Economic Burden of Foodborne Illnesses Acquired in the United States

Abstract

Foodborne disease burden estimates inform public health priorities and can help the public understand disease impact. This article provides new estimates of the cost of U.S. foodborne illness. Our research updated disease modeling underlying these cost estimates with a focus on enhancing chronic sequelae modeling and enhancing uncertainty modeling. Our cost estimates were based on U.S. Centers for Disease Control and Prevention estimates of the numbers of foodborne illnesses, hospitalizations, and deaths caused by 31 known foodborne pathogens and unspecified foodborne agents. We augmented these estimates of illnesses, hospitalizations, and deaths with more detailed modeling of health outcomes, including chronic sequelae. For health outcomes, we relied on U.S. data and research where possible, supplemented by the use of non-U.S. research where necessary and scientifically appropriate. Cost estimates were developed from large insurance or hospital charge databases, public data sources, and existing literature and were adjusted to 2023 dollars. We estimated the cost of foodborne illness in the United States circa 2023 to be $75 billion. Deaths accounted for 56% and chronic outcomes for 31% of the mean cost. The costliest pathogen was nontyphoidal Salmonella at $17.1 billion followed by Campylobacter at $11.3 billion. Toxoplasma ($5.7 billion) and Listeria ($4 billion) followed due primarily to deaths and chronic outcomes from pregnancy-associated cases. Per-case cost ranged from $196 for Bacillus cereus to $4.6 million for Vibrio vulnificus. Unspecified agents accounted for 38% of the total cost of foodborne illness, but these illnesses were generally mild (per-case cost $781). These cost estimates can help inform food safety priorities. Our pathogen-specific per-case cost estimates can also help inform benefit-cost analysis required for new federal food safety regulations.

Keywords: United States; chronic sequelae; cost-of-illness; foodborne; hospitalization cost; value of statistical life.