Friday, October 29, 2010

NYC Soda Ban, Revisited


I've been thinking about my comments on this blog regarding the NYC soda ban, and while I enjoy nerding out on paternalistic policy, you may not. You may also think my arguments weren't all that convincing. In composing an e-mail to a good friend I thought of slightly more succinct, conversational and persuasive way to write about this. Here's my email:

I would certainly concede that using SNAP to buy soda is not ideal. As taxpayers, we hope that our money is spent by government agencies and benefit recipients alike in a responsible and efficient manner. However, I think this soda ban is bad public policy because it is based on an overgeneralization of the facts and it, in my opinion, unfairly targets food stamp users for what I believe will be a very small effect on obesity in NYC. Here's why:

1. Though BMI and income are negatively correlated, USDA studies show that there is no credible evidence that food stamp users are more obese than comparable low-income shoppers who do not use food stamps. There is no good reason for targeting food stamp users over other low-income consumers except for the (decidedly undemocratic) reason that we can because we control the purse strings.
2. Though studies show that 6% of food stamp dollars go to purchase soda, there is no evidence that this is a higher than the percentage of food dollars comparable low-income families spent on soda. Again, targeting food stamp users over other low-income families is not justifiable.
3. Food stamp participant households stay on the program an average of 9 months. A 9-month soda ban will have no appreciable effect the BMIs of affected family members.
4. We don't know what a soda ban will do to food purchasing habits. Has anyone done any research on what types of foods food stamp users would buy instead of soda? I'm not aware of any study, for example, that compares food stamp users' food purchases before the stimulus SNAP bump and after. If we think food stamp users are incapable of or unwilling to make healthy choices without this ban, then shouldn't we also assume they'll substitute toward twinkies or ice cream or the coffee to get that nutrient-free caffeine fix? By the way, if the ban is not about obesity (which it is...), but rather just about the public expense of "non-food" items, then why isn't anyone talking about banning the purchase of those big red buckets of Folgers coffee?
5. The average SNAP benefit per person per week is about $30. 6% of $30 is $1.80. Do we really think that banning $1.80 worth of soda and encouraging (read: gambling on) a $1.80 purchase of fresh fruits or vegetables is really going to make people less obese?
6. Most food stamp participant households spend out-of-pocket monies on food to supplement their too-low food stamp budget. How much of that supplemental food budget is spent on soda? If we force non-soda purchases with food stamps, will people simply increase soda purchases with their out-of-pocket monies and buy non-soda items normally purchased with out-of-pocket money with food stamps? I wonder if food buying habits are a zero-sum game, so to speak.

For the above reasons, I would guess that the cost-benefit calculus just doesn't add up. We're talking about costs in city, state and federal staff time, costs to combat the soda lobbies, costs to determine and fight about what constitutes a "soda", costs to re-educate food retailers on SNAP regulations, and more abstract costs in preventing utility maximization by food stamp users, among others...Unless, of course, we think that food stamp users aren't currently maximizing their utility when they purchase soda because they're too stupid, which is a blatantly racist, classist statement, or too misinformed, which is a valid critique of our woefully inadequate SNAP nutrition education programs. And all of that for a negligible effect on obesity and, consequently, on obesity-related health expenditures.

I would also add that the fact that Mayor Bloomberg pursued a general soda tax, which failed in the state legislature, inadvertently admits that a soda ban for everyone, regardless of income, is a far more just and effective policy than a soda ban for food stamp users.

Frankly, the ban pisses me off. I can't make anything of this ban except that it's a purely political move to appear to be making good on a promise to reduce obesity in the city, all the while sidestepping the legislative process because it rejected a soda tax that might make voters--middle and high income people--mad. There are far better ways to reduce obesity--at least the soda tax would have generated some revenue for the city!

I clearly have a pretty strong stance on this, what do you all think? You could pretty easily avoid dealing with any of my objections if you said that (1) the ban is just about public purchase of non-food items and not primarily about obesity reduction, and (2) that you'd support a food stamp purchase ban on coffee, too. But then I'd invoke the ever-popular slippery slope argument...


I wonder if this re-framing of my thoughts is helpful. Looking for feedback!


