Dr. Yolondra Hancock is a professor at the Milken Institute School of Public Health at the George Washington University. (Courtesy Photo)
By Dr. Yolandra Hancock
Creating systems and environments to allow people to live long healthy lives has always been critical, but particularly coming out of a pandemic. The pandemic has highlighted once again the impact of health inequity as African American D.C. residents have accounted for 75% of COVID-19 fatalities, despite being only 47% of the population. Creating space for equitable access to healthy foods and funding those efforts should now be a priority. Supported by health advocates and leaders in the community, D.C. recently considered the Nutrition Equity Amendment Act of 2021 that would have helped to address the many health and nutrition inequities that have existed in the District for decades. The law will, among other things, institute an excise tax on the distribution of sugary drinks to raise revenue and address health inequities and racial disparities, while also encouraging a healthier beverage consumption. D.C. is not the only jurisdiction fighting health inequities and the big beverage industry. Sugary drinks, such as fruit-flavored drinks and regular soda, are major contributors to excess sugar consumption, which is directly linked to chronic illnesses including Type-2 diabetes and obesity, the same illnesses that are the leading risk factors for complications, including death, from COVID-19.
As the saying goes, health is wealth; and inequity is a key contributor to the health disparities apparent among the eight wards in the District. It is no secret that food insecurity East of the Anacostia River makes people vulnerable to developing diet-related chronic health conditions. Many D.C. residents do not have easy access to affordable healthy foods because they live in food deserts and food swamps, particularly in Ward 7 and Ward 8, according to D.C. Hunger Solutions. The legislation would have addressed these issues and invested millions of dollars into programs and projects that would’ve provided nutrition education, improve food security, invest in Black-owned food businesses, and serve healthier food at family shelters.
Skeptics of the tax often focus on how and whether it can help dismantle systemic nutritional inequities. Admittedly, there is a long way to go to significantly increase health equity, but it can be done. For as long as it is needed, a tax would generate the revenue required to launch and sustain the effort to improve access to nutritious foods and reduce excessive sugar intake amongst residents of underserved communities. Several major cities have demonstrated the benefits to be gained from such a tax. Philadelphia, Pa. used sugar tax revenue to fund early education and recreational programs in underserved communities. These types of programs are important given that children who consume high levels of sugar suffer negative impacts including obesity, tooth decay, mood instability, anxiety, lower concentration, immune system suppression and worse.
Critics argued that this bill would’ve had negative economic consequences, both for small businesses and for families who are under-resourced, calling the bill poorly timed and regressive. There is no better time than now to fight for nutrition and health equity as we collectively heal from this pandemic. Despite claims to the contrary, there has been no evidence to date demonstrating negative fiscal impacts on small businesses by similar legislation. In fact, a recent study out of California demonstrated that the majority of retailers in cities with similar taxes had no concerns about the impact of the tax and actually endorsed the health goals of the legislation, supporting statewide expansion. In regard to regressivity, there is nothing more regressive than the physical, mental, emotional and financial costs of chronic disease, particularly among families of color. Daily consumption of a 20-ounce soda after this legislation passes would equate to $109.50 per year in added cost. The average cost of out-or-pocket expenses for someone who has insulin dependent Type 2 diabetes is $4800 with insurance, which is 10% of the average American annual wage. There is no comparison in terms of cost.
We heard those who opposed the tax saying that it wouldn’t work because people could still consume excess sugar through other sources. Yes, there will still be other sugary foods readily available; but we must start somewhere and taxing sugary drinks, the single greatest source of added sugar in the U.S. diet, is the logical place to start.
As a community we should do all we can to support a suite of measures, including excise taxes, restrictions on marketing to kids, and incentives for health and nutrition programs, that will allow our community to live longer and healthier. Although there’s no single effort that will immediately get us there, these are the key first steps to consistently lower the rate of preventable chronic health conditions and create more equitable access to healthier nutrition sources for our residents; passing the Nutrition Equity Amendment Act would’ve been an important step to getting to a healthier D.C.
Dr. Yolondra Hancock is a professor at the Milken Institute School of Public Health at the George Washington University.
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