21 extra cents for that soda? It’s worth it

Cans of soda stacked inside a supermarket.

File photo of soft drinks in a supermarket. Jan. 29, 2013. (Photo by Lewis Whyld/Press Association via AP Images)

Sugary sodas and sports drinks destroyed Erica’s mouth.

She lost some teeth during childhood. By the time she was 21, Erica’s crumbling teeth prevented her from eating solid foods and she was embarrassed to smile. Her teeth had deteriorated beyond repair. Sadly, all her remaining teeth had to be pulled.

In addition to tooth decay, excess sugar contributes to many significant health problems including diabetes, heart disease and obesity. These health concerns inspired the city of Seattle to take action, tax junk drinks and invest the money in low-income communities. 

With profits on the line, the sugary drinks industry is putting big money into trying to overturn our city’s local policy. And to quash the young health-improvement effort before the community benefits can be felt (and replicated in other cities), this week a committee subsidized by the American Beverage Association and its partners filed paperwork with the Public Disclosure Commission in support of a possible initiative that would block other municipalities from following Seattle’s lead.

A 1.75 cent tax for each ounce of sugary beverage, or an additional 21 cents for a 12-ounce soda, might seem like a lot at first. But the human and financial toll of not doing anything is even higher.

Advertisers relentlessly promote sugary drinks to low-income households and communities of color. In the end, these vulnerable populations pay the price for our society's ready access to beverages that hold no nutritional value. So, it makes sense to direct revenue from the new tax to reduce health disparities where they are most predominant.

City leaders enacted the tax to decrease sugar consumption and reduce obesity, which according to the Centers for Disease Control and Prevention has reached record levels. Nearly 40 percent of U.S. adults and 20 percent of children have a body mass index that classifies them as obese. We know too much sugar is associated with Type 2 diabetes, a chronic disease described as an epidemic in communities of color.

The impact of sugary drinks on oral health, which is critically important to overall health, is pervasive. Tooth decay is the most prevalent chronic disease among children. Despite the fact that oral disease is virtually 100 percent preventable, poor oral health is an unfortunate and widespread reality in lower-income communities. And, sugar is a major culprit.

In Washington, nearly half of lower-income children and 78 percent of lower-income adults do not receive essential oral health care each year. This negatively impacts their ability to thrive in profound ways. Children who have cavities in baby teeth are more likely to have persistent and costly dental problems throughout life. Painful tooth decay makes it difficult for children to eat, sleep and do well in school. 

Oral disease is widespread, debilitating, costly and linked to heart disease, diabetes, pregnancy complications and many other severe medical conditions. Poor oral health increases health care costs.

A person's oral health can also be an indicator of economic status. Visible signs of poor oral health, including missing teeth, gum disease and tooth decay, make it challenging to get a job, creating a barrier to economic mobility.

To ensure equal opportunity, we must work to prevent dental disease and improve access to dental care for vulnerable populations. Some of the revenue from the sugar tax will support early childhood education, which benefits lower-income children. Using sugary drinks tax revenue for programs like this makes sense, and policymakers should also prioritize investments to improve oral health.

Cavities are almost always preventable, yet in King County, 29 percent of kindergarteners already have at least one cavity. Children of color and lower-income children have much higher rates of untreated decay and rampant decay (cavities in seven or more teeth). Using the tax revenue to get more children into care by their first birthday will improve kids' health, increase their chances for success and reduce health care costs. 

Supporting dental care for low-income pregnant women and people with diabetes also improves health and saves money. Poor oral health during pregnancy can affect the health of both the mother and the baby.

We need policies that promote good oral health and eliminate barriers that prevent people from accessing dental care. Local leaders should be permitted to consider all evidence-based policies to encourage healthier alternatives, including drinking tap water, to benefit public health.

To stay healthy, you need a healthy mouth.

Discouraging excessive consumption of sugary drinks is good policy. Acknowledging that lower-income communities are paying more than their fair share of the tax and reinvesting the revenue to improve oral health, overcome disparities, and support health equity — that's good policy and good leadership. It's also the right thing to do for our community.

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About the Authors & Contributors

Dr. Nwando Anyaoku

Nwando Anyaoku

Nwando Anyaoku is the executive medical director of pediatrics for Swedish Health Services.

Diane Oakes

Diane Oakes is president and CEO of Arcora Foundation.