Overview
- As of 2020, just 11% of Washtenaw County children (0-18 years old) were covered by Medicaid, with most children covered under an employer or private health plan. As such, the majority of children in the county who are potentially lead-exposed are not required to be tested by their physicians. (Source: https://www.washtenaw.org/DocumentCenter/View/5153/Priority-Health-Issue---Access-to-Care-PDF)
- Toward the end of 2023, bipartisan bills to guarantee the screening of minors for lead poisoning in Michigan were signed into law Tuesday by Gov. Gretchen Whitmer. The legislation requires all children be tested for lead poisoning between 12 and 24 months of age, while also allowing for parents to opt out if they choose to do so. (Source: *directly quoted* https://michiganadvance.com/blog/whitmer-signs-bills-guaranteeing-lead-screening-for-young-michigan-children/#:~:text=Bipartisan%20bills%20to%20guarantee%20the,they%20choose%20to%20do%20so.)
- Children most commonly become exposed to lead in Washtenaw County through contact with old, lead-based paint in homes built before 1980. About 60% of homes in the county fall in this category, with higher concentrations in the Ypsilanti and Ann Arbor city centers. In Wayne County, nearly 85% of homes are potential sources of lead, however, many more children are screened because more have Medicaid insurance. (Source: http://www.drawingdetroit.com/lead-and-housing-homes-built-before-1980 /;http://www.drawingdetroit.com/more-than-50-percent-of-wayne-county-children-on-medicaid/)
- Lead is a potent neurotoxin. Children who are exposed to lead may have reduced IQ and problems with attention, learning, behavior, hearing, and speech that can impact them throughout their lives. Lead is a highly toxic metal that was commonly used in paint, gasoline, and plumbing pipes and fixtures. Statistics show that 96,462 (14.1%) Michigan children under 6 years old had a blood lead test in 2021 (MiTracking Data Portal). Of those tested, 3.5% (3,401) children had elevated blood lead levels (EBLL) of 3.5 micrograms per deciliter (µg/dL) or greater (MiTracking Data Portal). Note: Blood lead testing throughout Michigan decreased starting in March 2020, associated with the COVID-19 pandemic. Stay-at-home orders, closures, and virtual care limited blood lead testing. The population tested in 2020 and 2021 is likely different from previous years. Comparing the EBLL percentage in 2020 and 2021 to other years will be. (Source: *directly quoted* https://www.ecocenter.org/cleaner-water-coming-all-schools)
- Children with values above the threshold are eligible for state-provided public health services to help them and their families lower their blood lead levels. Angela Medina, a public health consultant for MDHHS, expects the new standard to result in between 1200 and 4000 additional Michigan children identified as having elevated blood lead levels and becoming eligible for services per year. MDHHS is anticipating the expanded need for additional resources for non-Medicaid children.
- “Filter First” legislation, three bills that will require the installation of lead water filters in all schools and childcare centers. Costs will be offset by $50 million dollars set aside (so far) in the state budget at the end of 2023. Schools and daycares should be places where children are safe from dangerous neurotoxins, like lead," said Meli Garcia, regional environmental health organizer for the Ecology Center. “Lead impairs children’s brain development and can trigger serious and irreversible learning, and behavioral problems. Now water that has been sitting for extended periods in school pipes will be filtered before children and staff take a drink.
- “Michigan has recently passed two important pieces of legislation to move the needle on lead poisoning of Michigan children,” said Mary Sue Schottenfels, staff member with Wayne State University’s Detroit Lead Parent Advocacy Group (DLEAD). “Filter First assures safe drinking water in Michigan schools and Universal Lead Testing makes sure that ALL Michigan children will be tested for lead poisoning at ages 1 and 2. Although we need to do more to eradicate lead poisoning in our State, this is real and meaningful progress.” (Source: *directly quoted* https://www.ecocenter.org/cleaner-water-coming-all-schools)
Transcription
David Fair: This is 89 one WEMU. And I'd like to welcome you to the first Issues of the Environment segment of 2024. I'm David Fair. And today, we're going to look at some of the progress that's being made when it comes to childhood lead exposure and cover some of the work that remains to be done. Toward the end of 2023, Governor Gretchen Whitmer signed into law a couple of measures that are expected to make a difference when it comes to lead exposure. Our guest today advocated for passage of these laws. Mary Sue Schottenfels is a staff member with Wayne State University's Detroit Lead Parent Advocacy Group and works as a lead policy consultant with the Ann Arbor-based Ecology Center. Thank you so much for making time for us. And happy New Year to you!
