Abstract
This paper utilises logistic regression to identify ecological determinants of non-compliant food outlets in England and Wales. We consider socio-demographic, urbanness and business type features to better define vulnerable populations based on the characteristics of the area within which they live. We find a clear gradient of association between deprivation and non-compliance, with outlets in the most deprived areas 25% less likely (OR=0.75) to meet hygiene standards than those in the least deprived areas. Similarly, we find outlets located in conurbation areas have a lower probability of compliance (OR=0.678) than establishments located in rural and affluent areas. Therefore, individuals living in these neighbourhoods can be considered more situationally vulnerable than those living in rural and non-deprived areas. Whilst comparing compliance across business types, we find that takeaways and sandwich shops (OR=0.504) and convenience retailers (OR=0.905) are significantly less likely to meet hygiene standards compared to restaurants. This is particularly problematic for populations who may be unable to shop outside their immediate locality. Where traditional food safety interventions have failed to consider the prospect of increased risk based on proximity to unsafe and unhygienic food outlets, we re-assess the meaning of vulnerability by considering the type of neighbourhoods within which non-compliant establishments are located. In-lieu of accurate foodborne illness data, we recommend prioritised inspections for outlets in urban and deprived areas. Particularly takeaways, sandwich shops and small convenience retailers.
Highlights
Public health interventions, including those in the food safety domain, have focused their attention on distinct and well-defined populations with specific socio-demographic characteristics
Our logistic regression examines the determinants of non-compliant food establishments (n 1⁄4 297,119) in England and Wales, the results of which are displayed in Tables 3 and 4
We find a clear association between increased deprivation and noncompliance, for areas with decreased car access and over crowded households; the strength of the association weakens when adjusting for confounders
Summary
Public health interventions, including those in the food safety domain, have focused their attention on distinct and well-defined populations with specific socio-demographic characteristics These include young children, pregnant women, individuals with Limiting Long-Term Illness (LLTI), and people aged over 65 (Lund and O’brien, 2011). Whilst national-scale outbreak data (GOV.UK, 2019) evidences that these individuals are more susceptible to foodborne disease, these data host a myriad of problems. They are inaccurate and un representative of the whole population. An estimated 1.7 million cases of foodborne illness occur each year in the UK, resulting in 22,000 hospital admissions and 700 deaths (O’brien et al, 2016) Of these cases, the majority occur among groups of people considered inherently vulnerable. Decreased gastric acid production and slow bowel motility is common for this age group, prolonging exposure of the colonic tissue to toxins and further increasing susceptibility (Smith, 1998)
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