THE PROBLEM WITH FOOD POLICY.
To put some of the recent conversations over chronic disease and diet into economic perspective, consider the hackneyed statistic that we spend more on health care than on food. The stat is true: We spent $2.26 trillion on health care in 2007 and about $845 billion on food. Those numbers are not strangers to one another. To some degree, we spend more on health care because we spend less on food. Cheap food tends to be nutritionally hollow and purchased in spectacular quantity. Neither quality makes HoHos friendly to arterial health.
But the sobering corollary to talking about the public costs of bad diet is that we don't really know how to change the way people eat. Diansheng Dong and Biing Hwan-Lin recently conducted a study for the USDA's economic research service modeling the likely impact of a 10 percent discount on fruits and vegetables for low-income Americans (defined here as incomes below 130 percent of the poverty line). They concluded that the policy, which would cost $580 million, would increase the consumption of fruits by 2.1-to-5.2 percent and vegetables by 2.1-to-4.9 percent. It's not nothing, but it's not much. The graph below shows the effects of the policy, the effects of the policy doubled (20 percent off fruits and vegetables), and in the final column, how far even the double-subsidy world is from the USDA's recommended consumption of fruits and vegetables (which is probably still too low!):
And cost is just one barrier. Many people lack access to decent produce. Taking 10 percent off the price of the rotted bananas at the convenience store won't do much to encourage their consumption. They're still rotted bananas. More than that, it's foolish to imagine that poor eating habits are the simple outcome of inadequate nutritional education, incomes, and access. HoHos are delicious. Tired mothers don't want to fight with their kids over sugar in breakfast cereals. Cooking takes time, and when you're working multiple jobs and feeding a family, the undeniable ease of fast food is a powerful lure. And fast food is tasty! The fact that most low income Americans -- hell, most Americans -- live closer to a McDonald's than a grocery store only underscores the appeal. So this isn't a question with easy answers. Even if you could get the political system to focus on it, the policies are not obvious and the payoff would not be quick.
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COMMENTS (28)
Sounds like you backed off pretty quickly from your support of NYS's "soda tax".
If so, congratulations. It's exactly this sort of social engineering nonsense that turns people anti-liberal.
Raising sin taxes isn't about saving people from themselves, it's about finding a political fig leaf for regressive taxes. I live in NYS and Gov. Paterson is proposing all sorts of nickel-and-dime tax, fine and fee increases because this so-called Democrat is too cowardly or too bought to enact the "millionaire's tax". It would be small increases in the marginal income tax rate at levels of $250k, $500k and $1M dollars. NJ enacted such a tax and the talk about calamity proved to be pure BS. It was studied and perhaps a tiny number of the wealthy left. So what? The net effect was a increase in tax revenues from people who can afford it. Meanwhile here in NY out-of-a-job Joe Shmoe would pay more because he indulged himself with a Coke.
Of course support for the Coca-Cola tax often comes from the same people who rightly deride conservatives for wanting to take a purely punitive approach to problems like teenage pregnancy, AIDS and drug abuse. But drinking Coca-Cola, now that's beyond the pale. Where is your sense of personal responsibility you miscreant!
Posted by: alex | February 16, 2009 5:43 PM
... rotted bananas?
Posted by: glenstein | February 16, 2009 6:01 PM
Cooking's not the only option if we want people to have more healthy-food options. If fruits and produce are cheaper (instead of corn syrup and beef) then we'll see more healthy options at fast-food restaurants (a salad bar at McDonalds?) and near-fast-food restaurants (Chipotle).
Posted by: Sophomore | February 16, 2009 6:08 PM
Excellent post, its great you're creating awareness on the issue. Keep up the good work.
Posted by: wisewon | February 16, 2009 6:19 PM
That's because a 10% discount is too small to make a major impact. I think the threshold for behavioral change would be in the 30%+ range, and also you would need to do something more to ensure availability of quality goods in the places that need them most.
Posted by: matt | February 16, 2009 6:34 PM
Sorry if I gave the wrong impression: I support the soda tax 100 percent. Taxing negatives is a good way to tax. But I don't think you'll get all that far in changing eating tat way, nor should it be your primary strategy.
Posted by: Ezra | February 16, 2009 6:58 PM
If low-income people started buying more produce, probably stores in low-income areas would stock more produce. There is something of a chicken-and-egg situation here, but one thing the US economic system is good at is supplying demand for consumer goods by people who have the resources to pay for them.
Posted by: matt wilbert | February 16, 2009 6:59 PM
But it's about awareness too. And it's not just low-income folks - my brother-in-law and sister-in-law are both dentists and you should see the junk they eat. They come home tired from a long day, order Dominos, feed the baby Cheetos, etc. It's where the role-model-in-chief could play an important role. Another concept I'd love to see promoted is the WWII victory garden concept - especially in schools. Encourage kids/families to participate in community gardens, and it they have time/inclination provide incentives for growing their own food.
