Health benefits, particularly in high risk populations, projected from an excise tax on sugar-sweetened beverages intake in California

Consumption of sugar-sweetened beverage (SSB) has risen over the past two decades, with over 10 million Californians now drinking one or more SSB per day. High consumption of SSB increases risk of obesity, diabetes, hypertension, and coronary heart disease (CHD). A penny-per-ounce excise tax has been proposed to reduce SSB intake in California, though the health and cost implications for this diverse state have not been quantified.

We projected the impact of an excise tax on health outcomes among Californians from 2011-2020. We used the CHD Policy Model – CA, an established computer simulation of diabetes and CHD adapted to California. Based on price elasticity estimates, we assumed the tax would reduce SSB intake by 10-20%. We projected avoided cases of diabetes and CHD, along with healthcare cost savings in 2010 US dollars in the total California population and in high-risk subgroups.

Over the next decade, a 10-20% SSB consumption reduction is projected to reduce diabetes incidence by 2.9-5.6% and CHD by 0.6-1.2%. The greatest reductions in diabetes are expected in Mexican American (4.1-8.0%), African Americans (3.9-7.7%), and those with limited income regardless of race/ethnicity (4.0-7.8%). A greater reduction in CHD is also projected in the high-risk subgroups: Mexican American (1.0-2.0%), African Americans (0.9-1.8%), and limited income (0.9-1.9%). We projected $0.5-$1 billion in savings associated with diabetes cases avoided and an additional savings of $65-$130 million from CHD.

A tax-induced reduction of SSB could yield substantial population health benefits and cost savings for California, with high-risk subgroups benefiting proportionately more.