Universal Health 2030 Solving Complex Health System Problems
January 2016 YahooNews; In Flint, Mich., testing has found lead levels of more than 5 micrograms per deciliter of blood in 4 percent of that city’s children. The result is national outrage.
In neighborhoods of New Orleans and Boston, New York and Baltimore, across the country in urban pockets much the same size as Flint, those same levels are regularly found in up to 25 percent of children.
“That hasn’t been getting the same kind of attention,” says Howard Mielke, a professor in the department of pharmacology of Tulane University whose research includes mapping lead blood levels across urban populations. “Maybe what’s happening in Flint will shine a spotlight on the fact that lead risk is everywhere.”
Mielke and other experts agree that the outrage over Flint is well warranted. The fact that the problem was created by one government entity and then ignored by several others makes it particularly heinous, they say. But they would also like to see some of the same call to action for other neighborhoods where Flint-like levels of exposure are the norm.
“I think it’s perfectly appropriate to rally around Flint,” says Philip Landrigan, a pediatrician and dean for global health at the Mount Sinai School of Medicine in New York. “But people need to realize that Flint is not an isolated example and there are places that are even worse. It’s happening all over the country and it’s tightly tied to race, ethnicity and economic circumstances.”
Then he starts ticking off locations: “Central Harlem. Bushwick. Roxbury in Boston. Baltimore is probably the worst. New Orleans, another city that has lead paint and poorly maintained housing.”
Unlike Flint, where the source of the lead is drinking water, the cause in most other places is paint and soil. Until 1978 all paint contained lead, and until 1996, when lead was finally banned in gasoline, car fumes mixed with soil, remaining toxic for decades. Young children explore the world by putting it in their mouths, and both paint chips from the floor and dirt from outside play carry the lead into their bodies. The younger the brain, the more vulnerable it is to toxins, and the damage is irreversible — causing such problems as learning disabilities, attention deficits, reduction in IQ and anger-management issues.
Perhaps the most dramatic illustration of the invisible damage caused by lead is what happens when the element is eliminated. In several studies around the country, Landrigan says, researchers graphed the drop in lead blood levels in a community after lead was banned in gasoline there, and then graphed the murder rate in those same communities 20 years later (when the children in the original graph reached adulthood). “The slope of the decrease was exactly the same,” he says.
Other studies, he says, have shown that the lead levels in the blood of incarcerated youth are higher than those of non-incarcerated youth from the same neighborhoods.
The demonstrable dangers of lead exposure mean that children living in high-lead pockets of cities today are “condemned by where they live,” Mielke says. His research, he explains, has personal roots, beginning in 1983 when he had recently moved to St. Paul, Minn., and his then 3-year-old daughter had a routine blood test before eye surgery. Her blood levels were high (doctors say there is no safe level; any lead is too much). Mielke was already an expert, having worked on a map of lead exposure while an assistant professor at the University of Baltimore. He was alarmed that even with his awareness he had not been able to protect his child.
To find the source of her exposure, “I followed her through her day, taking samples from play areas,” he says. That’s how he learned “her childcare center playground was basically a hazardous waste site. It was an ordinary residential backyard, but it was close to the thruway, and the fumes contaminated the soil.” He worked for years to have lead banned from gasoline.
That the incidence of lead poisoning in American children dropped from 5 in 11 down to 1 in 11 since the gasoline ban took effect illustrates that prevention does work, he and other experts say. It also illustrates the imbalance between those who can afford to eliminate lead from their lives — using certified renovation contractors, conducting clearance tests of their environments, etc. — and those who cannot.
Landrigan notes that even while offering resources to the city of Flint, the Centers for Disease Control is cutting funding for New York City programs that teach low-income families to recognize and avoid the hazards of lead.
“The answer is more screening, more education, more remediating of lead paint, and instead they are doing less,” he says. (Calls to the New York City Department of Health were not returned.) The resources “belatedly” being showered on Flint, he says, are “what’s needed elsewhere in the country as well.”
