April 24: Lead Screening and Testing Commission, City of Cleveland
Covered by Documenter Lori Ingram (notes)
An effort to improve lead testing of young children is starting to turn up new data points on who is and isn’t getting screened in Cleveland.
That includes an estimate that one in five Cleveland children on Medicaid didn’t interact with any health care system at all by age two in 2024 – presenting a significant challenge to getting them screened for lead.
“These are kids who have not showed up at any of the health systems, federally qualified health centers, private practices in Greater Cleveland,” said Chris Mundorf, chief strategy officer at Better Health Partnership, a nonprofit health improvement collaborative.
Better Health Partnership received a $1 million grant from the Lead Safe Cleveland Coalition in January to increase lead testing in the city. The effort comes after the blood lead testing rate amongst children aged one to five in Cleveland hit a seven-year low in 2023. It increased slightly in 2024.
At Cleveland’s April 24 Lead Screening and Testing Commission, the nonprofit laid out their goals, timeline and some preliminary data that will help them improve the city’s lead testing rate.
Goals and timeline for lead testing project
Better Health Partnership has three goals: to get every Cleveland child tested for lead poisoning, to create a trusted source for education about lead and to connect children with high blood lead levels to the health department.
The organization is currently in the contracting and planning stages for how to accomplish these, PJ Kimmel, a project manager at Better Health Partnership, said during the meeting. In June, it will share more specifics with the group’s steering committee on how it will reach the goals.
Kimmel said possible strategies to increase testing rates include community screening and adding lead testing systems to locations where patients are already seeking medical care.
Better Health Partnership plans to begin implementing its program in August.
Early data on Cleveland lead testing rates
Better Health Partnership is working to synthesize lead testing data to better understand why some children are not getting screened.
The challenge is that the city lacks a reliable number of the total children living in Cleveland, said Mundorf, making it difficult to say what percentage of all children received a lead test.
So data must instead look at specific slices of the population – for example, kids who saw a doctor. Better Health Partnership shared some key statistics about children who turned two in 2024:
- 81% who visited a primary care physician were tested for lead
- 73% of those who had a healthcare interaction were tested for lead
Federal data about children on Medicaid allowed even more specifics. Of the Cleveland children on Medicaid who turned two in 2024:
- 51% had a lead test on record
- 19% had a well-care visit in 2024 but no lead test
- 10% had a sick visit in 2024 but no lead test
- 20% had no health system interaction in 2024
The kids who visited the doctor for a well-child visit but didn’t get tested are the “real missed opportunities,” Mundorf said.
“They were seen in a situation where they should have been tested and they weren’t tested,” Mundorf said. “So that’s really our core problem we want to address.”
But the data also had experts questioning how to get one in five young kids on Medicaid into a doctor’s office at all.
“That’s problem number one: understanding … what’s keeping them from getting engaged with healthcare?” Mundorf said.
Mundorf said Better Health Partnership is following up on the data to ensure these kids don’t see doctors in other metropolitan areas or have the wrong address recorded.
Mundorf also found that children who received health care within the city of Cleveland were more likely to get screened for lead than those who received it outside the city. That’s because Cleveland-based practices are much more likely to be aware of the dangers of lead, he said.
“What’s fascinating is a lot of kids in Cleveland don’t go to practices in Cleveland,” Mundorf said. “They go to where their parents work, or where their grandparents live, or all sorts of other reasons. … With those practices, they’re much, much less likely to be tested in these situations.”
发表回复