Blood Lead Testing Among Medically Underserved and Socially Vulnerable Children in the United States 2012-2017

An intense appetite for reforming and transforming child welfare services in the United States is yielding many new initiatives. Vulnerable children and families who become involved with child welfare clearly deserve higher quality and more effective services. New policies, programs, and practices should be built on sound evidence. Reforms based on misunderstandings about what the current data show may ultimately harm families. This review highlights 10 commonly held misconceptions which we assert are inconsistent with the best available contemporary evidence. Implications for better alignment of evidence and reform are discussed.

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Anxiety and depression among racial/ethnic minorities and impoverished women testing positive for BRCA1/2 mutations in the United States

10.21203/rs.3.rs-887893/v1 ◽

2021 ◽

Author(s):

Kate E Dibble ◽

Avonne E Connor

Keyword(s):

United States ◽

Depressive Symptoms ◽

Hispanic Women ◽

Ethnic Disparities ◽

The United States ◽

Medically Underserved ◽

Increased Risk ◽

Poverty Status ◽

Race Ethnicity ◽

Severe Anxiety

Abstract PurposeTo outline the association between race/ethnicity and poverty status and perceived anxiety and depressive symptomologies among BRCA1/2-positive United States (US) women to identify high-risk groups of mutation carriers from medically underserved backgrounds.Methods211 BRCA1/2-positive women from medically underserved backgrounds were recruited through national Facebook support groups and completed an online survey. Adjusted odds ratios (aOR) and 95% confidence intervals (CIs) were estimated using multivariable logistic regression for associations between race/ethnicity, poverty status, and self-reported moderate-to-severe anxiety and depressive symptoms.ResultsWomen ranged in age (18–75, M = 39.5, SD = 10.6). Most women were non-Hispanic white (NHW) (67.2%) and were not impoverished (76.7%). Hispanic women with BRCA1/2 mutations were 6.11 times more likely to report moderate-to-severe anxiety (95% CI, 2.16–17.2, p = 0.001) and 4.28 times more likely to report moderate-to-severe depressive symptoms (95% CI, 1.98–9.60, p = < 0.001) than NHW women with BRCA1/2. Associations were not statistically significant among other minority women. Women living in poverty were significantly less likely to report moderate-to-severe depressive symptoms than women not in poverty (aOR, 0.42, 95% CI, 0.18–0.95, p = 0.04).ConclusionHispanic women with BRCA1/2 mutations from medically underserved backgrounds are an important population at increased risk for worse anxiety and depressive symptomology. Our findings among Hispanic women with BRCA1/2 mutations add to the growing body of literature focused on ethnic disparities experienced across the cancer control continuum.

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Cognitive and Behavioral Manifestations of Lead

Cognitive and Behavioral Abnormalities of Pediatric Diseases ◽

10.1093/oso/9780195342680.003.0071 ◽

2010 ◽

Author(s):

Hugh L. Evans

Keyword(s):

United States ◽

Blood Lead ◽

The United States ◽

Conduct Disorders ◽

Lead Content ◽

Blood Lead Levels ◽

Toxic Exposure ◽

Postnatal Exposure ◽

Household Dust ◽

Lead Levels

The link between exposure to lead and children’s cognitive problems was implied in the earliest medical reports of frank lead poisoning of young children in Australia in the 1800s (Lin-Fu 1992). Children with acute severe toxicity of lead (Pb) are now rarely seen in the United States. However, millions of children may have subclinical neurobehavioral disorders associated with chronic low-level exposure to lead, representing a major public health concern (Bellinger 2008a). Lead is a nonessential metal that is recognized as a source of toxic exposure, with the developing nervous system particularly vulnerable. Because of this, U.S. regulations limiting the lead content of gasoline and household paint have led to a gradual reduction of the average blood lead concentration of Americans over the last three decades. Average blood lead levels of children in the United States dropped an estimated 78% from 1976 to 1991 (Brody et al. 1994; Caldwell et al. 2009). Despite these reductions in exposure to lead, new advances in research techniques have documented harmful consequences associated with lower blood lead levels. This raises the possibility that there is no threshold for occurrence of lead-induced toxicity. Bellinger (2008a) refers to “the silent pandemic of neurodevelopmental disorders resulting from children’s continuing exposure to low levels of lead.” The developing brain may be more sensitive to exposure to lead than the adult. Since the pioneering work of Needleman and colleagues (1979), a large scientific literature has documented the deleterious effects of pre- and neonatal exposure to lead. Decrements in IQ scores have proven to be among the most sensitive and consistent consequences of a child’s exposure to lead, but other cognitive and behavioral changes have been described as well, including attention-deficit hyperactivity disorder (ADHD). Among the important current sources of children’s exposure to lead is household dust (Dixon et al. 2009) the lead content in old water pipes, batteries, and from contamination by numerous industrial processes. Pre and postnatal exposure to cigarette smoke is a cofactor with lead exposure in children’s conduct disorders (Braun et al. 2008). Diagnosis of lead-induced disorders involves the determination of exposure to lead and the atomic absorption assay of lead in whole blood.

