Great Britain is to follow France, Mexico and some other countries that increased the tax on sugar-sweetened beverages. In the United States in the fight against excess sugar in foods are committed leading medical experts.
It’s not because according to them “only” obesity is concerned, which threatens to become a health epidemic of global dimensions. Added sugar is a cause for many diseases, including diabetes, cardiovascular problems, and other liver diseases, referred to collectively as metabolic diseases. Calories, which people often simply identify as sugar, are not just calories, depending on how they are metabolized by the organism. High blood sugar burdens pancreas due to excessive insulin secretion, suppresses signals representing excess of saturation leads to the deposition of fats and damages the blood vessels (Cawley et al, 2015).
The sugar tax will not only reduce the consumption of harmful products for children, but also the all-powerful companies would put in place and in the name of public health, as can be commented on the unstoppable trend that has taken place in countries like France, Italy and Mexico, and which is about to take place in the United Kingdome. To date, the food industry has used all their political influence to plant resistance that stands out and as the next big battle of public health: the ubiquitous presence of sugar. Large companies have been funded for years to doctors, “experts” and groups to question the scientific evidence on the effects of large amounts of sugar in processed foods and soft drinks. More than half of the American population is threatened metabolic diseases, which are caused by excessive intake of sugar adding that subject to this risk are residents of most countries of Western food culture (Cawley et al., 2015).
Tax on sugar and sweetened beverages is a controversial issue in England. The World Health Organisation (WHO) has recommended the Guideline of Sugar intake for adults and children which is reduced from less than 10% of total energy intake in 2002 to below 5% of them in 2015 (WHO, 2015). A number of researchers have reported that the high consumption of sugar and sugar sweetened drinks is associated with a wide range of health problems with weight gain and type 2 diabetes, as well as tooth decay (Vartanian, Schwartz and Brownell, 2007; Briggs, et al., 2013). As the product with added sugar-sweetened have taxed, it is aimed for citizens to health promotion like a decrease of obesity rate, tooth decay.
The issue of tax on sugar-sweetened beverages is both complex and contentious it would be impossible to cover in all aspects of the one within the essay therefore an overview of the relation between sugar and health and economic effect has been selected for discussion. This essay will be analysed in terms of ingredients model including legitimacy, feasibility and support to underpin how to take agenda-setting.
Sugar and Health
The consumption of sugar-sweetened beverages has been related to risks for obesity, diabetes, and dental caries (Kelly, et al., 2009). According to the statistics of current estimates of UK sugar intakes collected by the National Diet and Nutrition Survey programme (NDNS), mean figures are three times higher than the 5% maximum recommended intake level in school-aged children and teenagers (14.7% to 15.6% of energy intake) and approximately over twice the maximum recommended level in adults (12.1% of energy intake) (Bates, et al., 2014). It is contributed to the main sources of sugar in the UK diet including soft drinks, biscuits, buns, cakes, pastries and puddings, confectionery, table sugar, fruit juice, breakfast cereals, alcoholic drinks (for adults), and some foods. Especially, soft drinks without fruit juice account for the largest source of sugar intake for children aged 11 to 18 years who consume drink around 336ml per day. This means that the consumption of drink is roughly equal to one can of a sugary drink and provides 29% of daily sugar intake. For young children aged 4 to 10 years, the largest contributor of sugar intake is soft drinks. In adults aged 19 to 64 years, the main sources include table sugar, biscuits, buns, cakes, pastries and puddings, and soft drinks. As sugar intake has increased over time, the prevalence of health problems including obesity, diabetes, and dental caries grow significantly (Bomback, 2013).
