How­ev­er, the debate over whether to tax or not to tax is noth­ing more than a dis­trac­tion from the under­ly­ing prob­lem. It might edu­cate con­sumers or mar­gin­al­ly influ­ence buy­ing habits, but it’s still just a band-aid, allow­ing Amer­i­cans to heap blame on those who ​“chose poor­ly” with­out chal­leng­ing deep­er sys­tems of inequal­i­ty that afflict mar­gin­al­ized com­mu­ni­ties. It’s true — con­sumer choice heav­i­ly influ­ences obe­si­ty rates. But for low-income and minor­i­ty com­mu­ni­ties, who make up a large por­tion of America’s obese, the prob­lem isn’t an unwill­ing­ness to make good choic­es, but the absence of choice in any form.

Not every­one approves of this approach. The sug­ar tax has drawn crit­i­cism from pub­lic health offi­cials and jour­nal­ists alike. Some claim that it dis­pro­por­tion­al­ly tar­gets low-income com­mu­ni­ties. Oth­ers say it just won’t work . Mark Belle­mare, assis­tant pro­fes­sor of applied eco­nom­ics at the Uni­ver­si­ty of Min­neso­ta, pre­dicts the tax will result in a mea­ger a 0−2.6 per­cent decrease in soda and sug­ary bev­er­age consumption.

In the bat­tle to com­bat obe­si­ty and its asso­ci­at­ed health risks, there’s a new sher­iff in town: the sug­ar tax. In response to an omi­nous rise in rates of heart dis­ease and dia­betes, more than 43 cities have attempt­ed to levy a tax on soda and oth­er sug­ar-sweet­ened bev­er­ages. A soda in Berke­ley, Calif., is now taxed at a pen­ny per-ounce. In Mex­i­co, the rate is as high as 10 percent.

Nation­wide, both envi­ron­ment and income lev­el are strong­ly cor­re­lat­ed with the abil­i­ty to engage in healthy behav­iors — and there­fore, with obe­si­ty. A recent study from the Food Research and Action Cen­ter empha­sizes this rela­tion­ship, impli­cat­ing the dearth of gro­cery stores, the lack of time and resources to exer­cise, and the junk food mar­ket­ing cam­paigns that direct­ly tar­get low-income com­mu­ni­ties as core com­po­nents of the obe­si­ty epidemic.

Slap­ping a sug­ar tax on this prob­lem ignores its inher­ent com­plex­i­ty, allow­ing offi­cials to claim that they are doing their part with­out address­ing the press­ing under­ly­ing ele­ments. When famed UK health advo­cate Jamie Oliv­er cham­pi­oned a sug­ar tax to Britain’s House of Com­mons Health Com­mit­tee, he argued that the tax would be the ​“sin­gle most impor­tant change” that could be made in the fight against child­hood obe­si­ty, neglect­ing to con­sid­er oppor­tu­ni­ties for more sub­stan­tive reform. While sim­i­lar ini­tia­tives occa­sion­al­ly address socioe­co­nom­ic fac­tors, their over­whelm­ing focus on tax­a­tion nev­er­the­less encour­ages the notion that a sur­face-lev­el solu­tion will suffice.

This sim­ply isn’t true. Solv­ing the obe­si­ty epi­dem­ic will require major struc­tur­al changes, rang­ing from the inte­gra­tion of health­i­er options in low-income com­mu­ni­ties to stricter reg­u­la­tion of the cor­po­ra­tions that pro­duce such lethal products.

