Commentary: Big Soda Sugarcoats City’s Public Health Message

Recently the Express-News Editorial Board published an opinion piece regarding the need for an awareness campaign about sugary drinks. The article characterized the City government’s lack of action on this urgent health issue as “baffling,” and asked: “What’s the problem, City Council?”

I’ll tell you what the problem is: Big Soda. I saw it firsthand while working on the very awareness campaign that is conspicuously absent from our community. Big Soda wields big influence. And after you peek behind the curtain, you’ll be surprised who is calling some of the shots in San Antonio’s public health communications.

Last year, before Mayor Julián Castro left for Washington, D.C., City Council gave San Antonio’s director of the Metropolitan Health District, Dr. Thomas Schlenker, the go-ahead for a public education campaign to reduce sugary drink consumption. The goal was to fight the high rates of obesity and diabetes in our community by reducing the percentage of San Antonians who consume sugary drinks on a daily basis to less than 50%.

Public health advocates rallied to the cause. My advocacy marketing agency, Interlex Communications, offered its services pro bono and other organizations quickly supported Metro Health’s efforts, including the American Heart Association, Methodist Health Ministries, and Salud America, all nonprofits with public health missions.

(Read more: Sugary Drinks: Feeding San Antonio’s Obesity Epidemic.)

We went to work, reviewing best practices and research from around the country. We developed numerous concepts and messages, fielded surveys among stakeholders, and conducted focus groups to shape a campaign to motivate San Antonians to reduce their consumption of sugary drinks.

But we didn’t anticipate what happened next.

After meetings with the beverage industry, the City Manager’s office required that our workgroup include a representative from Big Soda itself. I was taken aback. Having worked on similar campaigns in California, Illinois, and Washington, D.C., I had never witnessed the participation of the very industry whose products we were trying to dissuade people from consuming. It seemed counterintuitive, but I pushed myself to keep an open mind. After all, the representative was an employee of Coca-Cola. Surely, she would “open happiness.”

Instead, all that was opened was a can of worms.

Coca-Cola Company Director of Public Affairs and Communications Luisa Casso, at times joined by representatives from the Texas Beverage Association, repeatedly took issue with any brand names, messages, or imagery that they perceived as “negative,” despite the fact that these concepts tested as most effective in raising awareness about the potentially harmful effects of sugary drinks and motivating people to reduce consumption.

When Interlex and the public health partners put forth our recommended approach, Deputy City Manager Erik Walsh informed us that the City would not use messages that were not approved by the beverage industry. In effect, Big Soda silenced the public health advocates and got to veto the science that shows:

• Sugary drinks, when consumed on a daily basis, contribute to obesity and diabetes. (Bexar County Communities Putting Prevention to Work – Behavioral Risk Factor Surveillance Survey 2010 and 2012)
• People who consume sugary drinks regularly—1 to 2 cans a day — have a 26% greater risk of developing type 2 diabetes than people who rarely have such drinks. (Diabetes Care, 2010)
• For every additional soda children drink in a day, their risk of obesity increases by 60%. (Lancet, 2001)
• Sugary drinks have more sugar than you may think—more than nine teaspoons per can. They are Americans’ #1 source of added sugar. (Dietary Guidelines for Americans)

Concerned about their image and their sales, the industry folks disingenuously labeled these messages as “negative.” Of course, they are negative. They are the facts about the negative impact sugary drinks have on people’s health. Only when people realize how bad sugary drinks are, will they reduce their consumption. That is the best way to motivate people to rethink their drink of choice, practice moderation as a family, and reduce consumption so that less than half of the city’s population consumes sugary drinks on a daily basis. Given that San Antonio has epidemic levels of obesity and diabetes, that behavioral change would have an immensely positive impact on people’s lives and on our economy through improved health.

Unfortunately, since the City’s management granted Big Soda de facto veto power over messaging crafted by public health experts to educate the community, we found ourselves mired in a stalemate. Big Soda would only support a campaign without any teeth, without any of the eye-opening, motivating facts about how sugary drinks affect our health. And the public health advocates in the workgroup, myself included, refused to let an evidence-based behavior change campaign be watered down. As a result, the workgroup was disbanded and the campaign fizzled out.

In the end, Big Soda achieved exactly what it wanted: no campaign at all – at least for the moment.

But this doesn’t have to be the end of the story. I urge the City’s management to allow Metro Health to reconvene the sugary drinks reduction workgroup, but without the troubling involvement of the beverage industry. Let’s face it: putting Coke and the Texas Beverage Association on a group working to reduce consumption of their products for the public good is at best a conflict of interest and – based on what I’ve witnessed first hand – a preposterous moral hazard.

And if the City doesn’t step up now, then voters should encourage their candidates for mayor and City Council to tackle this public health issue again after the May elections, prioritizing people’s health over industry profits and empowering Metro Health to do its job without industry interference.

Let’s stop Big Soda from dictating how we educate our community about the pressing public health issues they themselves have helped create in pursuit of their sickly sweet sales.

*Featured/top image: A campaign that never was. This brand name and logo were designed by Interlex and recommended for the sugary drink reduction campaign based on surveys and focus groups; but Big Soda didn’t like it one bit.

Related Stories:

Metro Health: Less Sugar, Better Health, Longer Life

Sugar Drinks: Feeding San Antonio’s Obesity Epidemic

Confronting San Antonio’s Weight Problem

Síclovía’s More Than Symbolic Impact on City’s Health and Fitness

A Reader Remembers When We Weren’t Fat