Exploring the acceptability of sugar-sweetened beverage taxes amongst residents of River Heights, Winnipeg: a critical discourse analysis

Abstract

Introduction: In response to public health focus on “obesity”, health organizations and governments have proposed a sugar-sweetened beverages (SSB) tax to reduce sugar intake, given their association with weight gain. However, “obesity” is already associated with social stigma, which intersects with other marginalized identities. Thus, a SSB tax may have unintended consequences because of the potential for exacerbating existing intersecting stigmas. Objectives: Our research objectives were: 1) To explore the discourses informing SSB taxation, and their underlying ideologies, amongst white residents of River Heights, Winnipeg, and 2) To determine the acceptability of SSB taxation to white residents of River Heights, Winnipeg. Methods: Qualitative interviews were performed with participants from River Heights, an upper-middle class neighbourhood in Winnipeg. Recruitment occurred based on: residence in River Heights, English-speaking, and being over 18 years old. We purposively recruited young adults, mothers, and regular consumers of SSB. The interviews were semi-structured, audio recorded and transcribed verbatim. Critical discourse analysis methods were used for analysis. Critical weight studies was used to inform analysis for objective 1, as well as theories of healthism and tax psychology for objective 2. Results: Eighteen participants were recruited; all were white, food secure, with high self-reported health, and spoke about (grand)parenting when discussing SSB. Fifteen participants were female. Objective 1: Discussion of SSB was framed by personal responsibility, which dictated the acceptability of SSB behaviours. Responsibilization of SSB behaviours were discussed in relation to weight and health, such that regular, or irresponsible, consumption, were largely discussed with negative emotions and judgement. Parental responsibility for SSB and juice intake of children was prominent throughout the interviews, and elicited judgement towards others and particularly among mothers, themselves. Objective 2: When discussing SSB taxation specifically, support for taxation mostly utilized healthism discourse, whereas criticism and concern was framed using concepts of fairness, and to a lesser extent, trust. Conclusions: SSB have complex social meanings, particularly in the context of taxation. The pervasiveness of moralisation with regard to SSB intake in participant discourse, and its priority over fairness concerns suggests that SSB taxation will have consequences for stigma and health equity.