It's all about a healthier Vermont

It's all about a healthier Vermont

Why an excise tax on sugar-sweetened beverages is good public policy

BELLOWS FALLS — In 2011, my organization, the Healthy Communities Coalition, was recognized as one of four “model success stories” in healthy communities work nationwide. So we speak with experience and credibility in (as our slogan says) “making the healthy choice the easy choice.”

In testifying in favor of the House bill, “An act relating to the imposition of an excise tax on sugar-sweetened beverages,” I represented many other Vermonters.

I went to Montpelier on behalf of:

• Vermont's youth, whose risk for obesity increases an average of 60 percent with every additional daily serving of a sugar-sweetened beverage.

• Our teens, whose number-one single source of all calories is sugar-sweetened beverages.

• Vermont's low-income parents, for whom the healthy choice is too often out of reach.

• All Vermonters with limited financial resources, whose Low Income Advocacy Council has endorsed this bill.

• Vermont's health seekers, the 55-65 percent of all of us who want to live a healthier lifestyle but who need ongoing guidance and supportive environments to achieve and maintain it.

• And Vermont's businesses, taxpayers, and insured citizens, who spent $615 million in 2010 to address issues of obesity and related chronic diseases.

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I ran dozens of maps on health behaviors (smoking, physical inactivity, etc.), social determinants of health (income, education, employment, etc.) and health outcomes, and none show as direct a correlation as these three.

While obesity and chronic diseases have multiple contributing factors, there is no question that consumption of sugar-sweetened beverages is directly related to obesity, mortality, and morbidity as these maps demonstrate.

This legislation can reduce soda consumption, which will, in turn, reduce rates of obesity and improve health outcomes.

My second map shows the retail food environment in Vermont - restaurants, grocery stores, farmers markets and mini-marts - and the relative balance of healthy food outlets versus unhealthy ones by census tract.

The map shows that are many people living in Vermont who do not have healthy food choices as an option, including many who receive 3Squares benefits. And, in several communities where the healthy choice is a much more difficult choice, no retail outlet accepts 3Squares benefits.

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It is elitist to say, as many do, that obesity and health is about personal responsibility or that education is the key.

When parents with limited financial means do not have access to healthy foods, it is unfair and unjust to suggest that if they only knew better or took more responsibility, they would eat healthier.

Right now, in far too many communities in Vermont, the healthy choice is not accessible, but the unhealthy ones are. This bill can help “make the healthy choice an easier choice” by directing revenues toward health-supporting initiatives, including efforts that increase access to healthy foods, particular for low-income Vermonters.

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We have learned a lot from earlier health movements. The use of cigarettes continued to climb until the introduction of policy and environmental changes like taxes, laws against smoking in restaurants, and campaigns against exposure to secondhand smoke.

As a result, smoking rates declined significantly.

Again, there is nothing in either health science literature or behavioral sciences that suggests that education, as Governor Peter Shumlin has suggested, will change behaviors. The changes that we have seen in smoking rates support the power of policy and environmental interventions.

Mark Fenton, a nationally-recognized consultant to our Healthy Communities Coalition and other alliances associated with the CDC's Pioneering Healthier Communities movement, says that we don't have an obesity epidemic in America so much as we have epidemics of physical inactivity and unhealthy eating. Two years ago, the Vermont Legislature passed the Complete Streets bill. This legislation is already having an impact in communities throughout the state in support of active transportation (walking, bicycling, public transit), or what we call “routine physical activity.”

At the signing of that bill, Health Commissioner Harry Chen said something to the effect of, “Today, the healthy choice became the default.” Just as the Complete Street's bill helped “change the default” related to physical activity, so too, can this legislation change the default related to healthy eating.

This bill is one of the best opportunities we have to lower rates of obesity and related preventable chronic diseases, which will result in a significant decrease in the associated economic burdens on individuals, families, businesses, communities, and the state of Vermont. I encourage lawmakers to become passionate champions for it as it moves through the legislative process.

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