Children's Health:

Elevated Blood Lead Levels in Medicaid and Hispanic Children

HEHS-98-169R: Published: May 18, 1998. Publicly Released: Jun 2, 1998.

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Pursuant to a congressional request, GAO provided additional information on its work on the prevalence of elevated blood lead levels associated with harmful health effects in children aged 1 through 5 and particularly in children who receive their health care coverage through Medicaid, focusing on: (1) Medicaid children aged 1 through 2; (2) Hispanic children aged 1 through 5 compared with other children; and (3) immigrant children aged 1 through 5.

GAO noted that: (1) nearly 10 percent of Medicaid children aged 1 through 2 had elevated levels of lead in their blood; (2) this was more than double the mean prevalence rate for non-Medicaid 1- and 2-year-olds and slightly higher than the rate for the larger group of Medicaid children aged 1 through 5; (3) although Medicaid policy requires that early and periodic screening, treatment, and diagnostic services include lead screening for all Medicaid children aged 1 through 2, only about 21 percent of Medicaid children in that age group had been screened; (4) for nearly 80 percent of the Medicaid children aged 1 and 2 identified through survey blood tests as having elevated blood levels, this was the first screening for lead that they had ever received; (5) projected to the entire Medicaid population of 1- and 2-year-olds, this represents about 206,000 of the estimated 262,000 Medicaid children aged 1 through 2 with elevated blood levels who have not been screened; (6) the prevalence of elevated blood lead levels in Hispanic children aged 1 through 5 was 4.8 percent, compared with 11.2 percent for black non-Hispanic children and 2.3 percent for white non-Hispanic children; (7) when comparing the risk of elevated blood levels by poverty status and age of housing, GAO found differences in how Hispanic, black, and white children were affected; (8) in particular, while residing in older housing was associated with an increased risk for children in each racial and ethnic group, poverty status was associated with an increased risk among black and white children but not Hispanic children; (9) the data from the Department of Health and Human Service's survey are not sufficiently detailed to determine the specific reasons why these differences exist; (10) however, the results add support to the concern that lead exposures may vary between different racial and ethnic groups; and (11) a statistically reliable estimate of the number of immigrant children with elevated blood levels could not be developed, because the survey sampled a relatively small number of children who were born outside the United States.

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