Los Angeles County

Over 1 million housing units in Los Angeles, 80% of the city’s housing stock, were built before 1980 and contain lead paint. In 2014, lead paint in housing was found to be the dominant or contributing source of lead exposure in approximately 75% of the lead poisoning cases managed by Los Angeles County.

The Los Angeles Housing and Community Investment Department (HCIDLA) historically identified hazards in rental properties through its Systematic Code Enforcement Program (SCEP), housing inspection and violation tracking software, and partnerships with community-based tenant advocacy organizations. However, HCIDLA’s CDC-funded lead poisoning reduction program learned through partnerships with community-based organizations focused on tenants’ rights and healthy housing that screening for high-risk children was low in the Los Angeles Promise Zone. According to 2014 data, the Promise Zone is at higher risk for lead poisoning because

• 61% of the population lived in poverty, with 33% of households earning less than $20,000 per year,
• 60% of families lived in rental properties, and
• 60% of the population was born outside the U.S.

With the Healthy Housing Collaborative, the program initiated two strategies to increase blood lead testing in the target community:

• Working with the Coalition for Economic Survival, Inquilinos Unidos, and Koreatown Immigrant Workers Alliance to educate parents about lead exposure risk factors in homes and the impact of lead poisoning on child development and educational attainment and refer them to AltaMed, a Federally Qualified Health Center, for a free blood lead test.
• Partnering with AltaMed and their Westlake satellite clinic near the Promise Zone to test all children under 6 years old in the target zip codes who have not been tested in the last 6 months and do not meet the clinic’s regular screening criteria.

The Los Angeles County Department of Public Health agreed to enroll all children who had elevated blood lead levels (BLLs) in a county healthcare program, ensuring follow up services could be provided as needed.

The intervention resulted in 291 children referred for testing, of which 77 received testing. While only 26% of children received testing, all referred families received information about lead and its detrimental health effects through one-on-one sessions, health fairs, and community meetings. Two of the tested children had elevated BLLs. These children were previously identified as having high BLLs and were already receiving case management services from the county health department.

The expanded screening program resulted in an additional 456 children screened, and 17 had BLLs at or above CDC’s blood lead reference value of 5 µg/dL. The prevalence of elevated BLLs in this population was 3.7%, which was higher than the county’s prevalence. This demonstrated a need to reevaluate clinical screening tools to identify more children who have been exposed to lead.

These programs successfully addressed needs in the community—both gaps in knowledge and services—and demonstrated that housing and health indicators could be used to identify high-risk neighborhoods and other target communities.

Funding for this work was made possible in part by EH14-1408 from the Centers for Disease Control and Prevention (CDC). The views expressed in this material do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.