Marie

Thursday, October 14, 2010

Food as jewelry: my new obsession

Friends,

There's something you should know about me: I'm obsessed with miniatures (and "megatures", as I call them). Combine that with my obsession with food and you've got the makings for a ridiculous desire to buy jewelry from http://www.etsy.com/shop/PetitPlat?order=price_asc&page=1. I know this isn't policy or social justice-y, but it's about food so it's somewhat appropriate for this blog, right? Anyway, check out a few of my favorites...








Sunday, October 10, 2010

Bloomberg fails to make good public health policy; targets SNAP users instead

I am increasingly disturbed by news out of New York City regarding a recent request from Mayor Michael Bloomberg to the USDA, the federal agency in charge of SNAP (formerly the Food Stamp Program), that soda and other sugar-sweetened beverages be removed from the list of items purchasable with SNAP benefits. (Read more here: http://www.nytimes.com/2010/10/07/nyregion/07stamps.html?_r=1)

FOOD STAMP USERS ARE NO MORE OBESE THAN EQUALLY POOR INDIVIDUALS

I admit that soda and sugar-sweetened beverages are disproportionately to blame for obesity in our country. It is also true that, roughly speaking, income is negatively correlated with BMI. If you are poor in the US, you are more likely to be overweight and obese. However, the USDA put out an important study of the literature on food stamp use and obesity, finding that studies have NOT conclusively shown that food stamp users are more obese than people with similar incomes who do not receive food stamps. Therefore, it's poverty, not the use of food stamps or factors determining whether a poor family receives or does not receive food stamps, that is causing most of the obesity in our country. Poverty reduces a family's ability to buy healthy food. Poverty reduces a family's ability to live in a neighborhood where the streets are safe for play and where there are parks and community recreation centers. Poverty in a neighborhood reduces incentives for grocers selling healthy, high-quality fruits and vegetables to locate their stores in those neighborhoods. The working poor work more hours (for less money), meaning they cannot make as much time for food shopping and preparation. A number of factors explain the well documented relationship between poverty and obesity. There is no well documented relationship between food stamp use and obesity that also controls for poverty.

The city says it is basing the policy on a recent study showing that a larger than desirable percentage of food stamps are spent on sodas and sugar sweetened beverages. This is indeed an unfortunate finding. I would challenge, however, the idea that food stamp users spend a larger portion of their food budgets on soda than other low-income shoppers. I would challenge this idea that food stamps are a reliable determinant of soda purchasing habits.

For these reasons alone the ban on food stamp purchases of soda does not make good public policy sense. This type of ban only targets part of the population who are so disproportionately burdened by obesity. Those who are poor but not on food stamps but statistically overweight can still buy soda. If the primary objective is reduction in obesity, a ban on purchasing it with food stamps is inefficient. I would also argue that the costs of doing so--monetary costs to retailers and reductions in freedom and ability to meet preferences to food stamp shoppers--are too high.

A SODA BAN IS NOT PERMISSIBLE PATERNALISM

Beyond the inefficiency argument, I can find no just, sensible reason for banning soda purchase to food stamp users. There are two possible arguments in my mind: justifiable paternalism and social cost.

The arguments for justifiable paternalism (a good reason that the state should intervene when we think we're making choices that only harm ourselves) just don't hold up. Possible "good reasons" for paternalism are if the person affected (in paternalism it should only be the decision-maker) is (1) a child; (2) mentally unable to make sound decisions; (3) someone whose ability to make a good decision is compromised by ignorance, deception, duress or clouded faculties. It is wrong to say that food stamp users as a whole, are mentally unable to make sound decisions, so I will not deal with the argument here. There is an interesting argument to be had that the decisions of food stamp shoppers affect children in families that use food stamps. If a parent buys soda for a child, that child does not have the information or autonomy to refuse the soda. I think this is an interesting and possibly valid argument, but does not present a large enough problem to justify a categorical ban on soda purchase with food stamps. There are better ways to tackle childhood obesity. The third idea, that people cannot make good decisions because they do not have enough information is, in my opinion, quite valid. The nutrition education component of SNAP is underfunded and woefully inadequate for educating the massive numbers of food stamp recipients. In this case, however, it is the inadequacy of nutrition education, not the ability of food stamp users to buy unhealthy foods, which is the key issue.

