Foodborne Illness: Consumer Costs, Consequences and Choices

Editor’s Note: This is a guest post by Kathryn Boys, an assistant professor of agricultural and resource economics at NC State whose research focuses on food systems and food safety policy. This post is part of our series on food safety.

Changes to our food system have increased the availability and variety of foods for U.S. consumers, but these changes have also introduced food safety challenges that can have significant impacts on human health and the economy. Researchers are working to develop new food safety tools – and in the meantime there are actions consumers can take to lower their risk of foodborne illness.

The U.S. Centers for Disease Control and Prevention (CDC) estimates that 48 million instances of foodborne illnesses occur annually in the U.S., resulting in 128,000 hospitalizations and 3,000 deaths. The value of medical costs, productivity losses, long-term mental and other health impacts, and the costs of premature deaths stemming from these events is substantial. The fourteen pathogens that account for a majority of U.S. foodborne illness have recently been estimated to cost the U.S. economy $14 billion and cause a loss of 61,000 quality-adjusted life years annually.

The potential for a specific foodborne illness outbreak to have a broad and significant impact on human health and the economy is compounded by the integration and globalization of food supply chains. Historically, because of perishability and the fact that produce was predominantly consumed in its raw form, incidents involving produce contaminated in a farm setting would have only affected consumers geographically near the farm. Today, through improved transportation and logistics networks and increased processing, that same produce has the potential to be used in a wider variety of products and affect consumers far from where it was grown.

In addition, identifying the source of contamination may be challenging and time consuming for food wholesalers and other distributors who aggregate products from across many suppliers and who have not implemented traceability practices. And that delay in tracing the source of the contamination means there is more time in which additional consumers may become sick.

When Illness Strikes: Impact on Individual Consumers

A majority of consumers who become ill due to foodborne illness recover at home or with minor medical assistance. In cases of severe illness that can be attributed to either food prepared outside of their home (i.e., restaurants), or contaminated prior to entering their home, consumers may pursue legal remedy for their illness. Information on the number or outcomes of cases settled out of court is not available. We do have some insight, however, of food safety cases settled through jury trials.

Buzby, et al., analyzed federal jury trials (1988-1997) for foodborne pathogens to determine which factors of the incident/case most influenced the trial outcomes. These authors found that 31.4 percent of cases were won by plaintiffs, and juries awarded a median of $25,560 (ranging from $0 to $2.37 million in 1998 dollars). Demographic characteristics of the plaintiff, the ability of plaintiffs to link their illness to a specific pathogen, and the severity of the health impact resulted in higher awards.

Given increasing public and media attention to foodborne illness, continued integration of food supply networks, and improved traceability systems, it is likely that both the number of cases and the amount of these awards will increase over time. I am currently working with collaborators at Virginia Tech and the USDA Economic Research Service to examine this issue.

Foodborne Illness: Preventative Market Measures

Most U.S. consumers have faith in the safety of food supply chain. In general, consumers expect their products to be free from dangerous levels of contamination and to be efficiently recalled if there is a problem. However, the incidence of foodborne illness suggests that problems remain.

Higher levels of food safety can be attained for most food products, lowering the risk of purchasing a contaminated product. But increased food safety comes at a cost.

Research has explored how much more consumers are willing to pay for higher levels of food safety.

In general, findings indicate that U.S. consumers are willing to pay more for higher levels of safety due to risk from microbial, chemical or physical (e.g., metal) contamination. How much more, however, has been found to vary considerably depending on the research setting, the particular food products being studied, the extent of risk reduction, and the research participants’ adherence to safe food handling practices, perception of risk, and demographic characteristics.  The same is true for perceived threats to food safety from other sources.

Consumers concerned about pesticide residues or genetic modification, for example, are willing to pay higher prices for organic and non-GMO foods. Consumer willingness to pay to avoid other food technologies, such as artificial colorants, fruit-ripening technologies, growth hormones and other growth promotants, and nanotechnology (among many others) has been summarized by Lusk, et al.

Consumers interested in decreasing their risk of foodborne illness have the option of buying products from companies with good food safety records, and to keep abreast of product recalls and safety alerts. Once food has entered the home, the food handling and sanitation practices that consumers can take to limit their risk of foodborne illness are generally well known. Information about safe food handling techniques can be found at http://www.foodsafety.gov/index.html.

In the future, additional tools are also likely to be available to consumers. By way of example, food producers often signal the presence (or absence) of specific food attributes through a growing array of food certification and labeling schemes. While at present, there is no label to identify products with higher levels of microbial food safety, it is possible that one may emerge. In addition, human vaccines are currently under development to protect against illness due to Escherichia coli, Salmonella, and Campylobacter. These and other tools are likely to significantly change the food safety market and policy landscape in coming years.