February 27, 2019

Our letter to the editor in the Wednesday, February 27th San Francisco Chronicle responded to an earlier editorial about the efficacy of soda taxes for improving public health. We introduced a healthy equity and justice perspective into the conversation. See the reprinted letter below:

Soda taxes and health justice

Regarding “Soda taxes have healthful effects” (Editorial, Feb. 25): Bravo to the editorial board for clearly explaining how soda taxes protect public health and why Big Soda is keen to stamp out these taxes. Readers should also understand that soda industry marketing practices don’t affect everyone equally. Disparities in sugary drink consumption didn’t happen by accident.

Mimicking the predatory strategies embraced by Big Tobacco, Big Soda makes a profit by spending billions of dollars targeting low-income neighborhoods and communities of color. This leads to a greater burden of obesity and chronic diseases for folks living in those communities. The beverage industry must take responsibility for the harms and injustices its products and marketing have created; soda taxes are government’s best tool to make that happen. Because soda taxes are regressive, meaning those with lower incomes pay more, the funds generated from these taxes must be reinvested in the communities that are targeted by beverage companies.

Soda taxes are a proven solution that can help build a healthy future for everyone.

Marice Ashe, CEO of ChangeLab Solutions, Oakland

The mission of ChangeLab Solutions is to create healthier communities for all through equitable laws and policies. Check out our online catalog, connect with us on Twitter or Facebook, join our email list, and support our work!

February 15, 2019

Though the headlines about the Ninth Circuit case would suggest otherwise, requiring warnings about the health harms of soda and other sugary drinks remains a viable and critical strategy.

“Federal Appeals Court Blocks San Francisco Law on Ad Warnings for Sugary Drinks.” “Court Strikes Down San Francisco’s Soda Health Warnings.” “11-Judge Appeals Court Panel Overturns Soda Warning, Citing U.S. Supreme Court.”

These headlines sum up the media’s reaction to a January 30 ruling of an en banc panel of the Ninth Circuit Court of Appeals. Reading them, it would be logical to assume that San Francisco had suffered a devastating loss in court.

When you take a deeper look at the ruling, however, it’s about as good a “loss” as San Francisco—and the public health community—could have hoped for.

Let’s start from the beginning. In 2015, San Francisco’s board of supervisors voted unanimously to require certain sugary drink advertisements, such as billboards and signs, to include the following statement: “WARNING: Drinking beverages with added sugar(s) contributes to obesity, diabetes, and tooth decay. This is a message from the City and County of San Francisco.” The warning statement would have to occupy at least 20 percent of the advertisement and be placed within a rectangular border.

The law was enacted in response to overwhelming evidence that, both locally and nationwide, sugary drinks are making us sick. A clear and compelling body of evidence links sugary drink consumption to chronic diseases like type 2 diabetes, obesity, and heart, liver, and dental diseases. Yet about half of adults, two-thirds of youth, and one-third of toddlers (babies 1-2 years old!) in the United States consume at least one sugary drink every day.

Health warnings are one of the best strategies for educating people about the risks of what they consume. Warning labels on tobacco products and advertisements, for example, have proven not only effective but also legally sound. The same is true for sugary drink labels. A recent study showed that parents were significantly less likely to choose a sugary drink for their child when that drink was labeled with a warning similar to the one required by San Francisco’s law.

Perhaps because health warnings are so effective, Big Soda swiftly took San Francisco to court. They challenged the warning requirement on First Amendment grounds, claiming that it compelled the beverage companies to speak against their will and in a way that violated the companies’ constitutional rights. The case made its way through the federal court system, eventually landing in front of an en banc panel of the Ninth Circuit.

Technically, the panel sided with the beverage industry, but not nearly to the degree that the headlines suggest. The court took no issue with the idea of a warning requirement, nor even with the specific warning language. The court was only concerned that, at least based on the evidence before it, the required warning may pose an undue burden on companies’ free speech (yes, the companies’ free speech rights) due to its size.

Text size is very fixable problem. San Francisco has several options at its disposal. Most simply, it can amend the law to require that the warning take up less space. Or it can establish a more thorough record on why a 20 percent standard is justified and necessary to get San Franciscans to fully understand the risks associated with sugary drinks. While there is no guarantee that a court would accept a smaller warning or a warning backed by more evidence, of all the problems the court could have had with the law, text size is by far the simplest to address.

Another critical yet underreported element of the ruling is the court’s unmistakable recognition that governments should and still do have substantial leeway when it comes to laws requiring businesses to disclose factual and uncontroversial information. A recent Supreme Court case that addressed disclosure requirements for so-called “crisis pregnancy centers” created some confusion about what standard of review should apply to such requirements, but the Ninth Circuit opinion is clear: as long as the law is reasonable (that’s where the size comes in), warning requirements are permissible. In other words, the FDA can continue to require health warnings on tobacco products, and the state of California can continue to require companies to disclose potential carcinogens in their products. Similarly, states and cities should also be able to require Big Soda to warn of the relationship between consuming sugary drinks and health problems such as type 2 diabetes, obesity, and tooth decay.

The ability of state and local governments to require sugary drink warnings is all the more important in light of industry-fueled efforts to thwart localities’ efforts to protect the health of their residents. Recently, beverage industry lobbyists strong-armed the California legislature into enacting a bill that prohibits cities from enacting new local sugary drink taxes through 2030, meaning that the only option for a new sugary drink tax in California is at the state level. Similar attempts to prohibit local sugary drink taxes through preemption (as this underhanded tactic is called) have recently passed in other states and continue to percolate. In spite of sugary drink taxes’ proven effectiveness—or, perhaps, because of it—industry is fighting tooth and nail to prevent local governments from even considering such taxes as an option, leaving warnings as a critical strategy.

