Low-income parents’ perceptions of a sweetened beverage tax in Philadelphia

Abstract

Objective: To characterise perceptions of the Philadelphia Beverage Tax among low-income parents. Design: We conducted semi-structured interviews and administered demographic questions via telephone. We based the interview guide and initial codebook on a conceptual model illustrating perceived fairness and effectiveness as essential for successfully adopting food policies. We performed thematic analysis using NVivo 12. Setting: We recruited from a primary care paediatrics clinic in Philadelphia, Pennsylvania from July to August 2020. Participants: Philadelphia parents/caregivers of 2- to 11-year-old children with Medicaid insurance. Results: Participants were predominantly African American (97 %), female (100 %), and had annual household incomes <$50 000 (80 %). Participants were 26- to 72-years old, with an average aged child of 5 years (range 7 months to 20 years). Themes emerged regarding tax perceptions, revenue use and behaviour change due to the tax. Using revenue for highly valued programmes and accountability of city government to use revenue as promised were critical elements in perceptions of tax fairness. Some parents avoided the tax through cross-border shopping and buying drink powders or concentrates, influencing perceptions of tax effectiveness. The tax signalled the health dangers of sweetened beverage consumption to most parents. Conclusion: Our findings bring to light four key takeaways for policymakers designing sweetened beverage taxes. (1) Dedication of tax revenue to programmes highly valued by parents and (2) transparency in revenue spending may improve acceptability. (3) State or national taxes may be more effective at decreasing consumption due to cross-border shopping. (4) Pairing taxes with health promotion campaigns may enhance behaviour change.

Leveraging Multiyear, Geospatial Social Media Data for Health Policy Evaluations: Lessons From the Philadelphia Beverage Tax

“…These findings may be explained by greater levels of clarity on the structure and benefit of the policy after its implementation. A qualitative study among low-income families in Philadelphia observed that awareness of the tax (particularly where its revenue was being used, and evidence of its positive impact) was pivotal in informing attitudes 23. However, a longitudinal qualitative study on the experiences of retailers interviewed in both 2017 and 2018 observed signs of increasing concerns toward the Philadelphia Beverage Tax and its potential economic impact 22.…”

“…A qualitative study among low-income families in Philadelphia observed that awareness of the tax (particularly where its revenue was being used, and evidence of its positive impact) was pivotal in informing attitudes. 23 However, a longitudinal qualitative study on the experiences of retailers interviewed in both 2017 and 2018 observed signs of increasing concerns toward the Philadelphia Beverage Tax and its potential economic impact. 22 Therefore, while sentiment analyses using natural language processes can provide unique insights from large quantities of data, it is nonetheless crucial to contextualize these findings with more in-depth qualitative explorations to disaggregate differences and reasons behind changes in sentiments.…”

“…20 While health promotion may have not been the explicit fundamental framing of the Philadelphia Beverage Tax, increasing the price of sugary drinks through taxation has been shown to reduce purchases and consumption of sugar-sweetened beverages (SSBs), 21 and thus reflects a great case study of a policy initiative with health promotion implications. Existing impact evaluations of the Philadelphia Beverage Tax have focused on postintervention experiences of retailers 22 and families of low income, 23 changes in purchasing [24][25][26][27][28] and consumption behaviors, 29,30 prices and product availability, [25][26][27]31 and employment. 32,33 Implementation evaluations have been conducted through interviews with those involved in the policymaking process, 34 analysis of public testimony provided to City Council, 35 and a review of the policy's development and enactment.…”