According to the Center for Disease Control there is no safe level of lead in children's blood. Elevated blood lead levels (BLL) can result in neurodevelopmental impairment, with no blood lead level known to be without a damaging effect. Why is there no safe level of lead? Why is that important to state?
Three of Santa Ana’s zip codes, including Madison Park’s 92707, are amongst the forty California zip codes with the highest reported number of children with Blood Lead Levels (BLL) 4.5 mcg/dL or greater (California Department of Public Health 2020). Reading the table, what do you notice? What questions do you have?
The actual number of children with lead blood levels is estimated to be higher than reported cases due to underreporting in California. A 2019 audit found that between 2009 and 2018, 1.4 million one- and two-year old children in California did not receive any of the required tests, and another 740,000 children missed one of the two tests. Why do you think blood lead level tests are missing? Why might missing tests be a problem?
The 2019 audit reported 285 missing BLL tests for children in Medi-Cal Ages 1 and 2 in the Madison Park census tract of Santa Ana. The audit reported 619 missing BLL tests for the nearby Cornerstone Village Census tract in Santa Ana. Given what you know about Santa Ana from the previous lesson, what do you think might be going on here? Why are there so many missing blood level tests in Santa Ana?
Many people in Santa Ana are undocumented and uninsured. Lack of transportation and long work hours also prevent people from accessing care. Distrust of healthcare and public health services also arises in response to a history of racist messaging in Orange County’s public health outreach on lead testing, which shifted blame to Mexican culture for lead exposure by emphasizing Mexican products as a source of lead pollution over other environmental sources (Lebron et al. 2019). This public health messaging emphasized individual responsibility for lead pollution, rather than recognizing the structural causes of environmental injustice. What is the effect of emphasizing individual responsibility for blood lead level tests? How is this different from emphasizing the structural causes of missing blood lead level tests?
An environmental justice advocacy organization, GREEN-MPNA, called for more accessible blood lead level screenings for the communities living in Santa Ana’s zip code 92707. Residents called the Orange County Health Care Agency (OCHCA) to request a pop-up or mobile blood lead level screening clinic hosted by the agency in the community. This effort reflects high levels of community concern about the limited data on children’s blood lead levels. The call to implement pop-up or mobile units also arose in response to barriers to primary care services through which blood lead testing is typically conducted. How might mobile testing help to improve blood lead level testing rates in Santa Ana?
