Biomedical Engineering Reference
In-Depth Information
high Hispanic populations were greater than for CHV rates in tracts of any other
population demographic. However, it was also seen that facilities in lower poverty
areas had the highest average number of CHV per inspection, but a greater by num-
ber of days between inspections, which is counterintuitive to what would be
expected if facilities in low poverty areas had more CHVs (Darcey and Quinlan
2011
). These results indicate that while GIS technology may have potential
applications to exploring relative safety and sanitation of retail facilities, the
technology is dependent on health inspection data to be completely objective and
not infl uenced by potential inspector bias (Medeiros and Wilcock
2006
). The limita-
tion to the use of this technology is the assumption that the number of critical code
violations and/or facility overall “scores” are true predictors of food safety. The
benefi t of this technology is that it is less labor intensive than microbiological test-
ing and much of the data may already be available through inspection records.
11.6
Retrospective Analysis of Food Purchasing Habits
While outbreaks of foodborne illness routinely include investigation of where food
has been accessed, sporadic cases of foodborne illness are not traditionally tracked
back to where food was purchased. Gillespie et al. examined laboratory surveillance
data on listeriosis cases reported in England between 2001 and 2007. It was reported
that incidence of listeriosis was highest in the most deprived areas of England when
compared to the most affl uent. Additionally, cases of listeriosis were more likely to
be associated with the purchasing of foods from convenience stores or local bakers,
butchers, fi shmongers, and greengrocers when compared to the general public
(Gillespie et al.
2010
). This type of retrospective analysis, therefore, more directly
links cases of foodborne illness with retail purchasing habits rather than just risks
for foodborne illness (i.e., microbial contamination or inspection reports) with retail
outlets. This approach may more defi nitively be able to be used to determine whether
the food desert phenomenon contributes to increased rates of foodborne illness
among populations of low SES and/or minority racial or ethnic background.
11.7
Conclusions and Needs for Further Research
It is generally agreed that differential retail food access in food deserts results in
low-income and minority populations having greater access to small independently
owned and convenience markets and fewer supermarkets. In addition to lower nutri-
tional quality food, the limited data available indicate that perishable foods avail-
able in these small markets may also be of poorer microbial quality and potentially
less safe. Additionally, both analysis of rates of critical code violations and empiri-
cal research have identifi ed barriers to safe food handling and sanitation for small,
independent retailers with limited resources. Only one study has retrospectively