Sugar and Economic effect
According to the review on exploring the acceptability of a tax on sugar-sweetened beverages, there is empirical evidence from countries where food tax relating to sugar has been implemented (Rachel and Hannah, 2013). In United States of America, soft drinks with added sugar-sweetened have taxed ranging from 1-7% with 38 states, as a means of raising revenue and decreasing obesity rate. The effect of this policy does not evaluate due to the recent policies. In France, all drinks with added sugar or artificial sweeteners have taxed at 0.07 EUR per litre and energy drinks have also taxed at 0.50 EUR per litre. The effect of this policy is that supermarket sales of all drinks declined in many years by 3.3%. In Hungary, the prevalence of obesity is the highest in the Europe according to the OECD statistic in 2013. To tackle obesity, government in Hungary has strongly implemented the taxation which sugary drinks added at 5 HUF (￡0.01) per litre, energy drinks added at 250 HUF (￡0.70) per litre, salty snacks and condiments added at 200 HUF (￡0.56) per kg and sweets, biscuits, ice-creams and chocolate at 100 HUF (￡0.28) per kg. Although the consumption of these products have decreased, this situation can be contributed to the general economic crisis.
The Ingredients Model (The Hall Model): legitimacy, feasibility and support
There are four theoretical models of agenda-setting including ‘Ingredients’ model, ‘Policy streams’ model, ‘Issue-attention cycles’, and ‘Advocacy coalition’ approach (Buse, et al., 2012). It is argued that the ‘Ingredients’ model can explain how issues get onto the policy agenda as a simple, quick-to-apply model (Hall, et al., 1975). The policy agenda can be seen as the list of problems or issues to which government officials, or those who are associated with policy decisions, draw attention (Kingdon, 2011). The process which is shift from issue to policy agenda are involved in legitimacy, feasibility and support (Hall, et al., 1975).
The ingredients model sheds new light on how to pay serious attention to the tax on sugar and sweetened beverages. It can be arguably seen as policy agenda can be led to high all three ingredients of social issue such as legitimacy, feasibility and support (Buse, et al., 2012). With the legitimacy, government has a responsibility to decrease the prevalence of obesity as a part of health care by implementing the tax on sugar-sweetened beverages. Regarding feasibility, it has been argued that the policy with tax on sugary drinks has been ready to implement at a national level. The PHE and other organisations related to this policy agenda have investigated and reviewed the implication of the policy (PHE, 2015). Also, the taxation with added sugary drinks has already implemented in some countries. In terms of support, the tax on sugar-sweetened beverages is a controversial issue.
Government should play an important role on taking action to improve health-related quality of life. It is widely held view that recent researches have been reported to the effect of taxation on sugar-sweetened beverages in relation to obesity, diabetes, and tooth decay around the world (Kelly, 2009; Ng, 2011; Wang, 2012).
First of all, obesity which is linked with sugar intake has been a serious issue, including social as well as health problems, in England. Furthermore, this situation could cause economic burdens on individuals and societies in respect of the treatment of complications relating to obesity as well as a wide range of chronic diseases including diabetes, hypertension, stroke and certain cancers (NOO, 2010). It is estimated the National Health Service (NHS) cost relating to treat of obesity and its consequences is￡5.1bn per year (Scarborough, 2011).
It is possible argued that the intake of sugar-sweetened beverages is associated with an increased risk of diabetes (Greenwood, 2014). Wang et al. (2012) points out the relevance between sugar-sweetened beverages and cost burdens of diabetes. This article analysed the extent to which the tax would reduce consumption of these beverages by 15 percent amongst adults aged 25 to 64 years and prevent 2.4 million dollars diabetes treatment per person.
Furthermore, according to the report on the state of children’s oral health in England, a third of five years are suffering from tooth decay which is mainly contributed to sugar intake (FDS, 2015). It is likely that the British Dental Health Foundation supports a tax on sugary drink in England and calls for the government to take note.
It is obvious that these evidences in relation to tax on sugar-sweetened beverages can lead to policy agenda from social issue. In addition, most studies in the field of taxation on sugary drinks from countries have already implemented suggest that reducing consumption of sugar-sweetened beverages can be affected by an increase price in their products (PHE, 2015).
However, legitimacy has been affected by the change over time and the gap from country to country (Buse, 2012). For example, WHO has revised the recommendation of sugar intake from 10% of total energy intake in 2002 to 5% of total energy intake in 2015 (WHO, 2015). As the prevalence of obesity become a tropical and serious issue, government has tried to tackle obesity by implementing a wide range of strategies such as the change of standard on sugar intake and food labelling (Jebb, et al., 2013).
