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New York State Sugary Drink Tax and Sugary & Diet Drink Tax

Context

This report details findings from modeling the implementation of either a sugary drink excise tax or a sugary and diet drink excise tax in New York state, each at three potential tax rates ($0.01/ounce, $0.015/ounce, and $0.02/ounce).

Findings

All six tax models resulted in lower levels of sugary drink consumption, thousands of people for whom obesity would be prevented (referred to as “cases” throughout the reports), improved health equity, and hundreds of millions of dollars in health care cost savings.

This report was published in November 2021.

New York City Sugary Drink Tax and Sugary & Diet Drink Tax

Context

This report details findings from modeling the implementation of either a sugary drink excise tax or a sugary and diet drink excise tax in New York City, each at three potential tax rates ($0.01/ounce, $0.015/ounce, and $0.02/ounce).

Findings

All six tax models resulted in lower levels of sugary drink consumption, thousands of people for whom obesity would be prevented (referred to as “cases” throughout the reports), improved health equity, and hundreds of millions of dollars in health care cost savings.

This report was published in November 2021.

Boston, MA Childhood Obesity Prevention Strategies

Context

Boston is a CHOICES Learning Collaborative Partnership location applying cost-effectiveness analysis to current or proposed strategies to reduce childhood obesity. Boston will use the results to inform decision-making, strategic planning, and potential implementation of the strategies.

Strategies of Interest

In partnership with the Boston Public Health Commission, CHOICES analyzed the impact and cost-effectiveness of strategies in early child care settings to improve physical activity, reduce screen time, and promote prevention of excess weight gain.

  • More Movement Program in Early Child Care Settings – models the potential implementation of a strategy that provides training opportunities and resources for early child care educators to implement actions in their programs to encourage physical activity
  • Reducing Screen Time in Early Child Care Settings – models the potential implementation of a strategy that provides voluntary training to early child care educators and resources to families to limit noneducational television time at child care and home.
  • Home Visits to Reduce Screen Time – models the potential implementation of a strategy to reduce the amount of screen time viewed at home by young children.
  • Movement Breaks in the Classroom – models the potential implementation of a strategy to incorporate five-to-10-minute classroom physical activity breaks during class time in kindergarten to fifth grade classrooms. 
  • Creating Healthier Afterschool Environments (OSNAP) – models the potential implementation of the Out-of-School Nutrition and Physical Activity initiative that helps afterschool programs improve practices and policies that increase physical activity and consumption of healthy snacks in Boston, MA.

Massachusetts Childhood Obesity Prevention Strategies

Context

Massachusetts is a CHOICES Learning Collaborative Partnership location applying cost-effectiveness analysis to current or proposed strategies to reduce childhood obesity. Massachusetts will use the results to inform decision-making, strategic planning, and potential implementation of the strategies.

Strategies of Interest

Along with key partners, CHOICES analyzed the impact and cost-effectiveness of strategies in schools to improve physical activity, improve water intake, and promote prevention of excess weight gain.

  • Movement Breaks in the Classroom – models the potential implementation of a strategy to incorporate five-to-10-minute physical activity breaks during class time into school classrooms in Massachusetts.
  • Water Dispensers in Schools – models the potential implementation of a strategy that involves the installation of touchless chilled water dispensers on or near school cafeteria lunch lines in K-8 public schools with adequate plumbing in Massachusetts.

Wisconsin Childhood Obesity Prevention Strategies

Context

Wisconsin is a CHOICES Learning Collaborative Partnership location applying cost-effectiveness analysis to current or proposed strategies to reduce childhood obesity. Wisconsin will use the results to inform decision-making, strategic planning, and potential implementation of the strategies.

Strategies of Interest

In partnership with the Wisconsin Department of Health Services, CHOICES is analyzing the impact and cost-effectiveness of interventions in the early and out-of-school care and community and government sectors to improve physical activity and promote healthy weight.

  • Healthy Beverage Policy: models the potential statewide implementation of a policy to promote healthy beverage choices in licensed out-of-school time (OST) programs in Wisconsin.
  • Safe Routes to School: models the potential statewide expansion of a regional Safe Routes to School program in K-8 public and private schools in Wisconsin.

California Childhood Obesity Prevention Strategies

Context

California is a CHOICES Learning Collaborative Partnership location applying cost-effectiveness analysis to current or proposed strategies to reduce childhood obesity. California will use the results to inform decision-making, strategic planning, and potential implementation of the strategies.

Strategies of Interest

In partnership with the California Department of Public Health and the County of Santa Clara Public Health Department, CHOICES analyzed the impact and cost-effectiveness of strategies in communities and government and school settings to reduce sugary drink consumption, improve water intake, and promote prevention of excess weight gain.

Iowa Childhood Obesity Prevention Strategies

Context

Iowa is a CHOICES Learning Collaborative Partnership location applying cost-effectiveness analysis to current or proposed strategies to reduce childhood obesity. Iowa will use the results to inform decision-making, strategic planning, and potential implementation of the strategies.

Strategies of Interest

In partnership with the Iowa Department of Public Health, CHOICES is analyzing the impact and cost-effectiveness of interventions in the school and clinical sectors to improve physical activity and promote healthy weight.

  • Active Physical Education (PE): models the potential statewide implementation of a guideline that 50% of physical education (PE) class time be spent in moderate-to-vigorous physical activity, consistent with best practice guidelines in quality physical education programs.

Arkansas Childhood Obesity Prevention Strategies

Context

Arkansas is a CHOICES Learning Collaborative Partnership location applying cost-effectiveness analysis to current or proposed strategies to reduce childhood obesity. Arkansas will use the results to inform decision-making, strategic planning, and potential implementation of the strategies.

