Background
The risk of foodborne illness is not uniformly distributed across the population in Scotland, with certain groups more likely to become ill and face a higher likelihood of severe illness from food poisoning. These populations are commonly referred to as clinically vulnerable groups to foodborne illness. The designation ‘clinically vulnerable’ is evidence-based and reflects differences in physiological resilience rather than personal behaviour or lifestyle. Its purpose is to support proportionate risk communication, targeted public health messaging, and the development of interventions that protect those most at risk of severe outcomes.
In 2023, Food Standards Scotland (FSS) commissioned academic researchers to review the existing definition of clinically vulnerable groups drawing on contemporary evidence regarding patterns of foodborne illness (“Examining Vulnerability to Foodborne Illness: A Comprehensive Review of “Clinically Vulnerable Groups”). The objective of this review was to ensure that the definition accurately reflects current evidence and supports proportionate and effective food safety messaging.
Based on the findings of this review, a revised definition of vulnerability to foodborne illness has been developed. Under this definition, individuals may be classified as vulnerable due to:
- Underlying medical conditions (for example, chronic illness or a weakened immune system),
- Use of certain medications or treatments that reduce immune response, and/or
- Age-related factors, particularly very young children and older adults, whose immune systems may be less able to fight infection (specifically, young children under five years of age and adults aged 65 years and over)
However, there is currently limited understanding of whether, and in what ways, consumers recognise and identify with the different vulnerability categories outlined in this revised definition. Qualitative research was therefore required to explore consumers’ interpretations and perceptions of the proposed vulnerable groups’ definition.
Further evidence was also needed regarding the most appropriate terminology for referring to the older population. In particular, FSS was considering the use of the term “older adults” as an alternative to an explicit age-based threshold (such as “65 years and over”). While at the time the term “older adults” was used in food safety messaging in the UK, concerns were raised that it may be unclear and that some people may not realise it applies to them, including people aged over 65 not recognising themselves as part of this group, or younger people incorrectly assuming inclusion. Evidence was therefore required to assess whether this confusion exists in practice.
Accordingly, qualitative consumer research was required to examine adults’ understanding of the revised vulnerable groups’ definition, their perceptions of personal susceptibility to foodborne illness, and their views on the use of the term ‘older adults’. Findings from this research will directly inform FSS consumer-facing food safety messaging, support improved identification of populations at highest risk, and contribute to the development of targeted interventions aimed at reducing the incidence and burden of foodborne disease in Scotland.
Research objectives
The overarching objective was to determine the most appropriate way to describe the older population group as well as determine adults’ understanding of the vulnerable groups' definition. Specifically, the study sought to explore:
The overarching objective was to determine the most appropriate way to describe the older population group as well as determine adults’ understanding of the vulnerable groups' definition. Specifically, the study sought to explore:
The definition of vulnerable groups
- Understanding and awareness of vulnerable groups to foodborne illness in general
- Test different versions of the vulnerable groups’ definition to determine which is preferred/best understood
- Understanding and awareness of susceptibility to foodborne illness
“Older adults” terminology
- Test wording/phrasing of ‘older adults’ versus an age-specific cut-off of ‘older adults’ (those aged 65 years and older)
- Determine whether respondents identify as ‘older adults’ versus ‘those aged 65 years and older’
Information and resources
- Gather information on where respondents obtained general (and specific) information about food safety/vulnerable groups
- Understand what their most used, trusted and useful sources of information are
- Determine what information people look for regarding food safety/vulnerable groups