Yet this sum­mer, Philadel­phia became the newest sub­scriber to the sug­ar tax phi­los­o­phy. On June 16, the City Coun­cil approved a 1.5 cent-per-ounce tax on sug­ary drinks and diet sodas. While pro­po­nents her­ald­ed the tax as a pub­lic health vic­to­ry, the results of pre­vi­ous ini­tia­tives cast fur­ther doubt upon their opti­mism. Although Mexico’s soda tax ini­tial­ly low­ered rates of soda con­sump­tion by 1.9 per­cent, the mar­ket has since expe­ri­enced a turn­around. By some esti­mates, soda con­sump­tion has now exceed­ed pre-tax lev­els, putting con­sumers at an even high­er risk for con­tract­ing obe­si­ty-relat­ed dis­eases than they were before the tax was imple­ment­ed. It’s clear that in the absence of seri­ous reform, the wound under­neath will con­tin­ue to bleed.

Fat in Philly

Philadelphia’s efforts to com­bat obe­si­ty first made head­lines in 2001, after Men’s Health mag­a­zine had recent­ly named Philadel­phia the ​“fat­test city in Amer­i­ca” and then-may­or John Street decid­ed to take action. Street set his city a lofty goal: lose 76 tons in 76 days. Team­ing up with an army of doc­tors, pub­lic health experts and celebri­ty fig­ures, he launched the ​“76 Tons of Fun” ini­tia­tive, a pletho­ra of city-wide health and fit­ness pro­grams that ranged from free exer­cise class­es to veg­e­tar­i­an cook­ing demon­stra­tions. In total, Street recruit­ed over 26,000 participants.

Unfor­tu­nate­ly for Street, ​“76 Tons of Fun” didn’t make a dent. Street nev­er dis­closed the results of his ini­tia­tive but, nine years lat­er, a CDC study report­ed that 60.1 per­cent of Philadel­phi­ans were still over­weight or obese.

A map of obe­si­ty in Philadel­phia where the CDC reports near­ly 70 per­cent of chil­dren in North Philly are over­weight or obese. (Image: RTI Inter­na­tion­al / philly​mag​.com)

In 2010, May­or Michael Nut­ter pro­posed a new plan: a 2 cent-per-ounce soda tax. This tax, he hoped, would dis­in­cen­tivize con­sumers from buy­ing unhealthy drinks while simul­ta­ne­ous­ly rais­ing cru­cial rev­enue for city infrastructure.

Unsur­pris­ing­ly, the Amer­i­can Bev­er­age Asso­ci­a­tion (ABA) respond­ed with fury. Giv­en that high-fruc­tose corn syrup, one of the ABA’s most prof­itable — and most dan­ger­ous — sweet­en­ing agents, was to be includ­ed in the tax (along with myr­i­ad oth­er corn-based sweet­en­ers), Philadelphia’s pro­pos­al posed a threat to the industry’s prof­it mar­gin. Between 2010 and 2016, the ABA spent over $5 mil­lion in Philadel­phia adver­tis­ing against the pro­posed tax, claim­ing that it would be inef­fec­tive in reduc­ing the city’s long-term obe­si­ty rates.

When pro-tax advo­cates final­ly claimed vic­to­ry this June, Nut­ter cel­e­brat­ed via Twit­ter, con­grat­u­lat­ing cur­rent may­or Jim Ken­ney on the vic­to­ry. ​“It was the right thing for Phi­la when I pro­posed it 5+ years ago,” he wrote, ​“& it’s right today!”

Although moti­vat­ed by prof­it, the ABA’s con­clu­sion is cor­rect. In Arkansas, where a sug­ar tax has been on the book for decades, obe­si­ty rates con­tin­ue to rise at an alarm­ing pace. Between 2011 and 2014, they jumped from 30.9 per­cent to 35.9 per­cent. In West Vir­ginia, a state with sim­i­lar leg­is­la­tion, they have grown from 32.4 per­cent to 35.7 per­cent. While this increase can’t direct­ly impli­cate the sug­ar tax, one thing is clear: it isn’t the ​“mag­ic bul­let” solu­tion its pro­po­nents promised.