Strategies of Interest

In partnership with the Arkansas Department of Health, CHOICES is analyzing the impact and cost-effectiveness of interventions in the early and out-of-school care and community and government sectors to improve physical activity and promote healthy weight.

  • NAPSACC in the Quality Rating Improvement System: models the potential implementation of a strategy incorporating the Nutrition and Physical Activity Self-Assessment for Child Care (NAP SACC) assessment tools into Better Beginnings, Arkansas’ Quality Rating and Improvement System, to support quality early child care program opportunities and promote child health.
  • Women, Infants, and Children (WIC) Television Time Reduction: models the potential implementation of a strategy to incorporate television time counseling into the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC).

Salt Lake County, UT State Childhood Obesity Prevention Strategies

Context

Salt Lake County is a CHOICES Learning Collaborative Partnership location applying cost-effectiveness analysis to current or proposed strategies to reduce childhood obesity. Salt Lake County will use the results to inform decision-making, strategic planning, and potential implementation of the strategies.

Strategies of Interest

In partnership with the Salt Lake County Health Department, CHOICES analyzed the impact and cost-effectiveness of strategies in communities and government and school settings to improve dietary intake, physical activity and prevention of excess weight gain.

  • Active Recess – models the potential implementation of a policy in schools in Salt Lake County, UT to increase students’ physical activity levels during recess by installing playground markings, providing portable play equipment, and/or providing adult-led engaging activity options
  • Sugary Drink Excise Tax – models the potential implementation of a state excise tax on sugary drinks at a rate of $0.02/ounce

Detroit, MI Childhood Obesity Prevention Strategies

Context

Detroit is a CHOICES Learning Collaborative Partnership location applying cost-effectiveness analysis to current or proposed strategies to reduce childhood obesity. Detroit will use the results to inform decision-making, strategic planning, and potential implementation of the strategies.

Strategies of Interest

In partnership with the Detroit Health Department and their core team partners – the United Way of Southeastern Michigan and Wayne State University – CHOICES analyzed the impact and cost-effectiveness of strategies in early care and out-of-school time settings to improve dietary intake, physical activity and prevention of excess weight gain.

  • Best Practice Guidelines for Healthy Childcare – models the potential implementation of Best Practice Guidelines for Healthy Childcare in Detroit, MI, assuming that a proportion of licensed programs would voluntarily adopt guidelines to eliminate sugary drinks and limit screen time
  • Out-of-School Nutrition and Physical Activity (OSNAP) Initiative – models the potential implementation of provide training and technical assistance to afterschool programs to meet healthy afterschool guidelines through the Out-of-School Nutrition and Physical Activity (OSNAP) Initiative, which would take place in programs serving children in Detroit ages 5-12 years attending grades K-5

Houston, TX Childhood Obesity Prevention Strategies

Context

Houston is a CHOICES Learning Collaborative Partnership location applying cost-effectiveness analysis to current or proposed strategies to reduce childhood obesity. Houston will use the results to inform decision-making, strategic planning, and potential implementation of the strategies.

Strategies of Interest

In partnership with the Houston Health Department, CHOICES analyzed the impact and cost-effectiveness of strategies in communities and government and school settings to improve dietary intake, physical activity and prevention of excess weight gain.

  • Safe Routes to School (SRTS) – models the potential implementation of Safe Routes to School (SRTS) initiatives in elementary and middle schools in Houston Independent School District, which aims to help children safely walk and bicycle to school through infrastructure improvements, education, and promotional activities
  • Supplemental Nutrition Assistance Program (SNAP) Healthy Incentives Program (HIP) – models the potential implementation of a Supplemental Nutrition Assistance Program (SNAP) Healthy Incentives Program (HIP) in Harris County, Texas that aims to increase fruit and vegetable consumption among SNAP recipients by providing a financial incentive of $0.30 for every $1 spent on fruits and vegetables

Allegheny County, PA Childhood Obesity Prevention Strategies

Intervention Status

Partners at the Allegheny County Health Department used the CHOICES framework and tools to engage partners in identifying and prioritizing strategic opportunities for action to promote healthy weight for children in their community. Read more in the Story from the Field: Allegheny County Strengthens Partnerships to Make Progress Toward Local Impact

Context

Allegheny County is a CHOICES Learning Collaborative Partnership location applying cost-effectiveness analysis to current or proposed strategies to reduce childhood obesity. Allegheny County will use the results to inform decision-making, strategic planning, and potential implementation of the strategies.

Strategies of Interest

In partnership with the Allegheny County Health Department, CHOICES analyzed the impact and cost-effectiveness of strategies in out-of-school time and school settings to improve dietary intake, physical activity and prevention of excess weight gain.

  • Active Physical Education (PE) – models the potential implementation of an Active Physical Education (PE) program in school districts participating in the Live Well Allegheny initiative in Allegheny County, Pennsylvania; Live Well Allegheny Schools will commit that 50% of PE class time be dedicated to moderate-to-vigorous physical activity (MVPA)
  • Supporting Healthy Food and Beverage Choices in Afterschool Programs – models the potential implementation of a healthy snack policy in afterschool programs that already provide snacks through the National School Lunch Program or the Child and Adult Care Food Program

Minnesota Childhood Obesity Prevention Strategies

Context

Minnesota is a CHOICES Learning Collaborative Partnership location applying cost-effectiveness analysis to current or proposed strategies to reduce childhood obesity. Minnesota will use the results to inform decision-making, strategic planning, and potential implementation of the strategies.

