Lead Exposure Sets More Cleveland Children On A Poisoned-To-Prison Path

By Rachel Dissell and Brie Zeltner

Exposure to high levels of lead at a young age greatly increased the chances of Cleveland school children following a poisoning-to-prison path of school struggles, juvenile crime, adult incarceration and homelessness, according to a study released Monday.

The study, by researchers at Case Western Reserve University’s (CWRU) Center on Urban Poverty and Community Development, followed the trajectory of thousands of Cleveland Metropolitan School District students over a 20-year period and compared those who had high lead levels to those who did not. 

Until now, studies on groups of children in other cities were the basis for the belief that Cleveland kids harmed by lead exposure were more likely to end up in juvenile court or prison.

The CWRU study confirms the local impact of lead poisoning and the high long-term costs to the individual and community in the form of special education, incarceration, lost wages and use of homeless shelters.

The costs to society are profound, particularly for black children who live in segregated neighborhoods, said Claudia Coulton, the study's lead author and co-director of the CWRU center. 

“All of the students in the study already faced challenges of poverty and racial discrimination… and even in light of that, there’s this huge extra burden of lead, and it has a huge effect,” Coulton said.

The study used a database tracking the experiences of children who remained students in the school district through 9th grade with multiple social service systems, aimed at measuring “downstream” effects of lead poisoning, including reliance on government programs for food and basic needs.

A wide body of research in the past 30 years has documented the negative impacts of lead on children’s health, particularly the developing brain. These include poor impulse control, lower IQ and other irreversible behavioral and health problems.

The CWRU study followed two groups of Cleveland children who had blood tests for lead before the age of 3. The first group is now in their late 20s and the second group is in their late teens or early 20s.

Those who, as children, had blood lead levels above 5 micrograms per deciliter, the current standard set by federal public health officials as the threshold of concern, were:

• 27 percent less likely to be ready for kindergarten;
• up to 30 percent more likely to enter the juvenile justice system;
• 34 percent more likely to be incarcerated as young adults;
• 40 percent more likely to experience some level of homelessness.

Children with high lead-level tests were also significantly more likely to be charged with crimes considered violent before turning 18, even as reports of violent crimes as a whole declined in Cleveland.

The first group of children, born between 1991 and 1993, were 26 percent more likely to be charged with a violent crime than peers with lower lead levels. The younger group of students, some of whom are now the age of high school seniors, were 43 percent more likely to be charged with a violent crime than peers with lower or no lead exposure.

Damage Can’t Be Undone

Previous studies of Cleveland students and lead poisoining focused mainly on the early costs to child development and learning, with an eye toward ameliorating the effects with interventions designed to boost reading skills and support social development.

The current study, which takes a much longer view of the effects of lead, cements the importance of a strategy aimed at preventing children from exposure to the toxin. Interventions after exposure cannot come close to undoing the damage, said Coulton.

“Prevention is really the only way out,” she said. “It’s almost always less costly both in human pain and suffering and in the economic sense to prevent [exposure], but it’s often a hard sell.”

One encouraging trend, researchers said, is that far fewer children tested in the second group — those born between 2000 and 2002 — had levels of lead in their blood high enough to require a public health response. The drop, though, was more significant among white children.

That is in line with a nationwide decline in lead poisoning, though Cleveland lags behind the rest of the country in reducing the number of children poisoned.

In 2019, the Ohio Department of Health recorded more than 1,000 Cleveland children with levels of lead in their blood requiring a public health response.

That was more than 8 percent of all children tested in Cleveland, though many children still are not screened for lead twice before the age of 2, as recommended by public health officials and required by Medicaid guidelines.

Cleveland City Councilman Blaine Griffin, who supported legislation that will require Cleveland rental homes to be tested for lead hazards beginning next year, said the CWRU study bolsters the community effort to focus on prevention by making homes lead safe.

“It means we have to stick with it,” said Griffin, who chairs the Health and Human Services Committee. “And not just because it was a hot topic. We have to make our efforts sustainable.”

The move toward a prevention strategy was pushed by grassroots advocates, parents of poisoned children, nurses, doctors and environmental groups who long sought to stem the problem at its main source: older, distressed homes with flaking and peeling paint.

The study also raises questions about what can and should be done to support young adults in the community, those still living with unacknowledged effects of being poisoned, Griffin said. Those young adults will be parents of the next generation of children, he said.

“We can’t just write them off,” he said. “We have to find ways to help and intervene and support them.”

The study was paid for by Mt. Sinai Healthcare Foundation, Saint Luke's Foundation, George Gund Foundation, and the Eva L. and Joseph M. Bruening Foundation. All of the organizations are members of the Lead Safe Cleveland Coalition, which officially formed in January 2019 with a goal of making Cleveland “lead safe” within a decade — a measure defined by City Council President Kevin Kelley at the time as having no children with lead tests above 5 micrograms per deciliter.

In addition to a string of “lead safe” ordinances passed last year, philanthropic groups have raised $18.1 million for a Lead Safe Home Fund to help clean up toxic hazards from homes and to open a resource center that will support families and landlords and remediation workers.

Coulton said the research underscores the importance of the Lead Safe Cleveland coalition’s work in preventing poisoning.

“We’re on the right path now, and this [report] supports the path we’re on and the importance of not stepping off that path,” she said.