Date of Conferral

2021

Degree

Ph.D.

School

Public Health

Advisor

David Anderson

Abstract

The Centers for Disease Control and Prevention recently declared that no amount of childhood blood lead level (BLL) is safe. The purpose of this quantitative study with a retrospective cohort design was to evaluate the effectiveness of case management intervention on children diagnosed with elevated BLL (EBLL; ≥ 5 μg/dL) in Marion, County, Indiana. The health belief model was used as the theoretical foundation for the study. A data set of 160 lead exposure case management records was analyzed to find whether: (a) BLL at post-case-management time significantly differ from BLL at baseline (b) BLL at post-case-management time is affected by race, poverty, zip code and, severity of BLL at baseline. Results indicated that case management had a significant (X2 = 147.62, df = 4, p < 0.0001) effect on children’s BLL. The geometric mean BLL dropped from 7.4 µg/dL at baseline to 3.0 µg/dL at post-case-management time. The highest (6.6 µg/dL) and lowest (5.3 µg/dL) mean BLL occurred in Latino and Asian children, respectively. Mean BLL in White (6.1 µg/dL) and Black (5.8 µg/dL) children were not statistically different. High risk zip codes showed the highest mean BLL (6.2 µg/dL). Low risk zip codes showed the lowest mean BLL (5.4 µg/dL). Medicaid eligible children showed a significantly higher reduction (34.31%) in their BLLs than non-Medicaid-eligible (24.67%) children. The severity of lead exposure at baseline had a significant effect on the outcome of the case management (f = 3.15, df = 3, p < 0.02). The higher the severity at baseline, the longer the time to recovery from EBLL. Public health authorities may use these findings to target the most affected communities for effective lead exposure prevention

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