Association of the sugary drink excise tax policy and diabetes and associated cardiometabolic risk biomarkers in primary care patients (aspire)

The National Institute of Diabetes and Digestive and Kidney Diseases awarded Oregon Health & Science University $1,561,626 on June 1, 2026, under the Diabetes, Digestive, and Kidney Diseases Extramural Research program (CFDA 93.847) to conduct a longitudinal study evaluating the association between sugar-sweetened beverage excise tax implementation and improvements in diabetes and cardiovascular risk biomarkers in primary care patients.

The study, titled ASPIRE (Association of the Sugary Drink Excise Tax Policy and Diabetes and Associated Cardiometabolic Risk Biomarkers in Primary Care Patients), will leverage electronic health record data from the OCHIN Network—a multi-state consortium of community health centers—to compare changes in biomarker outcomes across taxed and non-taxed municipalities using a quasi-experimental difference-in-differences design. The research will examine pre- to post-tax periods and stratify analysis by individual-level subgroups including age, income, language preference, and food insecurity status. The study addresses an evidence gap regarding health impacts of sugar-sweetened beverage taxation among low-income populations and will inform policy efforts at local, state, and national levels, including proposals to restrict such purchases through SNAP.

Performance is located in Portland, Oregon 97239. The award period extends through February 28, 2031.

Abstract

Sugar-sweetened beverage (SSB) consumption is a key contributor to obesity, diabetes, and cardiovascular disease (CVD) in the U.S. Seven U.S. Municipalities have implemented SSB excise taxes to reduce consumption, yet the downstream impact of these taxes on diabetes and cardiometabolic health remains unknown. This study will leverage longitudinal electronic health record (EHR) data from the ochin network-a large, multi-state consortium of community health centers (chcs)-to evaluate whether SSB excise tax implementation is associated with improvements in commonly assessed diabetes and cardiovascular risk biomarkers in real-world primary care settings. Using a quasi-experimental difference-in-differences design, we will compare changes in biomarker outcomes from pre- to post-tax periods in taxed versus matched non-taxed municipalities. We will also examine whether these effects differ across key individual-level subgroups, including by age, income, language preference, and food insecurity status. This work addresses a critical evidence GAP regarding the health impacts of SSB taxation among low-income populations and will inform local, state, and national policy efforts, including proposals to restrict SSB purchases through snap. By evaluating clinical outcomes in the context of real-world tax implementation, this study will provide actionable insights into how policy interventions may influence diabetes and cardiometabolic health at scale.