Analyzing the effects of a sugar-sweetened beverage tax on la county's low-income and communities of color: A health impact assessment study

Copious research demonstrates the health implications associated with high rates of sugar-sweetened beverage (SSB) consumption amongst American children and adults. These data have been utilized to inform various policy initiatives aimed at reducing SSB consumption throughout the country. However, many studies do not analyze the social, environmental and cultural factors of low-income and communities of color when projecting the impacts of the proposed policies on consumption patterns and health outcomes. Community Health Councils, a non-profit community-based organization in South Los Angeles, conducted a multi-sectorial Health Impact Assessment studying the effects of the latest SSB state tax proposal on the nutrition behaviors of predominantly African-American, Hispanic/Latino and Southeast Asian communities in Los Angeles County. These communities are plagued with the highest SSB consumption rates, the highest nutrition-related chronic disease rates, and the most prolific disparities in healthy food and beverage access in the County. To identify solutions that address these disparities, this study completed a retail environment assessment, focus groups, key informant interviews, GIS, surveys and empirical data research. Study results found that barriers to access to healthy beverage alternatives, perceptions of tap water quality, inequitable billboard marketing code enforcement, cultural predispositions and informal food economies are factors that could significantly undermine the effectiveness of a tax in improving nutrition behaviors. Strategies to reduce SSB consumption must address these factors to effectively reduce health disparities around SSBs in vulnerable communities.