Rep. Jean Philippe Barros, a Pawtucket Democrat, would enact a 1.5 cent per ounce tax on sugary beverages such as soda, with the revenue from the tax used to fund a Retail SNAP Incentive Program. It would increase purchasing power for Rhode Island’s most vulnerable populations by providing a 50 percent discount on fresh fruits and vegetables, and would serve more than 144,000 SNAP recipients in Rhode Island, which include more than 46,000 children and more than 30,0000 seniors.

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The impact could be huge. When a similar measure was implemented in Philadelphia in January 2017, it generated approximately $77.3 million annually.

Dr. Amy Nunn, a Brown University professor and executive director of the Rhode Island Public Health Institute, said this tax is crucial for public health. Sugary drinks are cheap and easy to find in stores, but they are also the leading source of added sugar in the American diet. And research shows a link between these beverages and an increased risk in Type 2 Diabetes, cardiovascular disease, dental caries, osteoporosis, and obesity — serious public health issues that are often treated using Medicaid.

Q: How could this program help change the people’s eating behaviors, especially those who receive SNAP benefits?

Nunn: There’s a lot of stigma associated with being poor and wanting to eat chips and soda. That’s not the case. What I’ve found is that the vast majority of our clients that receive SNAP benefits want to eat healthy but are so limited with their income, including with their benefits. Right now, the rate of hunger has increased (from 9 percent before the pandemic to 25 percent in late 2020) and it’s causing the quality of food that people are buying to get worse. People have to stretch their dollars. They end up buying calorie-dense foods that have no nutritional value, like boxes of pasta, potatoes, and rice. It’s a trend that will lead to diseases like diabetes, cancer, and heart disease. We’ve found that if you make produce just as affordable, people are going to gravitate toward it.

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And the people who have SNAP benefits are typically in the urban core, like Providence, Pawtucket, and Central Falls, and elderly populations that are on fixed incomes. And there are disproportionately higher rates of people of color.

Q: How would the tax affect those who don’t receive SNAP benefits?

Nunn: In addition to raising a lot of money for the SNAP program, this would also greatly reduce the amount of sugary drinks that people are consuming. It’s been proven in other cities that have already started to tax their sugary drinks that the consumption rates are greatly reduced. For example, Philadelphia started taxing sugar-sweetened beverages and adults went from drinking one regular soda per day to just one every three days after the tax. Similar data was found in Berkeley, California, where three years after a tax was implemented, the city saw a 50 percent decline in sugary drink consumption.

(Also, in a survey published in the Journal of Health Economics, the probability of consuming regular soda fell by 25 percent and water intake rose by 44 percent.)

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Q: Similar bills have been introduced before, but didn’t pass. What’s happening here?

Nunn: From the political perspective, people hear “taxes” and probably run in the other direction. But, the beverage industry engages in discriminatory and predatory marketing towards people of color, and to children in particular. They try to get children of color and low-income folks drinking soda early. And it contributes to a lot of the food-related health problems that we then have to later fund for Medicaid.

Q: What are some examples of these “discriminatory and predatory marketing” tactics?

Nunn: All the Coca-Cola ads run in lower-income communities here in Rhode Island. You won’t see them in Barrington, but you’ll see them in Pawtucket and Central Falls. In places like Barrington and East Greenwich (which have higher household incomes), you’ll see advertisements for seltzers and spritzers. Companies like Coke know that those towns with higher incomes are not their target audience.

I have two children who are Hispanic. I’m married to someone who is Columbian and I get really concerned about how the beverage industry targets my kids. But some kids in Rhode Island don’t even have a chance. And it’s getting worse.

Q: How is childhood obesity ranked in Rhode Island compared to the US?

Nunn: More than 17 percent of kids between the ages of 10 to 17 are obese — making Rhode Island 11th in the US for childhood obesity. That’s higher than Mississippi and Alabama. Those statistics are alarming to me and frankly, just really inexcusable. But really, it’s our disparities.

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In 2017, the Annie E. Casey Foundation said Rhode Island’s Latino children ranked No. 49 in a national study that measures children on their future success.

Q: Why is childhood obesity and disparities such an issue in Rhode Island?

Nunn: I think it’s a collective failure. The data shows that only 10 percent of your health outcomes are driven by things that happen in a clinical setting. The rest is driven by your life opportunities, your ZIP code, and your educational and health opportunities. This tax on sugary drinks would help create opportunities for people earlier in life by just removing unhealthy beverages.


Alexa Gagosz can be reached at alexa.gagosz@globe.com. Follow her on Twitter @alexagagosz.