Kevin MahoneySpring 2020 - Vol. 15, No. 1

Beyond Flint: Keeping Lancaster Safer from Lead
Kevin B. Mahoney
Chief Executive Officer
University of Pennsylvania Health System



The ongoing lead crisis in Flint, MI, has brought widespread attention to a harsh reality: that city is far from alone. Too many underserved communities around the country continue to have elevated levels of lead in their children’s bodies, which have been poisoned not only by tainted water, but also by lingering lead-based paint and dust that have never been properly abated. In all, it’s estimated that about half a million children are affected.

Unfortunately, that number includes those living in Lancaster County, PA, which has some of the highest rates in Pennsylvania of children with elevated levels of lead.

It’s worse than Flint, said Jeffrey R. Martin, MD, FAAFP, Chair of the Department of Family and Community Medicine at Penn Medicine Lancaster General Health (LG Health), during a recent Penn Medicine board meeting that addressed patient care and clinical quality.

Lancaster County ranks second on the list of Pennsylvania counties with high lead rates. Recent data show elevated blood lead levels of 5mg/dl or greater in 11 percent of the 4,700 children under the age of 6 in the city of Lancaster, compared with roughly 4 percent of the 8,000 comparable children in Flint.

As Dr. Martin pointed out, children with elevated blood lead levels are, unsurprisingly, living in areas of Lancaster City with old housing stock. The biggest culprits in lead poisoning are paint chips and dust from older homes.

These facts comprise a sobering truth that LG Health, the city, and its community partners, including the Lancaster Lead Coalition (LLC), are facing head on, and I thank Dr. Martin for speaking about Lancaster’s efforts to the Penn Medicine board. His presentation pushed the issue front and center, and underscored LG Health’s expertise on lead poisoning and abatement, along with its dedication and longstanding efforts to help the communities it serves.

LG Health and the LLC have worked tirelessly for years to make an impactful difference. They’ve increased screening, helped pass new lead ordinances and secure new funding, and developed educational materials to raise awareness about lead and its abatement.

Because LG Health has a major presence in most of the affected neighborhoods, they’ve also been able to identify hotspots and increase screening using EPIC, Penn’s electronic medical health records system. As Dr. Martin reminded us, that’s precisely how the crisis in Flint was discovered by Mona Hanna-Attisha, M.D., a pediatrician at Michigan State University and Hurley Children’s Hospital.

Most recently, the city of Lancaster received a $9.1 million Lead Hazard Reduction Grant through the U.S. Department of Housing and Urban Development, with an additional $600,000 of “Healthy Homes” supplemental funding, enough to abate 710 houses.

Lead stands as one of the most dangerous toxic substances for children. We know that exposure to even small amounts can lead to developmental problems and lower IQs. Lead poisoning has also been linked to an increased risk of ADHD, aggressive behavior, and a seven-fold increase in the dropout rate from high school.

Older and newer policies designed to reduce the risk of lead exposure have already helped keep homes and pipes safer, but it’s clear we need to take more preventive measures and stronger action to keep at-risk children healthy. LG Health, the city, and its partners will no doubt move us closer to that goal.

LG Health’s ongoing response to lead — and the 2020 goal to develop a feasibility assessment and plan to reduce exposure to lead in residential properties in Lancaster County — is just one piece of a larger story about the institution’s community impact.

Families living in poverty not only face greater exposure to lead, but a higher risk of diseases like cancer and diabetes. They’re also more likely to be uninsured or underinsured.

Poverty, along with food access, environment, and transportation issues, are just a few of the many social determinants of health we know can influence a person’s ability to maintain good health and well-being.   Addressing these complex issues requires all hands on deck; the health system’s administration, led by LG Health President and CEO Jan Bergen, along with clinicians, nurses, researchers, and other staff have been at the forefront of addressing such non-medical issues, helping connect underserved communities to clinical care and social services with innovative and thoughtful programs.

LG Health understands the critical importance of placing greater emphasis on these social forces — including ones that put children in harm’s way of lead — to ensure Lancaster’s communities become – and stay – healthier.

This effort is one of many reasons why LG Health was deservedly recognized in 2018 with the Foster G. McGaw Prize for Excellence in Community Service, one of the nation’s most esteemed community service honors in health care.