Local Health Department Roles in Food Safety Backgrounder

Recent Salmonella outbreaks involving peanut butter and fresh produce underscore the need to repair gaps in state and local food safety programs and integrate them better with federal food safety efforts, according to a new report prepared with extensive input from state and local officials. The report calls for leadership by Congress and the U.S. Department of Health and Human Services (HHS) to build an integrated national food safety system that makes effective use of the best science and all available public resources to prevent foodborne illness.

The new report, Stronger Partnerships for Safer Food: An Agenda for Strengthening State and Local Roles in the Nation’s Food Safety System, was produced by the Department of Health Policy at The George Washington University School of Public Health and Health Services in partnership with the organizations that represent food safety officials and practitioners at the state and local levels: the Association of Food and Drug Officials (AFDO), the Association of State and Territorial Health Officials (ASTHO) and the National Association of County and City Health Officials (NACCHO). For the first time, this diverse group of officials has come together to recommend a series of improvements in the roles of state and local agencies as partners in a national food safety system working to prevent foodborne illness. The report was funded by the Robert Wood Johnson Foundation.

“State and local agencies occupy the critical frontline in the nation’s food safety system,” said Michael R. Taylor, former Food and Drug Administration (FDA) and U.S. Department of Agriculture (USDA) official and research professor of health policy at the George Washington University School of Public Health and Health Services and one of the report’s authors. “Food safety reform at the federal level will be incomplete and insufficient unless it strengthens state and local roles and builds true partnership across all levels of government.”

Although food products are regulated on the federal level by the FDA and the USDA, local and state health departments have long been the backbone of the nation’s food safety system, with primary responsibility for illness surveillance, response to outbreaks and regulation of food safety in restaurants, grocery stores and many food processing plants across America. At the local level alone, the report points out, there are approximately 3,000 public health agencies involved in food safety. State-level departments of health and agriculture, as well as public health laboratories in most states, add to the complexity and fragmentation of the system, as does the important role of the federal Centers for Disease Control and Prevention, which interacts with agencies at all levels.

“The report highlights how local health departments protect people every day by helping to keep their food supply safe, whether they purchase food in a restaurant or store, “ said Robert M. Pestronk, executive director of NACCHO. “At the same time, the report reinforces the need for an effective partnership among, and a greater allocation of resources to, federal, state and local government agencies.  Staff capacities are eroding at an alarming rate due to the economic downturn and the graying of the workforce.”

“Protecting Americans and assuring them that the food they eat is safe is a fundamental responsibility of state and local health departments,” said Paul Jarris, M.D., M.B.A., executive director of ASTHO. “We look forward to a system-wide adoption of the recommendations made in this important report to support the ability of our health agencies to offer the highest level of protection.”

In addition to outlining the current roles of federal, state and local agencies in protecting Americans against foodborne illness, the report makes 27 detailed findings on the strengths and weaknesses in the current food safety system.  For example, the authors note progress in how federal, state and local agencies collaborate to detect foodborne outbreaks but also find that state and local agencies are hampered in their response to and prevention of outbreaks by lack of focused federal leadership to build an integrated system, chronic underfunding, wide disparities in capacity and diversity of practices in all areas of food safety, and barriers to information sharing and collaboration. The report makes 19 specific recommendations for strengthening state and local roles and building an integrated national food safety system that works effectively to prevent foodborne illness.

"Integrating the food safety efforts of federal, state, and local agencies is key to dramatically improve this country’s food safety system. This report provides a clear plan for accomplishing this integration,” said Joe Corby, executive director of AFDO. “We encourage legislative leaders to review the specific recommendations provided in this report and consider their inclusion in any federal food safety reform. Food safety cannot be enhanced without better harnessing the efforts of state and local agencies that perform the overwhelming majority of food safety work in this country."

Among other recommendations, the report suggests the establishment of a network of regional, federally-funded foodborne outbreak response centers to ensure an integrated “systems” approach to investigations to prevent far-reaching foodborne illness outbreaks such as this winter’s peanut butter outbreak or last summer’s pepper problems. Each center would be would be staffed with a multi-disciplinary team of federal, state, and local epidemiologists, environmental health official, regulators and communications experts to mount an effective response to outbreaks and conduct follow-up investigations to inform future prevention efforts. Another recommendation calls for the integration and modernization of manufacturing facility inspections, urging federal officials to dismantle legal, technical and bureaucratic barriers that prevent sharing of food safety data among federal, state and local agencies.

About the George Washington University Medical Center

The George Washington University Medical Center is an internationally recognized interdisciplinary academic health center that has consistently provided high-quality medical care in the Washington, D.C., metropolitan area, since 1824. The Medical Center comprises the School of Medicine and Health Sciences, the 11th oldest medical school in the country; the School of Public Health and Health Services, the only such school in the nation’s capital; GW Hospital, jointly owned and operated by a partnership between The George Washington University and a subsidiary of Universal Health Services, Inc.; and the GW Medical Faculty Associates, an independent faculty practice plan. For more information on GWUMC, visit www.gwumc.edu.

About the National Association of County and City Health Officials

NACCHO is the national organization representing the nation's nearly 3,000 local health departments. These agencies work every day on the front lines to protect and promote the health of their communities. NACCHO develops resources and programs and promotes national policies that support effective local public health practice.

About the Association of State and Territorial Health Officials

The Association of State and Territorial Health Officials (ASTHO) is the national non-profit membership association representing the state and territorial public health agencies of the United States, the U.S. Territories, and the District of Columbia. ASTHO’s members, the chief health officials of these jurisdictions, are dedicated to formulating and influencing sound public health policy and assuring excellence in public health practice.

About the Association of Food and Drug Officials

AFDO is an international, non-profit organization that is in the forefront of streamlining and simplifying regulations by either drafting regulatory rules or by commenting on government proposals. By developing a broad base of support for new approaches, AFDO has become a recognized voice in determining the rules and shape of the regulatory playing field of the future. The consensus that AFDO develops is key to advancing uniform laws, regulations, and guidelines that result in more efficient regulation and less confusion among industry in the marketplace. AFDO develops support for its positions by interfacing with high-level regulatory officials, industry representatives, trade associations, and consumer organizations. This continues to have a significant impact on regulations at the federal, state and local level.

About the Robert Wood Johnson Foundation

The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation's largest philanthropy devoted exclusively to improving the health and health care of all Americans, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, meaningful and timely change. For more than 35 years the Foundation has brought experience, commitment and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime.