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Evaluating the Effects of Lead Mitigation Policy on Childhood Lead Exposure in Rhode Island. Alyssa Sylvaria & Ryan Kelly The Providence Plan - Information Group. Outline. Background Data and Methods Compliance Childhood Lead Exposure Compliance Exemption Foreclosure Implications.
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Evaluating the Effects of Lead Mitigation Policy on Childhood Lead Exposure in Rhode Island Alyssa Sylvaria & Ryan Kelly The Providence Plan - Information Group
Outline • Background • Data and Methods • Compliance • Childhood Lead Exposure • Compliance • Exemption • Foreclosure • Implications
Childhood Lead Exposure 5 µg/dLCDC reference level for elevated blood lead levels (EBLL) as of 2012 Rhode Island 2002 Incidence 25% 2012 Incidence 5% Sources: ACCLPP. (2012). Low Level Lead Exposure Harms Children: A Renewed Call for Primary Prevention. Centers for Disease Control and Prevention. Childhood Lead Poisoning Prevention Program. (2014). Childhood Lead Poisoning. Rhode Island Department of Health. http://www.health.ri.gov/data/childhoodleadpoisoning/
Federal Primary Prevention Efforts • Title X: Lead Disclosure Rule • HUD Lead Safe Housing Rule • EPA Renovation, Repair, and Painting • OSHA Interim Lead in Construction Standard Sources: HUD Guidelines for the Evaluation and Control of Lead-Based Paint Hazards in Housing. (2012). http://portal.hud.gov/hudportal/HUD?src=/program_offices/healthy_homes/lbp/hudguidelines
RI Primary Prevention Efforts • As of 2005, most rental property owners need to obtain a compliance certificate • Exemptions: • 1978 or later Built after lead was banned in paint • Owner-occupiedpropertieswith <4 units • ≤100 days a year Temporary or seasonal units • Age 62+ Designated elderly housing
RI’s Lead Law Certificates of Conformance require that property owners • Attend a Lead Hazard Awareness Class • Visually assess the property • Get an Independent Clearance Inspection • Fix lead hazards • Use lead-safe work practices in any maintenance projects • Give tenants an Inspection Report and lead hazard info • Respond to tenants' concerns about any lead hazards
Population of Properties • Residential properties • 1 to 5 family properties • Apartments (6+ units) • Mixed use (commercial + residential) • Core cities in Rhode Island • Central Falls • Pawtucket • Providence • Woonsocket • Built before 1978 • For both exempt and non-exempt
Data • Property-Level Data • Child-Level Data • Compliance certificates • Tax Assessor Data • Current as of… • Providence, 2009 • Woonsocket, 2009 • Pawtucket, 2010 • Central Falls, 2011 • Master Look-Up Tables • Verifies the property associated with each address • Blood Lead Levels (BLLs) • Confirmed blood lead test results • Children living at addresses in the core cities • Ages 0-72 months
Linking Method • 1. Aggregate Lead Test Results to Properties • 2. Standardize Address Data to Properties and Match • Lead-exposed children • Lead • Compliance • Property • descriptives
Compliance Focus: Rates of compliance with the Lead Hazard Mitigation Act Population: 15,678 non-exempt properties • Did or did not have any children with blood lead tests (all non-exempt residential properties in our linked dataset) • 2005-2012
Properties with “Any Compliance” • Had a Certificate of Conformance orLead Safe Lead Free Certificate • At least one unit on the property (if multi-family) • Complied at any point between 2005 and 2012
Any Compliance & Lead Exposure • Any compliance includes properties that did not comply until after a child had an elevated blood lead level (EBLL) from 2005-2012 Compliance & Lead Exposure at Property ANY COMPLIANCE Not Compliant Until After EBLL Compliance Before EBLL or No EBLL NO COMPLIANCE
Compliance Results 30.4% of properties had ANY compliance
Compliance Summary • Most non-exempt properties did not comply from 2005 to 2012, regardless of how broadly we defined compliance
Lead Exposure & Compliance Population 9,127 non-exempt properties with at least one child tested for lead (2005-2012) Question Did compliant properties have lower rates of lead exposure than non-compliant properties?
Lead Exposure & Compliance Summary • Properties with any compliance had higher rates of lead-exposed childrenthan non-compliant properties. • Most of the compliant properties with lead-exposed children in 2005-2012 were multi-families and had lead-exposed children before 2005.
Lead Exposure & Exemption Population 20,974properties with at least one child tested for lead (2005-2012) Question Do exempt properties still have lead-exposed children?
Lead Exposure & Exemption 56.5% of properties are exempt from the law
Lead Exposure & Exemption Summary • Over half of the properties with children tested for lead are not subject to the law. • Non-exempt properties had higher rates of EBLLs on the property, but the non-exempt and exempt categories had similar numbers of properties with EBLLs • 4,291 non-exempt compared to 3,990 exempt
Lead Exposure & Foreclosure Population 39,903 children with blood lead test results Question Do foreclosed properties increase the likelihood of lead-exposed children? Context Housing market issues and home maintenance
Lead Exposure & Foreclosure Key Results • 5% of children lived in a property that foreclosed within 18 months of their lead test date (Adjusted for residence type, owner-occupancy, city of residence, year property built (pre-1950 vs. 1950-1977), and child’s age at time of test).
Lead Exposure & Foreclosure Summary Children living in foreclosed rented properties had significantly higher estimated BLLs once we controlled for other variables. Relationship was not significant for owner-occupied properties. Foreclosure is likely one important factor out of many that can contribute to lead exposure.
Data Limitations • Analysis is not unit-based • Compliance does not account for expired certificates
Takeaways • Enforcementis key to primary prevention • Owner-occupied properties not less likely to have lead-exposed children • Housing market issues can complicate efforts to reduce environmental health conditions
Implications & Next Steps • Emphasize connection with healthy housing • Asthma • Energy usage • Inspections • Local outreach around compliance and implications for child health
Contact us asylvaria@provplan.org 401-443-4327 rkelly@provplan.org 401-443-4315 White Paper Provplan.org