Sixteen years ago, a presidential task force mapped a plan for the United States to eliminate childhood lead poisoning by 2010.
It never happened.
Today, tens of thousands of Kansas City area homes still contain lead paint so dangerous that a tiny amount of paint dust can damage a young child’s brain.
As many as 1,500 children in Kansas City have lead poisoning, health officials estimate. Hundreds more have been poisoned in Wyandotte County and surrounding areas.
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Many of their parents don’t even realize it.
In Kansas City, the situation persists despite decades-long efforts to clean up contaminated homes. The number of problem houses, largely concentrated in poor and minority neighborhoods, is too immense.
At the current pace it would take centuries to safely contain the lead, a common ingredient in paint until a 1978 ban took effect.
In Kansas, the state’s lead poisoning prevention programs quietly disappeared years ago after the state lost federal funding to budget cuts. Kansas devotes almost no money to lead poisoning prevention, and when federal funding returned for some programs two years ago, Kansas did not apply for it.
Yet the need remains so great that Kansas City health workers are crossing the state line to help with the most urgent Kansas cases.
“It’s crazy,” said Tama Sawyer, director of the Poison Control Center at University of Kansas Hospital.
In recent years, scientists have discovered that lead is more toxic than previously understood.
Lifelong effects include lower IQ, hearing loss, learning disabilities, impulsiveness and a greater likelihood later in life to drop out of school, spend time in jail, commit violence and contract sexually transmitted diseases.
Many children never get tested for lead poisoning, allowing the problem to fester silently in pockets of the metropolitan area.
New families move into old homes unaware of the danger. Contrary to the popular image of children eating paint chips, small children often ingest nearly invisible lead paint dust that coats their toys and hands as they roam around the house.
Lead poisoning problems had faded from the news until city leaders in Flint, Mich., switched the water supply and caused a lead poisoning crisis in 2014.
But Flint is only the tip of the iceberg, health advocates say. Lead paint poses a bigger threat in many cities, including Kansas City, where some neighborhoods have even higher poisoning rates.
Area parents with lead-poisoned children call the Poison Control Center at KU Hospital.
In Missouri they can get help, Sawyer said. In Kansas, they usually can’t.
“That is a problem for the state of Kansas,” Sawyer said.
“We expect every child to achieve the best that they can achieve, but we’re really handicapping these kids, through no fault of their own.”
The damage done
Last year, a married couple bought one of the stately old houses in Kansas City’s Rockhill neighborhood.
The couple, a software physicist and a doctor, can see the Nelson-Atkins Museum of Art from their doorstep. Because the home was built in an era when house paint contained dangerous amounts of lead, the family’s pediatrician suggested testing their 16-month-old son for lead exposure.
The results came back above the Centers for Disease Control and Prevention’s poisoning threshold.
“The first couple of days, we were freaking out,” said the father, who asked The Star to identify him as Chris.
A city health worker inspected the house and found some sources of lead to clean up. When Chris had his son tested again, the lead levels had dropped.
“We’re lucky because we have resources,” Chris said. The family could afford painters and had access to good health care.
“I can imagine a scenario where it would be a lot harder.”
Many parents first learn about lead poisoning at Head Start, a pre-kindergarten program for low-income children that requires lead testing.
By then, the damage is done — not all at once, but through exposure over time.
KC is a high-risk area
Sonyetta McLaughlin had her children tested for lead poisoning at a back-to-school health fair put on last year by the Kansas City Health Department.
Tests confirmed dangerous lead levels in all six.
The culprit: flaking lead paint on the house McLaughlin had bought on Benton Avenue.
For help, she turned to the health department’s Project Lead Safe KC.
The city program grew out of a national war on childhood lead poisoning that took root here 20 years ago, backed by the U.S. Department of Housing and Urban Development and the CDC. Since then the program has removed lead hazards from 2,491 homes by repainting and by replacing windows — a common collecting point for toxic lead dust. The program tests about 2,000 children a year.
But even as Lead Safe KC chips away at the problem house by house, it has been hit by federal budget cuts and faces an enormous challenge. About half the city’s houses date to before 1950, when the lead content of paint was highest, putting as many as 40,000 homes at risk. The program has the capacity to fix at most 80 a year.
