Understanding beverage taxation: Perspective on the Philadelphia Beverage Tax's novel approach.

Abstract

Despite the growing global trend of sugar-sweetened beverage (SSB) taxes for their potential as an untapped source of revenue and as a public health boon, these legislative efforts remain controversial. Multiple articles have reviewed this trend in recent years from modeling of long-term impacts to short-term empirical studies, yet most comprehensive, long-term health impact assessments remain forthcoming. These multi-faceted efficacy studies combined with case-based assessments of the policy process, descriptive pieces highlighting unique features of the policy and reflective perspectives targeting unanswered questions create a comprehensive body of literature to help inform present and future legislative efforts. The passage of the Philadelphia Beverage tax required a mix of political entrepreneurs, timing and context; while uniquely employing a nonpublic health frame, specific earmarking and a broadened scope with the inclusion of diet beverages. This perspective on the Philadelphia Beverage Tax will describe the passage and novel features of the Philadelphia Beverage Tax with a discussion of the ethical questions unique to this case.Significance for public healthThe prevalence of obesity and its related non-communicable diseases has continued its upward trajectory globally, despite our decades-long awareness of this trend. Excess caloric intake is a principle factor for this growing global burden of disease − with overconsumption of liquid calories in the form of sugar-sweetened beverages (SSB) a central component of this imbalance. A relatively recent public health response to reduce SSB consumption and increase revenue for public health spending has been the passage of beverage taxes at the local, state and national levels. However, there are many nuances in the design, passage and goals for these beverage taxes globally. The Philadelphia Beverage Tax’s use of a non-health frame, its specified earmarking and its scope by including diet beverages both allowed for its passage and create unique ethical questions that have yet to be completely addressed by the literature. These ethical considerations in the context of the Philadelphia Beverage Tax’s passage are important for other public health professionals, policy-makers and advocates working towards their own legislative efforts.