“I am in total control in my kitchen”: Food Safety Risk Perceptions of Independently Living Older Adults in Southern Ontario, Canada

Abstract

Background: Foodborne illness is a significant global public health concern. Older adults are particularly vulnerable to foodborne illness due to age-related physiological changes, including weakened immune systems and chronic health conditions. In Canada, approximately four million cases of foodborne illness occur each year, resulting in over 240 deaths. While the aging population is rapidly growing, there is limited research on how older adults who live independently perceive and manage food safety risks. The overall aim of the thesis was to understand how independently living persons aged 65 and older, living in Southern Ontario (Kitchener-Waterloo, Cambridge, Guelph, and Woodstock) perceive and mitigate their risks of foodborne illness in their home environments. Specifically, the objectives were to explore: (i) how and why these individuals perceive their risk of developing foodborne illness, and (ii) whether these individuals follow recommended food safety practices and why or why not. Methods: I conducted 14 semi-structured interviews with persons aged 65 and older, who live independently in Southern Ontario, speak English, and are primary food preparers in their households. Participants were primarily recruited using flyers at community centres for older adults, a health fair hosted at one of these centres, the Schlegel-UW Research Institute for Aging, libraries, and religious institutions. The interview guide was informed by the World Health Organization’s Five Keys to Safer Food. Each interview lasted 45-60 minutes and was conducted in person (n=10) or virtually (n=4). In-person interviews were audio recorded using Microsoft Teams, while virtual interviews were both audio and video recorded using Zoom, and live transcription was enabled on both platforms. I manually transcribed each recording verbatim and carefully revised the auto-generated transcriptions for accuracy. This study used a post-positivist and interpretive theoretical orientation. I analyzed the data using a combination of inductive and deductive approaches through reflexive thematic analysis, following Braun & Clarke’s six-phase process. Results: Four themes were developed using an inductive approach based on the interviews with older adults: (1) Trusting my own cooking, (2) Doing what I’ve always done, (3) Being conscious of minimizing food waste, and (4) Cooking is a chore. Each theme encompassed subthemes that illuminated their nuanced perspectives and experiences. Participants expressed strong trust in their own food handling practices at home, which contributed to their perception of being at low risk for foodborne illness. They believed that preparing healthy meals makes their food naturally safe, leading them to believe that illness is unlikely to affect them. They engaged in varied food handling practices; some followed recommended guidelines, while others deviated, such as not using a food thermometer. Their practices were shaped by long-standing habits, experience, and reliance on both their food safety knowledge and their social networks. Participants described shopping and food preservation strategies aimed at minimizing food waste and costs, which resulted in neglecting best practices. In addition, limited kitchen space affected their food choices and storage practices. Reduced motivation to prepare meals and physical limitations prompted them to adjust their preparation methods and rely on convenience. Conclusion: This is the first study in Canada to explore older adults’ perceptions of food safety risks using semi-structured interviews. While participants demonstrated solid food safety knowledge, they perceived themselves at low risk for foodborne illness in their homes. The findings highlight the need for education and awareness of specific food handling practices. This study provides practical guidance for public health professionals and senior care organizations to develop tailored resources that promote safe food handling, support older adults’ independence, and bridge the gap between knowledge and practice to reduce their risk of foodborne illness.