Grading systems for retail food facilities: preference reversals of environmental health professionals

The authors asked a random sample of 89 environmental health professionals in California about their willingness to dine in restaurants under three different scenarios: 1) The restaurant has received an inspection grade of A, B, or C and is one they normally dine in; 2) the restaurant was closed for health violations but recently has reopened with a grade of A, B, or C, and 3) the restaurant has been given a numerical score only (88, 78, 68, or 58). A paired-samples sign test showed differences among the scenarios with statistical significance above 99.9 percent. Professionals were less willing to dine in a restaurant if it recently had been closed and more willing to dine in it if only the numerical scores were given. The results indicate various cases in which there is a preference reversal from the expected order of A, B, and C; these results are largely consistent with those of an earlier study of university students. The study reported here suggests that the attitudes of environmental health professionals are consistent with those of the public they represent, and that most professionals are quite willing to distinguish grades depending on the underlying conditions provided. Significant differences were found among environmental health professionals depending on whether they had experience with grading systems. In the interests of encouraging thought and dialogue on the subject, this paper closes with a courtroom scenario that examines some repercussions of grading systems.