By Laura Wilson
In the last several years, Detroit’s demolition program has received media attention for its potential association with increased blood lead levels in Detroit children. The demolition program, which began in 2014, has resulted in over 14,300 demolitions. The percentage of elevated blood lead levels (EBLL) in children has steadily decreased in Detroit and statewide. However, 2015 marked the first increase in this percentage in Detroit in decades, from6.5 percent to 7.9 percent. In 2016, the percentage increased again to 8.8 percent.
The topic resurfaced recently with a public feud between Dr. Abdul El-Sayed, the former director of the Health Department now running for governor, and Mayor Mike Duggan revolving around whether the city appropriately heeded Dr. El-Sayed’s warnings about demolitions and childhood lead exposure a few years ago. There is little evidence to know what occurred between Dr. El-Sayed and Mayor Duggan, but the conflictraises important questions around the prioritization and complexity of public health efforts.
The hazards of urban blight are well-known. Unfortunately, the renovation and demolition of older buildings brings its own environmental health hazards, as dust is kicked up into the air from homes that may contain lead or other harmful chemicals. This can be problematic in cities like Detroit, where 93 percent of homes were built before the banning of lead paint in 1978. As a result, such an expensive large-scale demolition program becomes a challenging balance act of efficiently removing blight while also trying to ensure hazardous exposures are minimized through appropriate protocol, contractor compliance, and educational programs.
Since the beginning of the program, the city has taken steps to mitigate the hazards of demolitions. In 2016, though, the Detroit Health Department, led by Dr. El-Sayed, conducted a study to evaluate the association between demolitions and children blood lead levels. They found that the odds of blood lead level elevation in children increased by 20 percent if they lived within 400 feet of a single demolition and 38 percent if there were two or more demolitions. This relationship was specific to summer months when kids are out of school and spending more time in their homes and neighborhoods. The researchers concluded that demolitions may have contributed to about 2.4 percent of cases of EBLL in Detroit, which would account for the recent uptick in EBLL percentages.
In light of these findings, Dr. El-Sayed convened aDemolitions and Health Task Force. In early 2017, the taskforce met four times to develop recommendations for the city,prior to Dr. El-Sayed’s gubernatorial run. In the last year, the city has incorporated a few of the taskforce’s recommendations, including protocol improvements and a texting service program launched in November 2017 that residents can enroll in to be notified of nearby demolitions.
This year, the city is taking a more proactive, preventive approach to lead paint exposure. A new Interagency Lead Poisoning Prevention Task Force was announced in March that is focused on exposure resulting from lead paint in the homes of children. As part of its $1.25 million pilot program, the city is halting summer demolitions in the fivezip codes with the greatest percentage of EBLL (48202, 48204, 48206, 48213, and 48214) where they will conductdoor-to-door outreach and educational programs, specifically targeting the homes of children and pregnant women.
Despite this promising new program, large demolition projects include a lot of players and a lot of moving parts. Detroit, like other cities, has a complicated history with management of demolition and ensuring compliance among contractors. For this reason, it is important for both residents and population health researchers to be watchful of what is being prioritized and what is being compromised in even the most well-intentioned efforts.
Laura Wilson is a Masters of Public Health Candidate at the University of Michigan School of Public Health. She is serving a Health and Housing internship at Authority Health.
|Percentage of children under age 6 with elevated blood lead levels|
|Data from Michigan DHHS Childhood Lead Poisoning Prevention Program Annual Reports
Elevated blood lead levels: > 5 µg/dL as defined by the CDC.
Figure 1: Blood Lead Levels by ZIP Code
Figure 2: Demolitions by City Council Zone
Figure 3: Demolitions by Location