Strategies of Interest

In partnership with the Minnesota Department of Health, CHOICES is analyzing the impact and cost-effectiveness of interventions in the community and government and school sectors to reduce sugary drink consumption and improve physical activity and dietary intake:

  • Sugary Drink Excise Tax: models the potential implementation of a state excise tax on sugary drinks at a rate of $0.02/ounce.
  • Safe Routes to School (SRTS): models the potential expansion of SRTS initiatives in elementary and middle schools in Minnesota. SRTS aims to help children safely walk and bicycle to school through infrastructure improvements, education, and promotional activities.

San Antonio, TX Childhood Obesity Prevention Strategies

Context

San Antonio is a CHOICES Learning Collaborative Partnership location applying cost-effectiveness analysis to current or proposed strategies to reduce childhood obesity. San Antonio will use the results to inform decision-making, strategic planning, and potential implementation of the strategies.

Strategies of Interest

In partnership with Metro Health, CHOICES is analyzing the impact and cost-effectiveness of interventions in the early child care and out of school time sectors to improve physical activity, dietary intake and screen time.

Denver, CO Childhood Obesity Prevention Strategies

Intervention Status

Denver Health began implementing components from STAR in 2019. Read more in the Story from the Field: Denver Takes Action to Promote Healthy Child Weight

Context

Denver is a CHOICES Learning Collaborative Partnership location applying cost-effectiveness analysis to current or proposed strategies to reduce childhood obesity. Denver will use the results to inform decision-making, strategic planning, and potential implementation of the strategies.

Strategies of Interest

In partnership with Denver Public Health, CHOICES analyzed the impact and cost-effectiveness of interventions in the community and government and clinical sectors to improve dietary intake, physical activity and prevention of excess weight gain.

  • Study of Technology to Accelerate Research (STAR) – models the potential implementation of the “Study of Technology to Accelerate Research” (STAR) intervention in Denver Health pediatric primary care settings;  Denver STAR leverages electronic health record (EHR) decision support tools to facilitate the diagnosis and management of childhood obesity during well-child care visits.
  • Sugary Drink Excise Tax– models the potential implementation of a city excise tax on sugary drinks at a $0.02 per ounce tax

Hawaii Childhood Obesity Prevention Strategies

Context

Hawaii is a CHOICES Learning Collaborative Partnership location applying cost-effectiveness analysis to current or proposed strategies to reduce childhood obesity. Hawaii will use the results to inform decision-making, strategic planning, and potential implementation of the strategies.

Strategies of Interest

In partnership with the Hawaii Department of Health, CHOICES is analyzing the impact and cost-effectiveness of interventions in the community and government and school sectors to improve physical activity and dietary intake.

  • Active Physical Education (PE): models the potential statewide implementation of the Hawaii State Department of Education (DOE) “Active PE” Wellness Guideline that requires 50% of physical education (PE) class be dedicated to moderate-to-vigorous physical activity (MVPA).
  • Sugary Drink Fee – models the potential implementation of state fees on sugary drinks at fees of $0.03/ounce, $0.02/ounce, and $0.01/ounce

 

 

Illinois Sugar-Sweetened Beverage Tax

Context

In early 2017, Illinois’ Senate budget plan included a proposal to tax sugary drinks, but it was removed from subsequent versions of the plan. Illinois was modeled as part of an effort CHOICES led in partnership with Healthy Food America that examined what the impact would be if the state moved forward and adopted a one-cent-per-ounce sugar-sweetened beverage excise tax.

Findings

In April 2017, CHOICES released a brief examining the cost-effectiveness and impact of a one-cent-per-ounce sugar-sweetened beverage tax in Illinois. CHOICES analysis found that the tax would prevent tens of thousands of cases of childhood and adult obesity, prevent new cases of diabetes, increase the number of healthy years lived by residents, and save more in future healthcare costs than it would cost to implement. Results include:

  • 116,000 cases of obesity prevented in 2025
  • $37.70 in health care costs saved per $1 invested (over 10 years)

Recent Developments

CHOICES analysis and results in the media:

Chicago Tribune: Illinois soda tax could cut health costs, raise $561 million in revenue annually

Seattle Sugar-Sweetened Beverage Tax

Context

In April 2017, Mayor Ed Murray proposed to Seattle’s City Council a 1.75-cent-per-ounce tax on sugar-sweetened and diet beverages in Seattle to help raise money for much-needed programs in the city to promote healthy eating, especially among low-income communities.

Findings

In May 2017, CHOICES released a brief examining the cost-effectiveness and impact of Seattle’s proposed 1.75-cent per-ounce sugar-sweetened and diet beverage tax. CHOICES analysis found that the tax would prevent thousands of cases of childhood and adult obesity, prevent new cases of diabetes, increase the number of healthy years lived by residents, and save more in future healthcare costs than it would cost to implement. Results include:

  • 3,170 cases of obesity prevented in 2025
  • $48.60 in health care costs saved per $1 invested (over 10 years)

Recent Developments

CHOICES analysis and results in the media:

Progressive Grocer: Sugary Drink Tax Good for Health Care Costs, Public Health: Study

In June 2017, the Seattle City Council in a 7.1 vote passed a 1.75-cent-per-ounce excise tax on sugar-sweetened beverages, but diet drinks were exempted.

San Jose Sugar-Sweetened Beverage Tax

Context

San Jose was modeled as part of an effort CHOICES led in partnership with Healthy Food America that examined what the impact would be if 15 of the country’s largest cities adopted a one-cent-per-ounce sugar-sweetened beverage excise tax.

