Social Determinants of Retail Food Safety Inspection Performance: A Franklin County, Ohio Case Study

Retail food safety inspections are an essential public health tool for preventing foodborne disease. While data generated through inspections have frequently been analyzed to identify foodborne disease risk factors, few analyses have considered how social determinants of health (SDOH) are associated with retail food safety inspection performance. This study aimed to evaluate various statistical and spatial methods that could be used to understand associations between retail food safety inspection performance and SDOH in Franklin County, Ohio. Data visualization, correlation, and regression approaches were used to explore how community-level SDOH metrics were associated with overall patterns of inspection performance. Correlation approaches for aggregate measures of inspection performance at the census tract level identified few significant associations between inspection performance and SDOH metrics. However, regression models identified several SDOH metrics significantly associated with the number of total or critical violations observed during routine inspections. Notably, associations between inspection performance and SDOH metrics changed when controlling for the inspector, suggesting that inspector variability is important to consider when evaluating associations between retail food safety inspection performance and SDOH. The analyses presented here provide a case study for how associations between inspection performance and SDOH metrics can be investigated. Identifying SDOH metrics associated with poorer food safety inspection performance can inform the allocation of resources to foodborne disease prevention activities.