Massachusetts

While U.S. Census data are useful, data are only collected every ten years. Therefore, lead screening rates based on census data may be inaccurate since populations can vary significantly over a decade. Conducting lead program activities based on data every collected every 10 years can result in programs making incorrect decisions that could leave children in need without services. Massachusetts was interested in identifying high-risk populations at a more localized level to help with outreach and prevention efforts and to develop more precise population estimates.

Massachusetts state law requires that childhood blood lead test results be reported to the Department of Public Health, Bureau of Environmental Health’s Childhood Lead Poisoning Prevention Program (CLPPP), which allows the program to record the number of children screened accurately. Identifying the number of children eligible for lead screening compared to the number screened requires an accurate estimate of children’s total population and age distribution in a community. Population estimates in the intercensal years were previously based on data collected during the last U.S. Census in 2010. Because significant demographic shifts in populations can occur over a 10 period, the Bureau of Environmental Health partnered with the University of Massachusetts to use scientifically approved and validated methods to estimate population by age, sex, and race/ethnicity for every year, census tract, and community in Massachusetts during 2010‑2020 (U.S. Census years).

CLPPP applied the new population estimates to screening rates for 2017 and determined that

• 48 small to medium-sized communities (median population=10,765) decreased screening rates from above or near the state average to below the state average by at least 5%.
• The overall state screening rate decreased from 76% to 73%.

CLPPP is using this information to target new outreach efforts to medical care providers and local health practitioners by

• Prioritizing educational in-service training for pediatric practices within the 48 communities.
• Contacting providers regarding requirements and best practices for screening, reporting (including in-house, point-of-care device test results), and parent education.
• Updating and providing Childhood Lead Screening Community Progress Reports.
• Reminding providers to conduct venous follow-up testing for children with elevated capillary tests; and
• Providing services and education to reduce lead exposures and to increase screening.