Table 3. State structural characteristics from all outbreak reporter states, Foodborne Disease Outbreak Surveillance System, United States, 2009–2018*.
| Characteristic | Highest 10 reporters | Middle 31 reporters | Lowest 10 reporters | p value |
|---|---|---|---|---|
| Reporting structure | 0.61 | |||
| No. centralized (%) | 5 (50.0) | 10 (32.3) | 4 (40) | |
| No. decentralized (%) |
5 (50.0) |
21 (67.7) |
6 (60) |
|
| State agency finance, median (IQR)† | ||||
| % State funds | 26.9 (22.5–32.6) | 29.2 (21.7–47.3) | 19.7 (12.9–23.7) | 0.11 |
| % Federal funds | 54.3 (39.9–63.1) | 51.1 (43.8–61.4) | 49.4 (39.7–69.0) | 0.96 |
| % CDC federal funds | 26.7 (23.6–36.5) | 20.6 (15–33.3) | 14.8 (14.2–28.3) | 0.14 |
| Median ELC funding per capita, US$‡ |
$1.30 ($0.91-2.12) |
$0.81 ($0.45–1.49) |
$0.44 ($0.34–0.59) |
<0.01 |
| State agency workforce | ||||
| FTEs per 10,000 population, median (IQR)† |
2.7 (2.2–4.9) |
2.2 (1.2–5.1) |
4.8 (2.6–6.8) |
0.37 |
| CDC ELC-funded foodborne programs§ | 0.35 | |||
| CoE | 3 (30.0) | 3 (9.7) | 0 | |
| FoodCORE | 1 (10.0) | 4 (12.9) | 0 | |
| OBNE | 5 (50.0) | 15 (48.4) | 5 (50.0) | |
| None |
1 (10.0) |
9 (29.3) |
5 (50.0) |
|
| NoroSTAT¶ |
3 (30.0) |
9 (29.3) |
0 |
0.18 |
| FoodNet# |
3 (30.0) |
7 (22.6) |
0 |
0.21 |
| Food safety environmental health programs | ||||
| FDA standard 5** | 4 (40.0) | 15 (48.4) | 3 (30.0) | 0.63 |
| State-level meat and poultry inspection | 4 (40.0) | 19 (61.3) | 5 (50.0) | 0.46 |
| RRT | 4 (40.0) | 16 (51.6) | 4 (40.0) | 0.79 |
| EHS-Net | 2 (20.0) | 3 (9.7) | 0 | 0.36 |
| NEARS | 5 (50.0) | 15 (48.4) | 4 (40.0) | 0.93 |
*Values are no. (%) except as indicated. The highest reporter states were the highest outbreak reporting quintile, middle reporters the middle 3 quintiles, and low reporters the lowest quintile, based on number of outbreaks reported per 10 million population. p values are from Kruskal-Wallis tests for continuous variables and Fisher exact test for categorical variables. CoE, Center of Excellence; ELC, Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases; FDA, Food and Drug Administration; FTE, full-time employee; NEARS, National Environmental Assessment Reporting System; OBNE, OutbreakNet Enhanced; RRT, FDA Rapid Response Team. †Association of State and Territorial Health Officials Profile of State and Territorial Public Health volume 4. ‡ELC funding per capita, fiscal years 2016–18. Excludes supplemental Zika virus funding for fiscal years 2016–20. §ELC-funded foodborne programs: Integrated Food Safety Centers of Excellence, Foodborne Diseases Centers for Outbreak Response Enhancement (FoodCORE), OBNE;.States with multiple programs were categorized into the category with more funding (e.g., states with CoE and FoodCORE were counted only in CoE) such that program categories are mutually exclusive. ¶Norovirus Sentinel Testing and Tracking (NoroSTAT). #Foodborne Diseases Active Surveillance Network. **State agency participation in FDA Voluntary National Retail Regulatory Food Program Standard 5 (Foodborne Illness and Food Defense Preparedness and Response) as of most recent assessment or audit.