Feasibility for tax on sugar-sweetened beverages needs to technical and theoretical knowledge, resources, availability of skilled staff, administrative capability and existence of the necessary infrastructure of government (Hall, et al., 1975). In terms of technical and theoretical knowledge, PHE reported ‘Sugar Reduction: The evidence for action’ in 2015, as the NHS costs have increased to combat obesity which resulted from poor diet and physical inactivity (PHE, 2015). In addition, WHO underpinned the recommendation sugar intake level reducing 5% of total energy intake with rational research (WHO, 2015).
Furthermore, it is obvious that NHS is a major responsibility for health promotion as a single national health insurance which is the biggest organisation across the world. Although the NHS has attempted to take action to tackle obesity, diabetes and tooth decay relating to sugar-sweetened beverages intake, the result is not effective, especially the prevalence of obesity (Jebb, et al., 2013; PHE, 2015). With the effort of NHS, it is possible to a time of take decisive action like tax on sugar-beverages regarding resources, availability of skilled staff, administrative capability and necessary infrastructure of government.
Despite the feasibility, the issue of tax on sugar-sweetened beverages has financial limitation. It is obvious that both excess weight and dental caries is significantly associated with deprivation (Kelly, 2009). For example, children both aged 4-5 years and aged 10-11 years in most deprived is twice as likely to the prevalence of obesity in least deprived communities (PHE, 2015). If the policy agenda become taking action, government should focus on the most deprived population. As mentioned earlier, the policy in relation to tax on sugar-sweetened beverages in Hungary has been led to the general economic crisis to decline of consumption (Rachel and Hannah, 2013). The problem relating to economic status in England is no exception.
There are a variety of support in relation to tax on sugar-sweetened beverages, such as the state, local authorities, PHE, NHS, and interest group like the British Medical Association (BMA), the British Dental Health Foundation (BDHF) and the British Soft Drinks Association (BSDA). Regards as the policy agenda, Commons’ health select committee, BMA and BDHF relating to health issue have strongly insisted the taxation of sugary drinks, while the interest groups like BSDA related to the beverage industry have opposed the taxation. Given the objections, the BDHF argued that the drinks with added sugar have already imposed a value-added tax at least 20%. Also, it would be regressive to a tax on sugar-sweetened beverages with respect to tobacco taxes (Powell, 2009). In addition, it can not only solve to the obesity and dental caries as well as other health problems but also lead to the general economic crisis (Briggs, 2013). For example, although the tax on sugary drinks had implemented during 13 months in Denmark, it caused the fierce industry response and could lead to being abolished the tax policy (Rachel and Hannah, 2013).
However, public and the organisations, who are expecting to decrease the prevalence of obesity and tooth decay, related to keeping and improving health have supported the tax on sugar-sweetened beverages (Kelly, 2009).
There is no doubt that global society experiences a serious problem of obesity and diabetes and that the economic costs of the latter are very high, contributing to a lower productivity at work as the direct costs of medical treatment, falling on the public health system. The latter is a case of negative externality, where individual acts (eating foods that generate obesity), impose a cost on the rest of society, in this case about taxpayers, as well as those who contribute directly to the public health system. In this regard, three general comments, can be formulated. First, while it is true that high intake of these products contributes to obesity and extreme obesity cases, one might ask if this is the main problem, as much of the food is fried, with a remarkable reuse of oil and low consumption of fruits and vegetables, being also a problem of cultural patterns of behavior. In case of increase of relative price of sugar, there is no guarantee that inelastic demand for these goods will have a positive impact on consumption. Thirdly, government interventions are attacks against individual freedoms, not only because the government gets into individual decisions about what goods are to be consumed, but for the sheer fact that the government will extract more resources from private agents, due to an increased tax burden.
Despite the support and the feasibility of the aforementioned tax imposed on sugar-sweetened beverages, the issue is likely to become a long term controversy in the United Kingdom, which is not to find an immediate and long-lasting legal as well as civic backing, due to complexity of tax related problems as well as civic liberties,
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