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Issue Brief Maternal and Child HealthMedical-Legal Partnerships

Improving Childhood Lead Screening Rates in Illinois and Ohio

October 24, 2019


This resource examines existing legal screening requirements in Illinois and Ohio (including state laws and Medicaid requirements) and explores legal and non-legal strategies for improving lead screening rates in these states.

Lead adversely affects almost every organ in the body and is especially harmful to young children. High blood lead levels (BLLs) in children and adults can result in seizures, coma and death. However, even low BLLs in children (i.e., ≤5 micrograms per deciliter (µg/dL)) are associated with behavioral and learning problems (such as hyperactivity, inattention, and aggression), lower IQ, and developmental delays. Accordingly, the American Academy of Pediatrics, CDC and others have observed that there is no safe level of lead exposure.

The primary sources of childhood lead exposure in the U.S. include lead-based paint and contaminated drinking water. Less prevalent lead exposure pathways include imported or cultural products such as candies, toys, toy jewelry, folk medicine, pottery and cosmetics. Despite the prevalence of lead in homes and infrastructure and the well-known harms associated with childhood lead exposure, lead screenings are not performed consistently. Without routine testing, lead poisoning is unlikely to be detected or treated and lead exposure is likely to continue, yielding cumulative and long-lasting adverse health impacts for affected children.

The U.S. Centers for Disease Control and Prevention (CDC) reported that in 2016, approximately 14 percent of Illinois children under age six were tested for lead. That same year, approximately 19 percent of Ohio kids under age six were tested. Although the CDC acknowledges limitations to this data and the data does not show how many kids have ever been tested (it only reflects 2016 testing), the numbers are alarmingly low: they signal an urgent need to increase lead screening rates to assure early detection of childhood lead poisoning. In addition, the data limitations highlight the importance of improving and standardizing nationwide surveillance of childhood lead testing and poisoning.

This resource examines for Illinois and Ohio:

  • common sources of childhood lead exposure;
  • Medicaid and state lead screening requirements;
  • common barriers to screening; and
  • legal and non-legal strategies to improve screening rates.