ArticleJournal of primary care & community health
Effects of Individual and Neighborhood Characteristics on Childhood Blood Lead Testing and Elevated Blood Lead Levels, A Pennsylvania Birth Cohort Analysis.
Article in Journal of primary care & community health. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 9 citations in OpenAlex.
- Lead Screening Among Immigrant Children Seeking Humanitarian Protection in New York and Massachusetts, 2022-2024.Public health reports (Washington, D.C. : 1974) · 2026Article
- Article
- Lead Data Mapping to Prioritize US Locations for Whole-of-Government Exposure Prevention Efforts: State of the Science, Federal Collaborations, and Remaining Challenges.American journal of public health · 2022Review
- The Shifting Landscape of Lead Exposure: Screening Gaps for Children in North Carolina.Environmental health perspectives · 2022Article
- Patterns of Children's Blood Lead Screening and Blood Lead Levels in North Carolina, 2011-2018-Who Is Tested, Who Is Missed?Environmental health perspectives · 2022Article
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite declining lead exposure among U.S. children, childhood blood lead level (BLL) undertesting and elevation remains a public health issue. This study explores the impacts of maternal, infant, and neighborhood characteristics on the receipt of lead testing and having elevated BLLs (EBLLs) among children under age two.
methodsPennsylvania infants born in 2015 and 2016 were followed to 24 months. Birth certificate data were linked to 2015 through 2018 blood lead surveillance data and neighborhood data on household income, poverty, and the burden of houses built before 1970. Generalized linear mixed models were used to examine the individual and neighborhood characteristics independently and/or interactively affecting the likelihood of lead testing and of having EBLLs.
resultsA total of 48.6% of children were tested for BLLs, and 2.6% of them had confirmed EBLLs. The likelihood of lead testing and of having EBLLs among non-Hispanic black children was respectively 7% and 18% higher than white children. Children born to mothers with the lowest educational attainment (<high school), with self-payment as a payment source for delivery, and without WIC enrollment were at higher risk of undertesting. Children living in neighborhoods of the lowest quartile of household income and the highest quartile of poverty and old housing were more likely to have EBLLs. Different neighborhood characteristics modified the associations between some individual factors (such as race/ethnicity, payment source for delivery, and WIC enrollment) and the odds of undertesting and of having EBLLs.
conclusionThis cohort analysis provides more accurate estimates of lead screening rates and the percentages of EBLLs than cross-sectional analysis. Some maternal and infant demographics significantly impact the risk of undertesting and of having EBLLs, and some of the effects vary across different neighborhood characteristics. These findings can help lead prevention programs to target screening and treatment resources to children with specific characteristics.
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