Public health ROI: Study finds investing in lead poisoning prevention could reap millions in benefits

Childhood lead poisoning is one of those health risks that everyone has likely heard about, but many probably think it’s a problem of the past. However, a recent study reminds us that in just one state — Michigan — the effects of childhood lead poisoning cost about $330 million every year. And that’s a conservative estimate.

But estimating the cost of childhood lead poisoning wasn’t the only goal of the study, which was released earlier this week. Study author Tracy Swinburn, a research specialist at the University of Michigan Risk Science Center, wanted to know what kind of financial return residents could expect if state policymakers decided to invest in lead abatement (decreasing or removing lead risks in homes). Knowing that the majority of child lead exposure is related to lead-based paint in older housing stock, she and her colleagues estimated it would cost $600 million to remediate the 100,000 high-risk housing units in Michigan. That investment, they found, would pay for itself in as little as three to six years. In fact, 30 years down the road, the accumulated return on investment for the lead poisoning prevention tactic would grow be $10.50 for every $1 invested.

“If we can offset some of these (health and social) costs with quality lead abatement programs then we can make an economic case as well as a public health case,” Swinburn told me. “Lead isn’t very sexy. It doesn’t get as much attention as other new public health and environmental pollutant issues, so we hope this study will help. We think it’s an issue worthy of more attention.”

Childhood lead poisoning is linked with behavior and attention problems, academic difficulty, hearing problems, irreversible declines in IQ, brain and nervous system damage, and delayed growth and development. To conduct the Michigan study, Swinburn and colleagues considered four well-documented effects of lead exposure: increased health care, increased crime, increased need for special education and a decline in lifetime earnings.

In terms of health care costs, the study estimated immediate treatment, which includes diagnostic testing, nurse visits and therapy to treat heavy metal poisoning, at $280,000 annually, as well as lead-associated ADHD treatment at more than $18 million annually. Crime costs were estimated at $32 million annually in incarceration for lead-related juvenile crime and $73 million in lead-related adult crimes, which included costs to victims, legal proceedings, incarceration, and lost earnings for both perpetrator and victim. (For more on the association between lead and crime, see this study and this study.) Special education costs were estimated at $2.5 million, and lead-related loss of lifetime earnings was estimated at $206 million. Swinburn noted that the costs are conservative estimates and don’t account for all of the secondary impacts of lead exposure, such as the parent of a child with ADHD who has to regularly miss work and lose income.

The study found that the $600 million needed to address lead within 100,000 of the most at-risk homes in the state would accrue benefits of $230 million annually, totaling more than the initial investment in just three years. The study is the first to compare the impact of lead exposure in Michigan to the cost of lead abatement. With the prevention tactic making good economic sense, Swinburn concluded:

These economic returns on investment in lead abatement are all in addition to the value of the health and well-being of thousands of Michigan children, and their families, who experience the effects of lead exposure each year. Even without this benefit, on an economic basis alone, this assessment suggests that lead abatement is an investment worth considering.

Sadly, it’s not likely that Michigan policymakers will invest $600 million in lead abatement, Swinburn said. Still, she said the study can illustrate the great benefits of preventing lead exposure and help justify current investments in lead poisoning prevention. Swinburn also told me that it’s not an over-reach to think that lead poisoning prevention could contribute significantly toward narrowing health and social inequities.

“I would certainly like to think that it’s a great way to start tipping things toward better equality, especially in communities and neighborhoods facing a lot of challenges,” she said. “(Lead abatement) could help boost public health and quality of life. …It could be a promising way to help make progress.”

According to 2012 data from the Michigan Department of Community Health, nearly 70 percent of Michigan children are tested for lead exposure within the first years of life. And while overall numbers of child lead poisoning have dramatically declined, certain communities face disproportionate burdens — for instance, 10 ZIP code areas in Detroit were home to lead poisoning rates higher than 2 percent. Nationwide, 535,000 young children have blood lead levels high enough to put their health at serious risk. In fact, a 2009 study examining the national benefits of lead paint control concluded that each $1 invested resulted in a return of $17–$221 or an overall savings of $181 billion to $269 billion.

Swinburn hopes her study will help shine a light on childhood lead poisoning and the sound economic argument in favor of prevention.

“There are a lot of advocates working hard on this issue,” she said. “But it is an issue that doesn’t often get attention because people thinks it’s been dealt with already. We hope we can help put it back on the radar.”

The full study, “Economic Impacts of Lead Exposure and Remediation in Michigan,” is available here. To read our previous coverage about the economic argument for lead poisoning prevention in Detroit, read Celeste Monforton's post here.

Kim Krisberg is a freelance public health writer living in Austin, Texas, and has been writing about public health for more than a decade.


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How refreshing to read quantification of the social impact of lead poisoning. This is the data we need to advocate for change and required testing of children.

By CATHERINE C. BROOKS (not verified) on 16 Jun 2014 #permalink

Wouldn't it be something if policymakers responded appropriately to data on the social cost of public health hazards---especially those affecting children. Regrettably, far too many are only interested in the "costs to business" or "unfunded mandates to government agencies." As Kim points out, the ROI for lead-paint abatement is immense. If we invested in ridding the housing stock of lead paint, we'd eventually not have to needlestick children to see if they are poisoned. Eliminating the hazard would prevent children from having to be poked.