Food, Health, and Politics: Inside the Health Department

If you ask anyone about the issue of food safety, they’re going to say they’re in favor of it. Start going into the details of how much regulation is enough and how it’s done and things can get a lot more divisive. It’s a complex subject, and nobody in Los Angeles knows more about it than the Department of Health.

The most visible sign that LA County has a Department of Health Services is the letter grades that are posted in restaurants, markets, and anywhere else food is legally sold. We caught up with Chief Environmental Health Specialist Terrance Powell at the downtown LA office of his boss, Dr. Jonathan Fielding, the county’s Director of Public Health. We started by asking a few questions about recent changes in California’s food safety laws that were spurred by the outrage of a well-connected ethnic community. Dr. Fielding added to the discussion, and where he did his answers are noted with his initials.

Q: Chinese restaurateurs got food safety laws changed to allow roast duck cooked at low temperatures over two decades ago, Korean restaurateurs their unrefrigerated rice cakes just a few months ago. Was this change entirely a matter of health or a matter of culture?

TP: The roast duck issue goes back to the 70’s. California recognized certain cultural differences in food preparation, and upon a scientific finding that (low-temperature roasting) was harmless, it was allowed into practice. With respect to the Korean rice cakes, it was some specialty legislation pushed through by a governor who was termed out of office. Having said that, there are many different practices for food preparation from all over the world, and they don’t always fit into the standards of this country. State and local jurisdictions are always grappling over how to ensure that food production different from the standards is safe. If they’re doing something different from the standard but they can scientifically show that it’s safe, the rules can be changed.

Q: The fact that this was done by an explicitly political process raises a question. If a community didn’t have the political clout that the Korean and Chinese communities have, would they be able to get their food practices even tested so it could be found that they were safe?

TP: I think there’s always a possibility for lobbyists to affect regulations… If you look back at the genesis of the law that legalized Korean rice cakes, we were already working closely with the Korean community to come to some solutions. I think we were very much there, but there were forces within that community that elected to go political.

JF: We’re not the food Gestapo – our role is to safeguard the public’s health. If someone is eating in a restaurant and they don’t know about the handling situation, that things haven’t been maintained at the right temperature or there’s contamination, they have no way of knowing that or seeing that. On the other hand, when they decide to make up their own mind to eat something prepared according to a cultural tradition, we make sure they have all the information and make up their own mind. That includes everything from the practices we’ve discussed already to having a caesar salad made with raw eggs.

TP: On any sort of new practice, either culturally based or a new technology, when it deviates from standard the onus is on the producer to prove that it’s safe. There are many methods within the health code that allow for that.

Q: With the proliferation of globally supplied produce, how can you try to control the spread of diseases that you may not be familiar with because they haven’t been seen in this country before? Also, with the lack of labels how can you tell the difference between commercially produced stuff and something that was grown in someone’s backyard with no standards at all?

A: It’s always a possibility that someone will own a restaurant and sell things that are from an unapproved source. The jurisdiction over imports lies with the federal government. Our mission is not so much the origin but how it is handled.

JF: I’m concerned that the federal government has not required source labeling for produce. Not that that alone would solve the problem of potential contamination, but it would be one of the thing s that consumers could take into account in their purchasing. I would like to see labeling of country of origin of all produce. It would make it much easier for epidemiologists to identify the source of an outbreak or decide whether disparate cases were all part of one outbreak. The more specificity we have, the more tools both we and consumers would have.

Q: I see people all the time selling produce out of the back of a truck or in a freeway median, and I’m pretty sure they don’t have a rating on their operation.

TP: It’s a very big problem for us and a very large drain on our resources. Often the sellers have no identification, or they’re employed by a central seller who we can’t find. The fruit sellers aren’t as much of a problem as the ones who sell tamales, corn, or shaved ice, where you have a lot more food handling going on. We not only have the problems with tracking these people, but the problem of knowing just how many illnesses they’ve caused. Food-borne illness is under-reported. That’s an educational issue that we just have to keep working on.

JF: It’s very difficult to control this, because it can be done from anyone’s kitchen or anyone’s pickup truck. We need to let people know that they’re taking a significant added risk when they purchase certain types of products from those type of vendors.

Q: How many do you catch every year?

A: That’s something I can’t tell you right now, but I can say that we have almost 50,000 licensed entities, whether restaurants or fixed entities like markets, ten thousand mobile units, and five thousand retail sites. Having said that, there is an unknown number of additional unlicensed vendors. That’s only the ones we happen to run into. If you were to ask what relation that is to the total picture, we can’t even give a good guess. We can’t catch them all, we can just try to educate the consumer to not buy.

Q: Some people have taken the crackdowns on street vendors as a racist action aimed at certain ethnic communities.

