Restaurants are a place where food is prepared and cooked directly for customers. Food safety in restaurants is a public health concern and a multidisciplinary issue that needs to be explored. To protect the health of consumers and identify external factors that may affect food safety risk, this study explores how economic development and population density at the local level relate to food safety inspection outcomes in restaurants of different sizes. Using food safety violation data from 2017 and 2018, we categorized restaurants in Gansu Province, China, into small and large ventures to examine the relationships among regional character, restaurant size, and food safety risk. Data were analyzed using Mann-Whitney U tests and negative binomial regression models. Our results show that large restaurants have a higher food safety risk than small restaurants. Moreover, the region with the lowest level of economic development had the highest food safety risk, while the region with the lowest population density had insufficient local inspections. By providing insight into which establishments demonstrate the highest food safety risks, our findings contribute to the development of processes that seek to effectively identifying food safety risks.

  • Food safety policy is based on the belief that restaurant size influences food safety.

  • No previous quantitative evidence confirms this relationship in China.

  • Study examines the relationship between restaurant size and food safety risk.

  • Association is analyzed according to economic development and population density.

  • Findings will help refine targeted FDA inspection policy and resource allocation.

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