Con­sid­er­ing these sta­tis­tics, how could so many elect­ed offi­cials get it wrong? Unfor­tu­nate­ly, they’re work­ing with a fun­da­men­tal­ly flawed log­ic. When con­sumers lack both super­mar­kets with healthy alter­na­tives and time to pre­pare their own food, and are the pri­ma­ry tar­gets of junk-food mar­ket­ing cam­paigns, incen­tiviz­ing bet­ter choic­es won’t change much. To begin to curb obe­si­ty rates, leg­is­la­tion must tar­get the con­text — the obe­si­ty induc­ing envi­ron­ments that cat­alyze these choic­es in the first place.

Choice vs. context

In a world where many still believe in the effi­ca­cy of choice-based pub­lic health cam­paigns, food jus­tice advo­cate Julie Guth­man is among the less devout. Guth­man links our cul­tur­al obses­sion with ​“choice” with the rise of neolib­er­al­ism, which asserts that we are all inde­pen­dent actors in the mar­ket­place, and that our health is a direct con­se­quence of our choice. Envi­ron­ment? Irrel­e­vant. Socioe­co­nom­ic sta­tus? An excuse. In the neolib­er­al world, we all get a cake, we all get an apple, and it’s up to us to decide out of which to take a bite.

Fol­low­ing this log­ic, the soda tax makes sense. As long as we are incen­tivized to make bet­ter choic­es, noth­ing should stop us from slim­ming down. Right?

The data from Arkansas and West Vir­ginia says oth­er­wise. And despite the reign of con­sumer-choice ide­ol­o­gy in recent years, Amer­i­ca is get­ting fat­ter in almost every state. In 2011 – 2012, the CDC report­ed that 34.9 per­cent of adult Amer­i­cans were obese. By 2014, that num­ber had risen to 37.7 per­cent, and there’s no evi­dence that it will fall any time soon. Graph show­ing preva­lence of obe­si­ty among adults aged 20 and over, by sex and age in the Unit­ed States from 2011 – 2014. (Image: CDC) Guth­man offers a dif­fer­ent solu­tion. In her 2006 book Weigh­ing In, she notes:

The absence from pub­lic dis­cus­sions of acknowl­edge­ment that our food sys­tem is part of a polit­i­cal econ­o­my that sys­tem­at­i­cal­ly pro­duces inequal­i­ty … instead pro­mul­gat­ing the notion that edu­ca­tion will change how peo­ple eat — and thus trans­form the food system.

The inequal­i­ty Guth­man cites is the key fac­tor in the obe­si­ty epi­dem­ic. The largest con­sumers of sug­ar-sweet­ened bev­er­ages are poor and peo­ple of col­or. Out of all demo­graph­ics, black women who earn less than 130 per­cent of the pover­ty line have the high­est rates of obesity. Despite what neolib­er­al advo­cates want us to believe, choic­es aren’t made in a socioe­co­nom­ic vac­u­um. We know that poor peo­ple aren’t poor because they’re lazy. We under­stand the var­i­ous struc­tur­al forces that con­tin­ue to mar­gin­al­ize the mar­gin­al­ized. Sim­i­lar­ly, poor peo­ple aren’t fat sim­ply because they make bad choic­es. It’s because choic­es are con­strained by socioe­co­nom­ic contexts. Debat­ing the effi­ca­cy of the soda tax fails to address the struc­tur­al vio­lence that draws low-income com­mu­ni­ties into this vicious cycle of processed food, obe­si­ty and pover­ty. Edu­ca­tion doesn’t work if 2.3 mil­lion U.S. house­holds with­out a vehi­cle live more than a mile from the near­est gro­cery store. These house­holds don’t have access to the prover­bial apple that neolib­er­al­ism sug­gests. If all that’s avail­able is the cake, can we real­ly blame peo­ple for eat­ing it?

A new solution

If con­sumer-choice ini­tia­tives won’t work, what will? As Guth­man sug­gests, com­pre­hen­sive reform is cru­cial. If gov­ern­ment and pub­lic health offi­cials are to expect at-risk com­mu­ni­ties to make bet­ter choic­es, they must ensure that these choic­es are accessible.