Health Impact Project Passes the Baton on Lead Exposure Work

Before the water crisis in Flint, Michigan, became national news, most Americans probably assumed that lead exposure and poisoning risks were concerns of the past, a public health issue resolved. But the recognition that Flint’s water system contained dangerous amounts of lead triggered an avalanche of reporting about elevated levels in public schools and private homes from coast to coast. Policymakers at all levels of government grappled with identifying appropriate measures to address the known risks from excessive lead exposure.   

In 2016, the Robert Wood Johnson Foundation asked the Health Impact Project, a collaboration between the foundation and The Pew Charitable Trusts, to undertake a special initiative to address this issue. The project convened a team of specialists across various sectors to develop a comprehensive report on childhood lead exposure.

The team built an extensive network of advisers and subject matter experts, organized focus groups, and used statistical modeling based on available data to generate specific policy recommendations. Many groups had conducted valuable research on the different sources of lead exposure and corresponding interventions, but no one had connected these threads. For this study, Altarum, a nonprofit health systems research and consulting organization, applied modeling methods to existing data to estimate the monetary benefits and costs to society for various policy proposals. The effort culminated with the publication of “10 Policies to Prevent and Respond to Childhood Lead Exposure” in August 2017.

The report contains the qualitative and quantitative research that informed the recommendations and strategies proposed to effectively prevent and respond to lead risks nationwide. The analysis allows policymakers to see the potential effectiveness of different interventions and their possible impact, including positive outcomes such as savings on federal and state assistance programs and increased tax revenues because of people’s higher earning potential.  

The research was widely disseminated to the media, policymakers, and stakeholders working to remove and respond to lead hazards. Since then, several groups have recommended implementing actions spelled out in the detailed document. In Pennsylvania, for example, the recommendations informed Allegheny County’s Lead Task Force report published in December 2017. And in March 2018, the Center for Children’s Advocacy, a Connecticut legal rights organization, cited the report in testimony supporting H.B. 5403, a bill before the state’s General Assembly that would create a state task force to study lead.

The Health Impact Project’s lead initiative helped spur collaboration among those engaged in efforts to respond to and prevent exposure. In December 2017, several organizations focused on children’s health hosted an event at Pew’s office in Washington entitled “Eliminating Lead in Schools and Child Care Facilities.” The workshop brought together 40 advocates from across the country to discuss the evidence on lead exposure and to identify strategies to protect children where they learn and play. The Children’s Environmental Health Network then summarized the strategic action plan that emerged from the workshop in a final report that was released during National Public Health Week this year.

While active, the initiative engaged community advocates across the country, efforts that are expected to continue. In one instance, the National Center for Healthy Housing administered a Health Impact Project-funded mini-grant competition for community-based organizations to help local residents and decision-makers discuss possible steps to advance lead poisoning prevention efforts. The 15 awardees held events last fall that reached an estimated 3,800 people in 12 states and the District of Columbia.

These events supported communities in various ways, including through the distribution of hundreds of lead cleaning kits and water filters. They also helped connect people and groups so they could work together on future projects. For example, one of the mini-grant recipients in Philadelphia, Public Citizens for Children and Youth (PCCY), received a separate grant of $65,000 from the Philadelphia Health Partnership to support lead prevention and other child health initiatives as a result of a workshop that PCCY hosted. Another mini-grant recipient, the East Chicago Calumet Coalition, established a relationship with a local university to institute free testing of soil samples for residents who participated in a lead awareness event.

The Health Impact Project leveraged its convening power and connected experts across disciplines to provide an opportunity to develop concrete solutions. Now that work is officially over. But the efforts to remove lead—and to address the related public health and societal problems it creates—did not start and will not end with this initiative. As policymakers act at all levels of government, they can seize upon the recommendations in the report and work with project partners and contributors to put a definitive end to childhood lead exposure.

Stacey Millett directs the Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts.