Presented at American Public Health Association (APHA) Annual Conference.

Background: Foodborne illnesses in the United States result in about 3,000 deaths and costs more than $15.6 billion each year. Objective: This study aims to generate practice-relevant evidence associated with the engagement of local health departments (LDHs) in food safety and policy issues. Methods: Data from the 2019 National Profile of Local Health Departments Survey of all 2,459 LHDs in the United States was analyzed. The census design (rather than the sample) resulted in a response rate of 61%. Descriptive, chi-square and logistic regression analyses were performed to model all multiple dichotomous variables. Results: During the year before the 2019 survey, 75.8% of LHDs directly provided nutrition services, 40.7% provided food processing inspection, 78.9% performed food safety inspections, 78.3% provided food safety education, and 48.4% engaged in policymaking and advocacy concerning food safety. The bivariate results showed statistically significant associations of LHD characteristics with these food safety activities as well as the policy engagement. Multivariable analysis showed that odds of LHDs directly providing preventive nutrition services were 20 times if the LHD had a nutritionist on staff (Adjusted Odds Ratio or AOR=20.0; Confidence Interval, CI=12.4-32.2). Other LHDs characteristics significantly associated with the provision of nutrition services (at pConclusion: LHDs play a critical role in ensuring safe food for Americans, and eliminating health inequities in food safety. Adequate funding and competent staffing are essential for LHDs to utilize evidence-based practices and engage in policymaking and advocacy concerning food safety.