Clinic number 27 in Tijuana is the biggest family medicine clinic in Mexico. A full 30 percent of workers in this border city — and their families — come here when they have a cold or joint pain. But the most common ailments, said clinic director Alonso Perez, are related to diabetes.
“That's basically one of the critical diseases we have here,” Perez said. “Obesity and diabetes are rising, their complications are rising, and every day it's from younger patients.”
Thirty percent of Mexico’s school children and 70 percent of adults are overweight or obese. In recent years, the country has competed with the U.S. for the unflattering title of fattest country in the world.
Diabetes in Mexico has increased along with its citizens’ waistlines. Excess weight and lack of exercise fuel Type 2 diabetes, the most common kind.
In hopes of stemming what’s become a public health crisis, Mexico slapped a one peso per liter tax — about 7 cents — on sugary drinks starting last January. It also added an 8 percent tax to high-caloric food like potato chips and cookies.
The city of Berkeley, Calif. passed its own sugary drink tax — 1 cent per ounce — in November by a wide margin, becoming the first U.S. city to do so. Dozens of other U.S. cities have tried, and failed, to regulate sodas and other sugary drinks as a way to combat obesity and related health problems.
“Taxation, just like it did for tobacco, is the most effective way to get people to change their behavior,” said Barry Popkin, an economist who teaches global nutrition at the University of North Carolina.
Popkin is working with researchers from Mexico’s National Institute of Public Health to document the effects of that country’s tax on sugar-sweetened beverages.
Their preliminary results show that during the first three months of 2014, purchases of sodas and other taxed beverages declined by 10 percent compared to the same time period last year.
Meanwhile purchases of untaxed drinks, like 100 percent fruit juice and milk, went up 7 percent, and purchases of bottled water went up 13 percent.
“Essentially people were substituting plain water, the healthiest beverage we could drink other than milk, for the sugary beverages,” Popkin said.
The beverage industry in Mexico fought hard against the tax there, and continues to criticize it.
Lorena Cerdán, director of ConMexico, Mexico’s major consumer product industry group, said the taxes were hitting poorer families especially hard.
“Really, what the consumer is doing is redistributing his money,” she said. "As a result, we see that he’s consuming less of everything.”
Surveys have shown that the Mexican public largely supports the sugary drink tax. But it’s not hard to find people in Tijuana who think it’s a bad idea.
“I don’t think taxing a product is going to do a lot of educating the public,” said Juan Valle, whose family owns a small market less than a mile from the U.S. border.
Valle said sales of Coke at his store were actually up, despite the tax.
But he also said his customers seemed to like a new product called Coca-Cola Life. It’s sweetened with half sugar, half Stevia, a no-calorie substitute.
Public health advocates say if consumers start choosing lower-sugar sodas or smaller-sized sodas, that would be a victory.
Back at Clinic 27, a nurse weighed Armando Huerta and checked his blood glucose level. Huerta found out he had diabetes two years ago.
“I used to eat a lot of fried stuff,” Huerta said. “Chicharrones, a lot of tortillas, mole, and always with soda. We Mexicans say it helps you burp and feel better.”
But that feel good effect can mask long-term damage. According to Harvard researchers, drinking one to two sugary beverages per day can increase a person’s risk of developing Type 2 diabetes by 26 percent.
Huerta said he eats healthy food now, and he doesn’t touch soda.
Revenue from the soda tax is supposed to fund health education programs, like the one that’s helped Huerta understand his disease and how to take care of himself. Revenue is also supposed to fund drinking fountains in public schools, though public health advocates complain that the program has been underfunded and slow to get off the ground.
In the border region, many Mexican consumers have a way of getting around the soda tax — they can just shop in the U.S.
Berkeley shoppers hoping to avoid their new soda tax could do the same and shop outside of the city. And they wouldn’t even need a passport.
