Public Knowledge and Attitudes Regarding Public Health Inspections of Restaurants

Background Foodborne diseases cause 76 million illnesses in the U.S. each year, and almost half of all money spent on food is spent in restaurants. Restaurant inspections are a critical public health intervention for the prevention of foodborne disease. Methods A telephone survey of randomly selected Tennessee residents aged ≥18 was performed. Data were collected on respondentsʹ demographics, knowledge, attitudes, and expectations regarding restaurant inspections. Results Of 2000 respondents, 97% were aware that restaurants are inspected regularly by the health department. More than half of the respondents believed that inspections should be performed at least 12 times per year; only one third were aware that inspections currently occur only twice per year in Tennessee. More than one third of the respondents considered an inspection score of ≥90 acceptable for a restaurant at which they would eat; the mean score in Tennessee is 82. When presented with a variety of scenarios, an overwhelming number of respondents felt that public health responses to safety violations should be far more draconian than they actually are. Survey answers did not differ consistently based on respondentsʹ race, gender, or history of having worked in a restaurant. Conclusions This study identified a number of public misconceptions and unrealistically high expectations of the public health restaurant-inspection system. It is important to improve consumersʹ understanding of inspection scores and the limitations of regulatory inspections, as well as the role of such inspections in disease prevention.