How Chicago's Political Past Resulted in Disproportionate Lead Poisoning in Minority Children of the Present: A Review (Preprint)
Authors: Goodwin Glenn , Belok Todd , Bengio Moshe , Winners Brett , Fan Kevin , Garey Mitchell , Scumpia Alexander , Tortora Laura 
Published: May 2023

BACKGROUND

Chicago's lead problem has been shown to disproportionately affect populations of color and lower socioeconomic status (SES). The disproportionate effects on low-income areas and communities of color can be traced back to several key decisions in Chicago's history, outlined by the paper.

OBJECTIVE

While America’s lead toxicity problem has most famously been reported in Flint, Michigan, the lesser-known but nonetheless pervasive problem in Chicago, Illinois continues to have devastating effects on the community. This paper comprehensively explores the history of lead use, the key political turning points that lead to the disproportionate effect on minority populations and lower socioeconomic status (SES), reviews the toxicology and pathophysiology behind lead poisoning, and concludes with steps being done to improve the situation. Shedding light on this issue will better equip physicians to make swift diagnoses regarding lead exposure, leading to improved patient outcomes. By exploring the city's history in how this problem came about, readers will appreciate how future legislative actions could have similar downstream effects, and hopefully curtail them accordingly. One can improve the future by exploring the past, which is the essence of this paper.

METHODS

A search of the National Library of Medicine’s MEDLINE/PubMed as well as Google, and Google Scholar was performed with the goal of finding all articles relating to lead poisoning in Chicago, lead utilization, Chicago's municipal and political history, and lead physiology between May 2020- May 2023. Scientific studies and major news articles were examined. Additionally, several studies and textbooks were reviewed regarding the latest advancements in lead poisoning, with emphasis on pathophysiology.

RESULTS

The study identified several key political moves over the course of Chicago's history that's resulted in the disproportionate toxicity in minority populations and those of lower SES. Lead is more readily absorbed in the pediatric population. Additionally, prior regulations had published acceptable blood lead levels (BLLs) in children, but more recent evidence indicates a myriad of detrimental effects in BLLs below that cutoff. There is substantial evidence to suggest that there is no acceptable BLL.

CONCLUSIONS

Lead toxicity is generally improving nationally but there still exists considerable need for improvement. Lead has serious health and cognitive effects, and disproportionately affects low socioeconomic communities. Programs should be expanded to ensure that individuals living in communities most at risk of lead exposure have the means to both replace lead contaminated infrastructure, and to be able to supply these communities with affordable housing without risk of toxic exposure. From a physician and clinician standpoint, knowing the increased risk of lead poisoning in these populations should prompt earlier testing. Earlier recognition and diagnosis of lead poisoning will lead to greatly improved patient and societal outcomes.