Making the case for lead safe housing: Downstream effects of lead exposure on outcomes for children and youth

Claudia Coulton, Francisca García Cobián Richter, Youngmin Cho, Jiho Park, Jeesoo Jeon, Robert L. Fischer

Research output: Contribution to journalArticlepeer-review


Lead based paint is a predominate source of lead exposure in children, which has a documented negative effect on their health and development. Despite public health efforts, the housing stock in disinvested neighborhoods in many cities continues to present significant risk of childhood lead exposure. In this article, we describe how a multi-agency integrated data system was used to document the impact of lead exposure on indicators of child and youth development as recorded in educational and human service systems. By tracking administrative data for two cohorts of Cleveland, Ohio children from birth to early adulthood and using rigorous matching methods to reduce confounders when comparing those with and without elevated blood lead levels, we document negative effects on developmental, behavioral and socio-economic outcomes due to early childhood lead exposure. The magnitude of disparities between individuals who had elevated blood lead levels (≥5 μg/dL) in early childhood, compared to their matched counterparts, is in the ranges of 20–40%. The analysis is framed by clarifying the context, assumptions and limitations associated with the use of administrative data. This type of information has been useful in illuminating the burden of lead exposure for children, families and youth serving agencies and engaging public officials, landlords and residents in initiatives to bring housing up to lead safe standards.

Original languageEnglish
Article number103118
JournalHealth and Place
StatePublished - Nov 2023

Bibliographical note

Publisher Copyright:
© 2023


  • Downstream effects
  • Integrated administrative data systems
  • Lead exposure


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