Trends and sociodemographic disparities in sugary drink consumption among adults in New York City, 2009-2017

The Health and Economic Impact of Using a Sugar Sweetened Beverage Tax to Fund Fruit and Vegetable Subsidies in New York City: A Modeling Study

Low fruit and vegetable (FV) intake and high sugar-sweetened beverage (SSB) consumption are independently associated with an increased risk of developing cardiovascular disease (CVD). Many people in New York City (NYC) have low FV intake and high SSB consumption, partly due to high cost of fresh FVs and low cost of and easy access to SSBs. A potential implementation of an SSB tax and an FV subsidy program could result in substantial public health and economic benefits. We used a validated microsimulation model for predicting CVD events to estimate the health impact and cost-effectiveness of SSB taxes, FV subsidies, and funding FV subsidies with an SSB tax in NYC. Population demographics and health profiles were estimated using data from the NYC Health and Nutrition Examination Survey. Policy effects and price elasticity were derived from recent meta-analyses. We found that funding FV subsidies with an SSB tax was projected to be the most cost-effective policy from the healthcare sector perspective. From the societal perspective, the most cost-effective policy was SSB taxes. All policy scenarios could prevent more CVD events and save more healthcare costs among men compared to women, and among Black vs. White adults. Public health practitioners and policymakers may want to consider adopting this combination of policy actions, while weighing feasibility considerations and other unintended consequences.

Secular trends and customer characteristics of sweetened beverage and water purchasing at US convenience and other small food stores, 2014-2017

Background

Cardiovascular health is linked to sugar- and artificially-sweetened beverages (SSBs and ASBs). Prior studies document declines in SSB purchases. However, it is unclear if similar trends exist at convenience and other small food outlets, which often serve lower-income communities and where objective point-of-sales data are difficult to obtain. We examined trends (2014–2017) in observed SSB, ASB, and water purchases at convenience and other small stores as well as differences in purchasing by customer characteristics.

Methods

We used observational purchase data collected annually (2014–2017) from 3010 adult customers at 147 randomly-sampled stores in Minneapolis/St. Paul, USA. SSB sub-types included any ready-to-drink sweetened soda, fruit, sport, energy, tea, or other drink, and ASBs included artificially-sweetened versions. Unsweetened water included ready-to-drink water. Mixed regression models examined trends over time and associations with customer characteristics, accounting for customers nested within stores and stores repeatedly measured over time.

Results

Nearly 50% of purchases included an SSB. Approximately 10% included an ASB. There was no evidence of change over time in SSB or ASB purchasing. Customer purchasing of unsweetened water significantly increased over time (5.7 to 8.4%; P for trend = 0.05). SSB purchasing was highest among men, young adults, customers with lower education/ income, and customers that shopped frequently. ASB purchasing was highest among women, those 40–59 years, non-Hispanic White, Hispanic, and customers with higher education/ income.

Conclusions

Despite research suggesting previous declines in SSB consumption and purchasing in the US, we identified a persistent, high trend of SSB purchasing overtime at convenience and other small food stores. Consumption of SSBs and water are growing targets for public policy and health campaigns. Results demonstrate additional work is needed curb sweetened beverage purchasing and promote water purchasing at convenience and other small food stores, which are often prevalent in low-income and marginalized communities.