A friend recently sent me a New York Times article entitled “The Decline of ‘Big Soda'” and asked me my thoughts. The article begins with this opening line:
“Five years ago, Michael A. Nutter proposed a tax on soda in Philadelphia, and the industry rose up to beat it back.”
Okay, let’s stop right here. Once upon a time, I felt ambivalent about the idea of a soda tax. Now, however, my stance is clear: I am firmly against a soda tax.
Our country’s health woes are complex, only partially understood, and not entirely in our hands to fix, yet for reasons that baffle me, we continue to place too much confidence in our oversimplified supposed solutions. Perhaps people are scared, yearn for a sense of control, and find it more comfortable to point fingers at scapegoats than to face the truth. Human history is riddled with atrocities stemming from scapegoating, and in the world of nutrition, the blame game is harmful as well.
Taxing one food, nutrient, or ingredient separate from the others reinforces a “good food, bad food” dichotomy. Eating only “good foods” is largely unsustainable for most people, and although doing so might sound good in theory, the reality is that such rigid eating often comes at the expense of health’s other facets. When we ultimately consume foods we view as “bad,” feelings of guilt and shame quickly follow. A popular misconception is that feeling bad about ourselves will inspire change, but actually quite the opposite is more the norm. The worse we feel about ourselves, the less inclined we are to treat ourselves well. We eat a “bad” food, feel guilty about it, and proceed to take worse care of ourselves.
Better to recognize that the “good food, bad food” dichotomy is a harmful system, remove moralization from eating, and instead teach people the importance of individuality and moderation. After all, one person’s “bad food” is someone else’s “good food” and vice versa, so what do those labels really mean anyway? Cantaloupe is high in potassium, which makes it very helpful for my patients with hypertension but quite problematic for my patients with kidney disease who are on potassium restrictions. So, is cantaloupe a “good food” or a “bad food”?
If the basis of the soda tax is the beverage’s sugar content, then why are sodas singled out while sports drinks, iced teas, chocolate milks, smoothies, lemonades, fruit drinks, milk alternatives, yogurt drinks, and other sugary beverages skate by without a special tax? Orange juice has almost as much sugar (31 grams per 12 ounces) as Coca Cola Classic (39 grams per 12 ounces), so why are we not stigmatizing OJ?
One might argue that orange juice has upsides despite the sugar content, a point with which I completely agree, but the same is true for soda as well. Every single food you see in the grocery store, including soda, has its upsides; otherwise, nobody would buy it, the store would cease stocking it, and it would not reside on the shelves for you to see.
Sugar is dense in calories, and calories are a measure of energy, so for our neighbors whose financial hardships make getting enough food a daily battle, soda is a cheap source of energy. Increasing taxes on low-cost foods places additional pressure on the already financially strapped people who are most likely to make such foods a staple of their diets out of necessity. When people talk about racism, classism, and privilege in healthcare, the soda tax is an example of what they mean.
For those with medical conditions that make consuming enough energy a challenge, such as cancer, HIV, and anorexia nervosa, the caloric density of sugar-sweetened beverages makes these drinks, including soda, helpful options. Let’s not create additional issues for people who are already sick by specially taxing and stigmatizing the beverages that are part of their care.
For other people, soda is a play food, something that they simply enjoy even if it is not the best option for their health. Whether they partake only occasionally or frequently is irrelevant. All of us engage in a whole slew of activities that do not prioritize our health. We know how detrimental inadequate sleep can be, so why not institute a special tax on people who do not get enough? Why don’t we impose a tax penalty on people who live in cities with poor air quality? Let’s place an additional tax on people who are not physically active, or at least not as active as some other people think they should be. High heels can lead to orthopedic problems, so let’s tax stilettos more than other footwear while we’re at it.
Penalizing other people for their behaviors and how they choose to balance their health with life’s other elements suddenly loses its coolness factor once we realize that opening the door to this kind of judgment means we ourselves are subject to similar stigmatization and punishment, too. In other words, the finger that currently points at them might someday swing right around and point directly at you.