Research Spotlight: Lead Poisoning Prevention Efforts in High-Risk Environments

Plenty of parents in the post-COVID-19 world are struggling with the prospects of reopening schools amid the virus surge.  Many parents feel overwhelmed by concerns about the untested efficacy of planned safety measures within brick and mortar schools and are awestruck by the gaping holes in proposed distance learning curricula.  It is difficult for parents, wage reliant or otherwise, to believe that schools are ready to open as teacher unions file lawsuits to prevent or delay reopenings. They find it hard to believe the assurances when the funding to ensure the implementation of curricula improvements, social distancing, and other COVID-19 related measures continues to lag.

Parents in Flint, Michigan, understand the horrors of raising children in dangerous conditions.   Drinking water quality in Flint was suddenly undermined in April 2014 when the State of Michigan changed the water supply source as a cost-cutting measure to a polluted source, the Flint River. At this time, through its emergency managers and water regulators, Michigan also neglected to make sure that the proper protocols were followed (like corrosion control), which would limit residents’ exposure to harmful toxins when the water source switch occurred.  As a result, many Flint residents were exposed to various toxic substances, including the neurotoxin lead, which is known for causing neurological and gastrointestinal problems, especially within vulnerable populations that include young children and immunosuppressed people.

 Luckily, for Flint parents and others contending with the high risk of pediatric lead poisoning, the dangers of lead are not new.  Public policies designed to protect children from lead poisoning have been instrumental in reducing this health problem’s prevalence. Lead screening tests help identify kids with high levels of this neurotoxin in their bodies. Follow-up testing of lead-poisoned children confirms elevated blood lead tests. Follow-up testing and related assessments also help ensure that lead levels are reducing and that the necessary steps are being made to identify and remove the sources of this toxic exposure from a child’s environment.

Although screening and confirmation testing efforts are critical in America’s attempts to control lead poisoning, research shows that many communities in this country fail to test for lead poisoning, even after a child’s blood level is elevated. Despite consistent lead testing recommendations by the American Academy of Pediatrics and the CDC, in addition to efforts to refine testing protocols for vulnerable populations, most kids in targeted communities do not get tested. Due to this disconnect, too many of the children who need testing fail to receive it and end up reaping the destructive rewards of lead poisoning in their lives.

I pursued an analysis of lead-poisoned children under six years old in Flint to determine the extent to which they received follow-up lead testing as mandated by state and Medicaid policy during the well-publicized Flint water crisis. In my paper, “Lead Poisoning Prevention Efforts in High-Risk Environments,” I examined whether these kids received follow-up testing within six months after an elevated test and identified factors associated with follow-up testing trends.

While I hoped to discover that children residing in Flint during the water crisis received the recommended testing, I was not incredibly shocked to find that few children received lead screening. Even fewer children with elevated blood lead levels underwent follow-up testing.  Although Flint doctors during wellness checks are prompted via computer alerts to administer these tests, and the results of all lead tests are reported to the Michigan’s Childhood Lead Poisoning Prevention program within a week, the children least likely to receive follow-up tests were those who are more likely to be lead exposed. Disparities in access to follow up testing were chiefly associated with class and racial differences in the community.

Given that lead screening and follow up testing for lead-exposed children was not readily available during the lead crisis, Flint parents had good reason to be worried about their kids’ health and well-being.  These parents, who continue to deal with poor quality water due to unresolved water infrastructure issues, should gain no comfort and confidence from these findings, which demonstrate that even when treatments and strategies to contend with health problems exist, they are not always distributed equally and reasonably within communities. These findings also suggest that while various stakeholders play a role in protecting children from harm, it is ultimately up to parents in Flint and elsewhere to be informed about the risks of environmental exposures and to get clear about how to keep these hazards away from their kids in the days ahead.

Katrinell Davis | Department of Sociology

Dr. Katrinell Davis is an Associate Professor in the Department of Sociology and African-American Studies as well as a Research Associate with the Center for Demography and Population Health. Dr. Davis’s article was recently published in the Journal of Racial and Ethnic Health Disparities.

The feature image is from CNN.

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