Child Lead Poisoning

The screening prevalence rate, or the percentage of children in the City of St. Louis under 5 years old tested who have blood lead levels of 10 µg/dl or higher

Equity Score
51
Indicator scores are represented on a scale from 1 to 100.
Disparity Ratio
1.73
Disparity direction: black-white
Children tested who have blood lead levels of 10 µg/dl or higher

Black children are nearly twice as likely as white children to test positive for elevated blood lead levels.

Source: Missouri Department of Health and Social Services

A score of 100 represents racial equity, meaning there are no racial disparities in outcomes between black and white populations. The lower the Equity Score, the greater the disparity.

For Child Lead Poisoning, a score of 100 — a score reflecting racial equity — would mean black and white children tested are equally likely to have high blood lead levels. It is important to note that for this indicator, equity is not our only goal: we also want to improve outcomes for all.

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What does this indicator measure?

Child Lead Poisoning measures the screening prevalence rate, or the percentage of children in the City of St. Louis under 5 years old tested who have blood lead levels of 10 µg/dl or higher, the standard threshold for high blood lead levels in Missouri. Guidelines call for all children under age 6 to be tested in St. Louis, but the City estimates only 48% of children were tested in 2016. In that year, 175 children under 5 tested positive for high blood lead levels. 

Child lead poisoning analysis

Children tested who have blood lead levels of 10 µg/dl or higher in St. Louis City.

  All Black White Disparity Ratio Equity Score
Children with high blood lead levels 175 112 27 - -
Child population tested under 5 11,610 6,973 2,912 - -
Child lead poisoning per 1,000 children tested 15.1 16.1 9.3 1.732 to 1 51

Data Source: Environmental Public Health Tracking Program, Missouri Department of Health and Senior Services, 2016.

Data Note: 10 µg/dl or higher is the standard measurement in Missouri for elevated blood lead level. The unit µg/dl means micrograms per deciliter. Rates for this indicator are provided by the Missouri DHSS and are age-adjusted based on 2000 standard population.

What does this analysis mean?

Black children are nearly twice as likely as white children to test positive for elevated blood lead levels. In 2016, 16 of every 1,000 black children tested had high blood lead levels compared to 9 of every 1,000 white children. If rates were equitable, 48 fewer black children would have tested with high blood lead levels.

Why does Child Lead Poisoning matter?

High blood lead levels have serious health impacts for children, including learning disabilities and behavioral problems. A major source of lead exposure is lead-based paint and dust in buildings constructed prior to the 1970s, which includes the majority of housing stock in St. Louis. The entire city is considered a high-risk area for lead poisoning by the Missouri Department of Health and Senior Services, which is why guidelines call for universal testing of children under age six. Based on population estimates, 64% of all black children under 5 were tested, compared to 42% of white children under 5. The Childhood Lead Poisoning (CLP) Prevention Program at the City of St. Louis has noted, "Race itself is not an indicator of CLP. Other factors associated with minority status, however, such as poverty, poor housing stock, insufficient access to medical care, and inadequate quality medical care, contribute to CLP."

Which Calls to Action from the Ferguson Commission report are linked with this indicator?

While the Ferguson Commission report does not directly reference child blood lead levels, it calls for “supporting the whole child.” Where children live affects their health, which affects their academic performance and behavior in school. The report also calls for the establishment of school-based health centers to improve childhood physical and mental health.

Questions for further investigation

  • Why is there a racial disparity in Child Lead Poisoning? 
  • What can St. Louis do to reduce racial disparities in Child Lead Poisoning?
  • What initiatives are currently underway to reduce racial disparities in Child Lead Poisoning?

How can I learn more about this issue?

Lead testing services are provided for free by the City of St. Louis Department of Health to children under the age of 6 who reside in the City of St. Louis.

The Department of Health has produced regular reports on childhood lead poisoning in St. Louis since 2002. 

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