“Kansas City is such a high-risk area, we recommend children get tested every year,” said Amy Roberts, manager of the city program.
Lead Safe KC has received more than $8 million in HUD grants since 1997, plus hundreds of thousands of dollars from the city each year. But it can cost thousands to remediate lead hazards in a single house, and the program also is responsible for children’s blood tests and investigating the sale of lead-tainted products. Recently the department started sending health workers to help families in Kansas because no services are available there.
The money goes fast. Federal budget cuts over the past decade cost the program a nurse and a home inspector.
“It’s been difficult to maintain services,” Roberts said.
If not for Lead Safe KC, McLaughlin said, she doesn’t know what she would have done.
The health department inspected her house, had it repainted and replaced the windows. The children’s lead levels dropped.
But lead’s effects are irreversible. Four of McLaughlin’s sons have been diagnosed with learning disabilities. Her 6-year-old may be held back from first grade.
McLaughlin suspects the children were first exposed to lead in some of the houses she rented over the past few years.
“It was like I could never escape it,” she said.
Separate from the city program, such cases are tracked by Missouri’s Childhood Lead Poisoning Prevention Program, which maps areas where children are most at risk, such as St. Louis and Kansas City.
The program provides case management to families and reports data to the CDC, which provided about half the program’s $747,000 budget this year. The other half comes from Medicaid and the state’s general fund.
Year after year, Missouri has pushed children’s lead levels downward.
Kansas gives up
For years, Kansas maintained a lead poisoning program like Missouri’s. In Wyandotte County, it helped create Lead Safe KCK, similar to Kansas City’s program.
But those efforts have been abandoned.
Lead Safe KCK lost its funding in 2009 and disappeared. The same thing happened to the statewide program three years later, when Congress wiped out the CDC funding that supported it. The same year, the CDC lowered the threshold for childhood lead poisoning by half.
Kansas no longer inspects houses for lead or provides home lead repairs and case management to families or reports how many children are poisoned by lead. The state stopped sending such data to the CDC, and communities no longer have resources to stop more children from being exposed.
“Our funding was cut 100 percent,” said Farah Ahmed, a health officer at the Kansas Department of Health and Environment. When the state lost CDC money for lead poisoning prevention in 2012, case management for lead-affected families was shifted to county health agencies, she said.
“It’s a huge burden.”
The Kansas health department still receives all lead tests in the state and sends them to county health departments, which inform parents. But they can offer little or no help.
For those warnings, Kansas still uses a threshold twice as high as what the CDC now recommends because there are too many affected children for local health offices to handle otherwise.
And although Medicaid requires that children enrolled in the program be tested for lead poisoning, Kansas does not follow that rule.
Today the neighborhood outside Nathan Barnes’ front door remains a hot spot for childhood lead poisoning, just as it was a decade ago.
The former Unified Government commissioner lives in northeast Kansas City, Kan., inside the loop formed by Interstate 635 and Interstate 70. It’s a place where lead has poisoned children by the hundreds.
State officials years ago identified Wyandotte County as No. 1 in Kansas for childhood lead poisoning. Home to large low-income and minority populations, the area counts more than 20,000 homes at risk for lead paint hazards. To tackle the problem, the state in 2003 helped secure millions in HUD grants to create Lead Safe KCK, which repaired homes and tested children for lead. But when the federal dollars stopped flowing, the program disappeared.
Now semi-retired, Barnes says Lead Safe KCK suffered from a lack of funds and commitment.
“The problem was so enormous, it was a drop in the bucket,” Barnes said. “We should have put more money behind it to make an impact. Of course, it fell on deaf ears.”
The program repaired more than 500 houses over six years for about $6,500 per house. A nurse tested children at day cares and schools. Health workers investigated homes for lead.
After 2009, the county stopped getting grants and Lead Safe KCK vanished.
Joe Connor, the Unified Government assistant county administrator, was the public health director at the time and was disappointed when HUD denied the program’s grant applications, which had been handled by the state.
Lead Safe KCK did a lot of good, he said.
“We got attention that we sorely needed,” Connor said. “We could really drill down and fix up some of these houses and get some kids on the right path.
