Mexico's soda tax could reduce diabetes, heart disease and health costs

The tax on sugar-sweetened beverages in Mexico could prevent hundreds of thousands of adults from developing Type 2 diabetes and cardiovascular disease while also saving approximately $1 billion in direct health care costs over the next decade, according to an international study that is the first to project potential long-term health and economic effects of the tax.

The study is published in PLOS Medicine.

Using a newly-created simulation model of diabetes and cardiovascular disease in Mexico – dubbed the “CVD Policy Model-Mexico” – investigators from UC San Francisco and the Instituto Nacional Salud de Publica (INSP) in Cuernavaca, Mexico, estimated that the Mexican sugary beverage tax would prevent approximately 190,000 cases of diabetes, 20,000 heart attacks and strokes, and 19,000 deaths among Mexican adults age 35-94 over the next 10 years.

“Over the last 25 years, diabetes rates have quadruples across the globe, and Mexico has among the highest rates of diabetes in the Americas,” said Kirsten Bibbins-Domingo, M.D., Ph.D., UCSF professor of medicine and epidemiology, director of the UCSF Center for Vulnerable Populations and senior author of the study.

The Mexican government has adopted several approaches in an attempt to address the nation’s chronic problems of diabetes and obesity, including instituting a 10 percent excise tax on sugary beverages in 2014.

“The tax on sugary beverages is just one tool to help Mexico turn the tide on the high rates of diabetes,” said Simon Barquera, M.D., Ph.D., senior investigator of the INSP team that initiated the study. “The results of this study suggest that the health and cost benefits of this tax will be substantial.”

The tax’s effect on diabetes alone is expected to reduce health care spending on clinic visits and hospitalizations by $983 billion in international dollars, an amount that corresponds to the cost of comparable goods and services in the United States. The researchers said the health benefits are likely to be concentrated most strongly in young adults, who consume more sugar-sweetened soda and represent a larger proportion of the Mexican population than older adults.

Previous research has linked the consumption of sugary drinks to diabetes, cardiovascular disease and the obesity epidemic in the U.S. and abroad.

On Oct. 11, the World Health Organization (WHO) issued an unrelated report which concluded that taxing sugary drinks can reduce obesity, Type 2 diabetes and tooth decay. An increase of at least 20 percent in the retail price of sugary beverages would trigger proportional reductions in the consumption of the drinks, according to the WHO report, which called the use of sugar-sweetened beverages a “major factor in the global increase of people suffering from obesity and diabetes.”

Obesity more than doubled worldwide between 1980 and 2014, with 11 percent of men and 15 percent of women – amounting to more than half a billion adults – being classified as obese, the WHO reported.

Diabetes rates have been rising in many countries, but the increase is particularly striking in Mexico, where nearly 75 percent of adults are considered overweight or obese, and where the prevalence of diabetes ranks among the highest in the world.

The model used in the study was developed based on a well-established U.S. model, adapted with data from multiple sources in Mexico, with funding from the National Institute of Health’s Fogarty Center, and by UC Mexus, an academic research institute established in 1980 by the University of California to support binational and Latino research and collaborative academic programs and exchanges.  

“This new model grew from long-standing collaborations between investigators at UCSF and INSP to develop tools to examine the impact of clinical and public health interventionsusing country-specific data,” said Bibbins-Domingo. “We are pleased to use it to estimate the health impact of the soda tax in Mexico.”

Prior research using consumer data demonstrates that the tax was associated with reductions in sugary beverage purchases in the first year following implementation. The new study quantifies the impact on health and spending that could be expected over the next decade.

“Because most of the new cases of diabetes prevented are likely to be in younger adults, the health benefits may extend well into the future,” Bibbins-Domingo said.

Other UCSF authors are research analyst Joanne Penko; study mathematician Pamela Coxson; and Alicia Fernandez, M.D., a professor of clinical medicine and an attending physician at Zuckerberg San Francisco General Hospital and Trauma Center.

The research was supported by the Fogarty International Center of the National Institutes of Health under Award Number R03TW009061, and by a Grant for Collaborative Projects from the University of California Institute for Mexico and the United States (UC Mexus) and the National Council of Science and Technology.