"Ben Carson, Get the Lead Out"
Black Entertainment Television (BET) recently presented a documentary about the effects of lead poisoning in children. The documentary rekindled interest in this epidemic, keeping the fires turned up on such a devastating topic, while at the same time exposing Ben Carson’s, the director of the Department of Housing and Urban Development (HUD), indifference to this situation.
Lead poisoning of children does not generally rank as an editor’s choice for headline news, except when Flint, Michigan captured national attention for the contamination of their entire water supply. BET’s documentary was a poignant reminder of what we know about lead poisoning as well as what we do not know. The primary focus dealt with lead poisoning of Baltimore residents, but no matter the locale, the effects remain the same. Nonetheless, residential segregation is at the genesis of this nationwide affliction.
Environmental Lead Poisoning
Racial residential segregation, defined as the physical separation of racial groups through residential means, is a historical, systemic condition that has blighted the lives of many people of color for years. During the 20th century, most blacks were living in dilapidated housing in the worst areas of the cities. Many blacks were not able to afford housing options that were available to whites; therefore, public housing in neighborhoods overwhelmed with dilapidated public buildings became home. Journal of Public Health Management and Practice. 25(): S115–S120, JAN 2019 (Canfield et al. 2003)
Not paying attention to its path of destruction is paramount to writing off a generation of human beings. Dr. Lawrence Brown, Morgan State University Professor, appeared on the season finale of the BET documentary series. Brown talked about the far-reaching consequences of not addressing the lead paint crisis…“Intentional damage was done to Black neighborhoods…so, if we’re not interested in repairing these neighborhoods, then there’s no way we can alter the trajectories of the people who live in these redlined communities.”
Whitehead & Buchanan (2019) maintain that the amount of lead in the environment has significantly decreased with the removal of lead in gasoline and paint, “… Even so, lead exposure is not equal for all children—low-income and minority children continue to bear a disproportionate burden of exposure primarily through contact with deteriorating lead-based paint from older housing and potentially through drinking contaminated water. These facts suggest that childhood lead poisoning has disproportionately high and adverse effects on low-income and minority communities.
Lead: A Costly Contaminate
Two federal reports released last year (Nation) lambasted HUD for failing to have procedures to adequately protect children in subsidized housing against lead paint exposure. While, Ben Carson does not believe the word “discrimination” should be in HUD’s mission statement, this is exactly why HUD began in 1968.
In children, 6 years and younger lead exposure are the highest, and this is the period when lead exposure produces the most significant damage. Children are more sensitive to lead than adults. Their exposure is increased by their hand-to-mouth activity and their gut absorbs lead more readily than an adult's. Abdominal pains are common early complaints. Clumsiness and staggering may be seen, followed by headache and behavioral changes; this may progress to alterations of consciousness, stupor, and convulsions according to Childhood Lead Toxicity.
Lead poisoning for children also causes significant biological and neurologic damage linked to cognitive and behavioral impairment (Bellinger 2008a, 2008b). “Recent research has broadened still the scope of our understanding of the societal costs of lead poisoning. For example, new studies have begun to analyze the correlation of lead poisoning with crime rates…”. Subjects whose lead levels were in a high-lead group had more school failure, reading disabilities, lower class standing in their final year of high school, and disturbances in fine motor function.
Medical and economic research has established a connection between early childhood lead exposure and criminal activity, especially of a violent nature. Also, increased lead exposure correlates strongly with social and emotional dysfunction. Needleman et al. (1996) examined schoolchildren between the ages of 7 and 11 years who had a clinical diagnosis of lead poisoning at an early age and found worsening of behavior patterns as children aged. Needleman et al. (2002) indicated that adjudicated delinquents are four times more likely to have blood lead concentrations than no delinquent adolescents.