If we wanted to delve deeper into the issue of permissible paternalism, we could think about the nature of people's preferences for soda. We admit that we want to respect people's preferences, but we have to ask some questions about those preferences to be sure that we are respecting the "right" ones. For example, we want to:

  1. Respect relevant preferences. This would say that the decision to purchase soda was made with some false information so people were considering the wrong factors in their personal cost-benefit analyses. We might say that their deeper preference is for good health, not for the taste of Coke, but I think that this concept is a bit too patronizing to consider seriously. While Sprite commercials may be weird (seriously, what's up with those?) and Coke commercials may pull at your domestically inclined heart strings, I don't think anyone thinks drinking soda is about anything other than enjoying something you like the taste of. I think most people's preference for soda, manifest in their purchase of that soda, is constructed with the idea that soda is not that healthy in mind.
  2. Respect people's settled preferences. This concept would claim that the preference for soda is transitory while the preference for health is the "settled preference", the one that comes to light after some time or after an adverse event has occurred as a result of the transitory preference. This has some validity in the case of soda, I think. I would imagine that many men and women with diabetes would prefer to go back and un-drink that soda if it meant that they would not have to deal with diabetes later on in life. However, because there is a de facto and, in many states, a de jure time limit to receiving food stamps, a ban on food stamp purchase of soda does almost nothing to ensure that people respect their own settled preferences in the long run. We come again to the inefficiency and now inadequacy argument.
  3. Respect preferred preferences. People have many preferences for things. For example, in the case of smoking, people may manifest a preference for smoking when they light up a cigarette but may at different times manifest a preference for not smoking when they try, without success, to quit. We could infer that their preferred preference is not to smoke but the addictive quality of tobacco prevents them from respecting their own preferred preference for quitting. The small effect of caffeine addiction (and you can ingest caffeine from other sources) notwithstanding, the addition/"preferred preferences" argument doesn't have much to say about soda.
  4. Respect your OWN preferences. This gets back to the idea that some people have bad information and their manifest preferences actually mirror preferences generated after unconsciously absorbing various types of persuasion. We might be able to make this case about soda, since soda advertising is so ubiquitous, but we cannot make this argument JUST about food stamp users. Everyone is subject to soda advertising, so if we are following false preferences, we are ALL doing so. A food stamp ban on soda doesn't make sense.

THE SOCIAL COST ARGUMENT CREATES A TOO-SLIPPERY SLOPE

The second argument is social cost. Unfortunately, it's a good one. It asks the question, "Why should we allow federal funds to be spent in ways that will increase expenditures on other federal programs?" The social cost (increase Medicaid expenses, for example) doesn't justify the social benefit of food stamp users being able to purchase and consume soda. I can't personally quantify the degree of preference food stamp users have for soda, but I would guess that the preferences of non-food stamp users to avoid taxes for soda-related Medicaid costs would be greater. However, I think that this generates an impossibly slippery slope. Can food stamp users then not purchase red meat due to the fat they may ingest? What about white bread? What about fruit popsicles? What about trail mix with M&Ms? The social cost argument, though theoretically a good one, presents too many expensive, political problems for sensible implementation.

BLOOMBERG ALREADY REVEALED THIS IS A SECOND-RATE POLICY

Furthermore, New York State legislators rejected laws to tax soda for all state residents! I can't help but notice that this law, which is good public policy in that it incentivizes healthier food purchases for ALL PEOPLE and does not categorically ban soda purchases for anyone, was not approved by people who supposedly represent all the state's residents. In response, Mayor Bloomberg made a move not subject to representative decision-making and targeted SNAP users. And why wouldn't he? SNAP users are a disempowered group by virtue of their poverty and by virtue of their use of public benefits. The idea that "beggars can't be choosers", as offensive as this seems to me, I think often prevents people from organizing in a meaningful way around the level of their benefit and, in this case, what their benefit really gets them. It's hard to organize and find a cohesive voice for a group of people who would rather not be in the group in question. I can only imagine that the basic thought process was this: Soda causes obesity and it's too cheap relative to healthier options, so let's tax it! We'll make some money (which we need) and some people will substitute away from soda, which is an added bonus. The state legislature said no? Well, it's really poor people who are obese anyway, so let's target the poor. How can I achieve this, bypass legislative red tape and cause the least amount of political friction possible? Let's ban soda for food stamp users. That targets some of the right people and no one really powerful will make a fuss. Thus, Bloomberg's request to the USDA.

While I support a lot of NYC DHMH policies and progressive ad campaigns, this ban on soda is an unjustifiable, inefficient, hypocritical move and just plain bad policy.

Wednesday, October 6, 2010