Findings

In December 2016, CHOICES released a report examining the cost-effectiveness and impact of a one-cent-per-ounce sugar-sweetened beverage excise tax in San Jose in addition to 14 other big U.S. cities. CHOICES analysis found that the tax in San Jose would prevent thousands of cases of childhood and adult obesity, prevent new cases of diabetes, increase the number of healthy years lived by residents, and save more in future healthcare costs than it would cost to implement. Results include:

  • 5,200 cases of obesity prevented in 2025
  • $27.50 in health care costs saved per $1 invested (over 10 years)
  • 164 cases of diabetes prevented once the tax reaches its full effect (over one year)

Recent Developments

San Diego Sugar-Sweetened Beverage Tax

Context

San Diego was modeled as part of an effort CHOICES led in partnership with Healthy Food America that examined what the impact would be if 15 of the country’s largest cities adopted a one-cent-per-ounce sugar-sweetened beverage excise tax.

Findings

In December 2016, CHOICES released a report examining the cost-effectiveness and impact of a one-cent-per-ounce sugar-sweetened beverage excise tax in San Diego in addition to 14 other big U.S. cities. CHOICES analysis found that the tax in San Diego would prevent thousands of cases of childhood and adult obesity, prevent new cases of diabetes, increase the number of healthy years lived by residents, and save more in future healthcare costs than it would cost to implement. Results include:

  • 7,100 cases of obesity prevented in 2025
  • $27.20 in health care costs saved per $1 invested (over 10 years)
  • 241 cases of diabetes prevented once the tax reaches its full effect (over one year)

Recent Developments

Phoenix Sugar-Sweetened Beverage Tax

Context

Phoenix was modeled as part of an effort CHOICES led in partnership with Healthy Food America that examined what the impact would be if 15 of the country’s largest cities adopted a one-cent-per-ounce sugar-sweetened beverage excise tax.

Findings

In December 2016, CHOICES released a report examining the cost-effectiveness and impact of a one-cent-per-ounce sugar-sweetened beverage excise tax in Phoenix in addition to 14 other big U.S. cities. CHOICES analysis found that the tax in Phoenix would prevent thousands of cases of childhood and adult obesity, prevent new cases of diabetes, increase the number of healthy years lived by residents, and save more in future healthcare costs than it would cost to implement. Results include:

  • 13,510 cases of obesity prevented in 2025
  • $35.80 in health care costs saved per $1 invested (over 10 years)
  • 496 cases of diabetes prevented once the tax reaches its full effect (over one year)

Recent Developments

Oklahoma City Sugar-Sweetened Beverage Tax

Context

Oklahoma City was modeled as part of an effort CHOICES led in partnership with Healthy Food America that examined what the impact would be if 15 of the country’s largest cities adopted a one-cent-per-ounce sugar-sweetened beverage excise tax.

Findings

In December 2016, CHOICES released a report examining the cost-effectiveness and impact of a one-cent-per-ounce sugar-sweetened beverage excise tax in Oklahoma City in addition to 14 other big U.S. cities. CHOICES analysis found that the tax in Oklahoma City would prevent thousands of cases of childhood and adult obesity, prevent new cases of diabetes, increase the number of healthy years lived by residents, and save more in future healthcare costs than it would cost to implement. Results include:

  • 4,590 cases of obesity prevented in 2025
  • $24.80 in health care costs saved per $1 invested (over 10 years)
  • 197 cases of diabetes prevented once the tax reaches its full effect (over one year)

Recent Developments

Louisville Sugar-Sweetened Beverage Tax

Context

Louisville was modeled as part of an effort CHOICES led in partnership with Healthy Food America that examined what the impact would be if 15 of the country’s largest cities adopted a one-cent-per-ounce sugar-sweetened beverage excise tax.

Findings

In December 2016, CHOICES released a report examining the cost-effectiveness and impact of a one-cent-per-ounce sugar-sweetened beverage excise tax in Louisville in addition to 14 other big U.S. cities. CHOICES analysis found that the tax in Louisville would prevent thousands of cases of childhood and adult obesity, prevent new cases of diabetes, increase the number of healthy years lived by residents, and save more in future healthcare costs than it would cost to implement. Results include:

  • 6,793 cases of obesity prevented in 2025
  • $52.10 in health care costs saved per $1 invested (over 10 years)
  • 448 cases of diabetes prevented once the tax reaches its full effect (over one year)

Recent Developments

Los Angeles Sugar-Sweetened Beverage Tax

Context

Los Angeles was modeled as part of an effort CHOICES led in partnership with Healthy Food America that examined what the impact would be if 15 of the country’s largest cities adopted a one-cent-per-ounce sugar-sweetened beverage excise tax.

Findings

In December 2016, CHOICES released a report examining the cost-effectiveness and impact of a one-cent-per-ounce sugar-sweetened beverage excise tax in Los Angeles in addition to 14 other big U.S. cities. CHOICES analysis found that the tax in Los Angeles would prevent thousands of cases of childhood and adult obesity, prevent new cases of diabetes, increase the number of healthy years lived by residents, and save more in future healthcare costs than it would cost to implement. Results include:

  • 21,700 cases of obesity prevented in 2025
  • $28.20 in health care costs saved per $1 invested (over 10 years)
  • 779 cases of diabetes prevented once the tax reaches its full effect (over one year)

Recent Developments

Las Vegas Sugar-Sweetened Beverage Tax

Context

Las Vegas was modeled as part of an effort CHOICES led in partnership with Healthy Food America that examined what the impact would be if 15 of the country’s largest cities adopted a one-cent-per-ounce sugar-sweetened beverage excise tax.

