evaluating the effects of lead mitigation policy on childhood lead exposure in rhode island alyssa...
TRANSCRIPT
Evaluating the Effects of Lead Mitigation Policy on Childhood Lead Exposure in Rhode Island
Alyssa Sylvaria & Ryan KellyThe Providence Plan - Information Group
2
Outline
1. Background2. Data and Methods3. Compliance4. Childhood Lead Exposure
– Compliance– Exemption – Foreclosure
5. Implications
3
BACKGROUND
4
Childhood Lead Exposure
5 µg/dL CDC reference level for elevated blood lead levels (EBLL) as of 2012
Rhode Island
2002 Incidence 25%2012 Incidence 5%
Sources: ACCLPP. (2012). Low Level Lead Exposure Harms Children: A Renewed Call for Primary Prevention. Centers for Disease Control and Prevention.Childhood Lead Poisoning Prevention Program. (2014). Childhood Lead Poisoning. Rhode Island Department of Health. http://www.health.ri.gov/data/childhoodleadpoisoning/
5
Federal Primary Prevention Efforts
• Title X: Lead Disclosure Rule• HUD Lead Safe Housing Rule• EPA Renovation, Repair, and Painting• OSHA Interim Lead in Construction Standard
Sources: HUD Guidelines for the Evaluation and Control of Lead-Based Paint Hazards in Housing. (2012). http://portal.hud.gov/hudportal/HUD?src=/program_offices/healthy_homes/lbp/hudguidelines
6
RI Primary Prevention Efforts
• As of 2005, most rental property owners need to obtain a compliance certificate
• Exemptions:–1978 or later Built after lead was banned in paint
–Owner-occupied properties with <4 units
–≤100 days a year Temporary or seasonal units
–Age 62+ Designated elderly housing
7
RI’s Lead Law
Certificates of Conformance require that property owners1. Attend a Lead Hazard Awareness Class2. Visually assess the property 3. Get an Independent Clearance Inspection 4. Fix lead hazards 5. Use lead-safe work practices in any maintenance projects6. Give tenants an Inspection Report and lead hazard info7. Respond to tenants' concerns about any lead hazards
8
DATA AND METHODS
9
Population of Properties
• Residential properties– 1 to 5 family properties– Apartments (6+ units)– Mixed use (commercial + residential)
• Core cities in Rhode Island– Central Falls– Pawtucket– Providence– Woonsocket
• Built before 1978 – For both exempt and non-exempt
10
Data
• Property-Level Data• Compliance certificates• Tax Assessor Data
– Current as of…• Providence, 2009• Woonsocket, 2009• Pawtucket, 2010• Central Falls, 2011
• Master Look-Up Tables– Verifies the property associated with each
address
• Child-Level Data• Blood Lead Levels (BLLs)
– Confirmed blood lead test results– Children living at addresses in the
core cities– Ages 0-72 months
11
Linking Method
2. Standardize Address Data to Properties and Match
1. Aggregate Lead Test Results to Properties
Lead-exposed children
Lead Compliance
Propertydescriptives
12
RESULTS 1: COMPLIANCE
13
Focus: Rates of compliance with the Lead Hazard Mitigation Act
Population:
15,678 non-exempt properties – Did or did not have any children with blood lead tests (all
non-exempt residential properties in our linked dataset)– 2005-2012
Compliance
14
Properties with “Any Compliance”
• Had a Certificate of Conformance or Lead Safe Lead Free Certificate –At least one unit on the property (if multi-family)
–Complied at any point between 2005 and 2012
15
Any Compliance & Lead Exposure
• Any compliance includes properties that did not comply until after a child had an elevated blood lead level (EBLL) from 2005-2012
Not Compliant Until After
EBLL
ComplianceBefore EBLL or No EBLL
NO COMPLIANCE
Compliance & Lead Exposure at Property
ANY COMPLIANCE
16
Compliance Results
2005 2006 2007 2008 2009 2010 2011 20120%
10%20%30%40%50%60%70%80%90%
100%
Compliance over Time
% o
f Pro
perti
es
30.4% of properties had ANY
compliance
17
Compliance Results
69.6
9.0
21.4 Non-Compliant
Compliant after EBLL
Compliant before or No EBLL
18
Compliance Results
Mixed U
se
Apartments
1 Family
2-5 Family
Total0%
10%20%30%40%50%60%70%80%90%
100%
Compliant before or No EBLLCompliant after EBLLNon-Compliant
19
Compliance Summary
• Most non-exempt properties did not comply from 2005 to 2012, regardless of how broadly we defined compliance
20
RESULTS 2: CHILDHOOD LEAD EXPOSURE
21
Lead Exposure & Compliance
Population 9,127 non-exempt properties with at least one child tested for lead (2005-2012)
Question Did compliant properties have lower rates of lead exposure than non-compliant properties?