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Lost Kids: Vulnerable Children and Youth in Twentieth-Century Canada and the United States (review)

The Journal of the History of Childhood and Youth ◽

10.1353/hcy.2012.0002 ◽

2012 ◽

Vol 5 (1) ◽

pp. 166-168

Author(s):

Myra Rutherdale

Keyword(s):

United States ◽

Twentieth Century ◽

The United States ◽

Children And Youth ◽

Vulnerable Children

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Designing strategies for eradication of Helicobacter pylori based on prevalence patterns of infection and antibiotic resistance in a low‐income, medically underserved community in the United States

Helicobacter ◽

10.1111/hel.12769 ◽

2020 ◽

Author(s):

Harpreet Singh ◽

Hansol Chung ◽

Imad Awan ◽

Anjali Mone ◽

Robert Cooper ◽

...

Keyword(s):

United States ◽

Helicobacter Pylori ◽

Antibiotic Resistance ◽

Low Income ◽

The United States ◽

Medically Underserved ◽

Underserved Community

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Implementation of CDC Refugee Blood Lead Testing Guidelines in Minnesota

Public Health Reports ◽

10.1177/003335490812300203 ◽

2008 ◽

Vol 123 (2) ◽

pp. 111-116 ◽

Cited By ~ 5

Author(s):

Erik W. Zabel ◽

Mary Ellen Smith ◽

Ann O'Fallon

Keyword(s):

Blood Lead ◽

Lead Testing ◽

Blood Lead Testing

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Demographic and Socioeconomic Factors Associated with Blood Lead Levels among Mexican-American Children and Adolescents in the United States

Public Health Reports ◽

10.1177/003335490512000412 ◽

2005 ◽

Vol 120 (4) ◽

pp. 448-454 ◽

Cited By ~ 28

Author(s):

Leo S. Morales ◽

Peter Gutierrez ◽

Jose J. Escarce

Keyword(s):

United States ◽

Drinking Water ◽

Mexican American ◽

Family Income ◽

Blood Lead ◽

The United States ◽

Blood Lead Levels ◽

Mexican American Youth ◽

Lead Levels ◽

American Children

Objective. This study was designed to assess demographic and socioeconomic differences in blood lead levels (BLLs) among Mexican-American children and adolescents in the United States. Methods. We analyzed data from the Third National Health and Nutrition Examination Survey, 1988–1994, for 3,325 Mexican-American youth aged 1 to 17 years. The main study outcome measures included a continuous measure (μg/dL) of BLL and two dichotomous measures of BLL (⩾5 μg/dL and ⩾10 μg/dL). Results. The mean BLL among Mexican-American children in the United States was 3.45 μg/dL (95% confidence interval [CI] 3.07, 3.87); 20% had BLL ⩾5 μg/dL (95% CI 15%, 24%); and 4% had BLL ⩾10 μg/dL (95% CI 2%, 6%). In multivariate analyses, gender, age, generational status, home language, family income, education of head of household, age of housing, and source of drinking water were statistically significant independent predictors ( p<0.05) of having higher BLLs and of having BLL ⩾5 μg/dL, whereas age, family income, housing age, and source of drinking water were significant predictors ( p<0.05) of having BLL ⩾10 μg/dL. Conclusions. Significant differences in the risk of having elevated BLLs exist among Mexican-American youth. Those at greatest risk should be prioritized for lead screening and lead exposure abatement interventions.

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