Mary Sue Schottenfels: Thanks, David. I'm really glad to be here and talk about this important issue.
David Fair: Well, we all became acutely aware of the dangers of lead exposure with the Flint water crisis, and we certainly been aware of the dangers of lead paint for a half century or more. But I was never tested for lead exposure when I was a kid or at any point in my life. Were you?
Mary Sue Schottenfels: No, I certainly wasn't when we were growing up. Lead was not on the radar in any way, shape or form like it needs to be and is now.
David Fair: Well, one of the new laws that Governor Whitmer signed at the end of 2023 will require that all children be tested between the ages of 12 and 24 months and, again, when they are between the ages of two and three. Now, there is allowance for parental opt-out in this measure. But up until now, it was only children on Medicaid who were being tested. And here in Washtenaw County, that amounts to just 11%. Is it fair to say we've been undertested to this point and don't really know the ramifications of that exposure?
Mary Sue Schottenfels: Yes, absolutely. Even all the children on Medicaid are not reliably tested, but, certainly, people in the general population are not even aware that lead could be an issue for their children. And this measure will allow us to get a true picture of the concern of lead, but also, more importantly, individual families will know what their children's lead status. And, believe it or not, it's not just an inner city problem. It's a problem in pockets all over the state, and individual children can be poisoned any number of ways.
David Fair: Well, most lead exposure for children does come through those lead-based paints that were used in homes that were built before 1980. In Washtenaw County alone, about 60% of all homes were built before 1980. So, should we take that to mean that we are dealing with a number of health issues in the community that may not have been properly identified because of insufficient testing and awareness?
Mary Sue Schottenfels: Yes, absolutely. People that live in old homes--homes built before '78 or '80--need to be aware that their children could be lead poisoned from their homes. Lead poisoning comes from old paint that disintegrates into lead dust. And if you can picture a child of age one, two, three or four crawling on the floor, touching everything, putting their hands in their mouths. And there are a number of exposure routes in a house that make it dangerous for children, especially if they're living in an older home. So, we really need to use this law and get the word out that lead is a serious toxic danger, and this law will help us urge people to get their children tested.
David Fair: Issues of the Environment continues on 89 one WEMU. Today, we're talking with Mary Sue Schottenfels. She is a staff member with Wayne State University's Detroit Lead Parent Advocacy Group. Now, Governor Whitmer also signed into law a Filter First legislation. This, more specifically, addresses some of the issues we've seen around the state and here in Washtenaw County with lead contaminated water. It's going to require installation of lead water filters in all schools and daycare centers. Are the majority of schools without such filters right now in Michigan?
Mary Sue Schottenfels: Oh, absolutely. It's kind of an untold issue that lead can be in water. Although, I will say in Michigan, all the studies show that more lead comes from house paint and lead dust. But, yes, it's a real bonus that children in Michigan schools soon will have filtered water in every school. It'll be a mandate, and I'm happy to say the state allocated $50 million toward installing these filters in every school. Just recently, in East Lansing, they serendipitously found lead in some of the water in one of their schools. So, it can be a lurking problem. That law and the other law for universal testing, as we've been discussing, are in the process of a rulemaking with the state of Michigan. And soon, within the next six months, this will be on the street. So, we're very excited that those are coming to fruition in the next six months.
David Fair: Well, we talk about lead filters that will be required at daycare centers. And does it include home daycare centers that may not only be unfiltered, but may have those lead-based paint we've been talking about?
Mary Sue Schottenfels: There's a lot of effort around daycare centers these days to try to get into those centers, small or large or home-based, to make sure that they're safe, both in terms of lead paint, which is a number one issue, and lead in water. The smaller, home-based daycare centers aren't necessarily registered with the state. Nonetheless, we're doing a great deal of outreach to those centers, too, because lots of kids spend much more time there or as much time as they do in their homes. So, while that won't be a mandate, it will still be very important to be one of our issues we spend some serious time on.
David Fair: And, Mary Sue, I want to talk a little bit about the environmental justice component of these bills. The fact of the matter: lead-related health issues do tend to affect low-income areas and communities of color more adversely. Will schools and daycares in those areas receive priority funding?
