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The Complex Nature of US Health Departments and its Downstream Impacts on Inspection Data and Actionability

Sanitary Inspection Grade (1)

Summary: Over 2,500 US health departments operate independently to conduct and publish data for health inspections, creating inconsistencies and inefficiencies that have negative impacts on the accuracy of health inspection data. As a result, consumers, restaurant operators, and food safety professionals are negatively impacted.

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Ensuring that the food we eat is safe is a top priority for not only consumers themselves but also restaurant operators and food safety professionals. However, the landscape of health inspection systems across the 2,500+ US health departments is a deceivingly complex operation, riddled with inconsistencies in enforcement practices, scoring methodologies, violation types, violation severities, leniencies, and more. This complexity creates inefficiencies that have negative impacts on both consumers and restaurant operators, but in particular, it creates significant challenges for food safety professionals.

Negative Impacts on Consumers

  • Confusion over inconsistent scoring systems and violation classifications
  • Difficulty relying on health inspection results/scores to make informed buying decisions

Negative Impacts on Restuarant Operators and Food Safety Professionals

  • Difficulty in accurately assessing compliance across different locations
  • Challenges in prioritizing efforts and making informed decisions about where to focus resources
  • Increased costs associated with consumer complaints, reinspection fees, and other fines
  • Extra costs to obtain health inspection reports from health departments or from storefronts

Let's break it down. Here are the ways the convoluted health inspection systems across the US create inefficiencies that negatively affect the accuracy and actionability of health inspection data.

Inconsistent Scoring Systems

One of the biggest challenges for food safety professionals is the lack of standardized scoring systems across health departments. Some health departments use a numeric score, while others use a pass/fail system, letter grades, or even emoji-based systems. Some don’t score inspections at all. Additionally, there is no consistent weighting of critical versus non-critical violations, leading to inconsistent scores across different health departments. This makes it difficult for food safety professionals to compare scores across different locations and make informed decisions about where to focus their efforts.

Scoring systems vary wildly across the country, even in directly adjacent/neighboring cities/counties. For example, residents of Los Angeles (County), CA are used to seeing numeric 1-100 scores or sometimes A-C letter grades on restaurant windows, while in Orange (County), CA, consumers are used to seeing categorical scores such as “Pass”, "Reinspection Due”, or “Closed.”  

Below is an in-depth breakdown of the different scoring systems used across the 30 major health departments in California that publish readily accessible inspection results online.

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Inconsistent Inspection Frequency and Leniency

Some health departments also conduct inspections more frequently than others, which on its own can impact the inspection results of a jurisdiction when compared to others that may not inspect restaurants as often. Although the FDA coordinates a program called  “Retail Program Standards,” aimed at taking a risk-based approach to determining inspection frequencies (e.g. facilities deemed to be associated with higher food safety risks are inspected more often), the program is voluntary and currently garners participation from only a portion of the thousands of US health departments.

Another challenge is the inconsistency in leniency across different health departments. Some health departments may be more lenient in their enforcement practices, leading to higher scores for establishments that may not be as compliant with food safety regulations. Conversely, some health departments may be more stringent in their enforcement practices, leading to lower scores for establishments that may have better compliance with food safety regulations. This inconsistency in leniency makes it difficult for food safety professionals to accurately assess the level of compliance across different locations, especially if their storefronts span multiple counties/cities/states.

For example, in Los Angeles (county), CA, establishments receive inspections almost 2x as often as their neighboring restaurants in Orange (county), CA do. Los Angeles (county) health inspections also receive 50% more violations on average than their neighbors just a few miles away.

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Differing Violation Types and Severities

Violations can vary widely in the food safety risks that they cover as well as in how they’re categorized and interpreted. Although the Food & Drug Administration (FDA) publishes food safety guidelines every 2-4 years via the FDA Food Code (the most current is the 2022 version), health departments are not mandated to follow or stay up to date with these guidelines. As a result, violation definitions and categories vary across the country, negatively impacting the comparability of violation citation results across jurisdictions.

A particularly important aspect of a violation is the severity or risk level associated with the food safety risk. Typically, health departments will use severity classifications to denote and bring special attention to violations that pose a higher risk of foodborne illness. However, the levels of severity assigned to violations also vary across the country. For example, in Allegheny (county), PA, violations are assigned severities of “High Risk”, “Medium Risk” or “Low Risk.” While in DuPage (county), IL, violations are labeled “Core”, “Priority Foundation”, or “Priority” to signal severity. 

Combined with the differences in enforcement leniency mentioned in the previous section, these variances make it harder to understand the true level of risk associated with any violation cited on a health inspection report. As a result, it can be significantly more difficult for consumers and food safety professionals to accurately assess the true level of food safety risks. For food safety professionals in particular, this can make interpreting inspection results and taking action to respond to risks a daunting task.

Differing Inspection Reporting/Publishing Practices

One of the biggest challenges facing the food safety industry is health inspection reporting itself. There are over 1,200 health departments serving locations with over 63M residents that don’t consistently publish inspection results online. Of those that do, the sheer volume of health departments, each with its own website and reporting practices, can make it incredibly challenging for food safety professionals to track down inspection records. This can be especially problematic for large food companies that operate in multiple states, as they may have to navigate a patchwork of different reporting systems to obtain a comprehensive picture of their food safety compliance.

And once they finally track down these records, the previously mentioned unstandardized enforcement practices can lead to the data being inconsistent, incomplete, or often unreliable, making it difficult to identify and track trends in food safety violations.

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In conclusion, the complexities and inconsistencies in health inspection systems in the US create significant challenges for food safety professionals and confusion for consumers. Without a standardized system for health inspections and guidelines, it is difficult to accurately assess compliance across different locations and make informed decisions about where to focus resources. Without easy access to timely and accurate inspection data, it's difficult for food safety professionals to address violations promptly and make informed decisions to prevent them from occurring again in the future. As a result, food safety teams incur unnecessary costs, while losing efficiency in their efforts to keep their customers safe and happy.

I'm a food safety professional at a restaurant/retail chain. Is there a better way?

At Hazel Analytics, one of our core missions is to research and grapple with this complex health inspection data to unlock the valuable underlying food safety insights. Since 2016, we’ve developed solutions that tackle the challenges mentioned above so that food safety professionals and consumers have timely, accurate, and standardized health inspection data.

Food safety and quality assurance teams at over 200+ global food service brands like Starbucks, The Cheesecake Factory, and Waffle House trust our Food Safety Insights (FSI) product to collect, analyze, and take action on their brand's health inspection data to protect their customers and their bottom line.

Check out our solutions for chain restaurants/retail to learn more about how Food Safety Insights helps brands:

  • Collect health inspections in near-real time
  • Standardize varying inspection, violation, and score types
  • Compare their performance against industry averages or specific peer brands
  • Assign, track, and automate action items to swiftly address issues

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