“I think we made a difference. Just — could we sustain it? That’s tough.”
Barnes said he recalls no public discussion when the program folded.
He thinks state and Unified Government officials gave up because the problem is so difficult and costly.
“They certainly didn’t want to bring more attention to it,” Barnes said.
Since then, the state has made a few unsuccessful bids for federal money for local lead programs like Lead Safe KCK.
In 2014 the CDC regained funding for state lead programs in Missouri and 28 other states after losing it to budget cuts for two years.
But Kansas has not applied, and all that remains of the former state lead program is a smaller office that licenses lead remediation workers, paid for by the Environmental Protection Agency. The state provides some free lead-testing materials to local agencies.
How many children have lead poisoning in Kansas now is hard to say, according to state health officials. Kansas stopped publishing the results of lead testing in 2012. That year, more than 5 percent of the children tested showed high lead levels. State officials say their database is not up to date.
“We’re kind of regrouping,” said Cassie Sparks, a spokeswoman for the state health department. “It’s not in great shape and we understand that.”
State health officials said they are preparing to release new data on lead poisoning in Kansas this year.
Stepping in to help
In March, two health workers from Children’s Mercy Hospital in Kansas City drove to Topeka to visit a young mother and her 4-year-old son, who recently had been diagnosed with lead poisoning.
The boy’s lead levels were four times the CDC threshold. At preschool he had trouble learning his letters.
The mother, who asked not to be named, didn’t know the lead’s source.
“I never thought about lead until we got tested,” she said. “I just want to get to the bottom of it before it’s 10 times worse.”
Children’s Mercy is often the only help for such families in Kansas today. After the state lead program stopped functioning, the hospital teamed up with the Kansas City Health Department to visit the homes of lead-poisoned children. But the hospital is not equipped to prevent lead poisoning across an entire state and it can’t repair houses in Kansas. The hospital maintains a list of more than 300 Kansas families who need help.
Jennifer Lowry, medical director at Children’s Mercy’s federally supported environmental health unit, said she offered the unit’s services to Kansas because she had taken calls from worried parents, doctors and local health officials all over the state.
“That’s just not acceptable,” Lowry said. “Someone has to help these kids.”
Lowry’s unit, which provides medical advice across the region, hired two lead specialists and has visited 15 lead-affected homes in Kansas City, Kan.; Emporia; Hays and other Kansas communities over the past few years.
“No one’s funding us to do this,” Lowry said. “Children’s Mercy is letting us do this.”
A referral system connecting the state health department to Children’s Mercy through the Poison Control Center led the health workers to the Topeka mother’s home.
They knew the small house was built in the 1920s and the woman’s 1-year-old son also had high lead levels.
The family had rented the house and moved in recently. Mom had felt lucky to find a house they could afford with a backyard. “We couldn’t pass it up,” she said.
Tracking down the source of the lead, the health workers zeroed in on an old shed in the backyard where flaking paint fell into the dirt where the children’s toys lay.
They suggested the mother take a sample of dirt to a state laboratory because the out-of-state health workers were not licensed in Kansas. They showed the mother how to take samples from inside the house for them to take back to their own lab.
They said they would check in with the mother later, but there was little more they could do.
Lead and violence
Lead not only harms children but causes ripple effects throughout society, researchers say.
Recent studies have linked childhood lead poisoning with higher rates of violent crime, sexually transmitted diseases and poor performance in schools. Generation after generation, every particle of lead translates to bigger problems in society and billions of dollars wasted, according to advocates for prevention programs. Anyone living in or renovating an old house could be at risk, but the burden hits low-income and minority neighborhoods hardest.
The CDC recommends action to find the source of lead poisoning and stop it when children have 5 micrograms of lead per deciliter of blood. A series of studies in North Carolina and Connecticut showed the damage begins at even lower levels.
At 3 micrograms, school children have lower test scores.
At 4 micrograms, learning disabilities appear. Speech delays and hearing loss follow.
For every 10-microgram increase, IQs drop four to seven points.
“If you don’t know how to read, you’re in big trouble,” said Patricia McLaine, a professor of public health at the University of Maryland, while speaking at a HUD conference earlier this year. “It’s a real burden on a school system to have this big increase in the number of schoolchildren who need special attention.”
