The more things change the more they stay the same: Persistent spatial inequity in pediatric lead poisoning in Chicago

Lead poisoning remains a major environmental health threat and a persistent source of health disparities in the United States, particularly in large cities such as Chicago. However, little research has considered the rapidly changing urban environment, due to processes like gentrification, when examining risk factors for pediatric lead poisoning. In this retrospective study, spatio-temporal analysis and spatial regression models have been applied to examine the distribution of elevated blood lead levels (EBLL) in children in 77 Chicago community areas annually from 1999 to 2013. Sociodemographic and built environment variables are calculated for each year of the study to account for changing urban community characteristics. Results show that while the overall rate of children with EBLL decreased greatly from 1999 to 2013, inequality between areas still persists. Hotspots of EBLL persist over time in communities in the South and Southwest Side. Spatial regression results indicate that, over the duration of the study period, higher rates of EBLL are frequently associated with higher minority populations, older house age in the community area and greater amounts of renter occupied houses. However, our closer examination on several representative communities indicate that different community development trajectories and renovation histories are associated with varying EBLL declines. Taking a dynamic perspective when understanding EBLL over time can highlight places where improvements in EBLL are the result of population displacement versus places where improvements in EBLL are related to changing housing stock, as well as areas of a city where lead poisoning prevention efforts can have the greatest impact.