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Study Looks at Connections Between Socioeconomic Status and Foodborne Illness

A study from the Emerging Infections Program at Yale School of Public Health found that, in adults, campylobacteriosis is more common among those of higher socioeconomic status, but, for children younger than 10, more cases occurred among those of lower socioeconomic status.

Researchers Kelley Bemis, Ruthanne Marcus and James Hadler grouped cases of campylobacteriosis reported in Connecticut between 1999 and 2009 based on the percentage of residents living below the federal poverty line in their U.S. Census tracts.

The researchers believe that adults of higher socioeconomic status are more likely to be exposed to Campylobacter when eating out or traveling.

Hadler told Food Safety News that children living in lower socioeconomic households might be more likely to be exposed to raw chicken or cross-contamination because of “smaller kitchens, more crowded households, and less knowledge [about food safety].”

It might even be that the adults in poorer homes are taking the appropriate precautions, but that there are just more opportunities for the children to be exposed, Hadler said.

“More focused studies would be very helpful to look at those risk factors,” he added.

The team also looked at Connecticut data in terms of access to healthcare and, Hadler said, found that “there’s not really any difference in terms of, if somebody gets diarrhea and gets it severe enough, the threshold for going to a doctor is not any different for poorer people than wealthier people.”

This is the first study in the U.S. that looks at socioeconomic status as a determinant for Campylobacter infection, but other studies using similar area-based methods in Denmark, Canada, Australia and Scotland reported similar findings.

And a study in Michigan showed that groups with lower educational attainment were less commonly represented among cases of Salmonella than those with higher levels of education.

Hadler said that the information from his study and others like it can be used in targeting interventions such as hand and kitchen hygiene or education about what foods to avoid when eating out or traveling.

“I think a lot of people who are of upper socioeconomic status may not realize that they actually are at higher risk than others,” he said. “They may not realize that there’s risk in some of the things they do.”

In terms of further research, Hadler said other jurisdictions and other states should look at their data in a similar way to see if they get similar results. He added that it might also be helpful to look at certain types of restaurants in terms of their risks.

“When looking at any disease — especially a disease that’s increasing in incidence — it’s important to look at it from multiple perspectives, and looking at things from a socioeconomic status perspective can be helpful, is feasible, and we think is something that should be used more,” Hadler said.

The study will appear in the July 2014 issue of the U.S. Centers of Disease Control and Prevention’s Emerging Infectious Diseases journal.

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