Twenty-five micrograms means an average $500,000 per child in special education and juvenile justice costs, according to a report by Ohio public officials.
Consider the effect on Kansas City, where some neighborhoods have higher lead poisoning rates than Flint’s water.
State records show Kansas City’s lead poisoning concentrated in 10 ZIP codes.
Eight of those were also in the top 10 for homicides over the past two years, The Star found.
Several studies around the country have found a link between childhood lead poisoning and violence later in life. Researchers say the effects of lead alone can’t explain a person’s behavior, but it is an important factor.
“This correlation is really strong,” said Roger Lewis, director of the Environmental Health Research Laboratory at Saint Louis University, and it is independent of factors such as poverty, race and social status.
The brain injuries caused by lead promote impulsive behavior and damage a person’s ability to think, learn from mistakes and experience empathy.
A study in Cincinnati that began in the 1970s followed lead-poisoned children through life. It found links between lead and a host of problems, including arrests and violence. Researchers using historical data have linked homicide rates to the rise and fall of lead in gasoline, paint and municipal water systems.
In Kansas City’s 64130 ZIP code, 7 percent of children tested had high lead levels. The eight square miles, straddling Brush Creek downstream from the Country Club Plaza, was labeled the Murder Factory by The Star in 2009 after the paper discovered 101 convicted murderers in Missouri prisons had lived there, more than any other ZIP code in the state.
Prevention works, Lewis said, but not enough is being done.
“We have to redouble our efforts,” Lewis said. “Oh my God, it’s critical. If you consider the implications to children’s health and to society in general, it’s critical.”
National lead prevention programs were credited with preventing lead poisoning in 200,000 children between 2008 and 2010, saving the country $7.5 billion, according to the National Center for Healthy Housing, a nonprofit founded in the 1990s to combat lead.
Lead-poisoned children are seven times as likely to drop out of school and six times as likely to be involved in the criminal justice system, according to the nonprofit Coalition to End Childhood Lead Poisoning.
African-American children are nearly three times as likely to be lead-poisoned as are white children, according to a national survey by the CDC. Poor children face double the risk of those who aren’t poor.
A new goal
If more isn’t done to prevent lead poisoning, future generations will be damaged too, health experts say.
But that doesn’t have to happen.
“It could be eliminated entirely,” said David Jacobs, former head of HUD’s lead poisoning prevention program. “We know how to solve this problem. It’s a question of getting the political will and the resources to solve it.”
Some advocates are seizing on the attention drawn to Flint to ask Congress to restore funding for lead poisoning prevention.
Public health efforts since the 1970s have lowered average childhood lead levels by more than 90 percent. Still, more than 535,000 children in the U.S. have lead poisoning today. The number of new cases every year could be driven to nearly zero with the same strategies that have reduced the scourge over the years, Jacobs said. And it makes sense to do so, given the costs lead poisoning adds to education and criminal justice.
“We already pay for lead,” said Jacobs, now chief scientist at the National Center for Healthy Housing.
A coalition of such advocates made its case in a recent letter to President Barack Obama and Congress, signed by hundreds of local officials and public health agencies in 35 states, including Missouri. But not Kansas.
The old goal of eliminating childhood lead poisoning by 2010 was doomed by a halfhearted effort, Jacobs said. In 2000, a presidential task force estimated the cost at about $230 million a year. But Congress provided a fraction of that.
The CDC’s new eradication goal is 2020. But that almost certainly won’t happen either.
“We’re not going to make it because the resources aren’t there,” Jacobs said. “We need to have a new national goal.”
How to get help
The Kansas City Health Department’s Project Lead Safe KC offers help for owners of homes and rental properties in Kansas City. The program sends a licensed lead inspector to the home, and licensed lead abatement contractors perform the needed work. Lead testing for children ages 6 and younger is available at the department. For more information, call 816-513-6048 or email firstname.lastname@example.org.
In Missouri, call the Childhood Lead Poisoning Prevention program at 573-751-6102.
In Kansas, call the national Poison Control Center at 800-222-1222 or your county health department.