Why Public Health Experts are Talking about Sugary Drinks during the Pandemic
By Jeff Hild and Milena Berhane
The COVID-19 pandemic has laid bare longstanding race-based inequities in communities across the country, including in the District of Columbia. These inequities are most disturbingly visible in the disproportionate burden of infection and death among the Black community from COVID-19. Nationwide, Black Americans account for one-third of COVID hospitalizations yet make up just 14 percent of the overall population. In the District, Black residents are 47 percent of the population but account for nearly 75 percent of COVID fatalities.
The drivers of disparity and inequity are complex but share a common root in structural racism. Many decades of policy choices have resulted in segregated neighborhoods lacking in services and investments needed to support healthy and thriving families. In the District, the 160,000 residents residing in the predominantly Black communities in Ward 7 and 8 are served by only three grocery stores. Compare that to eight grocery stores serving the 80,000 mostly white and affluent residents in Ward 3. Lack of access to healthy food is helping to drive an obesity and diabetes epidemic in parts of the District, with 34 percent of Black residents having obesity and death rates from diabetes that are up to six times the national average.
According to the Centers for Disease Control and Prevention (CDC), obesity and related comorbidities are the second greatest risk factor for COVID-19 severity, after only older age. It should shock, but not surprise us that Black residents in the District bear the brunt of both diet-related chronic disease and COVID-19. The same is true in communities across the country. Part of the reason is that Black and other communities of color, and particularly young people in those communities, are consistently and disproportionately targeted with advertising marketing by sugary drink corporations, resulting in higher rates of consumption of unhealthy products in those communities.
The COVID-19 pandemic will eventually be brought under control, but policymakers in the District and elsewhere must begin implementing changes that will dismantle the structures that have allowed the virus to decimate so many communities. The District Council is currently considering one such policy — the Healthy Beverage Choices Act. This legislation would create a 1.5 cent/ounce tax on sugary drinks sold in the District and use the revenue to fund programs and services, such as Food is Medicine vouchers, that can increase access to healthy food in underserved parts of the District.
The legislation follows the successful implementation of similar sugary drink taxes in other large cities, including Philadelphia, San Francisco, Oakland, and Seattle. Research from those cities has shown a steep drop in consumption of sugary drinks (the leading source of excess sugar in the American diet), which will have long-term health benefits in those communities. Importantly, a number of jurisdictions have used the revenue from their taxes to respond aggressively to the impacts of COVID-19. For example, Seattle has provided $800 grocery vouchers to over 6,000 families impacted by the pandemic. San Francisco has been able to allocate $1.65 million toward nutrition assistance. The opportunity exists for the District to take similar action to ensure all residents have access to healthy food.
At the federal level, COVID-19’s disproportionate impact on people with obesity shows the need for policies that allow obesity to be treated like other chronic diseases and allow for coverage of and equitable access to all evidence-based treatments. Many health plans offer minimal coverage for obesity treatment. The federal government can begin to change this by allowing Medicare to cover all types of obesity treatment, including Part D coverage of FDA-approved obesity drugs and full coverage of Intensive Behavioral Therapy. The bi-partisan Treat and Reduce Obesity Act (TROA) would do just that, opening up obesity treatment to many more Americans and pushing private insurers to do the same.
The opportunity exists to implement public policies that can support an equitable recovery from the COVID-19 pandemic and begin to address to the deep-seated inequities that are driving a chronic disease epidemic in many communities of color.
Jeff Hild is the Policy Director at the Sumner M. Redstone Global Center for Prevention and Wellness at the George Washington University Milken Institute School of Public Health.
Milena Berhane is a Master of Public Health student at the George Washington University Milken Institute School of Public Health.
