Snohomish County, WA

Establishing a Snohomish County Childhood Lead Poisoning Prevention Program Collaborative

Snohomish County is the third most populous county in Washington state with more than 840,000 residents. A smelter site operated in the county from 1894 to 1912 that resulted in lead-contaminated soil which was first identified in 1990. When compared with the general population of Snohomish County, a disproportionate number of children who are minorities, children whose caregiver speaks a language other than English, and children who are eligible for Medicaid have been identified as having higher blood lead levels (BLLs). In 2019, Snohomish County’s childhood blood lead testing rate of children younger than 6 years old was 3.4%. The Snohomish County Health Department (SHD) wanted to increase the number of children identified as high risk and get them tested so they can be connected to services.

As one of the first steps to reduce BLL inequities, the Snohomish County Childhood Lead Poisoning Prevention Program (CLPPP) invited 15 agencies or groups involved in lead poisoning prevention to participate in a collaborative to identify common goals and improve system linkages. Key program partners include state level agencies such as the Washington State Department of Health (DOH) and the Washington State Department of Ecology; local organizations like local housing authorities, childcare service agencies, and community health centers; and the regional Pediatric Environmental Health Specialty Unit (PEHSU).

The inaugural meeting occurred in March 2022 with 23 individuals from nine agencies in attendance, representing all the major sectors. Although many of these agencies had been working to reduce the burden of lead poisoning, they may not have been working together. Three meetings were held in 2022, and four are scheduled for 2023.

Each agency shared how they are involved in childhood lead poisoning prevention and offered ideas on how to collaborate. As a direct result of this collaboration, agencies found ways to

• Share materials, which saves efforts of having to create new resources
• Impart knowledge through discussions and presentations
• Identify additional children they serve (e.g., in child care settings, in low-income housing, within the Everett Smelter Site area) who are at higher risk to receive targeted educational campaigns to promote blood lead testing. The goal is for community-level interventions to result in an increase in requests for testing with a statistically significant increase in testing rates as a long-term outcome.
• Develop new partnership activities such as these:
  • DOH and SHD held joint public educational events with soil testing for childcare facilities and families.
  • The housing authority assisted SHD in surveying low-income housing residents to assess lead knowledge. Department of Ecology helped get surveys to smelter plume residents.
  • DOH and SHD are working together to create a training for childcare providers.
  • SHD, DOH, and PEHSU are developing a state-wide training for healthcare providers.

These meetings will continue at least quarterly with additional partners joining the collaborative as they are identified. Agencies will continue to have opportunities to share data and brainstorm ways in which groups can work together to reach the common goal of lowering the number of children adversely affected by lead poisoning in Snohomish County.