TP: There’s always going to be a tendency to say that these operations don’t affect anybody, that these unlicensed vendors are just poor immigrants trying to pull themselves up. However if you look at any number of stories that have been in the press serving those communities, particularly the Latin community, they point out a lot of egregious violations that really endanger everyone’s health. We get complaints from local schools where vendors sell products that are not only illegal, but sold in an unsafe manner. They double-park a truck right outside a school so the kids have to go into the street to access it, and sell dangerous products. The schools are the first ones to call us, and they’ve been very proactive. Last year we gave food safety programs to 19,000 students at schools that had called us to complain about vending around their grounds.

JF: In a county of ten million people, I’m sure there are things going on that we don’t know about.

Q: The food safety rules are available in English and Spanish, but there are restaurateurs here who don’t speak either language. What about the ones who speak Vietnamese, Ethiopian, or other languages?

TP: We teach a food safety class in seven languages, and if you look around the rest of the country I feel safe in saying that you won’t find that kind of effort to reach out in most other places.

Q: Do you have any problems with illegal operators who figure out when you’re coming and scram before you get there?

TP: I have seen situations where someone sets up an operation in a parking lot, with tables and chairs and a truck pulled up and cooking. As soon as our inspectors are spotted coming down the street they fold up shop, and by the time we get there there’s nothing but the faint odor of food cooking to suggest they were there at all. When we come down the street we’re often accompanied by the local police department, and we’re conspicuous. While we’re enforcing things on one particular entity, the rest disappear.

Q: There have been allegations in the past that some people have been tipped off about when you’re coming.

TP: We have a staff that represents the same demographics as Los Angeles – all walks of life, all income levels. Some may have links in a community, some may need money and be tempted. We have oversight to prevent that, but certainly there is the potential for some integrity issue. Sometimes there’s an appearance of a problem that is unwarranted, as when restaurateurs tell their employees take special care with food safety because they expect an inspector. We do inspect places with a certain frequency, and it doesn’t take a rocket scientist to say hey, this could be my month and it’s time to clean up my act. We generally inspect places three times a year, and if you know when you were inspected the last time, you might well guess when we’re coming next. We try to vary our timing, but we can’t be completely unpredictable.

Q: Has anyone ever been caught accepting bribes?

TP: Yes. One person, at the beginning of the program. We instituted the practice of sending supervisors out at random times to check to see if their scores matched the inspectors.

JF: We also rotate the inspectors so they can’t develop a relationship with a restaurateur. Does that totally eliminate the possibility? Of course not, because people are people. Most of the reports are the other way – our inspectors reporting that someone has offered them a bribe.

Q: What about the opposite – restaurants being marked down because the staff are rude to the inspector?

TP: We require that every inspector do their best to be objective. Tempers can get hot, and our staff are trained to try and defuse this sort of situation, to turn and walk away if that’s appropriate. It’s not worth risking life and limb to do it immediately. We’ll do the report, or go back again and do the report, but we’re going to do the job.

Q: Anything one of your inspectors found that were so bizarre that you hadn’t thought to forbid it?

TP: There’s always room for ingenuity. People who don’t have proper culinary equipment use bricks wrapped in banana leaves to press food. I’ve heard about a place that was poaching frog legs in their dishwasher, but I didn’t actually see that one.

Q: I have heard that fast food joints that use packaged ingredients score highly while turning out less healthy food, while places that use a lot of fresh vegetables have a more difficult time getting a top score.

A: That’s not completely inaccurate. Asian food is the most hand- intensive food you’re going to find, what with people chopping lots of vegetables, hand-rolling dough, and the like. You have to take extra measures to get it right.

Q: If a restaurant gets a rating below 70, can they get a re-test?

JF: Once a year. It’s done randomly, and they have to pay for two inspections.

Q: Given that restaurateurs pay for these inspections, have the recent budget cuts harmed your department?

TP: Our fees cover the cost of our service, so we’re revenue neutral.

Q: Places are allowed to remain open with a “C” grade. When I am walking up to a restaurant and I see that letter, I slow down a lot. Would you eat at a place that gotten a C?

JF: I never have. It’s a general reflection of an attitude to hygiene and sanitary practices. If there was anything that we found that said that the restaurant was doing something that imperiled the health and safety of a patron, we would have closed it, but a C means that people aren’t doing a lot of little things right. The percentage of C’s goes down each year, and it’s a sign of a changing attitude that we want to foster. The big complaint I hear now is from people who go to some other city and they don’t know where to go, because there are no letters in the window. They’ve come to rely on those grades so much…

TP: I have eaten at places that have a C. The fact that you’re hesitant and Dr. Fielding won’t is right at the heart of what we’re trying to do – to empower the consumer. We’re just providing a tool.

An abbreviated version of this article was published in CityBeat Los Angeles in 2004.