Does education promote health? A case study of foodborne disease on Guam

Leon Taylor Abstract In 1975, Guam stopped testing food workers for foodborne disease. Instead, it taught them how to avoid spreading disease to restaurant patrons. But this new policy did not much cut the rate of foodborne disease among patrons, suggests a statistical study. A major typhoon may have cut the disease rate more, perhaps by closing restaurants. [JEL I18, J28] Introduction More education may improve the health of many. Across countries, a high level of education may correlate with a low rate of infant death (Barro and Lee, 1993). But does specific training of workers in a key industry, such as food service, improve consumer health? A sharp transition in policy from traditional regulation of food workers and toward education of them could provide a useful case study. From 1950 to 1975, the U.S. territorial government of Guam required all food handlers -people who worked in places that prepared food for eating there or elsewhere -to obtain medical clearance each year. The test most relevant to food safety was the examination of the worker’s stool specimen for parasites and parasite ova. Such testing ended in 1975, when refugees from the Vietnam War almost doubled the population of the island. So pressured, the Guam Department of Public Health & Social Services cut back its routine workload by no longer requiring medical clearance each year for food handlers. Instead, they were to attend one lecture