Neighborhood disparities and the burden of lead poisoning

BackgroundTo assess the persistence of neighborhood-level lead poisoning disparities in Rhode Island.MethodsRhode Island Department of Health blood lead levels (BLL) collected from 2006-2019 were linked to census block group rates of poverty and housing built pre-1950. We computed multivariate logistic regression models of elevated BLLs (>= 5 mu g/dL and >= 10 mu g/dL).ResultsOf the 197,384 study children, 12.9% had BLLs >= 5 mu g/dL and 2.3% had BLLs >= 10 mu g/dL. The proportion of children with BLL >= 5 mu g/dL increased across quintiles of poverty and old housing. The odds ratio for highest quintiles was 1.44 (95% CI: 1.29, 1.60) and 1.92 (95% CI: 1.70, 2.17) for poverty and pre-1950 housing, respectively. A significant temporal decline was observed for BLL >= 5 mu g/dL (2006: 20.5%, 2019: 3.6%). Disparities narrowed over the study period across quintiles of poverty and old housing with a similar trend appearing in the proportion of children with BLL >= 10 mu g/dL.ConclusionDespite tremendous progress in reducing lead exposure, substantial neighborhood disparities in lead poisoning persist. These findings provide valuable considerations for primary childhood lead exposure prevention.ImpactThrough linkage of Rhode Island Department of Health childhood lead poisoning and census data, this study captures neighborhood-level disparities in lead poisoning from 2006-2019.This study demonstrates that the odds of lead poisoning increased in a stepwise fashion for neighborhood quintiles of poverty and housing built pre-1950. While the magnitude of lead poisoning disparities narrowed across quintiles of poverty and old housing, disparities persist.Children's exposure to sources of lead contamination continues to be an important public health concern. The burden of lead poisoning is not equally distributed among all children or communities.

Automated summary

This study examines the persistence of neighborhood-level lead poisoning disparities in Rhode Island from 2006 to 2019. It finds that despite significant progress in reducing lead exposure, disparities in lead poisoning persist at the neighborhood level.