A diet high in sugar sweetened beverages (SSB, has been shown to be associated with adverse health outcomes. Several cities across the US have implemented SSB taxes to decrease consumption and distribution of sugary drinks. Revenues generated from taxes were often allocated to fund public health programs and enhancements to reduce obesity. We examined efforts in San Francisco where the Sugary Drinks Distributor Tax (SDDT or “soda tax”) was implemented in 2018. SDDT legislation mandated the establishment of the Sugary Drinks Distributor Tax Advisory Committee (SDDTAC), responsible for making annual recommendations for the allocation of tax-generated revenues. We reviewed SDDTAC recommendations and funding for new and existing services that support public health through reduction and prevention of diet related diseases. We assessed if there was a significant increase in funding and number of health promotion programs implemented in San Francisco after the implementation of the SDDT. We documented obesity prevention initiatives resulting from increased tax revenue. We reviewed city government budget documents and press releases at least 1 year before tax implementation (2017) and 4 years post (2018-2022). We cataloged initiatives for adults and children including health education, nutrition and lifestyle, and community projects. The first full year of SDDT implementation (2018-19) saw the highest revenue generated at $16,097,908. Total revenue for the implementation period (2018-2021) was reported as $42,415,548. The revenue generated in the first six months of fiscal year (FY) 2018 was spent in FY2019-2020. During that period, the San Francisco Public Health Foundation awarded 26 one-year SDDT community grants - aligning with priority expenditure categories for SDDTAC - totaling $1,702,211. SDDTAC priority categories include decreasing consumption of sugary drinks, increasing water consumption, oral health, healthy food access, physical activity, and other (e.g. research/Community-Based Participatory Research, new innovations, etc.). [ACV1] In FY2019-2020 78% of SDDT revenues were spent on Healthy Communities, oral health, Healthy Food Purchasing Supplement grants and SF City Funded Agencies’ programming. The remaining 22% were spent on social media grants, infrastructure, and administrative costs. To address COVID-19, $1.65 million of unused funds from FY2019-20 supported food security and food distribution for vulnerable populations. Tax generated funding for 65 new or existing programs since implementation. New programs are funded each year: five new Policy Systems and Environmental Change programs were funded in FY2019-2020 and one new school-based program funded in FY2021-22. We observed a significant increase in number of health programs in San Francisco since SDDT implementation.
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