Purpose: The Hawaii Childhood Lead Poisoning Prevention Program (HI-CLPPP) will (a) improve blood lead screening test rates especially among the highest risk populations; (b) maintain and improve the surveillance system by working with laboratories and healthcare providers to improve the collection of sociodemographic and geographic risk factors from blood lead testing data to better identify the highest risk populations and improve health equity; and (c) collaborate closely with healthcare and service providers to ensure a comprehensive system of follow-up for children with elevated blood lead level (EBLL) that efficiently connects them with recommended services and tracks their progress.Background: Lead-based paint was banned for residential use in 1978. Over 54% of Hawaii?s housing and 61% of Honolulu?s housing were built before 1980. Hawaii?s warm and humid tropical climate creates a corrosive environment that accelerates paint deterioration. Hawaii also has the highest cost of living in the country combined with moderate salaries and a very competitive rental market. These factors prevent many people who can afford to own from properly maintaining their homes, while renters often avoid asking their landlords for repairs for fear of being given notice to move out. Hawaii also continues to welcome a significant number of immigrants from countries throughout the Asia Pacific Rim, creating large populations of non-English speaking groups that often live in multi-family homes within areas already affected by traditional environmental justice issues, including higher rates of childhood lead poisoning. Lead Sources and Data: Recent lead environmental investigations identified likely sources of lead exposure for children as lead-based paint, home smelting of fishing sinkers, contaminated soil, souvenir magnets, salvaged wood, used furniture, ceramic tiles, antique jars, dishes, beach debris, old toys, and occupational exposure. Hawaii?s statewide E
BLL rate in 2020 was 1.09%, but a neighbor island like Hawaii Island had higher EBLL rates (2.47%). The total number of children tested for blood lead dropped significantly (19.1%) in 2020 due to the COVID-19 pandemic. Twenty-five percent (25.0%) of all 1- and 2-year-old children were tested for blood lead levels in 2020 (up from a 23.8% baseline in 2017, but down from the peak of 26.7% in 2018). Of children enrolled in Medicaid, 43.4% of 1- and 2-year-old children were tested in 2019 (up from a 37.8% baseline in 2016), but these 2019 numbers that do not yet reflect the effects of COVID-19 in 2020. Project Period Outcomes:?Improve blood lead testing and reporting rates for children less than 6 years of age at risk for lead exposure (e.g., screening/testing penetrance and the incidence and prevalence of children with blood lead levels greater than or equal to the CDC blood lead reference value) and other important blood lead levels categories.?Improve use of surveillance system data to capture missing data on child demographic and follow-up information (e.g., address, race/ethnicity, socioeconomic status, small geographic area [zip code or census tract], referrals to recommended services, completion of services by type).?Improved rates of children less than 6 years of age with elevated blood lead levels linked to recommended services (e.g., environmental inspections, medical evaluations, nutritional counseling, developmental services).?Decrease disparities in blood lead levels by race/ethnicity and socioeconomic status.