How Restaurant Food Safety Grades Are Changing the Dining World

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A Revolutionary Idea to Post Health Department Inspection Scores

In 1998, Los Angeles County decided to require restauranteurs to post their food safety scores, converted to grades, where the public could easily see the results. There was confusion. There was anger. There was bewilderment. But after nearly twenty years, the effort has shown the public embracing the idea and restauranteurs are increasingly focused on food safety. In the past several years, the public has seen this idea spread to other municipalities. California municipalities, large municipalities like NYC, Boston, Dallas, Las Vegas, and Toronto have embraced the idea of posting grades at the restaurant. Additionally, many entire states like Florida, South Carolina, North Carolina, Pennsylvania, New York, Delaware, Rhode Island, Mississippi, Tennessee, and Louisiana have embraced the idea of openly sharing data and now offer website access to the public, listing scores. Unfortunately, some municipalities and states refuse to share any data.

Grading Improves Performance

From the LA experience we have learned that requiring the display of public inspection grades results in food safety improvement. From a study conducted, The Effect of Information on Product Quality: Evidence from Restaurant Hygiene Grade Cards*, it appears that the quality of restaurants in the entire county became more acceptable, with the average score going up from about 75% prior to July 1997 to nearly 90% in the year after restaurant grading was implemented.

According to an article in the Los Angeles Times by staff writer Daniela Perdomo, “the first six months of the program […]39.9 percent of restaurants earned the 90-100 inspection points required for an A. By mid-2007, 82.5 percent of restaurants merited the top mark.”

While I don’t personally know what the goals of the original decision were, I presume the greatest hope was to improve food safety performance was realized.

 Grading Protects the Public from Food Borne Illness

From The Impact of Restaurant Hygiene Grade Cards on Foodborne-Disease Hospitalization in Los Angeles County, we can see the results of grading. “The restaurant hygiene grading program was associated with a 13.1 percent decrease in the number of foodborne-disease hospitalizations in Los Angeles County in the year following implementation of the program. This decrease was sustained over the next two years.”

While this observation was challenged in a study reported by the CDC in 2004 using data from Tennessee dating back to the 1990s, a more recent study in the Journal for Food Protection J. food Port. 2012 Nov; 75(11):2007-15 from the International Association for Food Protection reported from a series of restaurants in Minnesota confirmed the LA results. “Significantly more violations were recorded at restaurants that had outbreaks. The majority of these violations were related to contamination in the facility and environment and to food handling procedures.” “…..11 violations significantly (were) more likely to be identified during routine inspections at outbreak restaurants than during inspections at nonoutbreak restaurants.”

It is indeed intuitive, and I think scientifically proven, that posting grades improves restaurant food safety practice performance; and that certain food safety violations are associated with increase food borne illness events. So why don’t all municipalities post grades?



Author: Dr. Harlan Stueven, MD

Harlan Stueven M.D. is a Board-Certified Emergency physician with sub-specialization in Environmental Toxicology and Board Certification in Medical Toxicology. Starting his career in the USAF, he served as a Flight Surgeon and Environmental Health Consultant Physician where one of his duties was monitoring food safety. In his nearly 40-year practice, he treated a range of medical, surgical and poisoning emergencies. He has been a Medical Director and/or Chairman of several hospital-based Emergency Medicine Departments, served as the President of Emergency and Environmental Medicine consulting group, a physician group Chief Financial Officer and sat on many national, state and local committees. Dr. Stueven founded Dining Grades and the Dining Safety Alliance to improve food safety by increasing awareness of food borne illness and the formation of partnerships within the food industry. He is a consultant to the Wisconsin Retail Food Establishment Grading Work Group; a Co-investigator in a CDC funded “Evaluation of Health Department Restaurant Inspection Programs” project. He has presented at several National, State and Regional conferences on restaurant grading and food safety. He is an accomplished leader, medical researcher, a champion of process improvement, author, and national and international speaker.

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