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The heterogeneous association between education and the adoption of safe food handling practices in Ethiopia

Author

Listed:
  • Kai Su

    (The Ohio State University)

  • Barbara Kowalcyk

    (The Ohio State University
    Translational Data Analytics Institute, The Ohio State University
    George Washington University)

  • Devin LaPolt

    (The Ohio State University)

  • Lina Gazu

    (Health Program, International Livestock Research Institute)

  • Silvia Alonso

    (Health Program, International Livestock Research Institute)

  • Binyam Moges Azmeraye

    (The Ohio State University Global One Health Initiative, Eastern Africa Regional Office)

  • Desalegne Degefaw

    (The Ohio State University Global One Health Initiative, Eastern Africa Regional Office)

  • Galana Mamo

    (College of Health and Medical Science, Haramaya University)

  • Dessie Abebaw Angaw

    (University of Gondar)

  • Amete Mihret Teshale

    (Ethiopian Public Health Institute)

  • Robert Scharff

    (The Ohio State University)

Abstract

Background Foodborne disease is a great concern to low- and middle-income countries. To prevent illness and death, intervention strategies need to be implemented across the food safety system and should include promoting the adoption of safe food handling practices. The positive association between education and health has been well-established, and one possible mechanism is that education may improve health by encouraging individuals to adopt more appropriate protective practices. Decisions regarding adoption of these practices may also be influenced by the food safety risks individuals face, the trade-offs they make to maximize utility, or behavior biases which may be correlated with education. This study aims to estimate the heterogeneous association between education and the adoption of safe food handling practices among people facing different levels of food safety risk. Methods Models were constructed based on the Grossman health model and risk as well as behavior bias theories. Multivariate logistic regression models were estimated to explore the heterogeneous associations using data from a community survey conducted in Ethiopia. Agricultural household status and livestock presence were used as proxies to represent varying risk levels. Average marginal effects were estimated to provide a more accessible interpretation of the results. Results Results showed that the association between education and certain safe food handling practices was positive among individuals in households assumed to face higher food safety risks, while the association was less pronounced (or even negative) for those facing lower levels of risk. We observed that secondary education attainment was associated with a 20 percentage points increase (p

Suggested Citation

  • Kai Su & Barbara Kowalcyk & Devin LaPolt & Lina Gazu & Silvia Alonso & Binyam Moges Azmeraye & Desalegne Degefaw & Galana Mamo & Dessie Abebaw Angaw & Amete Mihret Teshale & Robert Scharff, 2025. "The heterogeneous association between education and the adoption of safe food handling practices in Ethiopia," Health Economics Review, Springer, vol. 15(1), pages 1-16, December.
    • Handle: RePEc:spr:hecrev:v:15:y:2025:i:1:d:10.1186_s13561-025-00601-2
    DOI: 10.1186/s13561-025-00601-2
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    References listed on IDEAS

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    1. Michael Grossman, 1972. "The Demand for Health: A Theoretical and Empirical Investigation," NBER Books, National Bureau of Economic Research, Inc, number gros72-1, October.
    2. Ellen Meara, 2001. "Why is Health Related to Socioeconomic Status?," NBER Working Papers 8231, National Bureau of Economic Research, Inc.
    3. Adriana Lleras-Muney, 2005. "The Relationship Between Education and Adult Mortality in the United States," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 72(1), pages 189-221.
    4. Zajacova, Anna & Hummer, Robert A., 2009. "Gender differences in education effects on all-cause mortality for white and black adults in the United States," Social Science & Medicine, Elsevier, vol. 69(4), pages 529-537, August.
    5. Jahn Karl Hakes & W. Kip Viscusi, 2004. "Dead Reckoning: Demographic Determinants of the Accuracy of Mortality Risk Perceptions," Risk Analysis, John Wiley & Sons, vol. 24(3), pages 651-664, June.
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