Mary Sue Schottenfels: They won't receive priority funding for filters, but yes. The state of Michigan and the federal government have a lot of grant programs. And, of course, we focus those grant programs on the areas with the highest level of lead. I will say that the state level of lead for children is about 2 to 3% in terms of is it the lead poisoning, but in Detroit and other urban centers, 10%.
David Fair: Yeah.
Mary Sue Schottenfels: So, the money goes where the need is and, certainly, in old cities, especially with rental housing. And I'd like to just comment that part of the solution here is getting landlords to do their part in terms of fixing up their houses. So, it's a paint issue. It's an urban issue. But we found plenty of lead poisoning in old farmhouses and rural issues. And, as I said earlier, there are many sources of lead, including lead in dirt and soil and pottery. We just had a recall of applesauce. Cinnamon applesauce can be dangerous because of the lead level in the applesauce. So, that's what we were urging, David. Everybody should get tested because it's ubiquitous. It's really kind of everywhere. And only by testing the kids, we know where children's lead levels are.
David Fair: Once again, our Issues of the Environment conversation with Mary Sue Schottenfels continues on 89 one WEMU. And I want to go further down the line on that health care front. Systemic inequities in access and quality of care have often hampered those on Medicaid and, in particular, people of color. It's created a justified mistrust of the system. If there is a parental opt-out allowance in testing, how are we going to convince those who have experienced prejudice in the health care system to participate?
Mary Sue Schottenfels: That's a great question. And, yes, even though this is a state-mandated requirement, it's going to take everybody together to understand why it's important and get motivated to do it. Certainly, in the city of Detroit and in Grand Rapids and Benton Harbor, there are massive efforts going on to make sure that people are made aware of the issue, made aware of free resources, and understand that it is an environmental justice issue. And communities have to step up and do their part to make sure that folks know and believe that this is a serious issue. In fact, in Detroit, we have a group called DLEAD, and that's Detroit Lead Education Advocacy Group. And we work with parents, parents helping parents understand that this is their right to get their kid tested. And it's also their obligation. So, this is a group we have in Detroit. There's a group in Grand Rapids and other places in the state where not just health departments, but parent advocacy works to make people understand how important this is. You're never going to get everybody tested by trying to force them to test or obligate them to test. You have to make people understand that the downside of your child being lead poisoned is severe, lifelong, and yet completely preventable. Lead poisoning causes lowered IQ, hyperactivity, slowed learning. Kids with lead poisoning, David, are seven times more likely to drop out of high school and four times more likely to enter the criminal justice system. It impacts the brain at a very important time in a child's life. And so, we need to make people understand how crucial this is for the health and long-term success of their children.
David Fair: Well, testing is the first component, but then, if lead exposure and poisoning is diagnosed and treatment become necessary, is there additional money set aside federally or in the state of Michigan to help cover costs that go above and beyond what Medicaid and health insurance will provide?
Mary Sue Schottenfels: Absolutely. There's two levels of that question. One is health departments are funded to do all sorts of case management, which is often required. And the second thing is that the state and the cities--most large cities--have a grant from HUD or from Medicaid that allow people to get their homes tested and their homes abated of lead hazards. We'd really recommend that people go to the state website or the Ecology Center website and learn what resources are available because you can get your house tested. And you certainly, if you have a child under six and lead issues, can get that has abated. The only way to really get rid of lead is to protect the children from it. And it can be as simple as cleaning the floors and windowsills and window wells very thoroughly or weekly or it can be going all the way to getting a house fully abated of all the lead hazards.
David Fair: Well, thank you for spending the time with me today, and thank you for sharing the information. I'm most grateful.
Mary Sue Schottenfels: David, I'm very happy to talk about this at any time. We urge everybody to think about lead, think about asking your doctor for a test, and make sure to keep your kids safe.
David Fair: That is Mary Sue Schottenfels. She is a staff member with Wayne State University's Detroit Lead Parent Advocacy Group and works as a lead policy consultant with the Ann Arbor-based Ecology Center. For more information about our conversation on lead policy in progress, visit our website at WEMU dot org. We'll get you connected with all the resources available to you. Issues of the Environment is produced in partnership with the office of the Washtenaw County Water Resources Commissioner, and you hear it every Wednesday. I'm David Fair, and this is your community NPR station, 89 one WEMU FM, Ypsilanti.
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