Findings

In December 2016, CHOICES released a report examining the cost-effectiveness and impact of a one-cent-per-ounce sugar-sweetened beverage excise tax in Las Vegas in addition to 14 other big U.S. cities. CHOICES analysis found that the tax in Las Vegas would prevent thousands of cases of childhood and adult obesity, prevent new cases of diabetes, increase the number of healthy years lived by residents, and save more in future healthcare costs than it would cost to implement. Results include:

  • 4,678 cases of obesity prevented in 2025
  • $26.30 in health care costs saved per $1 invested (over 10 years)
  • 170 cases of diabetes prevented once the tax reaches its full effect (over one year)

Recent Developments

CHOICES analysis and results in the media:

Las Vegas Review Journal: Las Vegas could gain $25.2M in revenue from soda tax, report says

Jacksonville Sugar-Sweetened Beverage Tax

Context

Jacksonville was modeled as part of an effort CHOICES led in partnership with Healthy Food America that examined what the impact would be if 15 of the country’s largest cities adopted a one-cent-per-ounce sugar-sweetened beverage excise tax.

Findings

In December 2016, CHOICES released a report examining the cost-effectiveness and impact of a one-cent-per-ounce sugar-sweetened beverage excise tax in Jacksonville in addition to 14 other big U.S. cities. CHOICES analysis found that the tax in Jacksonville would prevent thousands of cases of childhood and adult obesity, prevent new cases of diabetes, increase the number of healthy years lived by residents, and save more in future healthcare costs than it would cost to implement. Results include:

  • 7,300 cases of obesity prevented in 2025
  • $34.84 in health care costs saved per $1 invested (over 10 years)
  • 394 cases of diabetes prevented once the tax reaches its full effect (over one year)

Recent Developments

CHOICES analysis and results in the media:

Jacksonville CBS affiliate: Tax on soda? Jacksonville organization pushes the proposed legislation
WJCT (Jacksonville NPR affiliate): 12/22/2016: Year In Review Media Roundtable; Soda Tax

 

 

Indianapolis Sugar-Sweetened Beverage Tax

Context

Indianapolis was modeled as part of an effort CHOICES led in partnership with Healthy Food America that examined what the impact would be if 15 of the country’s largest cities adopted a one-cent-per-ounce sugar-sweetened beverage excise tax.

Findings

In December 2016, CHOICES released a report examining the cost-effectiveness and impact of a one-cent-per-ounce sugar-sweetened beverage excise tax in Indianapolis in addition to 14 other big U.S. cities. CHOICES analysis found that the tax in Indianapolis would prevent thousands of cases of childhood and adult obesity, prevent new cases of diabetes, increase the number of healthy years lived by residents, and save more in future healthcare costs than it would cost to implement. Results include:

  • 7,710 cases of obesity prevented in 2025
  • $36.80 in health care costs saved per $1 invested (over 10 years)
  • 393 cases of diabetes prevented once the tax reaches its full effect (over one year)

Recent Developments

CHOICES analysis and results in the media:

WFYI (Indianapolis NPR affiliate): Could A Tax On Sugary Drinks Really Help Save Lives?

Detroit Sugar-Sweetened Beverage Tax

Context

Detroit was modeled as part of an effort CHOICES led in partnership with Healthy Food America that examined what the impact would be if 15 of the country’s largest cities adopted a one-cent-per-ounce sugar-sweetened beverage excise tax.

Findings

In December 2016, CHOICES released a report examining the cost-effectiveness and impact of a one-cent-per-ounce sugar-sweetened beverage excise tax in Detroit in addition to 14 other big U.S. cities. CHOICES analysis found that the tax in Detroit would prevent thousands of cases of childhood and adult obesity, prevent new cases of diabetes, increase the number of healthy years lived by residents, and save more in future healthcare costs than it would cost to implement. Results include:

  • 7,200 cases of obesity prevented in 2025
  • $29.50 in health care costs saved per $1 invested (over 10 years)
  • 350 cases of diabetes prevented once the tax reaches its full effect (over one year)

Recent Developments

Denver Sugary Drink Excise Tax

Context

In partnership with Denver Public Health, CHOICES analyzed the impact and cost-effectiveness of a sugary drink excise tax, which modeled the potential implementation of a city excise tax on sugary drinks at a $0.02 per ounce tax. Read the report for more details.

Findings

The Denver $0.02 per ounce sugary drink excise tax model was projected to be cost-saving and resulted in lower levels of sugary drink consumption, thousands of cases of obesity prevented, and hundreds of millions of dollars in health care cost savings. Health care cost savings per dollar invested was $11 in the model.

Read the report to see all the findings and more details.

Columbus Sugar-Sweetened Beverage Tax

Context

Columbus was modeled as part of an effort CHOICES led in partnership with Healthy Food America that examined what the impact would be if 15 of the country’s largest cities adopted a one-cent-per-ounce sugar-sweetened beverage excise tax.

Findings

In December 2016, CHOICES released a report examining the cost-effectiveness and impact of a one-cent-per-ounce sugar-sweetened beverage excise tax in Columbus in addition to 14 other big U.S. cities. CHOICES analysis found that the tax in Columbus would prevent thousands of cases of childhood and adult obesity, prevent new cases of diabetes, increase the number of healthy years lived by residents, and save more in future healthcare costs than it would cost to implement. Results include:

  • 7,690 cases of obesity prevented in 2025
  • $37.80 in health care costs saved per $1 invested (over 10 years)
  • 396 cases of diabetes prevented once the tax reaches its full effect (over one year)

Recent Developments

Charlotte Sugar-Sweetened Beverage Tax

Context

Charlotte was modeled as part of an effort CHOICES led in partnership with Healthy Food America that examined what the impact would be if 15 of the country’s largest cities adopted a one-cent-per-ounce sugar-sweetened beverage excise tax.

