Food has long been recognized as a vehicle of disease transmission; there are more reported illness associated with the consumption of food than all other environmental factors combined. The handling and storage of food are potentially dangerous and demanding chores for those who may have the sensory losses associated with advancing age, fragile health, and limited resources.

Group-administered questionnaires on the knowledge, attitudes, and practices of food handling were given to 276 seniors, aged 55 to 90, from ten mobile home parks randomly selected from San Bernardino and Riverside counties. As an indicator of possible foodborne illness, the questionnaire asked for the number of abrupt gastrointestinal episodes experienced in the previous six to nine months. The temperatures of home refrigerators and freezers were obtained from the 59 participants reporting any GI episodes along with a randomly selected equal number of those reporting none.

Gastrointestinal episodes were reported by 21.4% of participants; this was significantly greater than estimates in the U.S. population (2% to 10%). Most participants (88.4%) reported having eaten only at home preceding the episode.

Only 50.8% of home refrigerators and 52.5% of freezers were cold enough to be considered safe. The mean score for knowledge of proper food handling was only 58.3% correct. These three variables were the most significant of all variables studied in their relationship to higher numbers of GI episodes reported. Eating risky food (e.g., uncooked hot-dogs, soft-cooked or raw eggs, rare meat, and raw milk) was found to predict increased GI episodes. Poor food thawing practices and unsafe handling of leftover food were also found to be related to more GI episodes. More positive attitudes toward learning proper food handling and hand-washing before preparing or eating food were linked to fewer GI episodes.

Of 18 variables examined, 15 were associated with an increase in reported GI episodes. In order of the strength of association, these variables were: higher freezer temperature, higher refrigerator temperature, less knowledge of correct food handling practices, eating more risky food, unsafe handling of leftovers, poorer attitude toward learning proper food handling, poorer attitude toward hand-washing before preparing or eating food, unsafe food thawing practices, older age of home refrigerator, what others think about participants’ food handling practices (subjective norm), poorer cleaning of kitchen cutting board, feeling guilty about discarding old food, male gender, and age of participant.

Logistic regression showed that the above variables predicted GI episodes correctly 95% of the time. A prediction of no GI episodes was correct 96% of the time (specificity) and a prediction of at least one GI episode was correct 93% of the time (sensitivity).

These findings may help to promote further studies and health education programs that could help lower the rate of the preventable, widespread problem of foodborne illness.


School of Public Health

First Advisor

Christine Neish

Second Advisor

Jerry W. Lee

Third Advisor

Patrice Cruise

Fourth Advisor

Kenneth Burke

Degree Name

Doctor of Public Health (DrPH)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Food Handling; Aged



Page Count

xi; 115

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives