Sick leaves: The Nunes Company, which owns the Foxy brand, voluntarily recalled 8,500 crates of its lettuce after water samples tested positive for E. coli bacteria. Credit:

In the summer of 2006, consumers across the country began falling sick from a particularly nasty strain of Escherichia coli bacteria, known as 0157:H7. Not all E. coli bacteria are dangerous, but 0157:H7 belongs to the Shiga toxin-producing group of pathogens (known as STEC), which can cause severe, and sometimes fatal, illness. By early October, 199 people in twenty-six states had fallen ill, resulting in 102 hospitalizations and thirty-one cases of kidney failure. Three people died, including a two-year-old boy in Utah.

Government investigators eventually traced the bacteria to fresh spinach harvested from four fields in California’s Monterey and San Benito counties and processed by Natural Selection Foods, one of the nation’s biggest producers of bagged mixed salad. Though a relatively small amount of greens was involved—just one day’s worth of production—the tainted spinach made its way into seven different packing lines and thousands of bags of salad mix processed at one of the company’s two central facilities. It was sold under such well-known brands as Trader Joe’s, Earthbound Farm, and Natural Selection; 15,660 pounds were sold under the label Dole Baby Spinach. The spinach even made it overseas to Taiwan, Hong Kong, and Iceland, as well as to Canada and Mexico.

Apart from the irony—a quintessential health food causes a deadly national outbreak of illness—the 2006 spinach scare was something of a watershed moment for so-called multistate food outbreaks, which began to pick up in tempo around that time.

That same year, seventy-one people in five states were sickened by food from Taco Bell, and 183 people in twenty-one states suffered infections from Salmonella bacteria on tomatoes. Over the next five years, the number of multistate outbreaks per year more than doubled, from thirteen in 2006 to twenty-nine in 2010, according to the federal Centers for Disease Control and Prevention (CDC).

Many of these outbreaks were headline-grabbing national food scares involving trusted brands and popular foods: Veggie Booty (salmonella, 2007); Kroger’s ground beef (E. coli, 2008); Nestlé Toll House Cookie Dough (E. coli, 2009); eggs (salmonella, 2010); cantaloupes (involving the Listeria bacteria, 2011); sprouts (E. coli, 2012); Foster Farms frozen chicken (salmonella, 2013); caramel apples (listeria, 2014); Blue Bell ice cream (listeria, 2015); and cucumbers (salmonella, 2013, 2014, and 2015). In the fall of 2015, at least fifty-two people in nine states fell ill after eating at Chipotle restaurants, the paragon of “healthful” fast-casual food. From 2010 to 2014, the CDC reported 120 total multistate outbreaks, or an average of twenty-four per year. By comparison, from 1973 to 1980, the median annual number of multistate outbreaks was just 2.5.

While some of the rise in reported outbreaks is due to better detection—the CDC now uses sophisticated DNA fingerprinting of pathogens and a national system called PulseNet to identify outbreaks—a growing coterie of researchers, as well as the CDC, say that modern industrial food processing is also to blame. According to the CDC’s website, “Changing patterns in global food production … combined with increasing integration and consolidation of agriculture and food production can result in a contaminated food rapidly causing a geographically widespread outbreak.”

In other words, the same hyperefficient distribution system that brings you convenient and affordable salad greens and all the chicken nuggets you can eat can just as efficiently deliver E. coli, salmonella, and other dangerous bugs to your plate. Moreover, today’s industrialized food production processes carry other public health risks. Antibiotic use, for example, which is still endemic in so-called factory farming, is contributing to the rise of drug-resistant super-germs. And the reliance on monoculture—the cultivation of a single species to help standardize production—is leading to a potentially dangerous lack of biodiversity. “Consolidation has eliminated redundancies in the food system in the name of efficiency,” says Mary Hendrickson, assistant professor of rural sociology at the University of Missouri-Columbia. “But redundancies help protect us.” Today’s industrial food system has brought American consumers a wealth of affordable and convenient foods, but this benefit may come with a price that’s not listed on our grocery bills: food that’s not only the blandly uniform product of a few mega-sized producers, processors, and retailers but also isn’t as safe as we think it is.

Food safety experts are quick to point out that the U.S. food system is considerably safer than that of other countries, or indeed than the systems in America’s own past. The nation has come a long way from the situation described in Upton Sinclair’s The Jungle, with increasingly strict governmental and industry food safety standards as well as technological advances aimed at combating the spread of pathogens. In 2010, Congress passed the Food Safety Modernization Act, which dramatically broadened the authority of the U.S. Food and Drug Administration (FDA) to mandate standards, monitor imports, increase the number of inspections, and order recalls of tainted foods.

Industry groups also credit uniform, industry-wide food safety standards for keeping the rates of foodborne illness as low as possible. The National Chicken Council, for example, cites the use of antimicrobial “food-grade additives” and “approved rinses” for helping to reduce the incidence of salmonella on whole chickens by 63 percent between 2008 and 2014.

And given the sheer volume of food that is grown, harvested, and processed in the United States each year, the incidence of foodborne illness is astonishingly low. For example, in 2006, the same year as the E. coli outbreak involving fresh spinach, the total amount of spinach consumed by Americans was nearly 587 million pounds, according to the U.S. Department of Agriculture. Although the amount of produce ultimately recalled in 2006 was enormous, the actual contamination was limited to just 1,000 pounds of spinach.

Matthew Wise, who leads the Outbreak Response Team for the CDC’s Division of Foodborne, Waterborne and Environmental Diseases, also notes that the overall number of foodborne illnesses hasn’t appreciably grown. What might be happening, he says, is that “the types of outbreaks might be shifting over time.”

Nevertheless, multistate outbreaks present fresh worries for both consumers and public health officials—because of the speed at which outbreaks can spread nationwide and because of their relative lethality.

According to an analysis by Samuel Crowe, an Epidemic Intelligence Service officer who works with Wise at the CDC, multistate outbreaks accounted for just 3 percent of total foodborne outbreaks over the past five years, but were responsible for 34 percent of hospitalizations (1,460 out of 4,247) and 56 percent of deaths (66 of 118). That’s because multistate outbreaks typically involve the most noxious pathogens—salmonella, listeria, and Shiga toxin-producing E. coli. Listeriosis, for example, can lead to complications such as convulsions, septicemia, and meningitis. STEC can cause bloody diarrhea and a life-threatening complication called hemolytic uremic syndrome, which can result in permanent kidney damage or death. (In contrast, says Crowe, the pathogen most common in single-state and localized outbreaks is norovirus, which causes symptoms closer to what most people think of as a “24-hour” stomach flu.)

This lethality, coupled with the supply-chain efficiencies typical of today’s consolidated food system, is what gives multistate outbreaks such dramatic impact. “A single contamination event on a farm or an industrial-processing facility has the potential to make a lot more people sick than a localized food-handling issue at a birthday or a church supper,” Wise says.

Take, for example, a recent multistate outbreak involving imported cucumbers from Mexico and a strain of Salmonella bacteria called Poona. What began as a trickle of cases beginning in late July 2015 soon accelerated into an epidemic. By the end of August, 341 people in thirty states had fallen ill, and two people were dead. Even after two California-based produce companies—Andrew and Williamson Fresh Produce, and Custom Produce Sales—voluntarily recalled their cucumbers in early September, cases continued to pour in. By the end of the outbreak, the tainted cukes had caused 838 reported illnesses in thirty-eight states, including 165 hospitalizations and four deaths.

The outcomes are even worse when the adulteration is intentional or negligent—as was the case with the egg scare of 2010. When federal inspectors visited the Iowa facilities of Wright County Egg in the summer of 2010, they found that one of the nation’s then-largest egg producers was operating in unimaginable filth. In a subsequent summary of its investigation, the Food and Drug Administration (FDA) reported piles of manure eight feet high, “dead maggots and live flies that crunched under foot,” and “live and dead flies that were too numerous to count.” By then, Wright County Eggs had sickened 1,939 people across the country with salmonella, and the company (which also did business as the ironically named “Quality Egg LLC”) had recalled 500 million eggs nationwide.

In April 2015, Wright County Egg’s owner, Austin “Jack” DeCoster, and its chief operating officer, Peter DeCoster, were each sentenced to three months in federal prison and fined $100,000. The company was fined $6.79 million.

As egregious as the DeCosters’ behavior was, its impacts were likely amplified by the company’s size—the result of ongoing consolidation in the egg industry. Had Wright County Egg been a small local producer—which was the norm four decades ago—far fewer consumers would have been affected. In 1969, according to a study by a group of CDC researchers led by Jeremy Sobel, the nation’s eggs were produced by 470,832 layer-hen farms with an average of 632 hens per farm. By 1992, the number of farms had dropped by 85 percent, while the average number of hens per farm increased by 470 percent, to nearly 3,000 hens per flock. Today, according to the American Egg Board, approximately sixty-three companies—each with flocks of one million hens or more—produce roughly 86 percent of the nation’s eggs. Seventeen of these companies, says the American Egg Board, have flocks of five million hens or more.

The same trends are even more pronounced in the beef and pork industries, which have also undergone heavy consolidation over the last several decades. According to the University of Missouri’s Mary Hendrickson, just four companies and their subsidiaries—Cargill, Tyson Foods, JBS, and Natural Beef—controlled 82 percent of the nation’s beef-slaughtering industry as of 2011, while Cargill, Tyson, and JBS, along with Smithfield Foods, controlled 63 percent of the country’s pork-slaughtering operations. Companies affiliated with Cargill, JBS, and Smithfield are also major players in running cattle feedlots and pork production.

Giant, industrialized production and slaughter operations mean that large numbers of animals are often kept in tight quarters, where pathogens can easily spread, and that carcasses are commingled with plenty of opportunity for cross-contamination. In the case of eggs, for example, the CDC’s researchers say cases of salmonella resulting from eating raw or undercooked eggs rose dramatically between 1976 and 1986, just as flock sizes were also growing with the onset of the industry’s consolidation.

Figure 1. Number of Multistate Outbreaks

Source: Centers for Disease Control Credit:

This potential for infection is one reason why many producers still rely on antibiotics in their flocks or herds, which research suggests is contributing to the rise of drug-resistant super-germs. According to another report by the CDC on drug-resistant pathogens, “there are more kilograms of antibiotics sold in the United States for food-producing animals than for people.” And despite the seeming ubiquity of “antibiotic-free” eggs and meat, the FDA reports that the sale of antibiotics for animal use actually rose by 17 percent between 2009 and 2013.

Before the passage of the 2010 Food Safety Modernization Act, which strengthened the authority of the FDA, the federal regulation of food safety was arguably too diffuse, spread across fifteen different agencies tasked with administering thirty different laws, according to the Government Accounting Office. It was this diffusion of authority and lack of focus that were blamed for allowing a producer like Wright County Egg to operate unsanctioned for as long as it did.

The 2010 legislation was intended to remedy this situation through better regulatory coordination and centralization. And as a follow-up to this legislation, President Obama proposed earlier this year consolidating the food safety regulatory authority of the FDA and the USDA into a single regulatory agency. Likewise, Illinois Senator Dick Durbin and Connecticut Representative Rosa DeLauro (both Democrats) have reintroduced legislation, the Safe Food Act of 2015, that would create a single, independent food safety agency.

The creation of a single agency might seem a logical way to enforce uniform, industry-wide, evidence-based standards for food safety. But some experts argue that this is the wrong approach—both for food safety and for encouraging competition and diversity in America’s food system. By taking on a top-down, consolidated approach that in many ways mirrors the trends happening in the industry, food safety regulation is only reinforcing the concentration of players in the food industry, critics say—along with its potential risks for public health.

For example, one of the anticompetitive aspects cited by the critics of centralized national food safety regulation is the burdensome cost of compliance. “It creates a cost structure that only a company like Tyson can afford,” says Christopher Leonard, Schmidt Family Foundation Fellow at New America and author of The Meat Racket: The Secret Takeover of America’s Food Business. “An ‘Upstart Pure Mountain Farms’ can’t compete.” Moreover, Leonard points out, industry-wide standards generally tend to reflect the input of only those players with the wherewithal to influence policy, which leaves smaller producers by the sidelines.

Food systems expert Philip Howard, an associate professor at Michigan State University, argues that large companies are well aware of the impact that stringent food safety standards—sometimes designed to solve a problem of the companies’ own making—can have on smaller competitors. In a 2008 article with coauthor Laura DeLind, Howard noted that the immediate response of the Western Growers Association (WGA)—the produce industry’s lead trade association—in the aftermath of the 2006 spinach scare was to work with California regulators to develop a “voluntary” leafy-green marketing agreement, along with state and federal regulations.

According to DeLind and Howard,

Industry leaders clearly recognized the potential such regulations had (and have) for driving smaller firms out of business. Tim York, president of a buying group based in Salinas, applauded the voluntary guidelines, saying that “The regulations are going to be expensive, and some growers may not be able to do this, which may well change the nature of WGA’s membership.” … It is hardly tangential to mention that WGA members supply 90% of the fresh fruits, nuts, and vegetables in California and 75% in Arizona (roughly one half of the nation’s fresh produce).

Another example of how regulatory requirements might stifle competition is in meat and poultry production, where current law requires that any meat or poultry that enters “interstate commerce” be federally inspected at an approved facility.

While the USDA supplies inspectors free of charge, it’s the cost of building and maintaining a facility where the inspectors can work that deters small farmers from expansion. Mike Badger, who raises 1,000 chickens as well as other livestock on a thirteen-acre farm in Pennsylvania, is one farmer for whom those requirements are too expensive and impractical. As a result, he keeps his poultry sales within state borders, to a small group of regular customers. “One of the challenges to growing your market is access to legal slaughter,” Badger says.

Badger, who is the executive director of the American Pastured Poultry Producers Association—a trade association for poultry farmers who raise their flocks in open pastures rather than in barns—also questions the imprimatur of “safety” granted by federal inspection. “People think that because it’s a federally inspected chicken, the bird will somehow miraculously be safer. But that’s not the reality,” he says. “The inspectors are only looking at physical defects and compliance in the plant itself.”

According to the CDC, no evidence suggests that smaller or larger producers have an inherent advantage on food safety. “It has to do more with your practices than your size,” says the CDC’s Matthew Wise. But some researchers say that the safety of the food produced by industrial players rests on an increasingly rickety edifice of technology-dependent fixes, such as chlorine washes for leafy greens and patented bags to extend the shelf life of bagged salads as they make a cross-country trek to your grocery store. “We’re trying to find technology to eliminate risk,” says the University of Missouri’s Hendrickson. “But that’s not the way we’re going to be successful. You have to work with nature, not against [it].”

These technological interventions are what Diana Stuart, assistant professor at Northern Arizona University, calls “attempts to fix nature rather than fix the system.” In a 2011 study based on more than 130 interviews with growers, processors, retailers, and food experts, Stuart found “a unanimous perception that bagged greens are inherently less safe than whole heads or bunches of greens,” despite all the efforts by processors to create as safe a product as possible. One grower told Stuart, “I may work for a company that sells it, but I’m not going to eat it.” What makes bagged salads potentially less safe than their unprocessed counterparts, Stuart found, are the processes inherent to bagging salads on an industrial scale: the greens are mowed by machine because hand harvesting is too costly, mixed in large vats at centralized facilities, washed in chlorine at levels not quite strong enough to kill bacteria (the right levels would also be toxic to humans), and packed in bags that arguably also help incubate pathogens.

The small poultry producer Mike Badger doesn’t argue that his chickens, or chickens raised by small producers, are generally “safer” than chickens raised by industrial producers—i.e., less likely to be contaminated by Salmonella or Campylobacter bacteria, the two organisms endemic to poultry. But he also says that the practices he follows are intended to maximize the health of his birds, and he doesn’t use antibiotics. Raising birds on pasture, he says, means that his chickens are allowed to forage for insects and grass, and they are continually moved to clean ground. “The movement keeps them out of their own waste,” Badger says. “That’s one of the ways that a pastured flock will manage its health—they’re never in an accumulation of manure for any length of time.”

