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Eliminating Disparities in Children's Lead Exposure: An Unfinished Job

Mary Jean Brown1, MyDzung T Chu1, David C Bellinger1

  • 1Mary Jean Brown is with the Harvard T. H. Chan School of Public Health, Boston, MA. MyDzung T. Chu is with the Tufts University Medical School, Boston. David C. Bellinger is with the Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston. Joseph M. Braun is with the Department of Epidemiology, Brown University, Providence, RI. Eve C. Gartner is with Earthjustice, New York, NY. Mark Mitchell is with Climate Change, Energy & Environmental Health Equity, Health & Climate Solutions Program, George Mason University, Fairfax, VA. Carla Campbell (retired) is with the Dornsife School of Public Health, Drexel University, Philadelphia, PA. Charlotte Brody is with Healthy Babies Bright Futures, Charlottesville, VA. Christian Hoover is with the Harvard Injury Control Research Center, Harvard T. H. Chan School of Public Health. Arthur Lavin is a retired pediatrician, Cleveland, OH. Maureen Swanson is with Project TENDR, Hermitage, PA. Aimin Chen is with the Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia.

American Journal of Public Health
|June 11, 2026
PubMed

Insights

National blood lead levels (BLLs) in young children are declining, and racial disparities have been eliminated. However, state-level data reveal persistent geographic, racial, and ethnic disparities in BLLs.

Area of Science:

  • Environmental Health
  • Pediatric Health
  • Public Health Surveillance

Background:

  • Childhood lead exposure remains a significant public health concern.
  • Understanding trends in blood lead levels (BLLs) is crucial for effective prevention strategies.
  • Disparities in BLLs may persist despite national declines.

Purpose of the Study:

  • To analyze national and state trends in BLLs among US children aged 5 years or younger.
  • To identify demographic and geographic factors associated with BLLs.
  • To inform public health interventions and surveillance efforts.

Main Methods:

  • Analysis of National Health and Nutrition Examination Survey (NHANES) data from 2011-2023.
  • Examination of geometric means and prevalence of BLLs (≥3.5 and ≥5.0 µg/dL).
  • Summary of state-level surveillance data (2017-2023) from 7 states.

Main Results:

  • National BLLs show a continued decline, with lower geometric means and prevalence in 2021-2023 across all groups.
  • State-level data indicate disparities in BLLs based on geography, race, and ethnicity.
  • Limited sample sizes in NHANES and state data constrained detailed subgroup analyses.

Conclusions:

  • National data suggest decreasing BLLs and elimination of racial disparities in children.
  • State and local data highlight ongoing disparities, emphasizing the need for targeted interventions.
  • Enhanced national and state surveillance is recommended to better track and address childhood lead exposures.

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