22
Lead Exposure By Compliance Status
Non-Compliant Any Compliance Total0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
42.8%
52.9%47.0%
Properties with One or More EBLL 5+
23
Any Compliance EBLL Timing
No BLL 5+; 47.1%
BEFORE com-pliance; 25.0%
BEFORE & AFTER
compli-ance; 12.0%
AFTER compli-
ance; 15.9%
24
Any Compliance EBLL Timing
No BLL 5+
BEFORE co
mpliance
AFTER co
mpliance
BEFORE &
AFTER co
mpliance
0.0%20.0%40.0%60.0%80.0%
48.1%69.5% 63.8%
84.1%EBLL 5+ Before the Law (pre-2005)
25
Lead Exposure & Compliance Summary
• Properties with any compliance had higher rates of lead-exposed children than non-compliant properties.
• Most of the compliant properties with lead-exposed children in 2005-2012 were multi-families and had lead-exposed children before 2005.
26
Lead Exposure & Exemption
Population 20,974 properties with at least one child tested for lead (2005-2012)
Question Do exempt properties still have lead-exposed children?
27
Lead Exposure & Exemption
56.5% of properties are exempt from the law
Non-exempt Exempt Total0.0%5.0%
10.0%15.0%20.0%25.0%30.0%35.0%40.0%45.0%50.0% 47.0%
33.7%39.5%
One or More EBLL
28
Lead Exposure & Exemption
Mixed Use Apartments One Families 2-5 Families Total
44.1%
52.9%
33.1%
48.9% 47.0%
0.32258064516129
0.228332337118948
0.417381022760863
0.336794125094961
Properties with One or More EBLL 5+
Non-exempt Exempt
29
Lead Exposure & Exemption
Non-exempt Exempt Total0
100020003000400050006000700080009000
4,291 3,990
8,281
One or More EBLL
30
Lead Exposure & Exemption Summary
• Over half of the properties with children tested for lead are not subject to the law.
• Non-exempt properties had higher rates of EBLLs on the property, but the non-exempt and exempt categories had similar numbers of properties with EBLLs
• 4,291 non-exempt compared to 3,990 exempt
31
Lead Exposure & Foreclosure
Population 39,903 children with blood lead test results
Question Do foreclosed properties increase the likelihood of lead-exposed children?
Context Housing market issues and home maintenance
32
• 5% of children lived in a property that foreclosed within 18 months of their lead test date
(Adjusted for residence type, owner-occupancy, city of residence, year property built (pre-1950 vs. 1950-1977), and child’s age at time of test).
Lead Exposure & Foreclosure Key Results
Foreclosure within 18 months of test No: Yes: Difference
Estimated BLL Estimated BLL (p-value)
All children 3.17 3.37 -0.20 (-0.1715)
Children in owner-occupied properties 3.37 3.33 0.05 (-0.8586)
Children in non-owner-occupied properties 3.71 4.36 -0.64 (-0.0468)
33
Lead Exposure & Foreclosure Summary
Children living in foreclosed rented properties had significantly higher estimated BLLs once we controlled for other variables.
Relationship was not significant for owner-occupied properties.
Foreclosure is likely one important factor out of many that can contribute to lead exposure.
34
Data Limitations
• Analysis is not unit-based
• Compliance does not account for expired certificates
35
Takeaways
• Enforcement is key to primary prevention
• Owner-occupied properties not less likely to have lead-exposed children
• Housing market issues can complicate efforts to reduce environmental health conditions
36
Implications & Next Steps
• Emphasize connection with healthy housing–Asthma–Energy usage–Inspections
• Local outreach around compliance and implications for child health
37
Contact us
White PaperProvplan.org