Should Restaurants Post Health Ratings on Their Doors?
By Lydia Mulvany
Want to know how clean a restaurant is before you sit down to eat there?
Milwaukee Common Council President Michael Murphy has a simple solution for the dine-out crowd: Give restaurants a grade for hygiene and post it on the front door.
Murphy is working on an ordinance that would direct the city's health department to set up a grading system, and while the legislative details haven't been hashed out, he plans to fill those in over the next three weeks.
"This is something I've been pushing for years," Murphy said. "The whole point is to encourage restaurant owners to stay clean and let the marketplace dictate the response. So many food-borne pathogens have made people sick, it's incumbent upon government to help businesses to do a better job."
If the resolution passes, Milwaukee would join several other major cities and states that have embraced posting restaurant inspection grades despite adamant opposition from the restaurant industry. New York City, Los Angeles and the states of North Carolina and Ohio are among the many that have jumped on board.
"More local jurisdictions are adopting systems that provide restaurant patrons with on-site information, based upon the results of rigorous inspection," said Richard Withers, a fiscal analyst at Milwaukee's legislative reference bureau who has researched grading practices in U.S. cities.
Much is up for debate, like whether to use grades, like ABCs, or color-coded categories, like green, yellow and red. Either should reflect a restaurant's operations over time, rather than the results of one inspection, Murphy said. One thing's for sure:
transparency will be key.
"The most important thing with grading has to do with the placard on the front door," Murphy said.
The city's health department has been evaluating best practices for grading.
"We look forward to developing a process that will build upon our current practices, and translate the complexities of a food establishment inspection into something that is easily understandable by both the establishments and residents," Milwaukee Commissioner of Health Bevan Baker said in a statement.
But finding best practices may be a challenge. None has been found, according to Susan Quam, executive vice president of the Wisconsin Restaurant Association.
The WRA, which represents about 350 restaurants in Milwaukee and thousands of restaurants across the state, will oppose any grading or scoring initiatives in Milwaukee, Quam said, because it misleads consumers about the risk of illness at restaurants.
"We know the consumer would like to have the ability to have easy access to information and feel that a place they're eating at is doing the right thing," Quam said. "But (grades) can give a false impression, and they don't predict the likeliness of someone getting a food-borne illness."
For example, inspections are snapshots of a restaurant on a particular day, and a restaurant that gets an A one day might get a C on the next. Also, grading damages the collaboration between regulators and restaurants. Because stakes are so high, grades have been said to create an atmosphere that fosters corruption, according to Quam.
"We've worked so hard with the regulatory system in Wisconsin to develop a professional relationship between inspectors and restaurant owners, and now it's purely going to be animosity," Quam said.
Milwaukee would be the only city in Wisconsin to post grades. A few agencies in the state calculate scores, said Jim Kaplanek, head of Food Safety and Recreational Licensing for the Wisconsin Department of Health Services, which doesn't use grades or scores.
Kaplanek said little consensus about grading had emerged in research so far.
"You can find just as much information on the merits of a scoring or grading system as you can the failures or inadequacies of those systems," he said in an email.
A landmark 2005 study of Los Angeles County's foray into letter grading in the late 1990s found several pluses. Restaurants had enormous incentives to obtain good grades, as restaurants getting A's experienced an average revenue increase of 5.7%. The percentage of restaurants with A's grew from about 60% to more than 80% over a five-year period.
Studies also found significant decreases in hospitalizations for food-borne illnesses in Los Angeles County -- up to 20% -- after the county adopted letter grading.
Researchers drew more skeptical conclusions about grading in a 2012 study of systems in New York and San Diego. Findings included high grade inflation in San Diego, and New York's system showed no evidence of public health benefits despite large administrative costs in resolving appeals over grade disputes.
Nevertheless, in a recent national survey, a majority of health officials using grading systems said they believed the threat of bad publicity results in cleaner restaurants, Withers said.
Grading restaurants isn't a new phenomenon. It used to be popular in the 1940s and 1950s, when the Food and Drug Administration used scoring in inspections, and about 400 cities had systems in place in 1951. But when the FDA abandoned grading in the 1970s, it disappeared.
The U.S. Centers for Disease Control and Prevention estimates that each year 1 in 6 Americans, or about 48 million people, gets sick from a food-borne disease. About 128,000 are hospitalized, and 3,000 die. More than half of reported outbreaks occur at restaurants and delis.
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