Why has childhood lead testing plummeted in Cleveland, and what can be done about it?

Mayor Justin Bibb’s office recently posted a position for a senior strategist to oversee the city’s efforts to combat lead poisoning that would report to the mayor. One of the issues the new cabinet member will have to tackle is the plummeting numbers of children screened for the toxin during the pandemic.

Lead testing with Case Western Reserve University. Contributed photo.

Mayor Justin Bibb’s office recently posted a position for a senior strategist to oversee the city’s efforts to combat lead poisoning that would report to the mayor. The position aims to be pivotal in helping Cleveland finally address its childhood lead poisoning problem. One of the issues the new cabinet member will have to tackle is the plummeting numbers of children screened for the toxin during the pandemic. 

Recent studies by the CDC found that nationwide, half a million fewer children were tested for lead exposure during the first half of 2020 than during the same period in 2019. That’s potentially 10,000 children with elevated blood-lead levels who escaped notice. 

A similar scenario is playing out in the city of Cleveland. According to the Ohio Department of Health, testing among Cleveland kids under the age of 6 has decreased dramatically, from around 13,500 children per year as recently as 2019 to only 8,600 in 2020 and 9,600 in 2021. 

Lead is an environmental toxin that affects the brain, heart, bones, kidneys, and nervous system. The Centers for Disease Control (CDC) has determined that there is no safe level of lead in the bloodstream, especially for children. 

Lead is a particular threat to Northeast Ohio. According to the Lead Safe Cleveland Coalition, over 90 percent of rental units in Cleveland were built before 1978, when the federal government banned lead-based paint for use in residential homes. This disproportionately affects low-income households, and especially their children. 

Ohio began taking steps before the pandemic to address the childhood lead poisoning crisis, including in 2020-2021 providing $10 million to fund lead assessments, lead remediation, and lead-safe housing advertisements; up to $10 million for lead abatement; $4 million for the Help Me Grow program to serve children with elevated blood-lead levels; and $500,000 to hire more lead hazard control workers. The Governor’s Lead Advisory Committee continues to meet regularly, though their activity slowed during the pandemic.

Cleveland City Council also took up the mantle, implementing several laws that went into effect last year. With these new measures, Cleveland can now charge property owners in violation of housing codes, and landlords must pay for private inspections and secure lead-safe certificates for all rental units. Financial incentives are also available. 

The tricky aspect of lead poisoning is that symptoms only appear long after it’s too late, after lead has built up in the body. A toddler can ingest lead at age two but not begin to display learning disabilities from lead poisoning until age six or later. In teens, lead can be re-released into the bloodstream during periods of growth, and from there into vital organs, potentially causing problems with blood formation, kidney function, heart, reproduction, gastrointestinal symptoms, peripheral nerve damage (tingling in hands and feet) and even death.

There also is no cure for lead poisoning. The only defense is to test at an early age and implement strategies to eliminate further exposure. 

Leading testing at a Cleveland school. Contributed photo.

Sadly, however, testing has declined. For this, it would be easy to blame Covid-19, said Yvonka Hall, executive director of Cleveland Lead Advocates for Safe Housing (CLASH). The closure of schools and daycares during the pandemic resulted in more children being at home, increasing the risk of lead exposure. Additionally, the pandemic made it harder to test kids, since many testing sites were closed and primary care visits were virtual. 

But while the pandemic was certainly a factor, it may not be the sole culprit. Hall said Cleveland’s problems with lead exposure and testing are far older than the coronavirus. 

Yvonka Hall met with The Land in December to discuss these problems. She called on Mayor Justin Bibb to appoint a Lead Czar who would expand testing of children for lead, as well as speed up the process of creating certified lead-safe homes in Cleveland. 

The Land also reached out to Bibb’s office, but we have not yet heard back about how the new administration plans to address the decline in testing that has occurred during the pandemic.

The Land: The CDC has reported that lead testing has gone down due to COVID-19. Do you agree with that assessment? 

Hall: No! They haven’t done what they were supposed to do before Covid … We [have] to blame some of this on incompetence. Since 2016, our rates of testing children in the city of Cleveland have been on a steady decline … Unless we are testing the home and the children, we don’t know where the problem lies. (Editor’s note: The number of children being tested declined by 8.5% from 2016-2019. The number of children who are being tested is smaller than the number of children recommended for testing.) 

The Land: When you say “They,” who exactly do you mean? 

Hall: It would be the policymakers … That ordinance (the Lead Safe ordinance passed by the city of Cleveland in 2019) sat there for three years and never was moved into a vote. We sat there kicking a can and our kids were still being poisoned … This isn’t about politics. This is personal … [We] formed CLASH as a direct way to challenge the system and take it to the ballot … We met to do the research and make sure we had a solid piece of legislation that protected renters [and] held landlords accountable for making their properties lead-safe … Now, [they] have millions of dollars sitting in a pot, when it should be being depleted to ensure that Clevelanders are safe. But it’s not.

The Land: What do you believe to be the solution?

Yvonka Hall at a protest at Cleveland city hall. Contributed photo.

Hall: There is no such thing as lead-free. Lead is everywhere. It’s in our soil. If landlords make sure [their properties are] lead-safe, that will stop our children from being poisoned. CLASH is asking the new administration [of Mayor Justin Bibb] to create a Lead Czar. [This] will be a person who sits in the mayor’s office and is responsible for [making sure that] building, housing, city council, hospital systems, and communities are all on the same page about … the lead-safe network.

Another aspect is to have a mobilization truck that [goes to] the places clinics can’t go. The truck will meet people where they are … to ensure they have access to testing and educational information to take home to keep their families safe.

And let me make this clear: We need to do everything we can to save our children. Because the children we see in juvenile detention centers, the children we see are being suspended from school, being diagnosed with ADHD and autism, and other behavioral and mental health issues. A large percentage of those children are lead poisoned.

Lead poisoning is Public Enemy number one in Cleveland!

Learn more about lead testing and screening here: https://leadsafecle.org/about-lead/screening-testing. The Cleveland Department of Public Health maintains its own lead poisoning prevention program. Residents of the City of Cleveland should call 216.263.5323.

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El Jay’Em is a Cleveland native whose life purpose is community empowerment. Her motto: if you pay anything, you should pay attention.

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