At some Bronx grocery stores, drinks like Coca-Cola Classic, Fanta Orange, Nestea and Seagram’s Ginger Ale are cheaper than water. A recent weekly special at C-Town Supermarket in the Belmont neighborhood offered five 1.5-liter bottles of Coca-Cola for $5, while advertising the same-sized bottles of Poland Spring water for $7.45.
The incentive to buy drinks that promote obesity and diabetes can be seen and heard loud and clear on the supermarket shelves in the Bronx.
Mayor Bloomberg and Gov. David Paterson want to discourage people — that is, poor people — from consuming too much sugar, by banning food stamp recipients from using their benefits to buy certain sugary drinks.
Many Bronx residents believe this effort unfairly targets the poor, and worry about what’s next on the mayor’s hit list.
“If you drink too much of anything it’s not a good thing,” said Irving Scott, a Bronx carpenter, who receives food stamps and believes he’s responsible enough to moderate his own behavior. “Let people have the freedom to buy what they want.”
Outside a Fine Fare Supermarket in Hunts Point, another construction worker said the proposal felt like discrimination. “I think we should be able to have the same benefits as everyone else,” said Richard Cruz, who also relies on food stamps. “We aren’t even able to get hot sandwiches right now; they have to be cold.”
On Arthur Avenue, Virginia Martinez, who uses her food stamps to buy soda, found the proposal invasive. “Bloomberg is over-doing it,” she said.
“This time it’s soda – what’s next?”
Under the two-year plan, food stamp recipients would not be able use their electronic benefit transfer cards – the card recipients use to buy subsidized food – to buy drinks that contain more than the equivalent of one packet of table sugar in a 12-ounce serving. The only exceptions would be milk products, milk substitutes and fruit juices without any added sugar.
“The [food stamp] program has always excluded certain categories of products without nutritional value – like cigarettes and alcohol – and we believe that a strong case can be made for adding sugary drinks to that list,” Bloomberg said.
Many New York City residents are asking how far is too far, but particularly in the Bronx, where according to the U.S. Census, nearly one-quarter of Bronx residents received food stamps in 2007.
If approved by the United States Department of Agriculture, food stamp recipients in New York City could not use their benefits to buy sugary drinks. Other items already excluded from the food stamp program, also called the Supplemental Nutrition Assistance Program, include tobacco, liquor, vitamins, medicine, pet food, paper products, hot food and household supplies.
This proposal is not the first time elected officials have tried to block access to sugary drinks. In 2004, the Minnesota Department of Human Services asked the United States Department of Agriculture to ban sugary drinks and candy from food stamp purchases. The federal agency rejected the proposal, claiming it would cause customer stigma at supermarket cash registers and the belief that low-income people do not buy nutritious foods.
According to the department of agriculture, research showed that food stamp recipients are wise shoppers and their nutrient intakes are similar to those of higher income consumers.
In a related attempt earlier this year in New York, Gov. Paterson pushed for a penny-an-ounce tax on sugary drinks to help narrow the state’s $9.2 billion budget gap, but lawmakers eventually slashed the proposal from the revenue bill after the New Yorkers Against Unfair Taxes released series of unrelenting anti-tax ads. One of the ads featured a woman saying, “Tell Albany to trim their budget fat, and leave our grocery budgets alone.”
Now Bloomberg and Paterson are preparing for round two – this time with a proposal that applies to only food stamp recipients in New York City.
“There’s no denying that childhood obesity is an epidemic, and there’s no denying that it’s hurting our children in low-income communities the most,” said Bloomberg. “Eliminating these beverages from allowable food stamp purchases would give New York families millions of more dollars to spend on food and drinks that provide real nourishment to them and their children.”
Unlike the Minnesota plan, the current proposal focuses only on sugary drinks, not both candy and sugary drinks. But health officials say it is enough to put a dent in sugary drink sales, especially those coming from food stamp users.
According to the New York City Department of Health and Mental Hygiene, $75 million to $135 million in nutrition assistance benefits were spent on sugary drinks in New York City last year.
Many store owners and managers, some of whom are just starting to rebound from the recession, are concerned their sales will drop if the ban goes into effect.
Wally Hassen, the manager at Day & Night Deli Grocery in Little Italy, said his store makes about $700 a week from sugary drinks, and most of his customers use food stamps.
“It’s going to affect the small businesses,” Hassen said. “They [the government] are not fixing the economy like that.”
Spokespeople for the department of health and mental hygiene would not comment on whether a plan is in place to reimburse small businesses for sales lost because of the ban.
A statement issued by the American Beverage Association, the trade association representing companies that manufacture and distribute non-alcoholic drinks, criticized the proposal saying it is just another attempt by government to tell New Yorkers what they should eat and drink, and will only have an unfair impact on those who can least afford it.
Carl Smith, a food stamp user who was recently shopping with his wife at a Key Food Supermarket on Westchester Avenue, said the ban would affect what drinks he buys.
“I won’t be able to buy it [soda] because I have no money,” Smith said. “I think it’s stupid. We should be allowed to buy food.”
