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Lastly , modern risks are often politically explosive . There are extensive social , economic , and political side effects of health risks , a situation made apparent in the fallout following the discovery of the link between bovine spongiform encephalopathy ( BSE ) and Creutzfeldt-Jakob Disease ( CJD ) in the United Kingdom ( Palmer , 1996 ). Following such an outbreak , people tend to employ risk avoiding behaviors ( Yeung & Morris , 2001 ) and reduce their consumption of implicated foods , but then slowly return to previous consumption levels ( Bocker & Hanf , 2000 ; Knight , Worosz , & Todd , 2009 ). This element of consumer behavior is consistent with the risk society ; “ Where everything turns into a hazard , somehow nothing is dangerous anymore … The risk society shifts from hysteria to indifference and vice versa ” ( Beck , 1992 , pp . 36-37 ).
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Food supply chains now are more interconnected and complex than ever . Global food trade has increased from approximately 50 billion US dollar in 1960 , to 438 billion US dollar in 1998 , to 1060 billion in 2008 ( Ercsey-Ravasz , Toroczkai , Lakner , & Baranyi , 2012 ). Such a rapid increase has implications for foodborne disease outbreaks , especially since trade has moved away from staples and into finished products , which pose challenges for traceability . Ultimately , the complex global supply chain could allow for foodborne pathogens to spread very quickly and thus make it extremely difficult to isolate the source of an outbreak ( Ercsey-Ravasz et al ., 2012 ; Keusch , 2013 ; McEntire , 2013 ). Risks that are global in nature and extend beyond national boundaries are key elements of the risk society ( Beck , 1992 ). Since many foods are now imported , food safety is no longer an outcome of nationally bound systems ( Munro , Le Vallee , & Stuckey , 2012 , p . 3 ).
In addition , there is uncertainty about the number of foodborne disease cases per year in North America . The overall disease burden of food-borne diseases is unknown ( Newell et al ., 2010 ). The Public Health Agency of Canada ( PHAC ) estimates that 4 million Canadians , or 1 in 8 , are sick each year from foodborne illnesses ( Public Health Agency of Canada , 2013 ). The Centers for Disease Control and Prevention ( CDC ) estimates that , in the United States each year , there are 48 million cases , 128,000 hospitalizations , and 3000 deaths related to foodborne illness ( Centers for Disease Control and Prevention , 2013 ). These estimates are built upon numerous assumptions . Both the CDC and PHAC acknowledge that there is underreporting , in part because many cases are relatively mild and thus not officially diagnosed .
Differences between national reporting structures and surveillance make it difficult to compare data across countries and jurisdictions . A higher number of reported cases could simply be the result of better surveillance and reporting , and not necessarily because of more illnesses ( Rocourt , Moy , Vierk , & Schlundt , 2003 ). The uncertainty associated with estimates complicates evaluating the effectiveness of monitoring systems . Although the goals of risk governance in the food system are to reduce the number illnesses caused by foodborne diseases , determining whether this has occurred is tricky when there are gaps in our understanding of the true burden of foodborne diseases .
Further uncertainties in demographic shifts illustrate the interconnectedness of foodborne diseases and demographics . In Canada , as in other OECD countries , the population is aging at a rapid rate . Between 2006 and 2011 , the number of se-
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