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Blood Lead Testing Among Medically Underserved and Socially Vulnerable Children in the United States 2012-2017
Alejandro Azofeifa1, Alek Sripipatana
1Bureau of Primary Health Care, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, Maryland.
Insights
Health Resources and Services Administration (HRSA)-funded health centers (HCs) are vital for blood lead testing in children. Testing rates increased by 34.4% from 2012 to 2017, highlighting HCs
Area of Science:
- Public Health
- Pediatric Health
- Environmental Health
Background:
- Lead poisoning poses significant risks to children's development, including cognitive function, growth, and hearing.
- Vulnerable populations, including lower-income and minority children, are disproportionately affected by lead exposure.
- Health Resources and Services Administration (HRSA)-funded health centers (HCs) are crucial in serving these at-risk populations and monitoring blood lead testing.
Purpose of the Study:
- To assess the prevalence and characteristics of children who underwent blood lead testing at HRSA-funded HCs.
- To analyze trends in blood lead testing rates within these centers from 2012 to 2017.
Main Methods:
- Utilized self-reported data from HRSA's Health Center Patient Survey (2014-2015) for children aged 12-60 months.
- Employed HRSA's Uniform Data System, an administrative dataset, to calculate annual percentage changes in blood lead testing from 2012 to 2017.
Main Results:
- In 2014-2015, 72.9% of eligible children (1.1 million) received blood lead testing at HRSA-funded HCs.
- Testing rates were higher in urban HCs and among children who identified HCs as their usual source of care.
- A significant 34.4% increase in blood lead testing was observed at HRSA-funded HCs between 2012 and 2017.
Conclusions:
- HRSA-funded HCs are essential for providing blood lead testing access to underserved communities.
- Despite increased screening efforts, continued education for providers and parents is necessary to further improve testing rates among high-risk children.
- Sustained focus on screening and education is warranted to mitigate lead exposure risks in vulnerable pediatric populations.
Context:
Lead poisoning can affect intellectual development, growth, hearing, and other health problems. Children 6 years or younger are particularly susceptible to lead poisoning. Health Resources and Services Administration (HRSA)-funded health centers (HCs) serve lower-income, minority, and vulnerable populations across the United States, who may be at a higher risk for lead exposure. At HCs, blood lead testing is monitored; however, little is known about testing rates and characteristics of children tested by HCs.
Objectives:
We assessed the prevalence and characteristics of children who received a blood lead test at HCs from 2012 to 2017.
Design:
We assessed characteristics of children 12 to 60 months of age who had a blood lead test using available self-reported data from HRSA's Health Center Patient Survey (2014-2015). In addition, using HRSA's Uniform Data System, an administrative performance data set, we calculated the annual percentage change of blood lead testing from 2012 to 2017.
Results:
During 2014-2015, 1.1 million (72.9%; 95% CI, 64.6-81.3) out of the 1.5 million (n = 365 unweighted) eligible children 12 to 60 months of age self-reported receiving a blood lead test at an HRSA-funded HC. There was a significant higher proportion of children with a blood lead test among urban HCs (74.1%; 95% CI, 59.4-88.8) and among those who reported HCs as their usual source of care (99.9%; 95% CI, 99.7-100) (P ≤ .05).The total HC population of children younger than 72 months increased from 2 674 500 in 2012 to 2 989 184 in 2017, and we observed a 34.4% increase in blood lead testing at HRSA-funded HCs over the same time period.
Conclusions:
HCs play an important role in providing access to blood lead testing in underserved communities in the United States. While HRSA-funded HCs have made substantial efforts to screen and educate patients on lead exposure, nonetheless continued screening and education efforts with both health providers at HCs and parents/guardians are warranted to continue to improve blood lead screening rates among high-risk groups.
