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Food stamps and sodas: Stanford pediatrician weighs in


Earlier this week, New York City mayor Michael Bloomberg proposed a controversial modification to the food stamp program in his city: He wants to make it impossible to use food stamps to buy sodas.

As the New York Times reported:

The mayor requested a ban for two years to study whether it would have a positive impact on health and whether a permanent ban would be merited.

"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," the mayor said in a statement. "This initiative will give New York families more money to spend on foods and drinks that provide real nourishment."

I asked obesity researcher Thomas Robinson, MD, for his thoughts on the proposal. Robinson directs the highly successful Center for Healthy Weight at Lucile Packard Children's Hospital and recently received a $12.7 million NIH grant to develop better treatments for childhood obesity. Here's what he said in an e-mail:

I think it is great to see Mayor Bloomberg and other city, county and state officials getting creative with ideas to help make it easier for Americans to eat better and become more active. A lot of the most creative and exciting action for public health is occurring at local and state levels. We have seen this in our area in recent years.

It also suggests that public officials are finally understanding that eating and activity behaviors are mostly driven by social and environmental factors, like prices, access and availability, peers, and marketing, rather than solely by will power and personal responsibility.

I am not familiar with Bloomberg's specific proposal or how food stamps are administered in New York so I can't really comment on the particulars. In general, I prefer policies that apply to everyone, not just particular groups like the poor or those on food stamps. However, I think it is very important to try to align the economics and prices with the true costs of unhealthful foods and other products. This argument is accepted with pollution but it is also relevant for food. Right now, sodas, fast foods, and many other unhealthful foods are artificially cheap to buy because their costs to society are not factored into their prices. That is part of the problem, low prices driving people with less money to opt for the least expensive and least healthful foods, presumably part of what Mayor Bloomberg wants to address. Like manufacturers who sell products at a low cost by polluting the environment and not having to bear the costs of cleaning it up, sweetened beverages, fast food and other unhealthful foods are sold at an artificially low cost because they are both subsidized by government and they also do not have to pay the social costs of obesity, diabetes, disability, lost productivity, etc. It would make a lot more sense, and be more consistent with market principles, if the true societal costs of these foods were built into the price. One way to do this is to add taxes, like a soda tax, to raise prices to more realistic levels and to help cover the societal costs. In addition, governments can provide subsidies to lower the prices of fresh fruits and vegetables, to encourage more healthful eating patterns. These approaches provide incentives for the poor, along with everyone else, to eat more healthful foods.

Photo by Takashi Toyooka

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