Findings

In December 2016, CHOICES released a report examining the cost-effectiveness and impact of a one-cent-per-ounce sugar-sweetened beverage excise tax in Charlotte in addition to 14 other big U.S. cities. CHOICES analysis found that the tax in Charlotte would prevent thousands of cases of childhood and adult obesity, prevent new cases of diabetes, increase the number of healthy years lived by residents, and save more in future healthcare costs than it would cost to implement. Results include:

  • 7,140 cases of obesity prevented in 2025
  • $30.60 in health care costs saved per $1 invested (over 10 years)
  • 273 cases of diabetes prevented once the tax reaches its full effect (over one year)

Recent Developments

Baltimore Sugar-Sweetened Beverage Tax

Context

Baltimore was modeled as part of an effort CHOICES led in partnership with Healthy Food America that examined what the impact would be if 15 of the country’s largest cities adopted a one-cent-per-ounce sugar-sweetened beverage excise tax.

Findings

In December 2016, CHOICES released a report examining the cost-effectiveness and impact of a one-cent-per-ounce sugar-sweetened beverage excise tax in Baltimore in addition to 14 other big U.S. cities. CHOICES analysis found that the tax in Baltimore would prevent thousands of cases of childhood and adult obesity, prevent new cases of diabetes, increase the number of healthy years lived by residents, and save more in future healthcare costs than it would cost to implement. Results include:

  • 4,950 cases of obesity prevented in 2025
  • $31.70 in health care costs saved per $1 invested (over 10 years)
  • 303 cases of diabetes prevented once the tax reaches its full effect (over one year)

Recent Developments

CHOICES analysis and results in the media:

Baltimore Sun: Harvard study says soda tax would have health benefit if implemented in Baltimore

Cook County Sugar-Sweetened Beverage Tax

Context

In October 2016, the Cook County Board President Toni Preckwinkle proposed a one-cent-per-ounce tax on sugar-sweetened beverages in Cook County, Illinois to help close a 2017 budget shortfall. This tax would benefit 5.26 million people in the first year.

Findings

In November 2016, CHOICES released a brief examining the cost-effectiveness and impact of Cook County’s proposed one-cent-per-ounce sugar-sweetened and diet beverage tax. CHOICES analysis found that the tax would prevent thousands of cases of childhood and adult obesity, prevent new cases of diabetes, increase the number of healthy years lived by residents, and save more in future healthcare costs than it would cost to implement. Results include:

  • 37,000 cases of obesity prevented in 2025
  • $25.80 in health care costs saved per $1 invested (over 10 years)

Recent Developments

CHOICES analysis and results in the media:

Huffington Post: Soda Is About To Get Pricier For Another 5 Million Americans – November 11, 2016

In November 2016, the Cook County Board of Commissioners in a 9-8 vote passed a one-cent-per-ounce sugar-sweetened and diet beverage tax.

On October 11, 2017, the Cook County Board of Commissioners repealed the sugar-sweetened and diet beverage tax. The repeal will take effect December 1, 2017.

Philadelphia Childhood Obesity Prevention Strategies

Context

Philadelphia is a CHOICES Learning Collaborative Partnership location applying cost-effectiveness analysis to current or proposed strategies to reduce childhood obesity. Philadelphia will use the results to inform decision-making, strategic planning, and potential implementation of the strategies.

Strategies of Interest

In partnership with the Philadelphia Department of Public Health Division of Chronic Disease Prevention, CHOICES is analyzing the impact and cost-effectiveness of interventions to improve the health of children in school and early care settings.

New Hampshire Childhood Obesity Prevention Strategies

Context

New Hampshire is a CHOICES Learning Collaborative Partnership location applying cost-effectiveness analysis to current or proposed strategies to reduce childhood obesity. New Hampshire will use the results to inform decision-making, strategic planning, and potential implementation of the strategies.

Strategies of Interest

In partnership with the New Hampshire Division of Public Health Services, CHOICES is analyzing the impact and cost-effectiveness of interventions in the community and government sector that would improve dietary intake and interventions to improve the nutrition and physical activity in early care settings:

Alaska Childhood Obesity Prevention Strategies

Context

Alaska is a CHOICES Learning Collaborative Partnership location applying cost-effectiveness analysis to current or proposed strategies to reduce childhood obesity. Alaska will use the results to inform decision-making, strategic planning, and potential implementation of the strategies.

Strategies of Interest

In partnership with the Alaska Department of Health and Social Services, CHOICES is analyzing the impact and cost-effectiveness of interventions in the community and government sector to improve dietary intake.

  • Sugary Drink Excise Tax – models the potential implementation of a state excise tax on sugary drinks based on either solely the size of the beverage (volume-based tax; $0.03 per ounce) or both beverage size and sugar content (graduated tax; $0.03 per ounce for higher-sugar-content beverages and $0.02 per ounce for lower-sugar-content beverages)

Boulder Sugar-Sweetened Beverage Tax

Context

In September 2016 the City Clerk Lynnette Beck put the question of a two-cent-per-ounce tax on sugar-sweetened beverages on the ballot in Boulder. The tax revenues would be earmarked for administration of the tax and for health and wellness programs. City staff would produce an annual report of how the tax revenue is spent. This tax would benefit 97,600 people in the first year.

