From the mine is bigger than yours file: How much does foodborne illness cost?
Posted: March 3rd, 2010 - 2:17pm by Ben Chapman
At the start of pretty much every talk I’ve given in the past 3 years I have a slide about the societal cost and estimated burden of foodborne illness. I somewhat robotically spout out these two statistics:
- About 1-in 3 to 1-in-4 individuals will acquire illnesses from food each year
- The societal burden of these illnesses is estimated to be $1.4 trillion
The statistics I use come from a variety of sources including USDA Economic Research Service, WHO, CDC, Canadian health officials and Australian public health.
Today I woke up to a press release from the Produce Safety Coalition, the Make our Food Safe Coalition and the Pew Charitable Trust that cited a “landmark study” estimating the cost of foodborne illness to be $152 billion annually. 
From the report:
There are a number of ways to estimate the economic impact of foodborne illness. This report uses an FDA cost-estimate approach: health-related costs are the sum of medical costs (physician services, pharmaceuticals, and hospital costs) and losses to quality of life (lost life expectancy, pain and suffering, and functional disability).
Hardly landmark, unless you mean this estimate represents a reduction of almost a factor of 10 in estimated costs since 2007 (I don’t think that was what was intended). Tanya Roberts published a paper in 2007 estimating the cost of foodborne illness from a willingness-to-pay (WTP) standpoint at $1.4 trillion. According to Roberts, WTP is endorsed in the literature as the valuation method most consistent with economic theory and her calculation included all seventy-six million cases of acute food-borne illness. Previous estimates examined only a few specific pathogens.
Sure, the numbers matter when it comes to prioritizing the need to address or fund food safety work. Whether it’s $6 billion, $152 billion, $1.4 trillion or $2,500-$8,000 per case (pathogen dependant) it’s a huge number. But it’s also very abstract.
The statistics are nice, but they really don’t grab foodhandlers’ attention. More compelling is where the real cost of foodborne illness is born: with the individuals and in the families of those who have been affected by it. Billions and trillions are fodder for discussions with politicians and boards of directors. Where the real food safety work occurs, both positive and negative, is on the farm, in the restaurant kitchen, supermarket deli and homes. And the numbers don’t really matter there, what resonates is that foodborne illness sucks.
What matters so much more to individual food handlers who protect public health in the US are the stories of real people being affected by food they trusted would not make them ill.
The disconnect between statistics and stories is why I follow up the burden slide with more impactful tales of outbreaks that happen weekly. Like those who have affected real people including Mason Jones and Stephanie Smith both of whom were severely affected by E. coli O157. Tragically, Mason died at only 5 years of age and Stephanie, who is now 23, will probably never walk again. The numbers, while nice, don’t really do these stories justice.

Comments
Michael Batz says:
I'm sorry, Ben, but I take umbrage with this kind of post, which responds to a press release rather than the report itself, neglects important methodological information, and is almost willfully narrowminded in failing to actually consider WHY it might be relevant. It's as if you're allergic to the details. I work on cost of illness numbers because I happen to think it's quite relevant. If national policy matters, then estimating the impacts of overall foodborne illness is important. Dismissal of efforts to understand in cost terms the impacts of foodborne illness is easy if you don't actually have to make difficult choices that involve tradeoffs. Sure, every company should do everything they can to make their food safe, but they have to stay in business, too. Regulators spending effort in one way can't spend it another way. It's a zero sum game. It's good to remember that there are real people dying here, but having a photo of a small child in your pocket doesn't mean the problem is solved. Costs and benefits are the way most of the world outside of academia have to make many decisions. Moreover, you imply that all that matters is what's on the mind of a food handler. AKA all that matters is what you personally work on. I find this completely ridiculous when you consider the vastness and complexity of our global food chains and opportunities for contamination and growth at so many points. Many decisions have indirect impacts on safety - the declaration of O157 to be an adulterant changed incentives for many parties in the system and has had dramatic impacts on the technologies and effort placed into reducing bacteria on beef carcasses. And I should take you out to the woodshed for using Tanya's $1.4 trillion number. Though it did appear in AJAE, it was NOT peer reviewed, and I do not think it would pass peer review in that journal. As noted at the end of the article, "The articles in these sessions are not subjected to the journal's standard refereeing process." There is a reason that although she was at ERS at the time, ERS never published these numbers. I love Tanya but these numbers are indefensible. There are major flaws with that study that should be obvious to anyone who looks at the details (particularly the tables, which are not available in the link you share). There are major inconsistencies in the estimates (e.g. costs of a couple of days of mild illness are higher in than costs of hospitalization). The WTP study in question fails what are called scope tests, which are a way of saying the results should not be trusted. The study was a valiant effort to use WTP to estimate costs of illness, but the numbers make no sense and there is a reason why nobody else uses these numbers. The ERS $6 billion number is only for a couple of pathogens, so is of course low. My back of the envelope estimates come out with a low in the $50 billion ballpark, though $150 billion is not unreasonable. I have not read the recent report in full yet, however, so I can't really comment further.
Posted on March 8th, 2010 - 11:39am
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