By Christina Fernández-Morrow, Hola Iowa
In 2023, the Iowa Department of Health and Human Services (HHS) Childhood Lead Poisoning Prevention Program (CLPPP) analyzed results focused on 1- and 2-year-olds exposed to lead poisoning. Lead is highly toxic and can cause developmental delays, learning difficulties, headaches and other symptoms. Even small amounts of lead can be dangerous to a child. HHS collected data from 2 focus groups in the Latino community in Sioux City; one made up of families and the other of housing sector professionals. They chose Woodbury County because data showed 1- and 2-year-old Latino children tested with higher than normal lead in their blood and are tested less than other children, which means they face a higher risk for lead poisoning. HHS sees this as a double burden risk for lead poisoning. Kevin Officer, manager of HHS’s Childhood Lead Poisoning Prevention Program, along with the University of Iowa Institute of Public Health Practice, Research and Policy, led the efforts. “The purpose of the focus groups was for the childhood lead program to gain a better understanding of the double burden risks faced by these populations. Our goal is to empower communities to take charge in reversing the trends we are seeing in the data; create an awareness of the issues and educate communities on steps they can take to begin to address the health impacts lead poisoning can have on their children and their future potential.”
Facilitators asked the families about lead poisoning, testing, and where they turn for trusted health information. Housing professionals were asked about state, county and city housing regulations, certification practices, challenges in maintaining rental properties, and where they accessed public health information. When it comes to the double burden risks, Officer sees a trend in certain communities. “Analysis of the program’s blood lead testing data revealed that certain populations of children were more disproportionately impacted by the double burden risk of lead poisoning. Those populations in Iowa included Latino, Black/African American, and low-income children. We wanted to focus our efforts on Latinos in Woodbury County, Black/African American children in Scott County, and low-income children in Lee County. There are other counties in Iowa with these populations that are experiencing a double burden risk of lead poisoning also, but not at the rate we were seeing them in these three counties.”
Results in the HHS CLPPP report showed that, “When discussing experiences with medical providers, half of the participants noted a distrust of medical providers in the area.” Families trusted health information from the radio and social media more than healthcare professionals. “Many participants noted that they did not feel as if they were being taken seriously, had a difficult time communicating with providers, and many did not receive proper care, resulting in needing to treat with home remedies or having to travel out of the state or out of the country to Mexico for care.”
When it came to lead poisoning, families stated that medical practitioners did not provide information. They were unaware of the risks of lead poisoning and the importance of testing. Once informed, they were willing to have their children tested, highlighting the importance of information from a trusted source. This lack of information was shared among the housing professionals. The report found that, “Participants noted in their shared experiences with distrust of providers that the services they receive feel lacking due to miscommunication between providers and patients.” In other words, not enough care is taken to ensure there are adequate one-on-one conversations in the language patients prefer. This shows how ineffective translation and communication services in healthcare create skepticism and doubt. Because of this, families turn to social media, namely Spanish-language reels addressing health issues. Their phones become lifelines to information in place of the Iowa HHS website or online public health resources. Families indicated that, “the ideal way to learn is for caregivers to convene in a safe environment where they can have conversations.”
The lack of education about lead poisoning spans wider than family households. Neither group knew the importance of lead testing and lead prevention extends to daycares and schools. Housing professionals suggested that Iowa HHS provide them with a lead-specific checklist in Spanish and English to educate families on what to look for and how to handle lead paint. The focus group agreed there should be lead testing training and certification for qualified contractors to work on homes built before 1979 that are more likely to contain lead paint and require a lead certified contractor.
The most glaring outcome of the study found that local public health needs partnerships with Latino-serving organizations to help educate families on the dangers of lead poisoning, in addition to creating social media messages and videos on lead poisoning prevention in Spanish. Partnering with trusted local agencies like the Mary J Treglia Community House, Unity in Action, religious institutions, and highly attended community events throughout Woodbury County is critical in gaining trust, as is offering Spanish certification courses in Spanish for housing contractors who can share the information with their clients. These recommendations should result in greater knowledge about lead poisoning, increased testing rates, lower blood lead levels, and safer housing options for Latino families. In order for HHS to significantly lower the number of Latino children with lead poisoning, it will require a partnership between public health offices, local Latino-serving agencies, and the healthcare community using communication vehicles Latinos trust.
For more information about the study, or lead poisoning, visit:
Iowa Childhood Lead Poisoning Prevention Program: https://hhs.iowa.gov/programs/programs-and-services/childhood-lead-poisoning-prevention-program
Center for Disease Control and Prevention (CDC): https://www.cdc.gov/lead-prevention/es/site.html
US Environmental Protection Agency (EPA): https://www.epa.gov/lead/proteja-su-familia-contra-el-plomo-en-el-hogar
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