PROVIDENCE – There is no surprise to the fact that lead is a persistent, proven menace to the well being of Rhode Island’s children.

Lead poisoning is one of the key environmental metrics followed by Rhode Island Kids Count in its annual briefing book measuring the health and well-being of children that was released on Monday, April 13, one that shows continued improvement – but without a clear explanation why.

There is little if any shock value to the fact that elevated levels of lead in school children in Rhode Island and the nation have been found to have prolonged and deleterious effects on educational achievement and future economic attainment – in testing scores, in school readiness, in reading capability, in higher costs for special education interventions, and in school suspensions and in continued behavioral problems.

We have become inured to the threats to our children’s survival, much like the frogs that swim in gradually heated water and don’t leap out.

What was revelatory was the recent discussion led by Anna Aizer, associate professor of Economics at Brown University at The Population Studies and Training Center, who detailed some of her research on the deleterious effects of lead in Rhode Island’s children from the perspective of a health and labor economist at the Meeting Street School on Friday, April 10.

In particular, Aizer’s research focused on human capital – that in Rhode Island, “there was a whole subgroup for whom [human capital] is not being developed as it should be,” she explained, and as a result, “the economy is going to suffer.”

Looking at two cohorts, the children born in Rhode Island between 1997 and 1998, and again in 2004, Aizer documented in her research the disparity between white and black children with elevated lead exposure.

The room at Meeting Street was filled with about 40 researchers, community advocates, housing, and health specialists from across Rhode Island, who, at Aizer’s urging, interrupted her presentations with frequent questions.

Stubborn facts
Aizer’s economic research tracked the fact that as a result of the new laws, which demanded that houses be deemed lead-safe and lead-free, the incidence of lead poisoning in Rhode Island fell dramatically in the six years between 1998 and 2004, in direct correlation to the number of homes – more than 40,000 – that received the lead-safe and lead-free certificates. But despite those gains, the gap between white and black children remained a constant – with blacks at higher risk.

Despite the decline in the volume of children with exposure to lead, Aizer cautioned that researchers have begun to understand that even “very low levels of exposure to lead can have a deleterious effect; you can take that as a given.”

The basic reasons for the disparity in risk was not a puzzle, according to Aizer. African American children were much more likely to live in older housing, built before 1945, when the concentration of lead in paint was higher, or before 1978, when lead paint was banned. Some 83 percent of black children in Rhode Island – as well as poorer children – are much more likely to live in those older homes.

The greatest concentration of such older homes is in Providence, with 50 percent of its homes built before 1978, and Rhode Island’s black population is highly concentrated in Providence, according to Aizer.

The benefits of the new law
Aizer noted that, in what appeared to be direct correlation to a new Rhode Island law passed in 1977, the increase in lead-free and lead-safe certifications by the R.I. Department of Health and R.I. Housing went from 312 in 1997 to 41,000 in 2004, and there was a closing of the gap in the racial and income disparities around the incidence of lead poisoning.

“But the gap is persistent, and more needs to be done,” Aizer said, noting that only a small percentage of the homes in Rhode Island – around 5 percent – have been certified.

Unmasking the confounding aspects
In her research, Aizer also was able to address the problem that lead levels are often correlated with all different kinds of disadvantages, called a confounding factor. Her research showed distinctly that as lead levels increase, the reading scores go down, across all other factors.

Further, those effects don’t fade over time, and that 8th grade test scores are also problematic.

Continuing work
After her talk, Aizer talked with ConvergenceRI in a telephone interview, stressing the importance of additional research that was needed on lead – linking more economic meaningful outcomes, such as educational attainment and criminal justice activity.

“I couldn’t agree with you more,” Aizer said, responding to ConvergenceRI’s question about research studying the links between other kinds of behavior as children with lead poisoning as they become adults. “Research needs to establish the relationship between very early exposure to lead and later, arguably, more important outcomes.

A new research grant award is pending to look at crime data and outcomes with respect to criminal behavior and lead exposure, Aizer said, which would be a first in that respect.

The next step, Aizer continued, will be to look at the cohort links with labor market outcomes.

Studies of other toxics in the environment
Aizer’s work on the economic impact of lead poisoning may be joined shortly by new studies that look at other environmental toxins, such as mercury.

In looking at toxic substances such as mercury, Aizer said, it would be important to identify how toxic they are, how prevalent they are, and the ease in measuring and detecting them.

“Mercury is the next obvious choice,” she said.

Aizer also pointed to other studies underway, including a national study that was looking into neurotoxins that babies are exposed to in the first 1,000 days. Another study, a collaborative research effort by Brown University researchers and Women & Infants Hospital is focused on better understanding obesity by looking at all of the substances found in newborns.

Opening day
The pending new research focus on mercury identified by Aizer added a bit of irony to the headline in The Providence Journal that read: “DEM warns anglers not to risk exposure to cold water.”

The R.I. Department of Health warns: “avoid eating bass, pike, tilefish, king mackeral fish and pickerel. Swordfish, shark, bluefish, striped bass and freshwater fish [with the exception of stocked trout] that are caught in Rhode Island should also not be eaten.” The warning continues: “Although mercury levels in bluefish and striped based are low, the Food and Drug Administration cautions against eating these fish because of the presence of other contaminants known as polychlorinated biphenyls, or PCBs. Limit black crappie and eel consumption to one meal per month.”

The warning continues: “Take special precautions if you are pregnant or may become pregnant,” given the effects of mercury exposure on some fetuses…”