Inequities in Housing and Lead Exposure – Breaking the Link
June 2018

Alex Bodaken
Program Administrator
Green & Healthy Homes Initiative

Ruth Ann Norton
President and CEO
Green & Healthy Homes Initiative


The home environment can have a major impact on children and families, both immediately and into the future. Lead in children’s homes remains the primary source of lead poisoning in the United States. At least 535,000 and as many as 1.2 million children have an elevated blood lead (EBL) level of five micrograms/deciliter (µg/dl), even as the U.S. Centers for Disease Control and Prevention notes that there is no safe level of lead poisoning.

For children with lead poisoning, the impacts are devastating: Children with elevated lead levels are seven times more likely to drop out of school and six times more likely to become involved with the juvenile justice system; lose two IQ points for each 10 µg/dL increase in blood lead level; have an average loss of lifetime earnings of an estimated $900,000; and are more susceptible to a host of behavioral problems including ADHD, ADD, and aggression at lower lead levels; and reduced motor control, coma, and death at higher lead levels.

Just as we know about the dangerous health effects of unhealthy housing, so too do we know that these effects disproportionately impact communities of color and low-income families. Housing inequity disproportionately exposes black communities to environmental pollutants, and most highly trained physicians serve white communities. While lead poisoning does not discriminate, the continued disparities in resources and treatment means that the effects of lead poisoning are not evenly felt: As this Harvard University report shows, the scourge of lead poisoning particularly affects the futures of children of color.  Our responses to lead must also acknowledge this.

Founded in 1986 as Parents Against Lead, the Green & Healthy Homes Initiative seeks to end the toxic legacy of lead poisoning in America. Our core mission is breaking the link between unhealthy housing and unhealthy families by addressing the various home hazards that can impact children’s health.

GHHI’s whole-home, integrated approach looks at housing issues holistically from the perspective of what must be done to keep a family safe, rather than what can be done by each individual housing program given funding and programmatic constraints. This model braids funding from philanthropic and private sources as well as federal, state, and local governments to most effectively address the needs of individuals and families living in unhealthy housing. GHHI implements this model in their flagship Baltimore, Md., location, and provides technical assistance to 43 partner cities, counties, and states to implement the model nationwide. Our nation cannot, however, win this battle only through direct services to families; we must make legislative changes as well.  For instance, we know that laws preventing parents from accessing state and local resources until children were severely poisoned disproportionately hurt those with fewer resources. GHHI and partners fought to lower the actionable level for lead poisoning interventions in Maine. Data shows that improving healthy housing works better to reduce asthma attacks for all people than outdated models of health care, so GHHI worked to expand the types of asthma reduction initiatives supported by Medicaid.

GHHI is thrilled to be working with AMCHP and other national partners on the the Maternal and Child Environmental Health Collaborative Improvement and Innovation Network (MCEH CoIIN). The MCEH CoIIN is aimed at improving lead prevention and care for children across the country.

Through the MCEH CoIIN, 10 state teams will test improvements and innovations to increase in the number of infants and children with access to a system of coordinated care to address needs related to lead exposure. The national partners and state teams will identify those areas where the most gains need to be made and will use quality improvement and collaborative learning to create positive change. For information and updates, visit the MCEH CoIIN page.