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Baltimore’s Toxic Legacy Of Lead Paint

The red brick rowhouses on Inez Robb’s block in West Baltimore feature ornate cornices and detailed carvings above the doors and windows. Leaves are beginning to fill the trees along the median that divides the pristine block, though slender trunks betray their young age. Robb moved into her home in 1987 with a first-time home buyer’s grant from the city, just a few years before Freddie Gray and his family would move to a building that looks remarkably similar from the outside, just over a dozen blocks away.

Both blocks are located in Sandtown-Winchester, a neighborhood less than a square mile in size that came to national attention last month when Gray, 25, died after sustaining injuries while being transported in a Baltimore police van. As the media reported details of Gray’s past, it emerged that in his early years, he’d been poisoned by lead, one of the most devastating neurotoxins on the planet and one that’s especially common in Baltimore because of its poverty and the age of its housing stock.

State tests found more than 65,000 children in the city with dangerously high blood-lead levels from 1993 to 2013. Across the United States, more than half a million kids are poisoned by lead each year, and the majority come from cities like Baltimore: rust belt towns built up during the first half of the 20th century when leaded paint was dominant. As populations and employment opportunities shrank in recent decades, poverty and neglect combined with older housing allowed lead paint poisoning to plague the city.

Despite sharp declines, the city of Baltimore still has nearly three times the national rate of lead poisoning among children, and a look at the data reveals that, like other health disparities, just a handful of neighborhoods are responsible for almost all of the city’s cases over the last five years. Sandtown is one of them.

But even these relatively stark statistics hide much of the problem. The data here represents children with blood-lead levels of 10 micrograms per deciliter (ug/dL), while the acceptable limit was halved to 5ug/dL by the Centers for Disease Control and Prevention in 2012 after decades of research showed there is no safe threshold for lead exposure. More than a thousand children tested for blood-lead levels between 5 and 9 ug/dL in 2013 in Baltimore, according to the Maryland Department of the Environment.

Lead paint can be absorbed through the skin, and even a small amount of dust from frequently used doors and windows is a risk without professional abatement. Exposure to larger, lethal doses of lead is mostly non-existent in the U.S. today, but ingesting even tiny amounts can have lifelong effects, and is particularly dangerous for children under age six. Speech delays, lack of impulse control, aggressive tendencies, ADHD and other learning disabilities have been associated with exposure to lead. While it’s impossible to draw relationships between lead paint and an individual’s behavior, what happens when a population is exposed to lead is pretty clear, and it’s not pretty.

Though Baltimore has had a long and toxic relationship with lead paint, the city was originally at the forefront of enacting legislation to limit exposure for children. In 1949, the Maryland legislature was the first to ban the use of lead paint in children’s toys, but the law was overturned after pressure from the lead industry. Baltimore was the first city to offer free blood-lead level testing under the watch of an enterprising health commissioner who also spent decades showing the damage it did to the city’s children. Johns Hopkins University, located in Baltimore, was the epicenter of knowledge on the effects of lead poisoning in the 1950s, years before it approved a notorious study that knowingly exposed children to paint and dust in an effort to find cheap abatement techniques, and ended in a class-action lawsuit.

In the book “Lead Wars,” David Rosner, a professor at Columbia University, and Gerard Markowitz, a professor at the City University of New York, cite internal documents from the lead industry and other sources to write a compelling history of industry manipulation of data to both lay the blame on parents and families for the crisis of lead poisoning, and to keep it in products through the 1970s. In reality, the authors argue, the federal government was aware of the many dangers posed by lead, and in bowing to pressure from industry, allowed millions of children to be poisoned.

Federal legislation finally banned the use of lead paint in 1978, but by then it was in homes all over the city, and Baltimore had begun what would be a steep economic decline, leaving an increasing number of children at risk for lead poisoning as the old housing stock deteriorated.

Though dramatic reductions in lead poisoning have been made over the last two decades, inner-city kids from low-income black families still bear the burden of this legacy.

A national survey conducted in 1998-1999 found that an equal percentage of black and white families lived in homes with federally recognized risk for lead exposure. A follow-up study in 2006, the most recent national survey on housing hazards, found that, while there had been a significant drop in the percentage of white families who lived in homes with a serious lead-based paint hazard, the percentage of black families had actually increased from the previous survey [page 36].

Ruth Ann Norton, the president and CEO of Green & Healthy Homes Initiative, a national organization based in Baltimore that works to eradicate childhood lead poisoning, said the city’s historic blind eye to enforcement of laws regulating dangerous homes, and lack of will for serious investment, has left people languishing in toxic housing. In some ways, she said, the recent successes in reduction are hurting the people still at risk.

“When we tell people we’ve had a 98 percent reduction, I sometimes get applause,” Norton said in phone interview. “But the rest of that sentence is that we still have 535,000 children a year being poisoned in the United States.”

Funding for lead abatement has been subject to the same political and economic push-and-pull as many social programs. Back in 1990, the Department of Health and Human Services planned to spend $33 billion to clean up homes around the country, but only a fraction of that has been spent. In 2013, amid cutbacks, Congress slashed funding for lead abatement from $23 million to $2 million before restoring it to $15 million in 2014. Just cleaning up Baltimore’s problem could easily cost that much.

Inez Robb bought her home in 1987, at a time when the city was planning to fix up Sandtown-Winchester. Her entire block was remodeled as part of a revitalization project, and the homes are safe from lead. Today, most of the units on the block are occupied, even as the number of vacancies in the neighborhood grows. She and her neighbors don’t like the way the community has been portrayed over the last couple of weeks (“If you didn’t know, you would think that everyone was impoverished and uneducated, and it was a neighborhood full of rentals,” she said), but she acknowledged that vacant lots, empty buildings and decaying structures are holding the neighborhood back. While some people question what good came of the revitalization money, Robb sees her block as proof that housing problems can be fixed. But there is much more to be done.

CLARIFICATION (May 7, 9:52 a.m.): This article has been updated to clarify remarks made by Ruth Ann Norton reflecting the fact that while enforcement of lead laws has historically been a problem in Baltimore, it has improved over the last 15 years.

Anna Maria Barry-Jester is a senior reporter at Kaiser Health News and California Healthline, and formerly a reporter for FiveThirtyEight.