New York City

Demonstrating the Financial and Social Value of Lead Poisoning Case Management in New York City

To make the case for sustained investment in lead poisoning prevention, the New York City Department of Health recognized the need for a rigorous return-on-investment (ROI) analysis — one that could demonstrate not only the cost-effectiveness of its work, but also the broader social value it generates for communities.

With support from a CDC grant, NYC's Division of Finance established an internal public health ROI program and selected the Healthy Homes Program's lead poisoning case management services as its focus, analyzing data from November 2024 to June 2025. The analysis drew on three categories of data — financial inputs such as staff salaries and operating costs, clinical and social outcome data, and academic cost benchmarks — to calculate both a direct cost-savings ROI and a comprehensive social return on investment (SROI).

The findings were striking. The analysis revealed a positive ROI of 134%, meaning that every dollar invested in the program generated $2.34 in benefits through avoided medical costs and reduced special education expenditures. Even more compelling, the total monetized social value exceeded $98 million, with an SROI of $26.37 per dollar invested — reflecting gains in lifetime earnings, caregiver productivity, reduced juvenile justice involvement, improved quality of life, and neighborhood-level benefits such as housing stability and reduced crime. These results may offer a data-driven argument for maintaining and expanding funding for lead poisoning prevention programs nationwide.