Behavioral and Environmental Explanations of Elevated Blood Lead Levels in Immigrant Children and Children of Immigrants
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ORIGINAL PAPER
Behavioral and Environmental Explanations of Elevated Blood Lead Levels in Immigrant Children and Children of Immigrants Stan A. Kaplowitz1 • Harry Perlstadt1 • James D. Dziura2 • Lori A. Post2
Ó Springer Science+Business Media New York 2015
Abstract Immigrant/refugee children sometimes have substantially higher blood lead levels (BLLs) than US-born children in similar environments. We try to understand why, by exploring the relationship between immigration status of mother and the BLLs of US-born children. We compared BLLs of children born in Michigan to immigrant and non-immigrant parents, using the Michigan database of BLL tests for 2002–2005, which includes the child’s race, Medicaid eligibility and address. We added census data on socio-demographic/housing characteristics of the child’s block group, and information about parents. Low parental education, single parent households, mothers’ smoking and drinking, all increase the child’s BLL. However, immigrant parents had fewer characteristics associated with high BLL than US born parents, and their children had lower BLLs than children of US-born mothers. Our findings suggest that prior findings of higher BLLs among immigrant/refugee children probably result from them starting life in highlead environments. Keywords Lead poisoning Blood lead level Immigrants Health behaviors Family structure Abbreviations BLL Blood lead level EBLL Elevated blood lead level & Stan A. Kaplowitz [email protected] 1
Department of Sociology, Michigan State University, Rm 418B Berkey Hall, 509 E Circle Drive, East Lansing, MI 48824-1111, USA
2
Department of Emergency Medicine, Yale University, New Haven, CT, USA
lg CI Coeff. dL HLM Ln MDCH SD SE
Microgram Confidence interval Coefficient Deciliter Hierarchical linear modeling Logarithm to base e Michigan Department of Community Health Standard deviation Standard error
Background Much research (e.g. [1–4]) documents the characteristics of individuals and neighborhoods that are associated with Elevated Blood Lead Levels (EBLLs). Some of this literature specifies causal mechanisms for these associations. These include environmental factors such as lead paint in old and poorly maintained housing [3, 5–7]. They also include social/behavioral risk factors, such as use of folk medicines and cosmetics containing lead [8–12]. Several recent studies [13–16] found that immigrant and refugee children had substantially higher risks of EBLL compared with children born in the USA, even in similar high-risk environments. One study [14] found refugees from Africa to have especially high levels of BLL. These investigations revealed several risk factors for lead poisoning: living in old homes, the presence of lead hazards, behaviors that could increase the chance of ingesting lead, a lack of awareness of the dangers of lead, and evidence of chronic and acute malnutrition. One study [17] found that refugee children acquired EBLL after arriving in the US. However, another study
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J Immigrant Minority Health
[18] found t
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