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Segregation and Childhood Blood Lead Levels in North Carolina
Marie Lynn Miranda1,2, Aaron Lilienfeld1, Joshua Tootoo1
1Children's Environmental Health Initiative.
Insights
Racial isolation in neighborhoods is linked to higher childhood blood lead levels. This highlights environmental disparities in segregated communities, emphasizing the need for comprehensive child health care.
Area of Science:
- Environmental Health
- Pediatric Health
- Sociology
Background:
- Racial residential segregation is a persistent issue with potential health consequences.
- Childhood lead exposure remains a significant public health concern, particularly in vulnerable communities.
Purpose of the Study:
- To investigate the association between racial residential segregation and childhood blood lead levels in North Carolina.
- To assess changes in this association over time, from the early 1990s to mid-2010s.
Main Methods:
- Utilized a population-based observational study design.
- Analyzed individual-level blood lead testing records for over 320,000 children under 7 years old.
- Employed a local, spatial measure of racial isolation of non-Hispanic Blacks (RINHB) at the census tract level.
Main Results:
- Increased racial isolation of non-Hispanic Blacks (RINHB) was associated with elevated blood lead levels in children.
- This association persisted from 1992-1996 to 2013-2015, although it was attenuated in the later period.
- A 1-standard deviation increase in RINHB correlated with a 2.86% increase in blood lead levels for non-Hispanic Black children and 2.44% for non-Hispanic White children in the earlier period.
Conclusions:
- Racially isolated neighborhoods are linked to higher childhood lead levels.
- This demonstrates disproportionate environmental burdens in segregated communities.
- Highlights the need for targeted interventions and whole child health care approaches.
Background And Objectives:
Using a local measure of racial residential segregation, estimate the association between racial residential segregation and childhood blood lead levels between the early 1990s and 2015 in North Carolina.
Methods:
This population-based observational study uses individual-level blood lead testing records obtained from the NC Department of Health and Human Services for 320 916 children aged <7 years who were tested between 1992 and 1996 or 2013 and 2015. NC childhood blood lead levels were georeferenced to the census tract. Neighborhood racial residential segregation, assessed using a local, spatial measure of the racial isolation of non-Hispanic Blacks (RINHB), was calculated at the census tract level.
Results:
From 1990 to 2015, RINHB increased in 50% of 2195 NC census tracts, although the degree of change varied by geographic region. In 1992 to 1996 blood lead testing data, a 1-standard-deviation increase in tract-level RINHB was associated with a 2.86% (95% confidence interval: 0.96%-4.81%) and 2.44% (1.34%-3.56%) increase in BLL among non-Hispanic Black and non-Hispanic White children, respectively. In 2013 to 2015 blood lead testing data, this association was attenuated but persisted with a 1-standard-deviation increase in tract-level RINHB associated with a 1.59% (0.50%-2.70%) and 0.76% (0.08%-1.45%) increase in BLL among non-Hispanic Black and non-Hispanic White children, respectively. In the supplemental information, we show the change in racial residential segregation across the entire United States, demonstrating that RINHB increased in 69% of 72 899 US census tracts.
Conclusions:
Racially isolated neighborhoods are associated with higher childhood lead levels, demonstrating the disproportionate environmental burdens borne by segregated communities and warranting attention to providing whole child health care.
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