Posted by: KD | February 16, 2009 7:28 PM
According to this Yglesias post, there is a proposal to subsidize fruit/vegetable purchases in France amongst the needy. I wonder how far it's gotten.
http://matthewyglesias.theatlantic.com/archives/2008/04/vegetable_card.php
Posted by: Skip | February 16, 2009 7:31 PM
High cost and lack of availability are certainly two of the reasons our diets are bad. A third is credibility. A lot of people choose fast food because they see it advertised on television.
Produce, as Michael Pollan points out, does not usually have the kinds of flashy logos and brand-association as the products in the other parts of the supermarket.
Much of this impacts kids, who are barraged with advertising showing them how cool fast food is. Yes, HoHos taste good, but where would they be without their packaging and their fancy ad campaigns?
Thanks for the posting.
Posted by: DooF | February 16, 2009 8:39 PM
High cost and lack of availability are certainly two of the reasons our diets are bad. A third is credibility. A lot of people choose fast food because they see it advertised on television.
Produce, as Michael Pollan points out, does not usually have the kinds of flashy logos and brand-association as the products in the other parts of the supermarket.
Much of this impacts kids, who are barraged with advertising showing them how cool fast food is. Yes, HoHos taste good, but where would they be without their packaging and their fancy ad campaigns?
Thanks for the posting.
Posted by: DooF | February 16, 2009 8:41 PM
Ezra: Sorry if I gave the wrong impression: I support the soda tax 100 percent.
Sorry to hear that. My comments at 5:43 still stand. Quixotic attempts at social engineering, which people realize are nothing more than poorly disguised regressive taxes, are just going to piss people off and turn them anti-liberal. It won't change their behavior significantly.
And why a soda tax? Is the sugar (ok, HFCS) in soda magically worse than the sugar that's everywhere else? Even the supposedly healthy alternative of fruit juice is widely suspected of being just another form of empty calories. Do you want a tax on apple juice too?
Ezra: HoHos are delicious.
Aha! As long as we don't tax your vice, right? FWIW HoHo's taste like warmed over manure. Not that I'm above the sugar vice, but I prefer it in a form that doesn't taste like it already passed through the neighbor's dog.
Posted by: alex | February 16, 2009 8:44 PM
Well, HoHos were delicious when I ate them 10 years ago, anyway. My first move would not, incidentally, be a soda tax. I'd end subsidies for corn, which would raise the prices of things like coke and hohos and, for that matter, red meat. There's no reason we should be subsidizing a poor diet.
Posted by: Ezra | February 16, 2009 8:51 PM
1) Pigovian taxes to internalize the negative externalities (obesity, diabetes and comorbidities) associated with overconsumption of unhealthy foods. Sounds good to me. Problem would be calculating the tax on given foodstuffs. That'd be the soda tax you are 100% in favor of, though more broadly applied.
2) Ban advertising of foods during the afternoon hours on weekdays and mornings on weekends and demand for unhealthy foods will decline. After all, how many kids go shopping with their parents these days? Probably not many, and if they aren't there, they're less likely to ask mom and dad for that unhealthy snack they saw on TV.
Both of these measures would be incredibly unpopular, but wildly successful in the long run, I think. And something will have to give if we do indeed get some kind of national healthcare system in place at some point. As always a dollar spent in the name of public health is greater than that spent on a medical intervention.
Posted by: Rian | February 16, 2009 9:05 PM
Ezra's comment gets at the critical point: it's not about subsidizing produce: it's about ending subsidies for sweets and meats.
McDonalds isn't so desirable at $5 for a HappyMeal.
Posted by: JRoth | February 16, 2009 9:36 PM
1. The differnece between the typical American diet and some ideal diet are not all that clear healthwise. Volumn is the biggest problem.
2. Carrots, collard greens, Mustard greens are cheap. Also you need only a small patch of dirt to grow enough greens. Oranges and bananas are not very expensive.
Posted by: Floccina | February 16, 2009 10:02 PM
Ezra: Well, HoHos were delicious when I ate them 10 years ago, anyway.
Yeah, yeah. Just keep that stash in your bottom desk drawer under some papers and a bottle of booze - nobody will find them.
I'd end subsidies for corn, which would raise the prices of things like coke and hohos
Eliminating corn subsidies is a good idea, but the only reason HFCS is so widely used is because we have high sugar tariffs.
Posted by: alex | February 16, 2009 10:34 PM
Rian: Pigovian taxes to internalize the negative externalities (obesity, diabetes and comorbidities) associated with overconsumption of unhealthy foods.
