Fruit and vegetable subsidies may work five times better than soda taxes

Before we get into the details, let’s talk about the parties that’ll likely applaud these numbers. They include soda companies, which now have a little more fuel to shift the blame for cardiovascular disease from “too much sugar” to “not enough vegetables,” and small-scale vegetable farmers, who’d probably love a subsidy that lets them charge 10 percent less for what they grow. Add to the list just about anyone who believes that people basically know how to take care of themselves and can make their own decisions at the grocery store, thank you very much.

Back to the study. Using the US IMPACT Food Policy Model and probabilistic sensitivity analyses, researchers estimated and compared the reductions in cardiovascular disease mortality and socio-economic disparities in the U.S. population potentially achievable from 2015 to 2030, with four specific dietary policy scenarios. The first model focused on a mass media campaign promoting fruits and vegetables and discouraging sugary beverages. The second looked at taxing soda at a rate of 10 percent, and the third modeled a 10 percent fruit and vegetable subsidy across the board. The last scenario modeled a targeted intervention where people using food stamps (SNAP) got a 30 percent discount on fruits and vegetables. (Note: There’s a lot of debate over who bears the financial burden of a soda tax—some early research indicates that big companies like Coke and Pepsi absorb up to half of the tax before increasing prices. For simplicity’s sake, these models looked at subsidies and taxes as if the full discount or price increase made it all the way to the checkout line.)

When the results came in, subsidies for fruits and vegetables beat taxes on soda by a long shot when measured by the number of lives saved. According to the model, a 10 percent fruit and veggie subsidy would result in more than 150,000 “prevented or postponed” deaths due to cardiovascular disease by 2030. That’s almost five times the amount of lives saved by a soda tax (31,000), and a little over four times the estimated number of prevented or postponed deaths from the 30 percent incentive targeted at food stamps users (35,000). It’s worth noting, however, that the soda tax did beat a mass media campaign, which was estimated to save 25,000 lives.

Of course, hypothetical economic models don’t tell the whole story. In Philadelphia, for example, the mayor’s office just announced that soda tax revenue at the six-month mark is well below the projections (revenue being just one measure of success). And even if the models are perfectly accurate, fruit and veggie subsidies aren’t necessarily feasible. The researchers didn’t look at the costs of implementation for each scenario, but it stands to reason that subsidizing fruits and vegetables would cost a lot more than taxing soda. But the unmeasurables aren’t all bad. As the researchers point out, they only looked at prevented and postponed deaths. There are certainly benefits to cheaper fruits and veggies that can’t be measured by mortality rates.

The researchers also looked at whether or not any of these policies would reduce socioeconomic disparities in cardiovascular illness-related deaths. The findings showed none of the policies taken alone would result in a huge reduction in those disparities, though the SNAP-targeted fruit and veg subsidy would go the furthest.

The most effective approach, they point out, is pretty obvious: combine all of the above. Make fruits and veggies cheaper for everyone, and give even deeper discounts to people with less to spend at the checkout line. The researchers found that a combination of these approaches actually might reduce socioeconomic disparity (at a rate of 6 percent, but still). Throw in a soda tax and a mass media campaign, and you’re looking at preventing 230,000 deaths by 2030—a pretty huge chunk of the 200,000 annual losses due to preventable heart disease in the U.S., according to the Centers for Disease Control.