Policy to reduce consumption is ‘crucial’
The Commonwealth Healthcare Corp. is in favor of adding taxes on sugar-sweetened beverages and sugar-sweetened concentrate in the CNMI, saying that policy actions to reduce consumption levels of these products are crucial to the health of the population and that it does not remove choices.
In a letter of support sent to the Senate last February, CHCC said it is “in full support of the intent” of H.B. 19-99 HD4 or “To assess a Health Impact Tax on Sugar-sweetened beverages, sugar-sweetened concentrate, for the prevention and control of non-communicable diseases in the Commonwealth; to create a special health impact account.”
“Swift policy action to reduce consumption levels of sugar-sweetened beverages is crucial to the health of our population,” CHCC chief executive officer Esther Muna said.
The letter stated that although the “sugary drink culture is only a recent trend in the context of the long history of the Northern Mariana Islands,” the culture “promotes the consumption of these beverages and market relentlessly, especially to children.”
“We are inundated by a ‘culture’ of sugary drinks created by the beverage industry,” Muna said.
Muna said the bill does not remove choices and as the government is responsible for protecting the health of the public action must be taken “when products which detriment our health, like sugary drinks, are marketed to children and sold cheaply in our community.”
“Critics of health policies that are designed to change health behavior often use acrimonious terms like ‘nanny state’ to suggest government overreach into personal choice. This bill does not remove choices, but makes choosing healthier options more likely,” Muna said.
She added that the health of the population of the CNMI has declined rapidly as a “result of the ubiquity, high palatability, and low-cost of unhealthy food items such as sugar-sweetened beverages.”
Muna said that while education is important, awareness alone won’t change the “everyday behavior on the massive scale.”
“In order to help our residents make better lifestyle choices, the healthy choice needs to be the easy choice,” Muna said.
“When unhealthy beverages are cheap, frugal consumers save money at the cost of their own health. Historically, public health interventions have focused on changes to the behavior of individuals, but healthy living is the result of a variety of factors which influence health behaviors,” she added.
Public policies, Muna said, as well as interpersonal dynamics, organizational, and community policies are very important in determining the behaviors of individuals and their exposures to risk.
Healthy choice, funds for prevention
Citing a conceptual framework for public health action which “highlights the high population impact of interventions that change the environmental context to make healthy options the default choice,” Muna said such a tax as what is proposed by HB 19-99 will bring down consumption.
“A tax on sugar-sweetened beverages brings down consumption levels, incentivizes distributors and retailers to stock healthier beverage options, and has the potential to change our beliefs, attitudes and norms about sugary drink consumption,” Muna said.
Muna noted that science has clearly stated that sugary drinks are bad and that its consumption is not only strongly associated with obesity but is also related to chronic conditions such as type 2 diabetes, obesity, and heart, liver, and dental diseases.
Consuming a can or two of sodas per day can increase the risk of diabetes by 26 percent, she said.
“As an added benefit, a tax on sugary drinks raises much-needed revenue for diabetes prevention and management programs, opens up a funding source for local groups who want to take steps to improve health in their communities, and supports the CNMI’s safety-net healthcare provider, the CHCC,” she added.
The latest amendment to the bill as introduced by the Senate Committee on Health and Welfare and who recommended the passage of the bill, dealt mostly on the appropriations of the funds that would be collected—an estimated $6.8 million based on the current tax of $0.005 per fluid ounce on soft drinks alone that generated approximately $849,4000 in 2015.
The Senate broke down the taxes collected as follows: 60 percent of the taxes collected will go to the diabetes maintenance programs and the community health grants under the hospital, 10 percent for the CNMI Medical Referral program, 10 percent for PSS health education and drug-free programs, 10 percent to Customs to support enforcement, and 10 percent to the general fund.
“The CNMI is positioned to become a leader in health policy in the Pacific region and we hope to see the Senate send the message that good nutrition and the health of our population is crucial to the welfare of the Commonwealth by passing this bill,” Muna said.