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11. Racial disparities in the association between neighborhood socioeconomic index and blood lead



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Introduction: Milwaukee County, one of the most segregated cities in the US, has the highest rate of elevated childhood lead levels in Wisconsin and contains areas of concentrated socioeconomic disadvantage. We examined the effect of neighborhood socioeconomic disadvantage on blood lead levels in children in Milwaukee County between 2014-2016.   Methods: Data comes from the Wisconsin Department of Health Services childhood lead surveillance program (N=45,717) and the U.S. Census Bureau's American Community Survey. Neighborhood composite socioeconomic index (CSI) was generated from 9 indicators, including percent poverty, median household income, educational attainment, median housing value, homeownership, occupation, unemployment, households with a vehicle, median gross rent. Logistic regression was used to model the association between elevated individual blood lead level (≥5µg/dL) and neighborhood composite socioeconomic index (CSI) quintiles (Very Low, Low, Middle, High, Very High). A hierarchical linear model was then used to evaluate neighborhood difference in blood lead levels. Both models were adjusted for age, race/ethnicity, and sample type.  Results: More than 50% of children with elevated blood lead levels live in the lowest CSI neighborhoods. Minority children are disproportionately represented in the lowest CSI neighborhoods which have the highest poverty rates and poor-quality housing stock. Children in high CSI neighborhoods had 40% lower odds of elevated blood lead levels compared to children living in low CSI neighborhoods (OR=0.60, 95% CI: 0.60, 0.59). Approximately 4% of the total variability in blood lead levels exists at the neighborhood level (ICC=3.7%).  Conclusion: Children are not equally exposed to lead in Milwaukee County. Minority and low CSI communities bear a higher burden of lead exposure. Lead exposure prevention efforts should be targeted to protect these vulnerable populations. 

Sarah Laurent -
UW Milwaukee Joseph J. Zilber School of Public Health

Dr. Helen Meier, UW Milwaukee Joseph J. Zilber School of Public Health


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