Articles by Marianne Szeto

By Marianne Szeto

I started my career in public health in 2007 as a fresh-faced newbie who wanted to make the world a better place. I was so fortunate to land a job at the San Francisco Department of Public Health, staffing the Shape Up SF Coalition. In this role and in partnership with many others, I helped implement outreach and awareness campaigns (Soda Free Summer, Rethink Your Drink, Drink Water Said the Otter, Choose Healthy Drinks, Open Truth), countless tabling events in the community, train-the-trainers, trainings on industry tactics, sugar science, and more. All this to soften the ground in hopes of a sustainable funding stream to prevent chronic diseases like type 2 diabetes and heart disease. And in 2016, that dream came true! SF voters passed the soda tax, and then the hard work began to show that soda taxes are effective tools to reduce consumption of liquid sugar and over time, can lead to a decrease in preventable diet-sensitive chronic diseases.

I was beyond thrilled to celebrate the 5-year anniversary of the soda tax, and especially to help plan the last event of the week-long celebration: a virtual policy panel with phenomenal speakers. The American Heart Association and Sugary Drinks Distributor Tax Advisory Committee co-hosted a panel of policy champions (Senator Scott Wiener), grassroots organizers (Lolis Ramirez), community (Vanessa Bohm) and physician (Dr. John Maa) advocates, researchers (Roberto Vargas), and public health professionals (Dr. Susan Philip) to look at the lessons learned and future of sugary drink policies. Expertly co-hosted by Abby Cabrera, Co-chair of the Sugary Drinks Distributor Tax Advisory Committee, and moderated by Blythe Young, Community Advocacy Director for the American Heart Association, the cross-cutting theme that emerged for me was about the strength and power in community. If you didn’t get a chance to watch the live webinar, here’s the recording. 

Panelists discussed the early days of the political campaign, the challenges that an underfunded and under-resourced campaign faced against a multi-million dollar industry, preemption, and critical steps to implementing the advisory committee, gathering community input to inform the recommendations of the committee, and the importance of educating the public about where the funds are going. (This is an area in which San Francisco can certainly improve!)

Key to San Francisco’s successful implementation of the soda tax is holding the community at the center of our work. And in San Francisco, we’re doing just that. As Dr. Philip shared in her high level overview of the evaluation findings from Raimi + Associates, the funds that are going into the community to fund programs, services, systems-level and structural changes are the same communities that are most targeted by the beverage industry, and most impacted by diet-sensitive chronic diseases. Even more powerful is the realization that these maps also overlap with the redlining maps.  Soda taxes are a tool to address health equity because the community has been invested in this process from the very beginning. (Check out the interactive maps and data dashboards by our evaluators, Raimi + Associates.)

So where do we go from here? What does the next 5 years of San Francisco’s soda tax look like? What advice did panelists have for jurisdictions considering a local soda tax now that the penalty provision has been lifted from the state level preemption? Here are some powerful messages from panelists:

• “Start with community” – It needs to come from the community, for the community. Starting from grass bottoms to grass tops will lead to a better chance of success. 
• Find your trusted community leaders to share their stories with policy leaders. 
• Strength in numbers. Chances are stronger when cities band together, especially in a shared media market. 
• “Democracy is not a spectator sport” – everyone should engage in opportunities to strengthen the soda tax. 

It all starts with wanting to make a difference. Investing in our community is investing in our community’s long-term health and wellness because the community is at the root of all this work.

Don’t just take it from me. Watch the recording to hear it directly from our panelists and prepared to be inspired. See the slides.

Watch on YouTube

The San Francisco Public Health Foundation (SFPHF), in collaboration with the San Francisco Department of Public Health (SFDPH), is seeking panelists to serve on the community grants review panel for the 2023 Healthy Communities Grants Request for Proposals.

This is a great opportunity for community leaders who are interested in health and wellness and who have deep connections to San Francisco communities that are most harmed by sugary drinks and related illnesses (Black/African American, Latinx, Pacific Islander, Native American/American Indian, Asian, and Low-Income Populations). Panelists will have the opportunity to have a say in projects that get funded in their communities and be paid up to $575. No prior experience is necessary, and training will be provided.

Please help us spread the word by sharing this opportunity with your networks! Applications are due February 6, 2023.

Visit https://sfphf.org/cgrp for more information.

Ah, summer. I miss my lazy summers as a kid… floating on a raft in the pool with not a care in the world, sipping a sugary beverage on a hot summer day. 

Fast forward to the present day. School has been out for weeks, the fourth of July has come and gone, and parents are busy shuttling their kids from one summer camp to the next. Camps are different today insofar that sugary drinks are no longer as prevalent. In fact, in SF they should be close to non-existent… because we worked toward that outcome.

So much has happened to bring us to where we are today. Sugary drinks are linked to a whole host of chronic diseases like type 2 diabetes, tooth decay, and heart disease. 

So just how did we get here? Please join me for a walk down memory lane as I reflect on the work of Shape Up SF and the many partners who have helped lay the foundation for the soda tax in SF through education and systems-level approaches.

