Susan Saucedo, MD, MPH

2009-2010

Primary Care/Urgent Care Physician, Kaiser Permanente

Dr. Saucedo was most recently a Commonwealth Fund Harvard University Fellow in Minority Health Policy while earning her MPH at the Harvard School of Public Health. She was previously a staff physician at the University Muslim Medical Association (UMMA) Community Clinic, Los Angeles, CA, as well as a part-time staff physician in Kaiser Permanente, Los Angeles, CA. Prior to that, she was a substitute teacher for grades K-8 in the Lennox School District. She continues to mentor students and has given lectures at numerous schools including the Hawthorne Academy of Math and Science High School and Ascot Elementary School. She has gained leadership experience through her volunteer efforts in Tanzania, Costa Rica, and Mexico. Dr. Saucedo has been honored with the LMSA Commitment to the Community Awards in 2003 & 2004, a National Medical Fellowship Scholar from 2000-2002, and a California Community Service Scholar in 2003. She was also a Robert Wood Johnson Minority Medical Education Program (MMEP) Scholar in 1997. 

Dr. Saucedo received her medical degree from the David Geffen School of Medicine at UCLA, in 2004. She completed her residency in family medicine at the Kaiser Permanente Los Angeles Family Medicine Residency Program, Los Angeles, CA in 2007 and a Family Medicine Faculty Development Fellowship at Harbor-UCLA Medical Center, Torrance, CA in 2008.

Making the Case for a Sugar-Sweetened Beverage Tax in the New England States

Background: 

In the past 20 years, childhood obesity rates have doubled.  Nearly 30% of all children and adolescents in the United States are overweight or obese. The prevalence of obesity in low-income and minority children is even more striking.  This condition, now labeled a “chronic disease,” is a major contributor to preventable morbidity, premature death, and rising health care costs.  Obesity alone costs the health-care system an estimated $80 billion per year.  Obesity prevention efforts are crucial given that approximately 80% of children who are obese as children go on to develop obesity as adults.  The goal of this project is to make the case that a one penny per ounce excise tax on sugar-sweetened beverages in the New England states will have a positive impact on children’s health, generate revenues and reduce health care costs in the long-run.

Sugar-sweetened beverages (SSBs), also called soft drinks, include non-alcoholic beverages containing any amount of caloric sweeteners and less than 100% fruit juice.  These beverages tend to be calorie-dense, nutrient-poor, inexpensive, abundant and heavily marketed to children.  In fact, studies have shown that people compensate less well for liquid calories than from solid foods. Sugar-sweetened beverage consumption has been on the rise, accounting for up to 15% of calories consumed by children and adolescents. 

Methods:       

A first step in this project was to define the tax and the products to be taxed.  Reliable scientific evidence was also necessary to determine whether sugar-sweetened beverage consumption contributed to obesity, worse health outcomes and that a tax would impact consumption.  With guidance from the New England Alliance for Children’s Health (NEACH) staff, an extensive literature search, review, and analysis was performed to tackle these issues.  In addition, advocacy organization websites and newspaper articles were reviewed thoroughly.  Key informant interviews were conducted to discuss the political feasibility of such a tax, public opinion polls, and other states’ attempts at implementing a similar tax policy.  Findings are currently being prepared as policy briefs to present to NEACH partners.  After gaining partner support, the next steps will be to fundraise, form coalitions, campaign, and obtain political allies in order to move this tax policy forward.  

Conclusion:   

It is well known that obesity causes are multi-factorial and prevention requires a multifaceted approach, however, a sugar-sweetened beverage tax is a promising policy option for improving children’s health.  A thorough review of the literature showed that there is a clear link between sugar-sweetened beverage intake and obesity. Furthermore, scientific evidence points to an association between sugar-sweetened beverages and the risk for diabetes, heart disease and hypertension.  The price elasticity of sugar-sweetened beverages also suggests that a threshold price increase will decrease consumption.

While opponents claim that this tax will hurt low-income and minority populations because it is a regressive tax, research suggests that these populations may in fact benefit from such a policy as obesity affects these populations disproportionately and these beverages provide no nutritional value.  Using revenues to subsidize healthy food and beverage alternatives in disadvantaged communities will yield additional benefits.  Like alcohol and tobacco taxes, a tax on sugar-sweetened beverages will lead to decreased consumption, improved public health, and generate revenues which can be earmarked for childhood obesity prevention initiatives.  

Preceptor and Sponsoring Agency:

Amy Rosenthal, M.P.H., M.P.A., Senior Policy Analyst, Community Catalyst; Program Leader, New England Alliance for Children’s Health (NEACH)