San Francisco is not alone in recognizing the value of health warnings. New York City legislators have proposed requiring warnings about the amount of added sugars in restaurant meals. California’s legislature is considering requiring warnings directly on soda cans and bottles. Hawaii, New York, Baltimore, and other states and cities also have considered warnings for sugary drinks. This momentum is aligned with public opinion; surveys show that the public wants this information. One poll found that 78 percent of California voters support requiring beverage companies to post health warnings on soda and other sugary drinks.

Though the headlines about the Ninth Circuit case would suggest otherwise, requiring warnings about the health harms of soda and other sugary drinks remains a viable and critical strategy. Even the beverage industry admits that education can be an effective tool to lower sugary drink consumption. We couldn’t agree more. That’s exactly what warning labels are all about.

Sabrina Adler is a senior attorney and program director at ChangeLab Solutions, an Oakland, CA–based nonprofit devoted to improving health through legal- and policy-based solutions. ChangeLab Solutions created the model law requiring sugary drink warning labels on which San Francisco’s law is based.


Reprinted with permission from the February 11 issue of The Recorder. © 2019 ALM Media Properties, LLC. Further duplication without permission is prohibited. All rights reserved.


January 31, 2019

On Wednesday, the Commissioner of the New York City Department of Health and Mental Hygiene, and ChangeLab Solutions board member, Oxiris Barbot backed a city council proposal to ban the sale of all flavored tobacco and e-cigarette products in the city.

“The Administration fully supports banning all flavored, including mentholated, e-cigarettes, as well as banning the sale of menthol cigarettes and other tobacco products,” Barbot said in a statement released on Twitter. “Doing so is a critical step in protecting our City’s youth and communities of color.”

In support of Commissioner Barbot’s statements, ChangeLab Solutions fully endorses this proposed ban. Vast majorities of Black and Latino adults who smoke use menthol products – the result of discriminatory marketing and predatory retail practices by Big Tobacco companies. And the use of flavored e-cigarettes by children and teens has reached “epidemic proportion[s],” according to US Food & Drug Administration Commissioner Scott Gottlieb. Banning the sale of both products will go a long way towards improving public health and equity.

Read Commissioner Barbot’s city council full testimony here. The African American Tobacco Control Leadership Council also testified in support of the proposed ban. Finally, check out our fact sheet and model ordinance on restricting the sale of flavored tobacco products.

ChangeLab Solutions’ mission is to create healthier communities for all through equitable laws and policies. Contact us to learn more, subscribe to our emails, and support our work.

January 22, 2019

ChangeLab Solutions is pleased to announce that Julie Hutcheson Stoss, JD, is now a member of our board of directors. 

As vice president of government relations at Kaiser Permanente (KP), Julie leads the development of KP’s national policy positions and principles to advance strategic objectives. Under her leadership, the government relations team provides strategic counsel to KP’s legislative representatives at the state level.

Prior to joining Kaiser Permanente, Julie worked as a senior consultant for California Assemblymember Liz Figueroa and as an attorney in private practice at McCutchen, Doyle, Brown, & Enersen in San Francisco. An enrolled member of the Cherokee Nation, Julie is a nationally known leader in health care and policy; she was recognized by Diversity MBA Magazine as one of the Top 100 Under 50 Diverse Executive & Emerging Leaders in 2014.

“Julie brings a truly exceptional understanding of public policy and the legislative process,” says Marice Ashe, founder and CEO of ChangeLab Solutions. “Her leadership qualities and commitment to promoting high-quality, affordable health care will help ChangeLab Solutions further our mission of ensuring healthy communities for all.”

“I am thrilled to join this organization with the bold vision of advancing laws and policies that ensure healthy lives for everyone,” says Julie. “Going beyond education and advocacy, ChangeLab Solutions gives policymakers the tools they need to improve health and reduce disparities.”

Julie holds a bachelor’s degree in political science (with highest honors) from the University of California at Berkeley and a law degree cum laude from Harvard University.

January 22, 2019

ChangeLab Solutions’ Aysha Pamukcu was recently selected for the Center for Community Investment’s Fulcrum Fellowship for 2019-20, along with 13 other leaders from across the country. 

According to the center, Fulcrum Fellowships are awarded to “current and rising executives in the fields of population health, climate resilience, community development, and philanthropy.” Throughout this 12-month program, Aysha will strengthen her leadership, networking, and collaboration skills by participating in seminars, coaching, and cohort learning.

As ChangeLab Solutions’ health equity lead, Aysha oversees our health equity strategy, innovation, and implementation. Through research, training, and technical assistance, she helps communities use policy solutions to address unjust health disparities. As a Fulcrum Fellow, Aysha will design policy and implementation guidance on how to equitably enforce public health laws.

Previously, Aysha worked as policy counsel at the Greenlining Institute, where she used civil rights strategies to advance racial justice and economic equity. She currently serves on the board of directors of Baby-Friendly USA. Her volunteer work includes representing people seeking asylum in the United States and assisting judges at the Khmer Rouge Tribunal in Cambodia.

Please join us in congratulating Aysha! See her full bio here.