The New Health Dialogue

Should people be able to use food stamps to buy sodas and other sugary beverages? New York City thinks not.

As we’ve often noted, food policy will increasingly play a large role in health policy, as we institute programs and policies to curtail the obesity epidemic threatening the health of our nation. New York City, a city always at the top of fashion and food, has already begun a public education campaign about sugary beverages. It is now contemplating further action.

Nearly 57 percent of adults in New York City and 40 percent of children in New York City public schools are either overweight or obese. The potential health consequences are frightening, and obesity rates are particularly alarming in New York's low income neighborhoods (30 percent in the poorest neighborhoods versus 17 percent in the richest). Obesity-related health care conditions cost New Yorkers nearly $8 billion a year in tax dollars, or $770 per household. (That's one reason that the city was at the vanguard of the move to require menus to display calorie counts, now a part of the national health care law.)

Since research repeatedly demonstrates the relationship between the consumption of sugary beverages and obesity, the New York City Department of Health and Mental Hygiene initiated an on-going targeted campaign around those soft drinks and sweetened juices. Last year, the Health Department ran the "Are You Pouring On The Pounds?" campaign, and began the sequel last week, "If You Wouldn't Eat It, Why Drink It?" (Watch the commercials here and here -- the first highlights the number of calories sugary beverages add to people's daily diets and the second compares one 20 oz bottle of soda to 16 packets of sugar. PDFs of the advertisements are here and here.)

This map of New York City shows the areas with the greatest concentration of obesity and compares it to food stamp utilization and the consumption of sugary-beverages. It reveals a stark difference between low income and high income neighborhoods. Similarly, this table shows that high income New Yorkers are less likely to consume a daily sugary beverage than low-income New Yorkers. Drinking one sugary beverage a day can cause a 10 pound weight gain a year.

In an effort to curb obesity and discourage low-income New Yorkers from purchasing sweetened beverages, Mayor Michael R. Bloomberg and Governor David A. Paterson asked the U.S. Department of Agriculture by the State's Office of Temporary and Disability Assistant last week to allow them to do an experiment: exclude sugar-sweetened beverages from the list of allowable purchases through the Supplemental Nutrition Assistance Program for two years. The program would prohibit beneficiaries from purchasing any beverage with more than 10 calories per 8 oz with food stamps, excluding fruit juices without added sugar, milk and milk substitutes. The program would not lower the SNAP benefits but put more limitations on what can be purchased using tax dollars. SNAP already prohibits the purchase of cigarettes and alcohol, so why not extend it to sugary beverages also?

“In spite of the great gains we’ve made over the past eight years in making our communities healthier, there are still two areas where we’re losing ground -- obesity and diabetes,” said Mayor Bloomberg. “We know there is no quick fix to address these issues ... This initiative will give New York families more money to spend on foods and drinks that provide real nourishment."

Healthy living is an exercise in personal freedom. No one can be forced to eat healthy or exercise regularly and there are certainly external factors that contribute (like safe neighborhoods, sidewalks, distance to supermarkets). However, since its inception, SNAP has represented "improved levels of nutrition among low-income households." We know there is a debate about choice, "paternalism" and whether other food stamp purchases can or should be prohibited. But we'll be interested to see the outcome of NYC's SNAP decision.