Iowa Childhood Lead Poisoning Prevention Program

Iowa State Dept Of Public Health, Des Moines IA

Investigators

Abstract

The Iowa Department of Public Health (IDPH) is requesting $858,246 from the Centers for Disease[unreadable] Control and Prevention (CDC) in this competing continuation application to fund the 15th year of[unreadable] the Iowa Childhood Lead Poisoning Prevention Program (Iowa CLPPP). IDPH will provide[unreadable] $516,629 in matching funds, which exceeds the requirement that the applicant provide $1 in[unreadable] matching funds for each $2 of requested federal funds. In this project, IDPH is establishing[unreadable] community-based CLPPPs in rural and urban areas throughout Iowa with the eventual result of[unreadable] local CLPPP services being available in all counties in the state. This funding would not supplant[unreadable] current state and local funding, but would be used in addition to current funding to upgrade and[unreadable] increase total state and local program efforts.[unreadable] The number of children tested for lead poisoning in Iowa has increased steadily from 25,778 in 1997[unreadable] to 47,372 in 2004. The number of children with confirmed elevated blood lead levels has ranged[unreadable] from 1,019 to 1,376 per year. In some cases, the number of children with confirmed elevated blood[unreadable] lead levels has increased as the number of children tested has increased. Based on current[unreadable] surveillance data, IDPH predicts that 2,796 of Iowa?s 227,062 children will have confirmed elevated[unreadable] blood lead levels in calendar year 2006.[unreadable] Pre-1950 Housing[unreadable] According to CDC guidance on lead screening, ?Housing built before 1950 poses the greatest risk[unreadable] for lead exposure because it is much more likely to contain lead-based paint than is newer housing. .[unreadable] . . The focus should be on poor children and children of racial/ethnic minority groups because[unreadable] generally they are at higher risk than other children.? (Screening Young Children for Lead Poisoning:[unreadable] Guidance for State and Local Public Health Officials, CDC, November 1997) Housing data from the 2000[unreadable] census show that 39.3 percent (483,849 units) of the housing in Iowa was built before 1950. This is[unreadable] substantially greater than the national average of 22.3 percent. Iowa ranks fifth among the states in[unreadable] the percentage of housing built before 1950. The number of pre-1950 housing units per county[unreadable] ranges from 1,413 to 42,467. The percentage of pre-1950 housing per county ranges from 18[unreadable] percent to 61 percent.[unreadable] Minority and Hispanic Population[unreadable] Iowa's combined minority and Hispanic population is 7.8 percent. The combined minority and[unreadable] Hispanic population ranges from 0.7 to 23.3 percent and from 60 to 34,933 residents per county.[unreadable] According to 2000 census data, the rate of poverty in Iowa children under the age of 6 years is 12.9[unreadable] percent. By county, the number of children in poverty ranges from 36 to 3,947, and the poverty rate[unreadable] ranges from 4.5 to 27.2 percent. (Source: 2000 Census)[unreadable] High-risk Populations[unreadable] In the cohort population of children born in 2000 who were enrolled in Medicaid for at least one[unreadable] month, 65.7 percent have received at least one blood lead test, and 4.6 percent have confirmed[unreadable] elevated blood lead levels. For non-Medicaid children, 66.2 percent have received at least one blood[unreadable] lead test, and 1.45 percent have confirmed elevated blood lead levels. In another cohort, the[unreadable] children born in 2000 who participate in the Special Supplemental Nutrition Program for Women,[unreadable] Infants, and Children (WIC) program, 77.6 percent have received at least one blood lead test, and[unreadable] 4.6 percent have confirmed elevated blood lead levels. These data demonstrate that children who[unreadable] have been covered by Medicaid or WIC are at high risk for lead poisoning.[unreadable] Local CLPPPs[unreadable] A CLPPP should include the following activities: promoting screening, case management of leadpoisoned[unreadable] children, education and outreach, data management, and developing strategic partnerships[unreadable] within the community. In Iowa, a local CLPPP is one where these activities are carried out in an[unreadable] area ranging in size from one to seven counties by one or more local agencies. In the last 14 years,[unreadable] IDPH has established local CLPPPs in rural and urban areas throughout Iowa with the goal of[unreadable] having comprehensive local CLPPP services available in each of Iowa?s 99 counties. Iowa's local[unreadable] CLPPPs are based on agencies of county governments because most public health and[unreadable] environmental health activities are carried out at the county level, even in Iowa's largest cities. In[unreadable] Fiscal Year 2007, 29 local CLPPPs will provide complete CLPPP services to 74 of Iowa?s 99[unreadable] counties. IDPH is seeking state resources to expand local CLPPP coverage to all of Iowa?s 99[unreadable] counties. The implementation of the activities contained in this proposal will allow IDPH to[unreadable] continue the development of the Iowa CLPPP.[unreadable] Iowa?s lead-poisoned children are widely dispersed throughout Iowa and are not concentrated in a[unreadable] few urban counties; 40.7 percent are estimated to be in Iowa?s 9 metropolitan counties, 21.2 percent[unreadable] are estimated to be in Iowa?s 15 micropolitan counties, and 38.1 percent are estimated to be in[unreadable] Iowa?s 75 rural counties. These data show that IDPH must carry out childhood lead poisoning[unreadable] prevention efforts in each of the 99 counties to achieve the goal of eliminating childhood lead[unreadable] poisoning in Iowa. IDPH proposes to do this by allocating resources to local CLPPPs in amounts[unreadable] that are proportional to their share of the estimated confirmed lead-poisoned children in Iowa.[unreadable] IDPH will use a similar method to allocate its staff efforts in non-CLPPP counties.[unreadable] Integrated Lead Program[unreadable] IDPH has chosen to integrate lead poisoning prevention activities funded by CDC and by the[unreadable] Environmental Protection Agency (EPA) into a single lead poisoning prevention program.[unreadable] Although the CDC and EPA programs emphasize different activities, the goals of the CDC and[unreadable] EPA programs are similar -- to eliminate childhood lead poisoning in Iowa. Public and professional[unreadable] health education and communication are part of both the CDC and EPA lead poisoning prevention[unreadable] programs. IDPH believes that the integration of these activities and requiring each staff person to[unreadable] participate in both the CDC and the EPA program provides the most efficient and effective use of[unreadable] staff time. Since each staff member is fully trained in both CDC and EPA activities, Iowa citizens[unreadable] can get the answer to virtually any question about lead poisoning from any staff member.[unreadable] IDPH is requesting $858,246 from the Centers for Disease Control and Prevention (CDC) in this[unreadable] competing continuation application and will provide $516,629 in matching funds. With these funds,[unreadable] IDPH proposes to continue the expansion of the Iowa CLPPP and its efforts to eliminate childhood[unreadable] lead poisoning in Iowa by 2010.