Kaiser Permanente study finds lower BMI percentile for children, teens in 4 Bay Area cities that adopted tax on sugar-sweetened beverages
Young people living in 4 Northern California cities that began taxing sugar-sweetened beverages had lower body mass index (BMI) percentiles compared with young people living in cities without the tax, a new Kaiser Permanente study in JAMA Network Open shows.
The researchers studied more than 390,000 children and teens (aged 2 to 19) who were Kaiser Permanente members between 2009 and 2020. They compared 4 cities with sugar-sweetened beverage (SSB) taxes — Albany, Berkeley, Oakland, and San Francisco — with 40 California cities without SSB taxes.
They found youth in the cities with SSB taxes had an overall 1.64 percentage point lower average BMI percentile after tax approval. BMI percentile is a calculation that takes into account a child’s weight and height, compared with others of their age and sex.
There was a stronger association in children under 12, boys, and Asian and white youth. Researchers did not observe health-related benefits among Black youth or those living in high-poverty neighborhoods.
“These findings show us there is a way to have a positive impact on children’s health,” said the study’s lead author Deborah Young, PhD, MBA, director of the Division of Behavioral Research at the Kaiser Permanente Southern California Department of Research & Evaluation. “At the same time, additional research is needed to determine if the tax resulted in reduced purchases and consumption by youth or if the additional programs from the increased revenue were responsible for the results we found.”
It is not known why Black or low-income youth did not see the same benefit as other children.
“We need further studies to clarify who benefits most from these SSB taxes and why,” said Monique M. Hedderson, PhD, MPH, a research scientist with the Kaiser Permanente Northern California Division of Research. Living in lower-income environments may outweigh the possible beneficial effects of SSB taxes. “It is also possible that it may take a longer time to see the benefits of the health-related programs funded by these taxes.”
Prevalence of obesity among youth is high
During the time period of the study, about 16% of U.S. youth were overweight and 19.3% were obese. This excess weight increases young people’s risk of current and future chronic diseases. Studies have shown that sugar-sweetened beverages are among many contributors to obesity in children and adults.
In 2019 the American Academy of Pediatrics recommended policies such as SSB excise taxes to help reduce obesity. Berkeley was the first U.S. city to levy an SSB tax in 2015. The 4 Bay Area cities in this study approved a penny-per-ounce excise tax onto sugar-sweetened beverage distributors, so that a 12-ounce soda would cost an additional 12 cents. Other research has confirmed that the taxes were passed on to consumers and that sugar-sweetened beverage purchases and consumption declined in these cities.
The researchers said this was the first study to show health, rather than just economic, potential impacts from the soda taxes.
Revenues from the tax were mostly spent on public health and equity programs. Annual revenues ranged from $273,000 in Albany to $16 million in San Francisco, with most of the revenues supporting health-related programs (100% in Albany, 92% in Berkeley, 79% in San Francisco, and 51% in Oakland).
The study was funded by the National Institutes of Health.
Study co-authors also included Margo A. Sidell, ScD, Deborah A. Cohen, MD, MPH, Lee J. Barton, MS, Galina Inzhakova, MPH, Allison C. Voorhees, MPH, and senior author Bing Han, PhD, of the Department of Research & Evaluation; Emily F. Liu, MPH, and Sneha Sridhar, MPH, of the Division of Research; Catherine Lee, PhD, formerly of the Division of Research; and Jennifer Falbe, ScD, MPH, of the University of California, Davis.
This story is adapted from a news release by the Kaiser Permanente Department of Research & Evaluation.
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About the Kaiser Permanente Division of Research
The Kaiser Permanente Division of Research conducts, publishes and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and society at large. It seeks to understand the determinants of illness and well-being, and to improve the quality and cost-effectiveness of health care. Currently, DOR’s 600-plus staff is working on more than 450 epidemiological and health services research projects. For more information, visit divisionofresearch.kaiserpermanente.org or follow us @KPDOR.
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