Findings

In October 2016, CHOICES released a brief examining the cost-effectiveness and impact of Boulder’s proposed two-cent-per-ounce sugar-sweetened beverage tax. CHOICES analysis found that the tax would prevent hundreds of cases of childhood and adult obesity, prevent new cases of diabetes, increase the number of healthy years lived by residents, and save more in future healthcare costs than it would cost to implement. Results include:

  • 938 cases of obesity prevented in 2025
  • $42.20 in health care costs saved per $1 invested (over 10 years)

Recent Developments

CHOICES analysis and results in the media:

Business Insider: A new study says soda taxes could save millions of dollars in healthcare costs — and that should terrify Coke and Pepsi – October 27, 2016
Bloomberg: On the Ballot Nov. 8: Clinton, Trump, Obesity, and Coke – October 28, 2016
Forbes: Bay Area And Boulder Soda Taxes Would Save Lives, Lower Healthcare Costs, Says Harvard – October 27, 2016

On November 8th, 2016, the electorate in Boulder voted in a 54 to 46 percent vote to pass a two-cent-per-ounce sugar-sweetened beverage tax.

Albany Sugar-Sweetened Beverage Tax

Context

In mid-2016, the Albany City Council put the question of a one-cent-per-ounce tax on sugar-sweetened beverages on the ballot. The revenue would not be earmarked for any special purpose, but rather would require the City Council to hold an annual public process to consider how best to spend the funds raised by the tax. This tax would benefit 19,100 people in the first year.

Findings

In October 2016, CHOICES released a brief examining the cost-effectiveness and impact of Albany’s proposed one-cent-per-ounce sugar-sweetened beverage tax. CHOICES analysis found that the tax would prevent almost 100 cases of childhood and adult obesity, prevent new cases of diabetes, increase the number of healthy years lived by residents, and save more in future healthcare costs than it would cost to implement. Results include:

  • 92 cases of obesity prevented in 2025
  • $25.80 in health care costs saved per $1 invested (over 10 years)

Recent Developments

CHOICES analysis and results in the media:

Business Insider: A new study says soda taxes could save millions of dollars in healthcare costs — and that should terrify Coke and Pepsi – October 27, 2016

Bloomberg: On the Ballot Nov. 8: Clinton, Trump, Obesity, and Coke – October 28, 2016

Forbes: Bay Area And Boulder Soda Taxes Would Save Lives, Lower Healthcare Costs, Says Harvard – October 27, 2016

On November 8th, 2016, the electorate in Albany voted 71 to 28 percent vote to pass a one-cent-per-ounce sugar-sweetened beverage tax.

Oakland Sugar-Sweetened Beverage Tax

Context

In mid-2016, the Oakland City Council agreed unanimously to put the question of a one-cent-per-ounce tax on sugar-sweetened beverages on the ballot in Oakland. The revenue raised would go into the city’s general fund, and then earmarked to pay for health and education programs in the community and in schools. The measure requires the city to create an advisory board to recommend how to spend the money. This tax would benefit 397,000 people in the first year.

Findings

In October 2016, CHOICES released a brief examining the cost-effectiveness and impact of Oakland’s proposed one-cent-per-ounce sugar-sweetened beverage tax. CHOICES analysis found that the tax would prevent thousands of cases of childhood and adult obesity, prevent new cases of diabetes, increase the number of healthy years lived by residents, and save more in future healthcare costs than it would cost to implement. Results include:

  • 2,140 cases of obesity prevented in 2025
  • $30.40 in health care costs saved per $1 invested (over 10 years)

Recent Developments

CHOICES analysis and results in the media:

Business Insider: A new study says soda taxes could save millions of dollars in healthcare costs — and that should terrify Coke and Pepsi – October 27, 2016

Bloomberg: On the Ballot Nov. 8: Clinton, Trump, Obesity, and Coke – October 28, 2016

Forbes: Bay Area And Boulder Soda Taxes Would Save Lives, Lower Healthcare Costs, Says Harvard – October 27, 2016


On November 8th, 2016, the electorate in Oakland voted in a 61 to 39 percent vote to pass a one-cent-per-ounce sugar-sweetened beverage tax.

San Francisco Sugar-Sweetened Beverage Tax

Context

In mid-2016 City Supervisor Malia Cohen put the question of a one-cent-per-ounce tax on sugar-sweetened beverages on the ballot in San Francisco. The revenue would not be earmarked for any special purpose, but rather would go into the city’s general fund with an advisory panel set up to suggest ways to promote the dangers of heavy sugar consumption. This tax would benefit 801,000 people in the first year.

Findings

In October 2016, CHOICES released a brief examining the cost-effectiveness and impact of San Francisco’s proposed one-cent-per-ounce sugar-sweetened beverage tax. CHOICES analysis found that the tax would prevent thousands of cases of childhood and adult obesity, prevent new cases of diabetes, increase the number of healthy years lived by residents, and save more in future healthcare costs than it would cost to implement. Results include:

  • 3,750 cases of obesity prevented in 2025
  • $30.50 in health care costs saved per $1 invested (over 10 years)

Recent Developments

CHOICES analysis and results in the media:

Business Insider: A new study says soda taxes could save millions of dollars in healthcare costs — and that should terrify Coke and Pepsi – October 27, 2016

Bloomberg: On the Ballot Nov. 8: Clinton, Trump, Obesity, and Coke – October 28, 2016

Forbes: Bay Area And Boulder Soda Taxes Would Save Lives, Lower Healthcare Costs, Says Harvard – October 27, 2016

On November 8th, 2016, the electorate in San Francisco voted 62 to 38 percent vote to pass a one-cent-per-ounce sugar-sweetened beverage tax.

