Though lead exposure has decreased in recent years, 1 in every 14 rising RI kindergarten student has had a blood lead level of 5 µg/dL or above.

The percent of children eligible to enter kindergarten in Rhode Island who have a test result with an elevated blood lead level (greater than or equal to 5 µg/dL) has decreased from 8% to 7% between 2016 and 2019. Above, you can see the distribution of lead level categories across Rhode Island municipalities.

^{Source: Rhode Island Department of Health Lead Elimination Surveillance System (collects lead screening results for all children in the state)}

^{Note: Two schools are shown together to limit suppression. Results are suppressed for denominators of less than 10 and numerators between 1 and 4.}

From 2016 to 2019, there has been a promising decrease in the prevalence of elevated blood lead levels in Rhode Island children.

In the interactive dashboard above, you can easily see which districts have the highest concentration of students in grades Kindergarten through five who have ever had elevated blood lead levels. Additionally, in 2016, six municipalities had prevalence rates over 20%; whereas the no municipalities had prevalence rates greater than 20% in 2019.

Again, you may use the indicator selector to change the coloring of the map if you’re interested in other categories of lead exposure.

^{Note: The denominator for displayed percentages is total students tested, not total students. Not all schools have comparable percentages of students with matched lead test data.}

Each component of unhealthy housing is prevalent in urban areas.

The map is a composite analysis of three key indicators of unhealthy housing:

1. Percent of children younger than six years old with first-time elevated blood lead levels (5+ µg/dL)
2. Percent of housing units built before 1950
3. Median family income

Each indicator was tallied by census tract and calculated according to the category of most concern (increasing values for all measures except median family income), then combined into a ranking of unhealthy housing.

As exposure to lead increases, so does student absenteeism.

Families encounter a number of challenges when they are exposed to unhealthy environmental conditions. Unhealthy housing can be associated with chronic sickness in children keeping them out of school. Research finds that asthma contributes to higher levels of absenteeism. Concurrently, lead exposure has been found to be a reliable proxy for unhealthy environmental conditions that exacerbate asthma.

Grade retention also increases with increased exposure to lead.

Grade retention refers to the number of students who are "held back" and asked to repeat a year of school. Given the cognitive and developmental delays linked to elevated BLL in children, we would expect to see an association between BLL and grade retention.

In the 2018-19 school year 9% of all students in the lowest BLL category had ever been retained as opposed to 12% of students in the highest BLL category.

While grade retention is intended to give struggling students additional time and support to master grade-level goals, studies show mixed results on academic performance. Additionally, research has shown retained students to be more likely to have a myriad of social, behavioral, and emotional problems in the future. Grade retention is one of the most powerful predictors of dropout status and is linked to lower future earnings.

Children with higher blood lead levels are more likely to require an Individual Education Plan.

Research has shown a strong association between lead poisoning in children and IQ loss and learning disabilities. As a result, many lead-exposed children may require special education services, or Individual Education Plans (IEP) services.

Above, you can compare the association between students’ blood lead levels and whether they were identified as needing IEP services. Use the top menu to see the breakdown by grade or by maximum blood lead levels for students enrolled in kindergarten through eighth grades in Rhode Island public schools. Across all grade levels you can see that students with elevated blood lead levels are more likely to receive an IEP.

When taken as a whole, kindergarten through fifth grade students with an elevated BLL (≥ 5 µg/dL) are four percentage points more likely to have an IEP than their non-exposed peers (<5 µg/dL).

Although researchers agree that there is no “safe” level of lead exposure, other factors in a child’s life can affect cognitive development. While we cannot be certain which students’ IEP services are attributable to lead exposure, the next slide begins to estimate what lead-related IEPs may cost the state.

Additionally, in the visualization above, you can compare elevated BLL with a variety of other equity cuts including:

• Sex
• Race/Ethnicity
• English Language Proficiency
• Economically Disadvantaged

Unfortunately, lead exposure is often not a concern until after an elevated blood lead level is identified upon screening.

If, instead, we recognize environmental factors as a potential source of illness, we can identify ways to stop hazards from affecting children at all. This concept, primary prevention, is the best solution for protecting children’s health. In general, efforts should target high-risk neighborhoods. Basic strategies consist of: regular lead screenings, increased education and outreach, checking homes for hazards, enforcement of lead safe housing requirements, remediating any lead hazards, and maintaining a safe and healthy home.

The Rhode Island Department of Health recommendations for lead screenings are:

• One lead test by 15 months, and a second test at least 12 months later
• Two lead tests by 36 months, and then annual screenings until the age of 6

Identifying, controlling, and preventing lead health hazards could lead to improved outcomes for future students in Rhode Island.

^{Sources: Alliance for Healthy Homes, CDC Guidance on GIS Use, National Center for Healthy Housing}

For States:

• Direct community funding and early childhood resources to areas most at risk for unhealthy housing.
• Provide financial support to fix "problem properties" with multiple housing-related illnesses.

For Municipalities:

• Work with the Rhode Island Department of Health (RIDOH) to identify properties to target when enforcing healthy housing laws.
• Check for lead compliance at property transfer.
• With schools, support children who are absent or not performing academically well due to lead exposure health concerns and investigate if the paint, air, or other aspects of school buildings are unhealthy.

For Healthcare Providers:

• Become informed and direct parents toward available community resources.
• Educate parents of young children about lead screening and potential health hazards in the home.

^{Source: CDC Recommendations}

For further background on costs of lead exposure see these links:

• Article by Elise Gould
• Lead Safe Illinois Fact Sheets

Suggested citation for this data story, in APA format:

DataSpark URI, Rhode Island Department of Education, & Rhode Island Department of Health. (2020). The educational impact of lead exposure. Retrieved Today's Date, from RI DataHUB Web site: http://ridatahub.org/datastories/lead-exposure-impact/1/