Nutrition and Obesity Policy Research & Evaluation Network: Policy context of sugar-sweetened beverage and water access in Massachusetts and Boston

Background: Consumption of sugar-sweetened beverages (SSBs) is associated with excess weight gain in children and adolescents. Access to low-cost, healthy beverage alternatives, including water, may be limited by federal, state, district or agency/organizational policies and practices. Methods: We surveyed school, local, state and federal policy frameworks shaping current SSB and tap water availability in Boston's school and city agency settings via interview, legal review, document review and site audits. Results: Recent Massachusetts' legislation, existing public health regulation, school district policy and local plumbing code influence access to water in school settings. Statewide, few local school wellness policies (10%) addressed access to free drinking water. Policies more commonly address access to soda (45%) and other sugar-sweetened beverages (34%), though differ in strength of policy provision and in the grades to which they apply. In Boston, 94 of 135 public schools provide their students bottled water rather than plumbed water due to concerns about water quality. SSBs are commonly found within city agencies and on city property. Conclusions/Discussion: Several potential policy-related barriers and facilitators influence access to low-cost healthy beverages in school and community settings. Local and state policy approaches including action in school districts with water quality issues stemming from aging infrastructure, aligning water access in schools with existing plumbing code, prohibiting long term use of bottled water and improved enforcement and funding initiatives may support increased access to a healthier beverage mix. Specific policy efforts to decrease access to SSBs and improve water access on city property are underway.