Philadelphia Sugar-Sweetened Beverage Tax

Context

In early 2016, Mayor Jim Kenney proposed to the City Council a three-cents-per-ounce tax on sugar-sweetened beverages in Philadelphia to help raise money for much-needed services in the city such as universal pre-K and public parks. This tax would benefit 1.54 million people in the first year.

Findings

In April 2016, CHOICES released a brief examining the cost-effectiveness and impact of Philadelphia’s proposed three-cents-per-ounce sugar-sweetened beverage tax. CHOICES analysis found that the tax would prevent thousands of cases of childhood and adult obesity, prevent new cases of diabetes, increase the number of healthy years lived by residents, and save more in future healthcare costs than it would cost to implement. Results include:

  • 36,000 cases of obesity prevented in 2025
  • $84.05 in health care costs saved per $1 invested (over 10 years)

Recent Developments

CHOICES analysis and results in the media:

Philadelphia Inquirer: Harvard study: Soda tax would make Phila. Healthier April 28, 2016

PhillyVoice.com: Harvard study: Philly’s soda tax would save $197 million in health-care costs April 28, 2016

Forbes: Philadelphia Sugary Drink Tax Would Significantly Reduce Obesity, Type 2 Diabetes, Says Study- April 28, 2016

In June 2016, the Philadelphia City Council in a 13-4 vote passed a 1.5-cent-per-ounce excise tax, making Philadelphia the first major U.S. city to adopt a tax on sugary and diet drinks.

Mississippi Childhood Obesity Prevention Strategies

Context

Mississippi is a CHOICES Learning Collaborative Partnership location that applied cost-effectiveness analysis to current or proposed strategies to reduce childhood obesity. Mississippi is using the results to inform decision-making, strategic planning, and potential implementation of the strategies.

In partnership with the Mississippi State Department of Health, CHOICES analyzed the impact and cost-effectiveness of:

Strategies of Interest

  • Early Care and Education Screen Time – implement a statewide regulation to ensure screen time is limited to 30 minutes/week in licensed child care facilities; offer training for child care providers in an educational program to support families in reducing screen time
  • Active PE – implement a statewide regulation requiring that 50% of physical education (PE) time be devoted to moderate-to-vigorous physical activity in elementary and middle schools
  • Mind, Exercise, Nutrition…Do it! – MEND – offer clinical group counseling for children with obesity who are enrolled in Medicaid and their caregivers

Recent Developments

After Mississippi completed its collaboration with CHOICES, Tiffani Grant, Director of the Division of Nutrition, Physical Activity and Obesity in the Office of Preventive Health at the Mississippi State Department of Health, commented on how cost-effectiveness analysis can inform decision making.

West Virginia Childhood Obesity Prevention Strategies

Context

West Virginia is a CHOICES Learning Collaborative Partnership location that applied cost-effectiveness analysis to current or proposed strategies to reduce childhood obesity. West Virginia is using the results to inform decision-making, strategic planning, and potential implementation of the strategies.

In partnership with the West Virginia Bureau for Public Health, CHOICES analyzed the impact and cost-effectiveness of:

Strategies of Interest

  • Key 2 a Healthy Start – integrate the implementation of NAP SACC–early care and education (ECE) nutrition, physical activity, and screen time practices–into the reimbursement system for child care, which provides larger subsidies to programs that meet higher standards of care
  • Sugary Drink Tax – increase volume-based state excise tax on sugary drinks to either $0.01 per ounce or $0.02 per ounce

Recent Developments

After West Virginia completed its collaboration with CHOICES, Dr. Rahul Gupta, Commissioner for the West Virginia Bureau for Public Health, described the benefits of cost-effectiveness data.

Washington Childhood Obesity Prevention Strategies

Context

Washington is a CHOICES Learning Collaborative Partnership location that applied cost-effectiveness analysis to current or proposed strategies to reduce childhood obesity. Now Washington is using the results to inform decision-making, strategic planning, and potential implementation of the strategies.

Strategies of Interest

  • NAP SACC in Early Achievers – models the potential integration of NAP SACC early care and education (ECE) nutrition, physical activity, and screen time practices into Early Achievers, the statewide quality rating improvement system for ECE programs
  • Active Recess – models potential statewide support for school districts’ efforts by the Office of the Superintendent of Public Instruction to increase students’ activity levels during recess time by incorporating playground markings, portable play equipment, and/or structured activities
  • Sugar-Sweetened Beverage Tax – models the potential implementation of volume-based state excise tax on sugary drinks at either $0.01 per ounce,$0.02 per ounce; or $0.05 per ounce tax

Recent Developments

After Washington completed its collaboration with CHOICES, Janna Bardi, Assistant Secretary for Prevention and Community Health at the Washington State Department of Health, stressed the benefits of learning about the cost-effectiveness of the sugar-sweetened beverage tax intervention.

Oklahoma Childhood Obesity Prevention Strategies

Intervention Status

Screen time counseling in the Oklahoma WIC Program was rolled out in 2017. Read more in the Story from the Field: Oklahoma Takes Action to Improve Child Health

Context

Oklahoma is a CHOICES Learning Collaborative Partnership location applying cost-effectiveness analysis to current or proposed childhood obesity prevention interventions. Oklahoma will use the results to inform decision making, strategic planning, and potential implementation of the interventions.

Strategies of Interest

In partnership with the Oklahoma State Department of Health, CHOICES is analyzing the impact and cost-effectiveness of interventions that would improve the health of children ages 2-5 in the early care and community/government sectors.