A sugar sweetened beverage excise tax health impact assessment (HIA) for Maine

Maine is a largely poor and rural state and obesity costs the state in excess of 1 billion dollars annually. Large disparities in obesity are seen between racial and ethnic minority populations, those at lower income and educational levels, and the white majority. Although public health advocates had worked to describe the potential improvements in health from a Sugar Sweetened Beverage tax, no prior comprehensive assessment had been completed to help make the connection. Maine specific data plays an important role in helping elected officials decide whether and how to move forward with a policy. During all phases of this HIA, we obtained input from a broad group of stakeholders to determine the value and limitations of a SSB tax as a policy option. In the scoping stage we identified the risks and benefits and who may be affected; in the assessment phase we identified key sources of information and resources to analyze and interpret the data; in the recommendations phase we crafted language for legislation and potential alternatives; in reporting we identified stakeholders interested in the results and how those would be disseminated. Finally, we propose evaluating the HIA using the Re-AIM framework. The completion of the HIA coincides with the start of the 126th legislative session and will inform crafting of SSB tax legislation, if appropriate. The process of conducting the HIA helped ensure a non-partisan approach to building support for legislation to promotes health and minimize the risk for harm.