Disclosing Inspection Results at Point-of-Service: Affect on Foodborne Illness Outcomes and Recommended Practices
The rise in expenditures on foods eaten away from the home, combined with the significant proportion of foodborne illnesses attributed to restaurants, has highlighted the importance of food establishment inspections. Current inspection practices and disclosure methods vary widely across jurisdictions in the U.S. and this variation presents unique challenges to evaluating program effectiveness. Disclosure of health department inspection scores or grades at the point of service, such as at the food establishment, eliminates a barrier to using inspection data in the decision-making process. It does not require the added task of using technological resources to check a website. Mandated posting of restaurant inspection results at the point of service is an effective public policy that fosters transparency, population health, and informed consumer choice.Disclosing inspection ratings at the point of service was associated with a 55% reduction in outbreaks compared to disclosing only online.
Our study involved an online 36-question survey administered to 790 government-run food establishment programs in state, county, city, district, and territorial jurisdictions. The objectives of this cross-sectional study were to characterize local inspection programs and to evaluate the effects of programmatic characteristics, such as active public disclosure methods, on select operational and foodborne illness outcomes. Agencies that did not disclose inspection results to the public and those that did not grade inspections consistently had a higher number of outbreaks per one thousand establishments per year than their alternatives. The study found agencies that disclosed at the point of service reported fewer average number of re-inspections by 15%, complaints by 38%, outbreaks by 55% (p=0.03), and cases of Salmonella infections by 12% than did agencies that disclosed online only. A peer-reviewed manuscript titled, Disclosing Inspection Results at Point-of-Service: Affect of Characteristics of Food Establishment Inspection Programs on Foodborne Illness Outcomes, has been approved for publication by the Journal of ÀÖ²¥´«Ã½ and will show up in the January/February 2021 issue.
Restaurant hygiene information is something consumers desire, and when available, is often used to make dining decisions. Public disclosure of food establishment inspection results enables consumers to make informed decisions about where they choose to eat.
Posting restaurant inspection results at the point of service is an effective public policy that fosters transparency, population health, and informed consumer choice.
Additional Resources
View the Point of Service Food Inspection Disclosure as a Recommended Practice visual abstract, one-pager, and policy statement.
Background
In 2019, NEHA received funding through cooperative agreement (CDC-RFA-OT18-1802) with the Centers for Disease Control and Prevention to implement a project to evaluate restaurant inspection programs that publicly post inspection results. NEHA collaborated closely with the University of Minnesota School of Public Health to design and implement the study. Additional partners included the Dining Safety Alliance and the National Network of Public Health Institutes. The project targeted government-run food establishment programs from states, counties, cities, districts, and territories. Programs were surveyed on a variety of measures, including the number of restaurant re-inspections performed, inspection scores over time, number of foodborne illnesses and outbreaks reported, and perceptions of the programs from inspectors, the restaurant industry, and public perceptions. The findings and recommendations from this project (see above), will be used to support data-driven decision-making regarding how best to structure inspection programs to support food safety.
We thank the health departments who responded to our survey.
Disclaimer: NEHA recognizes that restaurant grading, scoring, or placarding isn't utilized consistently across the United States. It is reported that restaurants in the U.S. are regularly inspected by government entities, but few data exist regarding the variation of publishing restaurant inspection results and the implications, if any, to public health. Through this study, NEHA seeks to examine variations in disclosure of inspection results that exist between jurisdictions and the impact this may have on public health.