Challenging Dogma - Spring 2008

...Using social sciences to improve the practice of public health

Tuesday, April 22, 2008

Fast Food Tax: Economic Coercion and the Obesity Epidemic – Nicole Tinkey

In response to the increasing number of Americans suffering from obesity, some states have contemplated levying a tax on fast food (1). Supporters of fast food taxes argue that implementing an economic disincentive to purchasing fast food will lead to lower rates of fast food consumption, and ultimately, lower rates of obesity (1). The argument in favor of a fast food tax is too simplistic, however, because it overlooks the complex interaction of social and economic circumstances that drive obesity in the United States.

Taxing fast food will not economically pressure low-income consumers into eating more nutritious foods.
Taxes on fast food overlook many of the social factors that lead people to consume fast food in the first place. An individual makes food choices based on “taste, convenience, family structure and traditions, [and his/her] age, health status, knowledge, and lifestyle” (2). Unsurprisingly, studies have shown that the taste of food is an important factor influencing individual food choices (3). In a survey of low-income mothers, women reported that one reason they refrained from buying vegetables was because they did not know how to prepare vegetables “in ways that tasted good” and preferred other foods to vegetables (3). Many women were reluctant to buy vegetables because they lacked sufficient space in their homes to store fresh and frozen vegetables (3). Importantly, women also reported that cooking vegetables for meals was inconvenient and time-consuming (3). Over the past few decades, the demand for “convenience food” has increased as American women have worked increasingly longer hours outside the home (4). The association between the demand for convenience food and hours worked outside the home is particularly strong for women in low-income populations (4). One study concluded that because “[working] mothers have less time for cooking . . . children from low-income households are more likely to eat in fast food restaurants” (4). In addition, despite the fact that most fast food is consumed by people in low-income populations, some studies indicate that fresh foods are actually less expensive than fast food (5, 6). This suggests that disadvantaged individuals do not choose fast food over fresh foods simply because fast food is a more cost-efficient option (5). If cost-efficiency were the driving force behind food choice in low-income populations, disadvantaged individuals would be consuming more fresh foods than fast food – and this is clearly inconsistent with consumer behavior in low-income populations (7). The economic burden imposed by a fast food tax (usually only a few additional cents per item) will probably not be a significant enough cost to outweigh the perceived benefits of fast food to its most frequent consumers (1). Therefore, raising the price of fast food is not likely to compel people in low-income populations, who consume the most fast food, to stop purchasing fast food.

Fast food taxes fail to address issues surrounding access to nutritious food.
Fast food taxes can only successfully combat obesity if people who are deterred from purchasing fast foods replace these with healthy alternatives. Problematically, poor people, who consume the most fast food and are the most likely to suffer from obesity (5), may not have access to healthy food alternatives. People in low-income populations report an “inability to access healthy and nutritional food, particularly fresh fruits and vegetables” (5). Low-income areas are far less likely to have supermarkets than higher income areas (7). In addition, food outlets in low-income areas have a limited variety of food choices and are much less likely to offer nutritious food options than supermarkets in high-income areas (5, 7). Because disadvantaged individuals are often unable to visit supermarkets because of lack of transportation (5), food shopping may be entirely restricted to local food outlets. It is not surprising then that people living in low-income areas are more likely to consume “energy dense food, composed of refined grains, added sugars, and fats that represent the lowest cost options available to people [living in low income areas]” (5).
In the absence of programs that make nutritious food choices more accessible to habitual fast food consumers, fast food is more likely to be replaced with other high-calorie, low-cost foods that are readily available in low-income food outlets (5,7). As one study succinctly concluded, “Without a change in access to [nutritious] foods, individuals cannot change their eating behaviors” (5). Because fresh, nutritious foods are unavailable to many habitual fast food consumers, a fast food tax is not likely to result in people replacing fast food with healthier food choices.

Fast food taxes are under-inclusive and fail to discourage a wide range of poor food choices.
Studies of food economics have demonstrated that “the increase in the price of a food tends to drive consumption away towards its substitutes” (1). Thus, a fast food tax is likely to drive consumers to purchase foods that readily replace fast food – foods which are convenient, inexpensive, and calorie-dense. In order for a food tax to impact unhealthy eating habits, the base of taxable foods must be “sufficiently broad to induce better choices” (2). In other words, a decline in consumption of fast food will be accompanied by an increase in consumption of unhealthy substitute foods unless substitute foods are also taxed and made less attractive to consumers (1). Problematically, many food establishments offering unhealthy foods will evade taxation because they are not traditionally classified as fast food. While restaurants like McDonalds and Burger King seem to clearly fall within the realm of fast food, pizza parlors and take-out Chinese restaurants are more questionable (8). Family style restaurants and sit-down chain restaurants will also escape the fast food tax although many of these are notorious for offering high-fat, high-sugar foods in oversized portions (8). A fast food tax will also fail to reach snack foods and calorie-dense convenience foods. Thus, while the object of a fast food tax is to provide an economic disincentive to consuming unhealthy foods, it will not curb consumption of unhealthy food at a number of establishments that will not be subject to the tax. If prices at some restaurants increase, fast food consumers may simply be driven to eat at different, but equally undesirable, establishments.

A fast food tax is intended to combat obesity through providing an economic disincentive to fast food consumption. In order to succeed, the tax must effectively deter people from purchasing fast food; at the same time, nutritious, weight-loss promoting foods must replace fast food in people’s diets. Unfortunately, a fast food tax is unlikely accomplish either of these goals. People consume fast food for a number of reasons (3): besides being inexpensive, fast food is tasty, convenient and ubiquitous. A fast food tax fails to address these important social considerations. Tired, working mothers are not likely to be motivated to cook healthy, vegetable-based meals for their families because the price of fast food increases by a few cents. Moreover, studies show that even if people were inclined to replace fast food with fresh fruits and vegetables, many living in low-income communities may simply not have access to these healthier alternatives. Thus, the most likely effect of a fast food tax is to increase the consumption of unhealthy substitute foods among people who formerly purchased fast food.

1. Schmidhuber J. The Growing Global Obesity Problem: Some Policy Options to Address It. Journal of Agricultural and Developmental Economics 2004; 1:272-290.
2. Crutchfield SR, Golan E, Kutcher F, Variyam JN, Obesity Policy and the Law of Unintended Consequences. Amber Waves 2005; 3:26-33.
3. Sisson A. Fruit and Vegetable Consumption by Low-Income Americans. Nutrition Noteworthy 2002; 5:1-5.
4. Chou S. An Economic Analysis of Adult Obesity: Results From the Behavioral Risk Factor Surveillance System. The Economics of Obesity 2002; 1:10-13.
5. Sutton E. Obesity, Poverty, and the Case for Community Supported Agriculture in New York State. Hunger Action Network of New York State 2005; 1:1-8.
6. Raynor HA. A Cost-Analysis of Adopting a Healthful Diet in a Family-Based Obesity Treatment Program. J Am Diet Assoc 2002; 5:645-56.
7. Baker, EA. The Role of Race and Poverty in Access to Foods That Enable Individuals to Adhere to Dietary Guidelines. Preventing Chronic Disease 2006; 3:1-11.
8. Kuchler F. Taxing Snack Foods: What to Expect for Diet and Tax Revenues. Current Issues in Economics of Food Markets 2004; 1:1-12

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