Food outlets in the most deprived areas are less likely to meet hygiene standards than those in the least deprived regions of England and Wales, according to a study.

Takeaways, sandwich shops and convenience retailers are significantly less likely to meet hygiene standards compared to restaurants.

The study paper, published in the journal Health and Place, used statistics from the Food Hygiene Rating Scheme (FHRS) alongside small area socio-demographic data and neighborhood characteristics.

Researchers said based on bias and inaccurate data, food safety interventions have focused on the vulnerable, and fail to consider populations at risk due to negative neighborhood features.

Datasets were collected from the Office for National Statistics (ONS) digital boundaries, ONS 2011 census, ONS 2011 UK Townsend Deprivation Scores, ONS Rural and Urban Classification 2011 and FHRS scores from October 2018.

Food outlets are given a FHRS score ranging from zero, meaning urgent improvement required, to five, meaning very good. Display of scores is mandatory in Wales and optional in England.

Link between compliance and deprivation
Presence of non-white ethnicities is negatively associated with the probability of food establishment compliance. Results of modeling show that outlets in areas with a higher percentage of white individuals have an increased probability of compliance.

Food outlets in the fourth and fifth sections of deprivation have statistically decreased probability of compliance, showing an association between compliance and deprivation. Probability of food site compliance decreases as deprivation increases, with those in the most deprived areas 25 percent less likely to meet hygiene standards compared to the least deprived areas.

Outlets in areas with high percentages of individuals without access to a car, and zones with a high rate of overcrowded households have decreased probability of compliance.

For establishments in rural hamlets and isolated dwellings the probability of compliance is 24 percent higher than those in an urban city or town. Premises within a multi-municipality area have a decreased probability of compliance and are 32 percent less likely to meet FSA hygiene standards.

As rural areas have lower net-migration compared to urban ones, this could result in increased staff retention, more in-depth training, and a better understanding of food hygiene practices. In urban areas, higher business turnover could be a driver of decreased probability of compliance, according to researchers.

Compliance by outlet type
Supermarkets and hypermarkets are up to three times more likely to meet hygiene standards than restaurants, cafes and canteens. Takeaways and sandwich shops are 50 percent less likely to be compliant compared to restaurants.

Results show that age and ethnicity have small but significant associations with hygiene standards, whereas deprivation, urbaness and outlet type have a larger and significant impact.

Takeaways, sandwich shops, small retailers such as convenience stores, and outlets in deprived and metroplex areas have significantly decreased probability of compliance compared to restaurants, cafes, canteens, and sites in affluent areas, rural areas, cities and towns.

Populations of non-white ethnicity and those under 5 years of age should be considered at higher risk of exposure to a foodborne pathogen than white populations and individuals aged over 5 when eating outside the home, according to researchers.

Findings show that supermarkets and hypermarkets are more likely to have better hygiene practices than smaller stores such as newsagents, which increases food safety risk for deprived populations and those who may not be able to shop far away from their home.

Results could be used to prioritize inspections in places where the probability of compliance is lower. Increasing inspections in areas with a higher number of non-compliant outlets could decrease outbreaks. However, more inspections in deprived and primarily non-ethnic areas could be seen as an oppressive measure, which would place a larger burden on the proprietors, the scientists said..

“Based on our findings, we recommend that food establishment inspections are prioritized for takeaways, sandwich shops and small retailers such as convenience stores, especially in deprived and large urban areas. Conversely, restaurants, cafes, supermarkets, pubs, bars, hotels and guesthouses can be considered low risk, especially in more affluent and rural areas,” according to the research report.

The study does not account for food ordered via online delivery services which typically have a larger network than establishments offering traditional delivery services or behaviors such as consuming food after its use-by date and not cooking it thoroughly.

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