Wide Disparities in Childhood Lead Poisoning Revealed by City-Level Data
January 31, 2025

Above: The bar graph depicts the percent of children aged <6 years old with elevated blood lead levels in 20221
Lead in blood has been linked to numerous pediatric health problems with cognitive function, motor skills, attention and behavior, and lower IQ. Leading federal agencies note that there is no safe blood lead level for children.
In 2022, more than 12,000 children living in big cities had elevated blood lead levels (≥5 micrograms per deciliter, the CDC’s blood lead reference value during 2012-2021).
Children living in cities with the highest poverty rates and oldest homes were disproportionately affected by lead, namely 4x higher prevalence of elevated blood lead compared to children living in other cities.
This was the most striking finding in analyses conducted by the Urban Health Collaborative at Drexel University's Dornsife School of Public Health using data from childhood lead poisoning programs in 34 of the largest U.S. cities that comprise the Big Cities Health Coalition (BCHC).
Click to view infographic, "Childhood Lead Poisoning in Big Cities 2013-2022"
Background
Reduction of childhood lead levels is a public health success. Forty years ago, almost all children under the age of 6 had elevated levels of lead in their blood; now, approximately one percent have elevated levels. This outstanding success resulted primarily from federal action in the 1970s that discontinued the use of lead in gasoline and residential paint.
Nevertheless, lead-based paint remains the most common source of childhood lead poisoning and is present in millions of older homes. Deteriorated lead-based paint is more likely found in older homes in lower-income areas.1 Young children are at high risk for poisoning due to frequent hand-to-mouth activities and their bodies absorb lead at faster rates than adults. Children with insufficient micronutrient intake — more prevalent in poorer cities — are at even higher risk.
What We Did And What We Found
We compiled pediatric blood lead data for the BCHC data platform.
Elevated blood lead levels were much higher in five cities (Cleveland, Detroit, Philadelphia, Baltimore, and Milwaukee). In these five cities, one out of 25 children tested had elevated levels, compared to one out of 100 children in other BCHC cities.
Compared to other BCHC cities, these five cities had higher proportions of older housing, families living in poverty, racial segregation, and Black residents. The disproportionate burden of lead poisoning in these communities highlights environmental injustices perpetuated by long-standing systems of structural racism and economic inequality.
1 Click here for an explanation of the blood lead reference value and lead based paint.
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The Big Cities Health Inventory data platform is primarily funded by the U.S. Centers for Disease Control and Prevention through a cooperative agreement with the National Association of County and City Health Officials. The views expressed on the data platform do not necessarily represent the views of the funders.
Suggested citation: Jack Pellegrino, Amy Auchincloss, Jennifer Kolker, Vahan Boyajyan, Saima Niamatullah. (2025) Wide disparities in childhood lead poisoning revealed by city-level data. Drexel University, Urban Health Collaborative. Philadelphia, PA.