Badger also says his slaughtering practices are intended to make cross-contamination less likely. Unlike industrial slaughterhouses with mechanized processing lines, Badger slaughters his chickens by hand. He says it takes him and an assistant up to six hours to process 140 chickens, while an industrial slaughterhouse would take just minutes. “A lot of contamination happens at processing time,” says Badger. “The industry uses high-speed processing lines that make it more likely you will damage the bird, rip it open, and spill out the intestinal lining where the bacteria are. If you do it by hand in a much smaller operation and at slower line speeds, you can mitigate those errors a lot easier.”

But the amount of space that a “pastured” chicken requires makes it harder to achieve the scale of production necessary to meet Americans’ insatiable demand for nuggets; Badger says his chickens take up three times the space as industrially raised birds. He says that while some of his association’s members are raising flocks with a hundred thousand birds or more, most flocks are significantly smaller. His birds are also far pricier than what Tyson or Pilgrim’s Pride produce. “The retail cost of a chicken at the store is about as much as what I spend just on feed,” Badger says.

Yet if current trends in consolidation continue, consumers who want to buy the more expensive chickens that farmers like Badger produce may not have that option at all. The final step in the consolidation of the U.S. food industry is retail, which has seen the emergence of mega-sized grocery chains over the last twenty years. Not only is America’s food being increasingly produced by a few massive suppliers, it’s also being sold to consumers through a smaller number of channels. According to the U.S. Department of Agriculture’s Economic Research Service, the nation’s top twenty grocery stores grabbed 63.8 percent of total grocery sales in 2013, up from 39.9 percent in 1993. The top four chains alone—Walmart, Kroger, Safeway, and Publix—accounted for nearly 40 percent of sales.

Michigan State’s Philip Howard says certain practices by these large retailers are also reinforcing the consolidation among food producers and processors. To make their supply chains as lean as possible, Howard said, retailers are increasingly relying on a practice called “cross-docking,” where inventory is transferred straight from suppliers’ to retailers’ trucks with no intermediate stop in a warehouse. “That means Walmart is only dealing with producers that can meet Walmart’s needs,” said Howard. “A lot of processors are merging and acquiring other firms just so they can be big enough to deal with Walmart.”

Much of this consolidation, Howard said, is not apparent to the consumer because of the continuing multiplicity of brand names. The spinach sold in the 2006 E. coli incident, for example, was sold under more than thirty different brands, even though it came from a single processor. The result, Howard wrote in his 2008 article on the spinach scare, is “the illusion of vast consumer choice.” And, some would add, the illusion of safety.

To bring back competition and true consumer choice, researchers like Howard advocate reforming the government’s current centralized approach to food safety regulation. Instead, Howard proposes what he calls “subsidiarity,” where local health officials—who have the best knowledge of the producers in their purview—have the greatest authority to regulate.

Other researchers, such as New America’s Christopher Leonard, argue for a more dramatic approach. “The only counterbalance to monopolistic control of the market is federal intervention,” Leonard said. “Monopolies don’t heal themselves.”

Breaking up America’s big food trusts—in production, processing, and retail—could indeed help bring back the diversity that America’s food system once had and advocates say is desperately needed, for aesthetic reasons and for public health. But the ultimate power to heal the nation’s food system lies with consumers. While policymakers can take the first step—by creating opportunities for smaller producers to enter the marketplace and compete on level turf—consumers can also do their part by demonstrating demand for the kinds of products that farmers like Badger supply and sustaining the marketplace for smaller producers. “Consumers need to think about the impact of their decisions,” says the University of Missouri’s Hendrickson.

Most importantly, Americans—as both consumers and voters—need to accept the notion that “cheap” prices at the checkout line may carry hidden long-term costs to public health. Foregoing mass-produced food from industrial conglomerates may be more costly in the short term, but the long-term benefits to national well-being are well worth the trade-off.

Anne Kim

Anne Kim is a Washington Monthly contributing editor and the author of Abandoned: America’s Lost Youth and the Crisis of Disconnection. Follow Anne on Twitter @Anne_S_Kim.