An externality is a cost imposed on people who are not a party to the transaction. That doesn't apply to obesity. The currently fashionable talk about social costs related to the health care costs of obesity overlooks the simple fact that fat people die earlier, which reduces their lifetime health care costs. Any actuary who overlooked that simple fact would be incompetent.
Ergo, any talk of taxing fattening foods is an exercise in social engineering, not taxing externalities.
http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371%2Fjournal.pmed.0050029&ct=1&SESSID=0f8b774df579b86bd0490858a567873f
Posted by: alex | February 16, 2009 10:49 PM
Advertising definitely plays a big role here, when the ad budget for M&M’s dwarfs the amount spent to promote the food pyramid then you know there’s a long uphill climb ahead.
Posted by: RogueDem | February 17, 2009 12:35 AM
The question of value should enter the equation here. This idea that society is interested in how much money it pays for health care, rather than what it gets for that money, is very strange. There's an unnecessary cost imposed when we're paying money to treat diseases that could be prevented more cheaply. Trying to keep people healthier through prevention is no more -- and no less -- social engineering than trying to keep them healthy through subsidized health care.
Posted by: Ezra | February 17, 2009 1:11 AM
Sugary food is not inherently tastier, while less sugary food is not inherently less tasty. A person's tastes follow from a lot of cultural factors as well as from advertising, etc.
This fact is obvious to anybody who has switched from sugary soda to diet soda. After a couple years drinking diet cola, sugary cola tastes horribly over-sweet.
A lot of people who don't eat vegetables literally don't like them at all. While vegetarians think they are wonderfully delicious, and find red meat horribly fatty.
Posted by: Whispers | February 17, 2009 1:45 AM
A year ago, I lost 30 pounds (I am a woman of average height; I went from 157 to 129 pounds). I can honestly say that I spend somewhere around 3 hours per day thinking about food. And I think ONLY about eating fat. Preferably, fat mixed with carbs. Pizza. Bacon sandwiches. Buttered bread. I am educated -- in fact, I have a PhD. I work in the fitness industry, and have for 20 years, as an aerobics instructor. I know all about leafy green vegetables and sustainable agriculture and high fructose corn syrup and all of it. And yet, on a daily basis, I am in a battle for survival with my craving for potato chips, dipped in cheese sauce. What is that? Seriously -- with what do I fight this war? Lack of availability? Lack of education? Nah. This is primal.
You can provide better access to healthy options, and it will help some. Often, I have to really struggle to find a way to purchase a healthy snack in the middle of the day if I haven't packed one. But even if the apples and bananas were in full supply at every convenience store, I'd still hear the siren call of the Cheetos. I think we kid ourselves to think that very many people will resist. I wonder how long I will manage it.
Posted by: Fatty | February 17, 2009 4:36 AM
Fatty above raises an important point about comfort food -- junk food is also a quality of life issue for most people. Poor people may not have jacuzzis, the latest front projection HDTV setups, and backyard built-in barbeque rigs, but they can stuff their face with yummy snacks.
Posted by: Troy | February 17, 2009 5:51 AM
And cost is just one barrier.
With 20% subsidies the increase is nominal -- meaning that the barrier here is not the price at all.
Posted by: John Galt | February 17, 2009 8:41 AM
I'm glad to see you recognize the problem of time. In a one-parent household, or a two-parent household where both parents work, the time and mental energy to plan meals, shop well, and cook well, day after day, is sorely lacking. Because of health issues I recently reduced my work hours to about 10 a week, and it's now a pleasure to cook for myself and my husband. I wish everyone could be so lucky as to have making dinner be something to enjoy.
Posted by: Hana | February 17, 2009 10:25 AM
alex offers a brilliant argument: "The currently fashionable talk about social costs related to the health care costs of obesity overlooks the simple fact that fat people die earlier, which reduces their lifetime health care costs.".
According to this reasoning, any business practice that kills people or makes them sick is not imposing an (external) cost on society that needs to be internalized, it is actually saving society money by reducing the population. Now, why don't we just poison the whole population? That would solve the health care problem once and for all.
Posted by: piglet | February 17, 2009 10:46 AM
"why dont we just poison the whole population..."
isnt that what we are doing?
in the past year...
arsenic in tap water, poison peanut butter,lethal pet food, lead~painted toys, mercury in corn syrup,colony collapse disorder, antibiotics and hormones in livestock, mercury in fish, chemical~laced gluten,bacteria infested beaches, human beings that are walking medicine cabinets.
is it solving the health care problem once and for all?
Posted by: Anonymous | February 17, 2009 11:58 AM
piglet: why don't we just poison the whole population?
Who is "we"? Is society some sort of monolithic entity that only makes group decisions, or is it composed of individuals?
Society has a right to take punitive measures against an individual only if an individual's actions adversely affect society as a whole. That's not the case with obesity.
Posted by: alex | February 17, 2009 12:52 PM