Excessive size: Soda drinks or corporate influence?

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By Dr. Nicole Dubus

Is it a government’s (city, state, or federal) right, ethically or legally, to enforce rules on the size of soft drinks? If one defines ethics as values put into action, then what are the values of a government and what should they be? Recently a judge struck down a proposed limit on the size of sugary drinks sold in New York City (Boston Globe, 3/15/13). Mayor Bloomberg saw the sale of large sugary drinks to be a cause of obesity and therefore saw this issue a public health issue. This battle reminds me of when I was working in a spinal injury floor of a county hospital when the state was trying to pass a helmet law for motorcyclists. On one side are folks who feel that government should value the independence of the individual: the right to make his/her own choices. This side feels that one has the right to drink high sugared drinks and ride without helmets. This group feels that the ethics of the government should be to protect an individual’s right to live freely. Many in this perspective would feel this is true as long as the individual isn’t harming others. They would say that government should keep their hands off of our right to make personal decisions. And what could possibly be more personal than what we choose to put in our bodies and on our heads (except whom we might want to marry, but I digress).

sugarstacksOthers see government ethics to be to uphold the equality, rights, and safety of all of us, especially our most vulnerable. How do sugary drinks relate to these ethics? It brings me back to helmets and working on the spinal injury floor. Most of these patients lay up in hospital beds for weeks, and many for months, were young men between the ages of 18-25. Most of these injuries that resulted in permanent disability were caused by motorcycle accidents and reckless behavior. As the social worker on the floor, it was my job to find them medical coverage and supports that would care for them for many years to come. Their stays were long and expensive. Their rehabilitation was on-going, intensive, and required many teams of specialists. These patients were costly and would continue to be costly for the rest of their lives. Who bore the burden of these costs? State and federal health programs funded by tax dollars. The cost of these young men not wearing a helmet: all taxpayers chipping in more each year. Do you look at a young man of 22 lying in a hospital bed with a mangled spine and tell him that because he chose not to wear a helmet we will not provide him care? Wearing a helmet then becomes not a personal decision but a societal compromise: you can choose to ride a motorcycle, but that freedom comes with responsibility, to yourself and to all of us who may need to care for you.

How does this relate to sugary drinks? Many scientific studies and common sense tells us that sugary drinks drunk in excess (is over 16 ounces excessive?) contribute to obesity, diabetes, poor nutrition. Do we apply the same guidelines to this as we do to helmets and seatbelts? Where do we draw the line? If you don’t take action to reduce your high cholesterol, or to stop smoking, or you don’t exercise, do we look at you and tell you we won’t pay for your medical coverage? Do we charge you extra? Do we accept your individual right to eat poorly, not exercise, smoke, etc… and then pay for your heart treatments, diabetes care, cancer treatments, organ transplants? Let’s look at this with a wider lens, a lens that includes what influences some to make poor decisions in their self-care. Why is obesity 50% more likely in black women and Latinas than white women? Why did the New York Chapter of the NAACP and the Hispanic Federation support the beverage industry in striking down the drink size limit in New York City? Does the fact that the Coca-Cola industry provides $100,000 to the NAACP wellness program, $100,000 to the Urban League, and $150,000 to the National Association of Hispanic Nurses have any bearing? Interestingly, when a penny-per-ounce soda tax measure was proposed in Richmond California, the beverage industry spent $2.5 million to defeat the measure by enlisting the support of the local NAACP  through payments to top black political action groups (Boston Globe, 3/15/13).

Much has been written about food deserts in poor urban neighborhoods, neighborhoods that have corner convenience stores but no low-cost grocery stores. As one who lives near such a store and sees the wrappings of snack foods and soda bottles littered about my front yard, I can attest to a paucity of health food selections in these corner stores. Does government have a right or obligation to limit the influence of large corporations on the individual choices we make? If you live in a neighborhood where there are no healthy and low cost choices, is it a choice? Are humans so immune to corporate influences that we have free choice even among the estimated 3,000 advertisements we are exposed to each day? Even if we are free agents, able to resist corporate influences, do we have a responsibility to a larger society that will have to carry the burden of our personal decisions? If we are a society that is an extended family, then we might acknowledge that our actions affect others, and that as long as we want to live “under the same roof” we must be mindful of our actions. In this case, government would be there to balance the scales so that individuals, and those most vulnerable, are not unduly harmed or influenced by powerful groups (corporations). In this case, limiting soda size is a public health issue and a protection from corporate exploitation of our most vulnerable.

Dr. Nicole Dubus is Assistant Professor of Social Work at Wheelock College. Nicole Dubus has been active in the field since the mid-1980s, working in northern California and Massachusetts in public and private settings. Her research interests are in community-based research, home-visitation programs, early parenthood, culturally-sensitive clinical skills, and the experiences of refugees throughout the life course.

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  1. Excellent, well reasoned and thought provoking. The surprising take away for me is the responsibility of non profit advocacy agencies , NNACP for example, to protect themselves from corporate influence.

  2. Although I agree we need to balance corporate influence, it seems like a never- ending task as corporations have more and more influence each day. I saw Michael Bloomberg on a new show this morning and I liked his argument, which was that he wasn’t stopping anybody from doing anything,he was just making them very aware of what they were doing. So that if you want double or triple the amount of soda that is reasonable, you just have to put two or three separate big sodas on your tray and carry them back with you to your seat. He’s hoping that the act of doing that will make people think about the choices they make and what they feel is reasonable. That is not stopping anybody from having exactly what they really want, but like with cigarette warnings, it is educating them about what they are doing.