Food Consumption, Food Handling, and Diarrheal Illness

Introduction: Food safety education is designed to teach consumers about risks in foods and how those risks may be avoided or mitigated. Previous research has shown that educational interventions improve food safety knowledge and self-reported behaviors in the home. However, the evidence on effects of behavior on actual risk are mixed, with, for example, Azevedo et. al (2014) finding no link between behavior and presence of microorganisms in Portugal, while Sheth and Obrah (2004) found a link between education, behavioral change, and reduced diarrheal illness in India.

Purpose:  This study seeks to evaluate the effect of self-reported food consumption and food handling behavior (at home) on incidence of diarrheal illness in the United States.

Methods: Data is taken from a supplement to the Behavioral Risk Factor Surveillance System and was obtained directly from four states that participated in the supplement. The cleaned data yielded a working sample of 8,870 observations. OLS and Probit regression models were used to assess the effect of cross-contamination and food consumption variables on incidence of diarrheal illnesses, controlling for other risk factors and demographics. Multiple model specifications were examined to assess the robustness of results.

Results: Approximately 11% of the sample had experienced diarrheal illness in the last month, over 60% of respondents engage in optimal food handling practices, and between 1.3% and 32.0% of respondents consume various risky foods. Self-reported optimal food handling behaviors have no significant effect on diarrheal illness, while consumption of some risky foods (pink hamburger, raw eggs) increases the risk of diarrhea (p<0.05).

Significance: These results suggest that we should be cautious in asserting that self-reported reductions in food handling behaviors are equivalent to reductions in foodborne illness.