State and Community Based Childhood Lead Poisoning Prev & Surveil of Blood Lead

Indiana State Department Of Health, Indianapolis IN

Investigators

Abstract

The Indiana Childhood Lead Poisoning Prevention Program (ICLPPP) is located within the[unreadable] Community and Family Health Services Commission of the Indiana State Department of[unreadable] Health (ISDH). This program began in the early 1980s and has received Centers for Disease[unreadable] Control and Prevention (CDC) support since the 1998-1999 funding year.[unreadable] ICLPPP accepted the CDC challenge to eliminate childhood lead poisoning by the year 2010[unreadable] utilizing a holistic approach to eliminating Indiana?s considerable lead hazard issues. ICLPPP[unreadable] will work to implement the State?s elimination plan. The plan allows for continuous evaluation[unreadable] and mid-course corrections to ensure that program goals are achieved.[unreadable] Indiana has determined that the key components necessary to establish a comprehensive lead[unreadable] poisoning prevention program statewide include: development of strong codes at the local level;[unreadable] addressing housing with lead hazards including requiring clearance; increasing testing of at-risk[unreadable] children; providing surveillance data to communities; and supporting the network of services of[unreadable] case management needed to protect children already poisoned. This plan encompasses rural,[unreadable] suburban and urban areas throughout Indiana, but concentrating its efforts on areas identified as[unreadable] posing the greatest threat to the highest number of at-risk children.[unreadable] Through the evaluation of Hoosier data specific to Indiana, ICLPPP determined hazard specific[unreadable] target areas based on risk factors. Factors proving the greatest risk of lead poisoning include: housing built prior to 1950, of which Indiana ranks 11th in the nation for prevalence; child population, poverty, and Medicaid based on 2004 census data; estimated 520,805 child population under the age of 6 o 23% of these children living in poverty; 48% enrolled in Medicaid for any period of time within the year ; minority disparate population (African-American, Hispanic, and refugee populations); the Hispanic population has increase by 117% in the past decade; the African-American population while not increasing in size, does show the greater increase in EBLLs when compared to all other races; refugee population (631) consists of 39% children. Based on the data collected and analyzed, the ICLPPP lead poisoning prevention program emphasizes a geographical targeted community approach to produce the greatest reduction in lead poisoning in Indiana. This community approach plan includes the following components:[unreadable] statistical mapping to predict geographical areas having potentially higher rates of lead hazards[unreadable] and children at-risk, targeted environmental investigation and primary prevention efforts,[unreadable] targeted blood testing of at-risk children, medical management, laboratory support, case[unreadable] management, development of a housing database, maintenance of a childhood lead testing[unreadable] database, public and professional education, and community empowerment through resource[unreadable] development and local task force groups.[unreadable] By analyzing geographical and demographical information and targeting areas most at risk,[unreadable] ICLPPP examined the combination of pre-1950 housing, children living in poverty, Medicaid[unreadable] eligible children, and testing rate. The analysis consistently indicated eight counties, Marion,[unreadable] St. Joseph, Allen, Elkhart, Delaware, Vanderburgh, Vigo, and Lake. Including these eight[unreadable] counties in the grant, covers 42 percent of all children under six years old, 47 percent of all[unreadable] pre-1950 housing, 54 percent of all Medicaid children and 77 percent of all minorities, and[unreadable] 73% of EBLLs. As discussed above, these eight counties also contain 93 percent of Indiana[unreadable] refugees. ICLPPP has identified three additional target areas on which to concentrate funding[unreadable] and efforts. ICLPPP proposes adding the local health departments, Delaware, Elkhart, and[unreadable] Vigo, that service those additional areas to the five health departments, which receive passthrough[unreadable] funds from the current CDC grant. The addition of these counties will ensure that 54%[unreadable] of the children at risk will be targeted for primary prevention and secondary prevention[unreadable] activities.[unreadable] Indiana?s primary prevention approach includes concerted efforts to address lead hazards in areas[unreadable] and audiences at highest risk. Capacity to identify housing-based lead hazards and remediate[unreadable] those hazards is increasing with increased awareness of the prevalence of hazards and the need[unreadable] for lead safe practices. ICLPPP?s proactive education, screening, and case management plans[unreadable] address diverse and wide ranged audiences. Through these plans, ICLPPP provides data, primary[unreadable] prevention guidance, lead safe practices information, testing and medical management[unreadable] recommendations for healthcare providers, case management instruction, professional training[unreadable] and public awareness and education targeted to high-risk areas and audiences.[unreadable] ICLPPP has made significant progress in building a solid foundation and comprehensive network[unreadable] of strategic partners throughout the state. Even considering a dedicated professional staff[unreadable] ICLPPP has recruited to combat childhood lead poisoning prevention in Indiana extending the[unreadable] program further than expected. These efforts are multiplied through the incredible assemblage of[unreadable] stakeholders accepting to eliminate lead poisoning of Indiana?s children. ICLPPP will continue[unreadable] its collaboration with its strategic partners and will be diligent in revitalizing efforts to eliminate[unreadable] childhood lead poisoning.[unreadable] Indiana demonstrates both the need for additional funding and the capacity to meet the[unreadable] challenges facing childhood lead poisoning prevention programs in 2007. The needs have been[unreadable] identified, the vision is implemented, and the challenge accepted. Through the continued support[unreadable] of CDC, both through funding and guidance, Indiana will succeed in its goal to eliminate lead[unreadable] poisoning by 2010.[unreadable]