By Elizabeth Brasington, NACCHO Marketing/ Communications Intern

Lead Poisoning: Still an American Burden

There are 24 million homes in the United States that contain deteriorated lead-based paint and elevated levels of lead-based dust and four million of those households contain children. As a direct result, approximately 535,000 children between ages one and five have blood lead levels above five micrograms per deciliter (µg/dL). Although, the Centers for Disease Control and Prevention (CDC) recommends public health action for children with blood levels above five µg/dL, in reality any amount of lead present in a child’s blood is dangerous. Lead poisoning in children can lead to brain and nervous-system damage, learning and behavior problems, slow growth and development, hearing and speech problems, and headaches. In response to this public health problem and the lead-water crisis in Flint, MI, three U.S. Senators and a U.S. Representatives recently appealed to the Center for Medicare & Medicaid Services to update its policies on lead exposure testing in children.

While childhood lead poisoning has declined throughout the United States in the last 20 years, the burden of this disease disproportionally affects low-income families and families of color. These populations often reside in homes built prior to 1978, which likely have lead-based paint. (In 1978, the federal government banned consumer use of lead-containing paint). To address the health-burden of older housing stock on population health, the U.S. Department of Housing and Urban Development (HUD) created the Lead Hazard Reduction Demonstration (LHRD) grant supporting communities to identify and reduce housing-related lead exposures. HUD recently awarded 15 LHRD grantees across 12 different states.

In an effort to highlight the work made possible through this grant, NACCHO reached out to three health departments, each taking an active role in implementing lead prevention programming using LHRD funds. Through this three-part blog series, Ingham County Health Department (MI), Cook County Health Department (IL), and Albany County Health Department (NY) share their community’s need to address lead exposure, and their progress as a result of being funded.

Not Just Flint: Addressing Lead-Based Paint in Lansing, MI

While the lead-crisis in Flint caught the nation’s attention, Michigan faces a significant lead exposure burden throughout the state. The annual cost of lead exposure in Michigan is approximately $330 million and $145 million of that burden is paid by tax payers. To address this health issue, throughout the next three years, Ingham County Health Department, in partnership with the City of Lansing, is using their $2.3 million LHRD grant plus $775,000 in matching local funds and in-kind support to implement removal of lead-based paint and dust in 150 low-income units in Lansing. The majority of the residences in need of attention are rental properties, evidenced by 70% of lead-poisoned children living in rented low-income housing throughout Ingham County. The city-county partnership will include the Office of Code Enforcement, three local community-based organizations for outreach, and the Rental Property Owners Association of Mid-Michigan.

Linda Vail, MPA, Health Officer for the Ingham County Health Department, believes the Flint crisis played a role in the city’s increased investment to combat its own lead-related health issues.

“We are in Michigan, so I think the whole Flint situation has captured the attention of our Mayor and the rest of the city in terms of getting involved in local efforts,” Vail said. “Before Flint the urgency was substantially lower.”

The Ingham County Health Department sees roughly 200-300 children annually affected by lead poisoning. As a key partner supporting the city’s HUD grant, the health department will have a community health worker providing targeted outreach to the families of children with elevated blood lead levels, and their landlords. The funds will target local children under the age of six, especially WIC participants and Lansing’s refugee population, which is disproportionately affected by lead.

“We are also going to work closely with the city to provide and coordinate services around owner-occupied buildings,” Vail said.

While lead remediation work provides substantial health benefits, particularly to children in homes with lead-paint, local landlords have historically been resistant to these type of efforts. Their concerns are typically centered on the cost related to both the actual lead remediation and other expenses such as providing alternative housing for temporarily displaced residents. To help address this challenge, grant funds will provide at least 70 participating landlords with U.S. Environmental Protection Agency’s Lead Renovation, Repair and Painting program training. Vail believes the financial burden is largely insignificant when compared to the overall benefit lead remediation will have for the community’s children.

“We need to prevent our kids from getting poisoned,” Vail said. “We know that lead paint from older housing stock is the most significant exposure issue. Why we wouldn’t want to take care of that as opposed to doing nothing, I don’t know.”

Vail also emphasized that lead-based paint is a health inequity issue not just for Ingham County, but for the nation as a whole.

“When you realize that it’s older housing stock, generally in poor neighborhoods, there are two immediate outcomes. First, this issue is disproportionately affecting lower-income people, and second, this unfortunately largely includes people of color. Through this partnership, we will be able to target resources more effectively than ever before and give all of our kids a better shot in school and life.”

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Stay tuned for part two and three of this blog series highlighting two more lead prevention initiatives made possible through the LHRD grant. Next week’s post will come from Cook County, Illinois, detailing their local local health department’s crucial role in working to lower instances of lead exposure for the community’s most vulnerable residents. Learn more about the HUD LHRD grant program, here.