Sugar-sweetened Beverages are the Largest Single Contributor to the Obesity Epidemic
Initiative to Enhance City’s Nutrition Standards and Eliminate Empty Calories in Government Subsidized Nutrition Program
Governor David A. Paterson and Mayor Michael R. Bloomberg today unveiled an initiative submitted to the U.S. Department of Agriculture by the State’s Office of Temporary and Disability Assistance to exclude sugar-sweetened beverages, the largest single contributor to the obesity epidemic, from the list of allowable purchases through the nation’s food stamp program (also known as Supplemental Nutrition Assistance Program, or SNAP). Under the proposal, City food stamp recipients would continue to receive the same amount of government-funded benefits, but would not be able to use food stamps to buy sugar-sweetened beverages for two years. The initiative is part of the larger citywide strategy to improve nutrition of all New Yorkers. The Governor and Mayor were joined at the Kings County Hospital Diabetes Resource Center announcement by Deputy Mayor for Health and Human Services Linda I. Gibbs, New York State Health Commissioner Dr. Richard F. Daines, New York City Health Commissioner Dr. Thomas Farley, New York City Human Resources Administration Commissioner Robert Doar and Health and Hospitals Corporation President Alan D. Aviles.
“The use of food stamp benefits to support the purchase of sugar sweetened drinks not only contradicts the intent of this vital program, but it also subsidizes a serious public health epidemic,” Governor Paterson said. “We are helping record numbers of low-income families put food on the table, and we are very proud of that accomplishment. But there is clear evidence that low-income individuals have higher rates of obesity and are more at risk of becoming obese than other groups. The serious chronic illnesses related to obesity – diabetes, cancer and heart disease – take a toll on our family, friends and neighbors, but also carry a cost that we all bear, as nearly half of the $147 billion spent nationally on treatment per year is paid by Medicaid and Medicare.”
“In spite of the great gains we’ve made over the past eight years in making our communities healthier, there are still two areas where we’re losing ground – obesity and diabetes,” Mayor Bloomberg said. “We know there is no quick fix to address these issues. That’s why New York City has already implemented a series of programs that bring fresh fruits and vegetables to the communities that need them and set nutrition standards for all meals and snacks the City provides. We have to continue developing new strategies and initiatives to complement what has already been done. And that’s why we are looking to eliminate sugary beverages from allowable food stamp purchases. This initiative will give New York families more money to spend on foods and drinks that provide real nourishment.”
Sugar-sweetened beverages contain large amounts of sugar and are largely devoid of nutritional value. Americans now consume an average of 200 to 300 more calories each day than we did 30 years ago. Nearly half of these calories come from sugar-sweetened drinks, which can contain as many as 16 packets of sugar in a 20-ounce bottle and a staggering 26 packets in a 32-ounce serving. The empty calories from these drinks foster obesity, which was almost twice as prevalent among the City’s poorest households compared to the wealthiest (30 percent vs. 17 percent) last year. Obesity is the key risk factor for type 2 diabetes, which is also twice as prevalent among the City’s poorest residents as its wealthiest (14 percent vs. 7 percent being diagnosed with the condition). Obesity-related illness costs New York State residents nearly $8 billion, $770 per household, in medical costs each year. More than half of adults (57 percent) in New York City are overweight or obese, and diabetes causes more than 22,300 hospitalizations annually among them – nearly half (46 percent) of those hospitalized live in low-income neighborhoods.
The obesity epidemic is also taking a toll on children. In New York City, close to 40 percent of public school students in kindergarten through 8th grade are overweight or obese. The figure is 46 percent for Hispanic students and 40 percent for black students. If this pattern continues, the next generation of New Yorkers could face increases in many chronic diseases, including heart disease – the number one killer in New York City.
Since its introduction in the Federal Food Stamp Act of 1964, the program’s intent has been to “provide for improved levels of nutrition among low-income households.” This proposal reflects the USDA’s own approach to the National School Lunch/School Breakfast Program, which already includes only healthier foods and does not include sugar-sweetened beverages. USDA’s Women, Infants, and Children (WIC) program also has never allowed the purchase of sugar-sweetened beverages with WIC benefits.
Food stamp users are already prohibited from using their benefits to purchase some unhealthy items like alcohol and cigarettes. This new proposal seeks permission from the USDA to assess the effect of a temporary modification to the list of allowable food items to be purchased with food stamps in New York City. The proposal for this initiative will not affect the total benefits received, but by cutting out sugary drinks it would increase the amount of money available for more nutritious foods and beverages.
Unfortunately, poorer children – who are the primary beneficiaries of the food stamp program – are more likely to be overweight, and the link between obesity and socioeconomic status has become stronger in the past two decades. In 2009, New Yorkers with the lowest income were most likely to consume one or more sugar-sweetened beverages a day (see attached map), and did so at a rate almost double that of New Yorkers with the highest incomes (38 percent vs. 19 percent). A child who consumes one sugary drink a day has a 60 percent higher risk of obesity, than those who do not.