While teaching at a program for juvenile offenders, who were wards of the State of Michigan, this writer taught one student who exhibited extreme mood swings, had prolonged bouts of physical aggression, and revealed a very limited attention span. He was a loner, yet he craved attention. The whites of his eyes were pale beige. He was in the program after permanent expulsion from public schools. His case history revealed that as a small child he had eaten the paint chips off of the window seal in his bedroom—he was diagnosed with significant levels of lead poisoning in his system. He was thirteen and only recognized words that were connected to pictures. This young man did not complete the program and he fell off of the state’s radar shortly after absconding. A treatment plan was never finalized for him.
(HUND) Housing Urban, No Development
HUD has been slow to address the hazards of lead poisoning in children. And as evidenced in BET’s documentary, Ben Carson refused to meet with a community activist who wanted to discuss the percentage of subsidized housing infested with lead paint that children are exposed to. The costs of inaction has proven to be significantly greater than a plan to combat the epidemic. “For every dollar spent on controlling lead hazards, $17–$221 would be returned in health benefits, increased IQ, higher lifetime earnings, tax revenue, reduced spending on special education, and reduced criminal activity”. https://doi.org/10.1289/ehp.0800408
According to The US Environmental Protection Agency (EPA) roughly 6.5 to 10 million homes and buildings have service lines that are at least partially made of lead. Paint hazards occur in older units with low-income families. Among the approximately 24 million housing units in the United States that have deteriorated lead-based paint and elevated levels of lead-contaminated house dust, more than 4 million are homes to 1 or younger children aged 1 to 5 years. Lead contamination in drinking water is also a major public health concern.
Public Health Management and Practice. 25(): S115–S120 (JAN 2019) contends that those in lead infested environments tend to live in the poorest neighborhoods and are disproportionately African American and Hispanic. The Centers for Disease Control and Prevention confirms that black children tend to have higher blood lead levels than white children.
Herbert Needleman, known for research studies on the neurodevelopmental damage caused by lead poisoning, was a pediatrician, child psychiatrist, researcher, and professor, advocated that there is no known safe level of lead exposure. Lead levels may be higher in lower income and predominately minority neighborhoods because older housing stock, which is more likely to have lead exposure, is associated with lower property values and more affordable housing (American Academy of Pediatrics (AAP) 1998; Kruse 2015). Because of the historical political disempowerment of racial minority communities, freeways and lead smelters—were much more likely to be built in or near non-white neighborhoods (Sampson and Winter 2016).
The neighborhood of residence at birth has consistent and lasting effects on academic achievement (Burdick-Will et al. 2011; Sharkey and Faber 2014)….” [Alternatively], we posit that lead exposure could be a critical missing link between early childhood differences in environmental quality and later educational gaps”.
On June 1, 2018, Carson said the following, “While lead poisoning is entirely preventable, we continue to see far too many children being exposed to lead hazards in their own homes…. All of us have a responsibility to protect kids, and that includes those who rent or sell older homes that may contain potentially harmful lead.”
On March 22, 2019, Congressman Jared Goldman said the following, “Washington has failed… kids when it comes to preventing lead poisoning….Lead is a public health crisis …; it robs our children of bright futures and strains our health care, education…. The status quo just isn’t acceptable, so I’m calling on Secretary Carson to take three critical steps: require lead removal from all homes owned by the federal government or financed with government mortgages, set common-sense standards for states receiving lead prevention funding, and finally provide the funding necessary to remove the lead paint found in a million homes across the country.”
(NBC) Under Ben Carson, more families live in HUD housing that fails health and safety inspections. While Carson pledged to fix low-income housing, the number of properties cited for health and safety violations has been on the rise (Nov. 14, 2018).
Ben Carson inherited a monumental undertaking. He was not forced into this position but rather accepted a calling. One cannot dispute the range of his responsibilities, but one also cannot excuse the rise of violations under his tenure. As a medical doctor who holds a professorship in pediatrics, it would appear that Carson should know and value the benefits of a healthy mind and body, thereby making a pledge to eliminate lead poisoning of children a national emergency.
LaToria S.Whitehead, Ph.D., MPH; Sharunda D. Buchanan, Ph.D., MS
Whitehead, L., & Buchanan, S. (2019). Childhood Lead Poisoning. Journal of Public Health Management and Practice, 25.