Carl’s wife, Lori, said she buys four cases of soda a month, and Coca-Cola, Pepsi and Sprite are among her favorites. She, too, thinks the ban goes too far.
“What’s next? Coffee?” she asked.
Although the proposal has many Bronxites fired-up, it is part of a larger citywide effort to fight obesity and Type 2 diabetes, two conditions exacerbated by eating or drinking too much sugar.
A 2007 neighborhood report from the Bronx District Public Health Office found that obesity is more common in the Bronx than in New York City overall.
The long-term care required to treat these conditions puts stress on the health care system, causing local and national health expenditures to skyrocket. The New York State Department of Health estimates that treatment for obesity-related diseases – like Type 2 diabetes – costs the State more than $7.6 billion every year and the U.S. $150 billion.
In 1998, Medicare and Medicaid financed approximately half of the costs of obesity-related diseases in the U.S., according to a study published in the Health Affairs journal by Eric Finkelstein and his colleagues.
Obesity-related diseases affect more than just the patients; these diseases also affect current and future generations of taxpayers.
“We feel strongly that the government should not be subsidizing or promoting a product that we know makes people sick, especially in the name of nutrition,” said Dr. Thomas Farley, the New York City Health Commissioner.
Farley said the proposal targets drinks that are essentially nothing more than sugar water.
A 12-ounce serving of water contains no sugar, but original lemon-lime Gatorade has the equivalent of about five packets of table sugar and Coca-Cola Classic has nearly 10. Under the ban, most drinks with more than one packet of sugar would be excluded from allowable food stamp purchases.
Sugary drinks contain empty calories, which pump extra energy into a person’s diet without providing nourishment, just like a roommate who takes up space in an apartment but does not help with chores.
Most sugary drinks run up calorie intake without giving the body a satisfied appetite in return, causing people to consume even more calories than they would by drinking water alone. These extra calories promote excess weight gain, a risk factor for Type 2 diabetes.
Type 2 diabetes occurs when the body does not produce enough of the hormone insulin – the ticket sugar uses to gain admission into cells – or when the body ignores it. When sugar cannot move into cells, it backs up in the blood, sometimes with insulin, acting like a line of people waiting to get inside a movie theatre.
Over time, high levels of blood sugar can damage the kidneys, eyes, heart and blood vessels.
There is a clear, independent link between sugar consumption and risk of developing Type 2 diabetes, according to Dr. Frank Hu, a professor at Harvard Medical School, who studies the effect of diet on Type 2 diabetes.
“The increase in consumption of sugar has paralleled with the epidemic of obesity and Type 2 diabetes in the U.S.,” Hu said. “Sugar-sweetened beverages have not been on the radar screen for most health professionals until recently. In the past, so much emphasis was put on fat, but now we recognize that sugary drinks are more deleterious.”
Hu said the evidence against sugary drinks is now strong enough to start making public health recommendations.
But is the best way for a city government to combat obesity and diabetes through restricting soda for the poor?
Another solution to tax all soda drinkers crumbled earlier this year after Paterson’s penny-an-ounce tax faced opposition from the New Yorkers Against Unfair Taxes.
Reducing the size of cans and bottles in vending machines is also an alternative, according to Dr. Robert Kushner, a professor at the Northwestern University Feinberg School of Medicine.
“It makes intuitive sense that the key is to reduce access,” Kushner said.
One of the challenges of reducing access, though, is identifying the many different sources of sugar available to consumers. According to Kushner, sugar is not like cigarette smoke, which comes from a single source.
Other experts, and some food stamp users, argue that restricting access alone is not enough because it does not teach people how to adopt healthier behaviors.
“There needs to be education to complement the SNAP program,” said Amy Lesh, the clinical nutrition manager at St. Barnabas Hospital. “Nothing is going to work without education.”
Food stamp recipient, Richard Cruz, a 34-year resident of Hunts Point, said he understands what the mayor is trying to do, but he does not think Bloomberg is going about it the right way.
“If he would have a class on things that make you fat, then may be people would relate to that better,” Cruz said. “I would attend one even though I’m not overweight – it’s for my health.”
Bloomberg admitted in early October that banning soda from food stamp purchases is not a perfect solution, but after a failed tax proposal, he said it is another way of going about the problem.
Dr. Peter Selwyn, a professor at the Albert Einstein College of Medicine of Yeshiva University, said political officials should speak with different stakeholders in the affected population before making policies.
“This should inform the decision making,” said Selwyn. “I’m not aware this was part of the process or not.”
The proposal is currently in Washington, D.C., where it is undergoing thoughtful and careful review, according to Hans Billger, a public affairs specialist at the United States Department of Agriculture.
Some Bronxites said even if the federal agency does approve the proposal, they are not convinced it will actually stop people from buying sugary drinks.
“If they don’t buy it with food stamps, they’re going to buy it with cash,” said Ivette Lee, a food stamp user who buys ginger ale at C-Town. “Are they going to stop making cash, too?”