Friday, May 13, 2005

Detroit Obesity Tax

According to the CDC

  • 62% of Michigan adults are overweight (BMI > 25) or obese (BMI > 30). (CDC BRFSS, 2002)
  • 24% of non-Hispanic white adults, 35% of non-Hispanic black adults, and 31% of Hispanic adults in Michigan are obese. (CDC BRFSS, 2002)
  • The obesity rate among Michigan adults increased by 80% from 1990 to 2002. (CDC BRFSS, 2002)
  • 24% of Michigan high school students are overweight or at risk of becoming overweight. (CDC YRBSS, 2001)
  • 28% of low-income children aged 2–5 years in Michigan are overweight or at risk of becoming overweight. (CDC PedNSS, 2002)

Michigan is not the only state in the country getting fat, as you can see comparing data from 1990 and 2003

U.S. Obesity Prevalence 1990

U.S. Obesity Prevalence 2003

While Michigan may not be the only fat state, and maybe not even the fattest (down to the third spot overall in 2005 after being ranked #1 fattest state by Men's Health in 2003), Michigan combines their fatness with a collapsed infrastructure, economically depressed cities, and questionable city leaders (more on that some other time).

Given this combination of poor health indicators, it is not suprising that the Mayor of Detroit is considering passing a "fast-food tax" within the city.

I am a strong advocate of using public policy to improve public health outcomes. For example, neighborhood variables and therefore zip code are an excellent predictor for cardiovascular disease. Therefore, neighborhood analysis is ideal for allocating city resources, such as parks and clean-up programs, which are positively correlated to lowering CVD risk. Furthermore, I am not opposed to a carefully thought out use/luxury tax being applied to high-fat food items and fast foods. But the proposal in Detroit is myopic, greedy, poorly timed, and biased. In addition, the tax could end up taking money out of the city instead of bring in additional funds.

Currently, there is a 6% state sales tax in Michigan. If the Mayor's proposal passes, there will be an additional 2% imposed on sales of fast-food, namely places like McDonald's, Burger King, etc. These businesses SHOULD be regulated. They provide a product which strongly contributes to one of the three highest public health threats facing our country (obesity), along with the comorbidities associated with the disease (atherosclerosis, myocardial infarction, diabetes mellitus, etc). However, this tax is not the proper regulation - it will lead to absoultely no decline in obesity prevelance.

Detroit is over 80% African-American, 31% of Detroit children live in poverty, and the median household income in the poorest zipcode is under $8000 (national average = $43,000). The literature is still out on whether fast-food industries differentially target low-income populations, but either way, this 2% tax will certainly differentially affect some of the lowest income populations in Michigan. However, a 2% tax is not a significant deterent to poor individual dietary choices. People within Detroit will still go to McDonald's but will also be forced to carry a large share of the economic burden for the city's past and future bad decisions.

In order to really affect dietary choices, and to shift the economic burden more fairly, the tax should be shifted away from consumers at the local level and towards distributors and corporations. Without the choice-infrastructure in place to make other food choices, it is unfair to burden consumers. Until high quality foods are made affordable, many consumers have no choice but to eat low-quality foods in order match their economic and calric budgets. Subsidies must be made available to encourage companies to offer healthy choices and to make those choices affordable to low-income families. In addition, changes must be made at a larger level than the city municipality - otherwise consumers or businesses will leave those areas for more favorable locations. In order to make a real impact in the obesity-epidemic the infrastructure must be in place to fully support significant dietary changes that will be difficult for many families.

The legislature is one way to make changes, but to fully affect change within corporations, the judicial system is another avenue that must be explored. Public health and policy makers were able to make significant headway against tobacco companies during the 1990s by linking tobacoo companies directly to negative health outcomes of smokers. Tobacco prevalence has declined significantly and tobacco companies have had to change their marketing strategies and tactis. The fear of large jury settlements is one way to change corporate behavior. Professor John Banzhaf at GWU School of Law is the major advocate of using the judicial system to change the landscape of dietary choices and the public perception of the obesity epidemic.

There is absolutely no quantitative data in place to measure the success of the Mayor's proposed tax. How will we know if the tax leads to decreaded prevelance of negative health outcomes associated with obesity? Who will be doing that data collection and who will pay for it? The likely answer is that none of this has been considered because it is not part of the plan. The only thing that will decrease is the poorly managed Detroit budget deficit, allowing Kwame and his crew to roll around in expensive SUVs while his constituents struggle to make ends meet.

Detroit Mayor's Tax Proposal
Detroit News
Another from Detroit News
Detroit Free Press
John Banzhaf

1 comment:

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