It all started with a Soda Free Summer. Alameda County Public Health Department launched the first Soda Free Summer in 2007, educating residents about the health harms of sugary drinks and challenging them to go soda-free for 10 weeks and to drink healthy alternatives like water, milk or 100% fruit juice.

The campaign was so successful that in 2008, the Bay Area Nutrition and Physical Activity Collaborative (BANPAC) took the Soda Free Summer campaign regional. Six Bay Area counties (Alameda, Contra Costa, Marin, Santa Clara, San Francisco, and San Mateo) participated in the campaign thanks to funding from Kaiser Permanente Regional Community Benefit and The California Endowment who funded the evaluation.  Over 100 organizations in San Francisco participated including schools, child care homes and centers, churches, and community based organizations. 20,000 commitment cards were sent to families through these organizations. Nearly half (47%) of survey respondents reported they were drinking less soda and sports drinks since being exposed to the campaign. 

Soda Free Summer was becoming a household phrase. In 2009, the Board of Supervisors and the State of California declared it a Soda Free Summer! The education efforts continued, but with a new focus on families with young children and infants. SF FIRST 5 funded Shape Up SF to develop Soda Free Summer (SFS) materials for early childhood and “‘Drink Water!’ Said the Otter” (DWSTO) was born. Over 5,000 DWSTO books were distributed to every pre-k and kindergarten class in the SFUSD and hundreds more to SF Children’s Council, Kaiser Permanente, and other partners. 

In 2010, the “Rethink Your Drink” movement gained speed. The awareness efforts continued: SF ran NYC’s Pouring on the Pounds campaign on MUNI. The beloved Otter of “Drink Water!” fame was translated into Spanish and distributed to hundreds of providers across the city. 

But there were exciting systems-level changes happening too. Mayor Newsom issued an executive directive establishing healthy vending guidelines for vending machines on City property; and that summer, SF’s Recreation and Parks Department included a “no soda” policy in the Summer Camp manual that applied to campers and counselors. 

The awareness and education coupled with policy changes were beginning to have a big impact. In 2012, Kaiser Permanente funded Shape Up SF to support three organizations to adopt healthy beverage policies. Over 63,000 people were impacted by the healthy food and beverage policies at the YMCA, Bayview Hunters Point Foundation and SF Children’s Council!

In 2013, Shape Up SF partnered with UCSF’s Center for Vulnerable Populations and Youth Speaks to focus on the negative impacts of sugary drinks on health and how Big Soda targets young people and communities of color. Watch the powerful videos at TheBiggerPicture.org.

In 2014, there was a big push on awareness and education as key partners prepared for a soda tax on the November ballot. Shape Up SF launched the “Choose Healthy Drinks” campaign with other Bay Area counties to increase awareness about the amount of sugar in drinks. These ads saturated the community at corner stores, billboards, and on public transit. SUSF developed a training of trainers that focused on how sugary drinks are making us sick and Big Soda’s tactics. Although the tax did not pass in SF, Berkeley became the first city in the US to pass a voter approved soda tax despite Big Soda spending over $10 million in the Bay Area to defeat these efforts.  

2015 started with the launch of our Open Truth Campaign, which opened doors and paved the way for new  partnerships and exciting victories against Big Soda:

• San Francisco State University students, led by the Real Food Challenge, kept Big Soda from entering into a pouring rights contract and having a beverage monopoly and significant marketing presence on campus. 
• SFDPH continued to “walk the talk” by issuing a directive that sugary drinks are not allowed for any event led by DPH or on DPH property; or to be paid for with DPH funding. Zuckerberg SF General Hospital also adopted a groundbreaking sugar-sweetened beverage-free policy in the fall. 
• SF Supervisors introduced three landmark policies to reduce sugary drinks impacts on SF: Mandating warning labels on SSB ads in SF; Prohibiting SSB ads on public property; and Prohibiting use of City funds to purchase SSB. 

2016 proved to be a standout year for the movement to decrease consumption of sugary drinks. 

• Philadelphia, Boulder, and Cook County all passed soda taxes! 
• Shape Up SF led the transcreation of Open Truth Campaign into Spanish: Destapa la Verdad; and partnered with SFHIP to support health equity coalition members educate the Chinese, Black, and Latino communities about sugary drinks through grassroots education and advocacy.
• Decreasing consumption of sugary drinks is important, but we also needed to promote the consumption of healthy drinks like tap water. Shape Up SF partnered with SFHIP, the City and County of SF, and SF Public Utilities Commission to ensure equitable access to public sources of clean drinking water they can trust, resulting in the installation of hydration stations in schools and public spaces across the City. 

On January 1, 2018,  the voter-approved “soda tax” went into effect, collecting millions of dollars to fund health education, access to healthy food, opportunities for physical activity, awareness campaigns, oral health, access to water, and so much more. 

As you have read, a lot of hard work and collaboration led to the passage of the SF soda tax. To everyone who has helped pave the way and to all organizations who are passing the policies, providing the services and programs to create healthy environments for our communities… thank you!!