Lead Poisoning Prevention in Texas Communities Through the CHER Program
By Stephanie Zeller
Though many of us may consider lead poisoning a problem of the ‘50’s, according to recent studies, it remains an important public health issue. Lead poisoning is particularly harmful to developing brains and is exceptionally potent in children under the age of six. Texas has over 2.5 million children under six, and of those on Medicaid insurance, only 13% have been tested for lead in their blood (compared to the estimated US average of 41%).
Exposure to lead in the early years of a child’s life can lead to markedly lower intelligence, attention problems, damage to the nervous system, low academic achievement, and hearing and speech problems. The good news is blood lead poisoning has a simple remedy, and it begins with a test that takes less than 15 seconds to administer. So, why is the Texas so far behind, and how can we begin to catch up?
Anjum Khurshid, MD, PhD, Director of Data Integration and Assistant Professor of Population Health at the Dell Medical School, along with colleagues Brad Love, PhD, Associate Director at the Center for Health Communication and Associate Professor at the Moody College of Communication, and Kate Pounders, PhD and Assistant Professor at the Moody College, are working to answer this question through a unique interdisciplinary research model. The team hopes to develop effective strategies to engage healthcare providers and community health stakeholders in childhood lead poisoning prevention as part of a funded grant with the Center for Health Communication.
Severity and Impact
Lead poisoning can largely be attributed to paint in older homes, but in fewer cases, can also come from soil or water sources.
“Since almost half the housing in Texas is from a time when lead was actively used in paints, the potential for exposure is pretty high,” said Dr. Khurshid. Fortunately, Khurshid acknowledged that prevention is straightforward: identifying and then removing the source of lead from the child’s environment is all that is necessary.
His team believes that the fundamental issue at hand is one of communication rather than of technical healthcare.
“This is somewhat of an awareness issue -- pediatricians just don’t think to test for it,” Said Dr. Love. “But a lot of this is system based. How do you prioritize what to test for at a one-year well-child visit? There are other things that can seem a lot more pressing in terms of susceptibility.” The Centers for Disease Control and Prevention mandates nationwide screening for lead poisoning, yet only 11 U.S. states and Washington D.C. are required by law to test children for lead poisoning. There remains a fundamental disconnect between healthcare providers and their patients when it comes to actually testing children.
Lead poisoning has a potent social impact beyond individual children.
“If there’s a community that has lead in the pipes, every kid in that area is now dealing with some severity of it,” said Love. “They’re not thriving. We can guarantee that.” Accordingly, this communication challenge is not limited to just healthcare providers, but to the community at large.
Methods: Prevention, Awareness, and Communication
With the support of the CHER grant, the team hopes to identify avenues of communication that will raise awareness of the dangers of lead poisoning among pediatricians and parents alike, and eventually, increase instances of screening around the state. The goals of the research project are two-fold: (1) to employ numerous methods of data gathering and targeted campaigning, and (2) careful evaluation and measurement of the specific effects of campaign efforts.
The initial exploratory research will focus on discovering the most effective strategies to persuade pediatricians to test their patients for lead poisoning. Interviews with Travis County pediatricians and community stakeholders will be the primary method of data gathering. This qualitative data will be used to inform the creation of various communications campaigns, including social media and educational components. Finally, a follow-up survey of the local pediatricians exposed to the message will provide feedback on the campaign’s effectiveness.
“What we would like to discover through this process is, what are the best media to communicate with families and providers, what is the best messaging or language that can engage and, at the same time, educate people effectively, and then, how can we measure the impact of that?” said Khurshid, whose expertise in data analysis will encourage a focus on quantifiable results. “We not only want to think we have made a difference, but also be able to demonstrate that.”
As the project moves forward, the team hopes their research will go beyond lead poisoning alone. In the past, healthcare has been primarily focused on treatment rather than prevention, but things are beginning to change.
“If we can help orient clinical environments, through blood lead testing, to be more preventative and have some of those conversations in the clinic as a whole, then hopefully we can head off more impactful issues that are the top causes of mortality throughout most of America,” said Love.
As the flow of revenue and billing shifts toward prevention rather than treatment alone, communication efforts can shift as well. The team hopes that their research on lead poisoning prevention can be a significant player during this change.
“If we can set up some of the norms and help reorient some thinking, starting with lead poisoning,” says Love, “hopefully we can produce some better numbers on other issues too.”
The Center for Health Communication is as a joint academic center of both Moody College of Communication and Dell Medical School at the University of Texas at Austin. It was established in 2014 to bring together researchers and experts from diverse backgrounds of health communication into one organizational unit where they can collaborate, share ideas and innovations, and advance their scholarship. It is an interdisciplinary group whose goal lies in improving health through evidence-based communication research, thereby advancing the health of people and populations.
About the Author
Stephanie Zeller is a rising senior at the University of Texas at Austin studying Public Relations in the Moody College of Communication, Studio Art in Fine Arts, and McCombs School of Business foundations certificate. Stephanie has a special interest in health, as well as in astronomy and biology and will begin to marry her varied interests during a public affairs internship with NASA in the summer of 2018. She hopes to build a career around writing and creating visual works to bridge what she views as an unnecessary gap between the arts and the sciences.