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THE ARGUMENT

Should Massachusetts enact a junk food tax?

Read two views and vote in our online poll.

YES

Jon Santiago

State representative, Boston Democrat; Emergency room physician at Boston Medical Center

Jon Santiago

Junk food kills. And that’s no exaggeration. It’s also a financial drain on our country. Include the disproportionate impact it has on poor communities and it becomes clear we must take urgent action. Like the successful campaign to assess cigarettes, taxing junk food — processed foods with a high caloric density from sugar, fat, and salt — is an opportunity to decrease consumption, improve health, and raise revenue to tackle health disparities.

As an ER physician and state representative serving Boston, I’m constantly reminded of the vast health inequities that have been exacerbated during COVID-19. These disparities are driven by many acquired ailments — like heart disease and diabetes — strongly associated with an unhealthy diet. In fact, one study found consuming fast food at least twice a week can increase risk of dying from heart disease 50 percent.

And these health effects also carry a heavy financial cost. A Boston study estimated an added $50 billion is annually spent on health care due to our nation’s poor diet. Every additional health care dollar spent is one less dollar to combat climate change, fund schools, and build more housing.

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Junk food also exacerbates health inequity by exploiting low-income communities. Faced with food deserts and a higher proportion of convenience stores, our most vulnerable neighborhoods have limited healthy food options. Reducing junk food consumption is more than just a public health issue, it is a racial justice issue, too.

Taxing junk food is an effective way to limit its impact on public health and rising health care costs. A large systematic review showed that minor excise taxes on items like sugary drinks can decrease sales by approximately 15 percent. Taxing cigarettes — another addictive commodity greatly impacting health — became a very successful public health intervention that has saved countless lives.

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As with cigarettes, decreasing junk food consumption can reduce the burden of associated diseases. Raising revenue from a junk food excise tax can create funds to reinvest in healthy initiatives. Harvard researchers estimate adding pennies to sugary drinks alone would raise $368 million annually in Massachusetts. And junk food taxes have shown no negative impact on employment.

If policymakers want to improve health, decrease health care costs, and create revenue to tackle health disparities, taxing junk food can get us there.

NO

Laura T. Housman

Founder of health care consulting business, public health doctoral student at Boston University School of Public Health, Framingham resident

Laura T. Housman

According to federal data, adults aged 18-24 are half as likely to have obesity as those 45-54. While an encouraging data point, reducing obesity and its accompanying chronic health care issues necessarily remains an important public health challenge to be addressed.

Yet levying a tax on “junk food,” or food we typically think of as having low nutritional value and requiring little to no preparation, is not the approach to achieve these goals.

There is no consistent definition of what constitutes junk food. A serving of Cape Cod Original potato chips has fewer calories, sugar, sodium, and carbohydrates than a serving of Nature Valley peanut butter granola bars. So should the chips be taxed as junk food and not the granola bars?

Moreover, data supporting the long-term impact of taxation on sugar-sweetened beverages — one category of junk food — is, in my view, lacking.

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A study of the effects of a tax on sugary beverages in Oakland, Calif., two years after it took effect estimated the prices of those beverages increased, on average 16 percent, with two-thirds of the estimated overall reduction in taxed beverage volume sold in Oakland offset by cross-border shopping. While Oakland saw a 6 percent net decline in sales volume of those beverages, the report did not assess the impact the tax had on retailers, or on residents who lacked easy access to shopping in other communities.

Estimates suggest that a 55 percent junk food tax rate would be needed to decrease the proportion of overweight and obese individuals by just .7 percent. It stands to reason that weight outcomes inevitably will depend on which product substitutions, if any, consumers choose to make.

Through promoting the concept of individual choice, food manufacturers, public health and municipal leaders, and retailers can “nudge” individuals to make healthier food choices. This kind of non-taxation encouragement could include introducing changes into the shopping environment, such as creating an enticing display of fruits and vegetables or keeping healthy snacks at the front of store or checkout line. Creative packaging and marketing of healthy foods could also help change perceptions of what is considered “healthy.”

Getting people to eat better is an important public health goal, but imposing a burdensome tax is not the way to achieve it.

As told to Globe correspondent John Laidler. To suggest a topic, please contact laidler@globe.com.

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