In September 2010, there were 1.7 million New York City residents receiving food stamp benefits – out of 2.9 million food stamp beneficiaries statewide – to supplement their nutritional needs. According to data from the USDA, 6 percent of nutrition assistance benefits nationwide, approximately $75 to $135 million here in New York City, are used to purchase sugar-sweetened beverages.
Stopping the food stamp program’s subsidy of sugary beverages would enhance the City’s comprehensive approach to reduce the consumption of sugar-sweetened beverages citywide, and complement the City’s extensive efforts to increase access and consumption of healthy foods in the neighborhoods that need them most. These efforts include educating food stamp recipients about healthy eating habits through the New York State Eat Smart New York Program; the Health Bucks program, which provides a financial incentive for food stamp beneficiaries to purchase fruits and vegetables in farmers markets; the Green Carts program, which has already placed 450 produce carts in New York City’s poorest communities; the Healthy Bodegas and Stellar Farmers Market programs, which educate corner store owners and consumers in low-income neighborhoods on fruit and vegetable storage and preparation, and the nation’s first nutrition standards which guide the City’s 225 million publicly financed meals and snacks served in schools, afterschool programs, daycare centers and senior centers. The City also supported Governor Paterson’s proposal to increase the taxes on sugar-sweetened beverages.
Similarly, the State has also pioneered the use of fresh fruits and vegetables in its Women, Infants, Children (WIC) nutrition program, increased access to healthy foods in underserved communities and invested in local efforts to prevent obesity, type 2 diabetes and other chronic diseases in areas where people live, work and play.
For the purposes of this proposal, sugar-sweetened beverages are defined as those containing more than 10 calories per 8 ounces (except fruit juices without added sugar, milk products and milk substitutes). A 12 ounce soda, for example contains 150 calories and the equivalent of 10 packets of sugar, without any other nutrients. The amount of calories consumed by drinking 12 ounces of soda a day can increase a person’s weight by 15 pounds a year.
All food stamp recipients receive their benefits through an Electronic Benefits Transfer (EBT) system that allows them to purchase eligible items using an EBT debit card. All retailers who accept Food Stamp benefits use the EBT system and most already program their systems to automatically determine whether items scanned for purchase are allowed under program guidelines. After securing approval from USDA, the City will conduct a public information campaign to ensure that retailers and benefit recipients are notified of the new policy. A rigorous evaluation will also be conducted to determine if the initiative results in fewer purchases of sugar-sweetened drinks, and assists in combating the associated health effects.
The following statements were provided in support of excluding sugary beverages from food stamp purchases in New York City:
State Health Commissioner Richard F. Daines, M.D., said: “We continue to see a dramatic rise in obesity among children, especially in low-income communities. This initiative targets a major public health threat – the high consumption of sugary beverages – which have little to no nutritional value. Good nutrition is vital for a child’s growth and development, and I am pleased that New York is taking steps to ensure that families consume nutritious foods that promote good health, not obesity and a lifetime of serious health problems associated with it.”
Kristin Proud, Deputy Secretary for Human Services, Technology and Operations, who is currently overseeing the State Office of Temporary and Disability Assistance, said: “At a time when we are seeing a record number of people seeking help in providing for their, and their families,’ nutritional needs, it is vital that we ensure this assistance is not being used to undermine their health. Sugar-sweetened beverages are a major contributor to obesity, and although federal food assistance policy increasingly has emphasized nutrition, this epidemic and its related health problems continue to worsen. We are confident these steps will result in more nutritious foods being consumed by the families and individuals served by the Food Stamp program in New York City.”
New York City Deputy Mayor Linda Gibbs said: “Sugary drinks are the single largest contributor to the obesity epidemic, and these beverages are affecting our children and families now more than ever. This initiative will expand our efforts to make healthy food the default option in our City and help reduce the burden of diabetes in our poorest communities.”
New York City Health Commissioner Thomas Farley, M.D., said: “The twin epidemics of obesity and diabetes are taking a toll on our country, and on New Yorkers,” “The good news is now we know more than we did before about what is fueling these epidemics, and sugar-sweetened beverages are major contributors. The City is working to encourage residents to take sugary drinks out of their everyday diets. This proposal will complement the many other steps we are taking to slow the epidemic by supporting a healthier diet for everyone.”
New York City Human Resources Administration Commissioner Robert Doar said: “The food stamp program is one of our nation’s great achievements, but it can always be improved. By excluding unhealthy, sugary drinks from the list of items allowed to be purchased with food stamp benefits, the program will come closer to meeting its goal of being a nutritional assistance program. Government should not be in the business of subsidizing poor health habits that end up costing taxpayers through higher Medicaid and Medicare costs.”
Alan Aviles, President of the Health and Hospitals Corporation (HHC), said: “Diabetes has reached epidemic proportions in New York City, and HHC hospitals and community health centers are battling the disease on many fronts. We care for more than 56,000 adults with diabetes and thousands more children and adolescents who are at the verge of the disease. We see too many cases of patients with heart attacks, kidney failure, blindness, and amputations as a result of complications from obesity related illness. By encouraging more families to choose healthier dietary options and avoid sugary drinks, we can address some of the adverse effects of diabetes which threatens the long term health status of whole communities, and increases the long term healthcare costs for our society at large.”