[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-113252-en":3,"doc-seo-113252-105":29,"detail-sidebar-cat-0-en-105":83},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":20,"is_downloadable":20,"audit_status":20,"page_count":21,"language":22,"language_code":23,"site_id":24,"html_lang":23,"table_of_contents":25,"faqs":26,"seo_title":13,"seo_description":14,"update_tm":27,"read_time":28},113252,2336464648322,"Aria","https://ap-avatar.wpscdn.com/avatar/2200025388227c56fec?_k=1778556882303663488",8,"Research & Report","Local Water Quality, Diarrheal Disease, and the Unintended Consequences of Soda Taxes","Could taxing sugar-sweetened beverages in places without clean drinking water raise diarrheal disease risk? Evidence from Mexico’s 2014 excise tax shows a 6.6% increase in gastrointestinal disease rates in areas lacking safe water during the first year, with a smaller effect in the second year. Patterns suggest households without safe water shifted toward bottled water two years later, potentially explaining the decline. Despite modest implied costs, results indicate soda taxes should be paired with policies that guarantee safe drinking water for vulnerable groups.","Pub lic Disclosure Authorized Pub lic Disclosure Authorized  \nThe World Bank Economic Review, 36(1), 2022, 1–18  \n[https://doi.org10.1093/wber/lhab008](https://doi.org10.1093/wber/lhab008)  \nArticle  \nLocal Water Quality, Diarrheal Disease, and the Unintended Consequences of Soda Taxes Emilio Gutierrez and Adrian Rubli   \nAbstract  \nCould taxing sugar-sweetened beverages in areas where clean water is unavailable lead to increases in diarrheal disease? An excise tax introduced in Mexico in 2014 led to a significant 6.6 percent increase in gastrointestinal disease rates in areas lacking safe drinking water throughout the first year of the tax, with evidence of a diminishing impact in the second year. Suggestive evidence of a differential increase in the consumption of bottled water by households without access to safe water two years post-tax provides a potential explanation for this declining pattern. The costs implied by these results are small, particularly compared to tax revenues and the potential public health benefits. However, these findings inform the need for accompanying soda taxes with policy interventions that guarantee safe drinking water for vulnerable populations.  \nJEL classification: I18, I15, Q53, H23  \nKeywords: water quality, sugar taxes, gastrointestinal diseases, avoidance behavior  \n1. Introduction  \nDeveloping countries face a disease-burden mix of acute and chronic conditions. In these settings, the need to provide clean drinking water to reduce diarrheal diseases (Kremer et al. 2011; Dupas and Miguel 2017) coexists with recent actions aimed at reducing obesity, like taxing sugar-sweetened beverages (SSBs) (Cawley 2015; Allcott, Lockwood, and Taubinsky 2019) . Figure 1 presents two motivating, descriptive pictures. From a total of 39 countries that have implemented a national tax on SSBs since 1940, 31 have done so over the last decade, and 22 correspond to developing countries. Furthermore, as expected, these countries have a higher mortality rate from gastrointestinal diseases (GIDs), which has been linked to the lower availability of safe drinking water in these settings.  \nBroadly speaking, the effectiveness of SSB taxes depends on consumers’ substitution patterns (Allcott, Lockwood, and Taubinsky 2019) . Many empirical studies have documented substitution from SSBs to  \nEmilio Gutierrez is an associate professor at Instituto Tecnologico Autonomo de Mexico (ITAM), Department of Economics, Mexico City, Mexico; his email address is [emilio.gutierrez@itam.mx. Adrian Rubli](emilio.gutierrez@itam.mx. Adrian Rubli) (corresponding author) is an assistant professor at Instituto Tecnologico Autonomo de Mexico (ITAM), Department of Business Administration, Mexico City, Mexico; his email address is [adrian.rubli@itam.mx. The](adrian.rubli@itam.mx. The) authors thank Eric Edmonds (the editor) and three anonymous referees, as well as Anna Aizer, Jay Bhattacharya, Janet Currie, Andrew Foster, Joshua Graff Zivin, Michelle Marcus, Emily Oster, Jody Sindelar, and seminar participants at the Frontiers of Health Economics Research in Latin America workshop (iHEA 2017), Latin American and Caribbean Economic Association (LACEA 2017), Northeastern Universities Development Consortium (NEUDC 2018), and ITAM-UCSD conference for insightful comments and Ricardo Enrique Miranda and Daniela Soto for expert research assistance. The authors acknowledge support from the Asociación Mexicana de Cultura. A supplementary online appendix is available with this article at The World Bank Economic Review website.  \n© The Author(s) 2021 . Published by Oxford University Press on behalf of the International Bank for Reconstruction and Development / THE WORLD BANK.  \nAll rights reserved. For permissions, please e-mail: [journals.permissions@oup.com](journals.permissions@oup.com)  \nDownloaded from [https://academic.oup.com/wber/article/36/1/1/6238549 by LEGVP Law Library user on 08 December 2023](https://academic.oup.com/wber/article/36/1/1/62","cbCaitZOB4bS1FVK","https://ap.wps.com/l/cbCaitZOB4bS1FVK","pdf",2800913,1,41,"English","en",105,"# Introduction\n## Policy context: SSB taxes and health trade-offs\n## Research question and Mexico’s setting\n## Data and empirical approach","[{\"question\":\"How might bottled water consumption explain the change over time?\",\"answer\":\"The study provides suggestive evidence that households without access to safe water increased consumption of bottled water two years after the tax, which could help explain the declining pattern in later effects.\"}]",1784501900,103,{"code":4,"msg":30,"data":31},"ok",{"site_id":24,"language":23,"slug":32,"title":13,"keywords":33,"description":14,"schema_data":34,"social_meta":78,"head_meta":80,"extra_data":82,"updated_unix":27},"local-water-quality-diarrheal-disease-and-the-unintended-consequences-of-soda-taxes","",{"@graph":35,"@context":77},[36,53,68],{"@type":37,"itemListElement":38},"BreadcrumbList",[39,43,47,50],{"item":40,"name":41,"@type":42,"position":20},"https://docshare.wps.com","Home","ListItem",{"item":44,"name":45,"@type":42,"position":46},"https://docshare.wps.com/document/","Document",2,{"item":48,"name":12,"@type":42,"position":49},"https://docshare.wps.com/document/research-report/",3,{"item":51,"name":13,"@type":42,"position":52},"https://docshare.wps.com/document/local-water-quality-diarrheal-disease-and-the-unintended-consequences-of-soda-taxes/113252/",4,{"url":51,"name":13,"@type":54,"author":55,"headline":13,"publisher":57,"fileFormat":60,"inLanguage":23,"description":14,"dateModified":61,"datePublished":62,"encodingFormat":60,"isAccessibleForFree":63,"interactionStatistic":64},"DigitalDocument",{"name":9,"@type":56},"Person",{"url":40,"name":58,"@type":59},"DocShare","Organization","application/pdf","2026-07-20","2026-07-19",true,{"@type":65,"interactionType":66,"userInteractionCount":20},"InteractionCounter",{"@type":67},"ViewAction",{"@type":69,"mainEntity":70},"FAQPage",[71],{"name":72,"@type":73,"acceptedAnswer":74},"How might bottled water consumption explain the change over time?","Question",{"text":75,"@type":76},"The study provides suggestive evidence that households without access to safe water increased consumption of bottled water two years after the tax, which could help explain the declining pattern in later effects.","Answer","https://schema.org",{"og:url":51,"og:type":79,"og:title":13,"og:site_name":58,"og:description":14},"article",{"robots":81,"canonical":51},"index,follow",{"doc_id":7,"site_id":24},{"code":4,"msg":5,"data":84},[85,89,93,97,102,107,112,115,120,123,127],{"id":20,"doc_module":4,"doc_module_name":45,"category_name":86,"show_sort_weight":87,"slug":88},"Story & Novel",90,"story-novel",{"id":46,"doc_module":4,"doc_module_name":45,"category_name":90,"show_sort_weight":91,"slug":92},"Literature",80,"literature",{"id":52,"doc_module":4,"doc_module_name":45,"category_name":94,"show_sort_weight":95,"slug":96},"Exam",70,"exam",{"id":98,"doc_module":4,"doc_module_name":45,"category_name":99,"show_sort_weight":100,"slug":101},5,"Comic",60,"comic",{"id":103,"doc_module":4,"doc_module_name":45,"category_name":104,"show_sort_weight":105,"slug":106},6,"Technology",50,"technology",{"id":108,"doc_module":4,"doc_module_name":45,"category_name":109,"show_sort_weight":110,"slug":111},7,"Healthcare",40,"healthcare",{"id":11,"doc_module":4,"doc_module_name":45,"category_name":12,"show_sort_weight":113,"slug":114},30,"research-report",{"id":116,"doc_module":4,"doc_module_name":45,"category_name":117,"show_sort_weight":118,"slug":119},9,"Religion & Spirituality",20,"religion-spirituality",{"id":118,"doc_module":4,"doc_module_name":45,"category_name":121,"show_sort_weight":118,"slug":122},"World Cup","world-cup",{"id":124,"doc_module":4,"doc_module_name":45,"category_name":125,"show_sort_weight":124,"slug":126},10,"Lifestyle","lifestyle",{"id":128,"doc_module":4,"doc_module_name":45,"category_name":129,"show_sort_weight":98,"slug":130},19,"General","general"]