Executive summary
Background and research approach
Food Standards Scotland (FSS) commissioned qualitative consumer research to explore adults’ understanding of people at higher risk of food poisoning, referred to in this report as the clinically “vulnerable groups” to foodborne illness, with a particular focus on definitions, terminology, and self identification. The research was undertaken in response to a revised, evidence based definition of increased vulnerability to foodborne illness, developed following an academic review commissioned by FSS in 2023. While the revised definition reflects current scientific understanding, there was limited insight into whether consumers recognise, understand, or identify with these vulnerability categories in practice.
Seven one hour online focus groups were conducted between 3rd and 17th February 2026 with a total of 29 respondents from across Scotland. The sample comprised four different types of respondent that included members of the general public aged from 50 to 64 years old, older adults aged 65 and over, people who are immunocompromised, and carers. Respondents represented a mix of socio economic groups, genders, and geographic locations. Discussions explored perceptions of food poisoning, awareness and understanding of vulnerable groups, responses to alternative definitions and terminology, sources of food safety information, and information needs.
Key findings
Understanding of food poisoning
Food poisoning was not a top-of-mind concern for most respondents. Knowledge was mainly based on personal experience rather than official guidance, and respondents were confident in their habits despite engaging in risky behaviours (e.g. ignoring use-by dates, washing raw chicken, reheating food repeatedly, judging safety by smell/appearance).
- Carers are more cautious due to responsibility for others
- Immunocompromised individuals do not show consistently higher awareness of food poisoning and food safety
- Older adults rely heavily on long-standing habits and recall little recent guidance
Understanding of vulnerable groups
Respondents showed a broad, intuitive understanding of vulnerability, commonly identifying young children, older people with poor health, individuals with weakened immune systems, and those undergoing treatments such as chemotherapy as being at higher risk of severe illness from food poisoning. There was a lack of clarity on why some people are vulnerable. Other areas of confusion included:
- What counts as a “young child”
- Which conditions increase risk
- How treatments/medications affect immunity
Explaining vulnerability through immune system function significantly improved understanding and self-identification.
Defining older adults
- Age 65 years and older was recognised, but many in this group rejected the label “older adults”, especially if they felt healthy
- People responded better to functional descriptions (e.g. immune decline) rather than age alone
- Adding flexibility (e.g. “typically aged 65 and over”) reduced resistance to self-identify with this group
Testing definitions of vulnerable groups
The most effective and preferred definition was detailed and condition based. This version was favoured by five of the seven groups because it:
- Clearly explained why certain people are more vulnerable
- Used plain, accessible language without being overly simplistic
- Included concrete examples of health conditions and medications (e.g. chemotherapy, immunosuppressants, omeprazole)
- Encouraged people to recognise that vulnerability can be cumulative
- Supported self-identification across multiple categories
Definitions that lacked explanatory detail were consistently viewed as less credible, less helpful, and more likely to prompt resistance, particularly among older adults.
Sources of information
People rarely sought food safety information proactively. Instead, they relied on:
- Packaging, recipes, and cooking instructions
- Family advice and personal experience (often outdated)
Digital tools like Google and AI (e.g. ChatGPT, Copilot) were used as starting points, but information was often cross-checked with trusted sources like NHS or government websites.
Implications and recommendations
The findings highlight a clear gap between intuitive awareness of vulnerability and informed understanding of risk. Explaining why certain groups are vulnerable, particularly in relation to immune function, was critical in supporting understanding, acceptance, and self-identification.
Overall, a detailed, condition-based definition was found to provide a robust, inclusive and well understood framework for communicating vulnerability to foodborne illness and offers a strong foundation for future FSS food safety messaging and interventions.
Future consumer-facing food safety messaging should:
- Adopt condition-based definitions with clear explanations
- Include qualifying language and rationale for age based terminology
- Provide examples of medications and conditions that are specific and familiar
- Account for entrenched habits and low salience of food poisoning risk, particularly among older adults
- Prioritise food safety messages on issues that are commonly misunderstood such as washing chicken, fridge temperature control, use-by dates and reheating food
- Embed food safety guidance into everyday information sources (e.g. packaging, recipes, healthcare interactions)