The link between sugary drinks, cancer and poor neighborhoods

As I leave the lakefront downtown Chicago neighborhood where I work and head toward my home in a predominately black neighborhood, the commercial food landscape changes drastically. In my community, “red juice drink” replaces bottled water supplemented with electrolytes at the checkout lines. 

That is why a large study reporting that sugar sweetened beverage intake increases the chance of developing certain cancers caught my attention. Even if you rightly approach findings from observational studies of nutrition and disease with some skepticism, the body of evidence pointing to health harms from dietary habits, still gives pause. 

The link between sugared beverage intake and cancer follows prior studies showing that sugared beverages are associated with higher rates of obesity, diabetes and cardiovascular diseases. 

The consistency of these findings across multiple diseases begs the question of why discussion about these recent findings ignores the disproportionate marketing and sales of sugared beverages in low income and racial minority communities? 

Sugared beverages hold prominent real estate on store shelves to promote sales. They are featured in high traffic areas around the perimeter of the store and near the checkout counter where shoppers are likely to see them and toss them in the cart. 

While these patterns are not restricted to corner stores and convenience stores, sugared beverages make up a larger proportion of sales in these smaller stores than in full service supermarkets, that carry a large volume of fresh fruits, vegetables and protein at competitive prices.

These corner stores, convenience stores, quickie marts and bodegas are often the only choice for minority and low-income communities. “Food deserts” (defined by the USDA when at least 500 residents or 33 percent of the population live further than one mile from a full service supermarket), are often the only option for purchasing food in low income communities. 

A 2018 study reported that on days when benefits are issued from the Supplemental Nutritional Assistance Programs (SNAP) stores serving these populations increase their marketing of sugared beverages. Coincidence or conspiracy? 

If you are still only convinced that these practices are nothing more than good business sense, these patterns are not restricted to poor in the US. In a global trends analysis, sugared beverages became rapidly more affordable relative to income than bottled water between 1990 and 2016; these patterns were most prominent in developing world economy countries. 

In our research on the urban food scape in Chicago, we mapped the distance to supermarkets in U.S. Bureau tracts across the socioeconomic spectrum from calendar years that spanned the Great Recession. We found the opening of more full service supermarkets only benefited wealthier communities. Because there was little change in low-income and predominately minority populations, disparities in food access worsened.

The result of disparities in healthy beverage and food access is the perpetuation of disparities is major chronic diseases that develop secondary to obesity. 

I share the criticism of many nutrition and lifestyle studies that we cannot take everything we hear from these studies as “truth.” I also believe that with education about the harms of these sugared products and proper motivation, individuals can choose not to consume these items. 

However, food injustice is a structural problem that is particularly relevant for low income and minority adults because they lack the resources and access to make different choices. 

The answer isn’t to ask people to move from their communities. Rather, it is to improve our communities. We chose to live in our predominately black community because it provides a sense of cultural belonging coupled with affordable housing prices. However, we deserve to have “quick” access to healthy beverages and food. 

A national commitment to addressing disparities must make healthy drinks and food affordable and available with subsidies and enhanced access. Just as the Clinton-era Alliance for a Healthier Generation restricted sugared beverages in schools through vending machine restrictions, the same can be done in workplaces to promote health among adults. 

The cost of subsidization and policies is a much sweeter option than continuing to pay the price of health-care disparities from obesity, diabetes, cardiovascular diseases and cancers. 

Mercedes Carnethon, Ph.D., is the Mary Harris Thompson Professor of Preventive Medicine and chief of the division of epidemiology at the Feinberg School of Medicine at Northwestern University and a Public Voices Fellow through The OpEd Project.