Racial Equity Impact Analysis:
Eliminating Lead Paint Hazards
in Oakland & Alameda County
By: Marybelle N. Tobias
Principal, Environmental / Justice Solutions
For: Darlene Flynn
Director, Oakland Department of Race and Equity
September 2021
Attachment B
Environmental / Justice Solutions
Environmental / Justice Solutions (E/J Solutions) is a diverse, multilingual consulting practice dedicated to achieving environmental justice, equity, sustainability, and meaningful community engagement. Our approach to planning and policy development is data-oriented and community-based.
Our Services
★ Gather and ground-truth quantitative and qualitative data to identify over-burdened and under-served areas and priority community needs.
★ Community outreach, engagement, and meeting facilitation to enable consensus-oriented participatory decision making.
★ Inform policy initiatives with community-supported best practices to maximize equitable outcomes, including ongoing community oversight during implementation. ★ Develop equity performance indicators and metrics for guidance and accountability during implementation.
Principal
Marybelle Nzegwu
Tobias
Senior Associates
Colin Miller
Saki Bailey
Associates
Tran Diep Lam
Aitran Doan
ej.solutions
© 2021
Environmental / Justice Solutions | 2
Table of Contents
EXECUTIVE SUMMARY 5
Existing Racial Disparities in Oakland & Alameda County 6 Recommended Actions 7
Conclusion 10
INTRODUCTION 11
Racial Equity Assessment of Lead Paint Hazards in Oakland & Alameda County 12 Lead Paint Lawsuit & Settlement Agreement 13
Alameda County’s Proposal: Lead-Safe Alameda County: 2030 14 Lead Paint 14
Lead Poisoning 16
Lead Poisoning Prevention 20
Primary Prevention 20
Secondary Prevention 21
Racial Disparities in Oakland & Alameda County 22
Racial/Ethnic Demographics 22
Historical Legacies 23
Mapping Disparities 24
Predominant Race (with Lead Risk Percentile statewide ranking) by Census Tract 27 Life Outcomes by Race 35
Equity Gaps in Lead Poisoning Prevention Programs 38
Lead Paint Hazard Equity Indicators 41
Increased Exposure to Lead Hazards 42
High Numbers of Lead Poisoned Children and/or Low Lead Testing Rates 42 Lead Risk 47
Density of Dwellings Built before 1940 48
Most Disadvantaged / Socially Vulnerable Communities 51 CalEnviroScreen 3.0 (2018) 51
Draft CalEnviroScreen 4.0 (2021) 55
Social Vulnerability Index 60
California Healthy Places Index 63
Housing Habitability / Substandard Housing Conditions 65 Oakland Baseline Equity Indicators 65
Housing Habitability Complaints 65
Small Rental Properties and High Housing Cost Burden 66 Additional Housing Related Indicators 67
Race/Ethnicity 68
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Poverty (Low Income & Low Wealth) 68
Density of Children in Poverty 69
Youth Educational Success & Overall Level of Educational Attainment 69 Increased Sensitivity to Lead Hazards 69
Poverty 70
Extremely Elevated Blood Lead Levels 70
Density of Children in Poverty 71
Pregnant Women & Low Birthweight Infants 71
Pre-existing conditions 74
Reduced Capacity for Protective Action 74
Desired Future Outcomes: Recommendations for Racially Equitable Lead Abatement in Oakland & Alameda County 75
Establish a Robust Joint Lead Hazard Abatement Program 75 Increase Community Governance and Oversight 76
Exceed Primary Prevention Standards & Meet Priority Community Needs 77 Adopt Proactive Secondary Prevention Policies 88
CONCLUSION 90
APPENDIX A: Key Resources 91
APPENDIX B: Background on Lead Poisoning Programs 92
Federal Government 92
State of California 92
Alameda County Public Health Department- Healthy Homes Department 93 City of Oakland 94
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EXECUTIVE SUMMARY
Lead poisoning caused by lead paint remains a dire threat to public health, well-being, and life outcomes in Oakland and Alameda County. The problem is so large that the rate of lead poisoning in some Oakland zip codes is higher than in Flint, Michigan at the height of its lead in the water crisis.
Lead paint hazards disproportionately a ff
ect low-income and Black, Indigenous, and Latinx
communities due to the prevalence of older, dilapidated housing, which exposes children in poverty to lead paint hazards at the greatest rates. Moreover, after lead exposure, children in poverty suff
er greater harms than children from higher-income families.
Environmental Justice Solutions (E/J Solutions) prepared this Racial Equity Impact Analysis (“REIA”) on behalf of the City of Oakland's Department of Race and Equity (“DRE”) toguide the City of Oaklandin partnering with Alameda County to develop and implement an equitable lead hazard abatement program. E/J Solutions conducted an independent review of existing research and quantitative data, to isolate indicators that can be used to identify the racial demographics and geographic locations of the communities most vulnerable to lead paint hazards. In addition, relying on best practices proposed by public health departments, lead equity advocates, or implemented in other cities, this report recommends policies that prioritize at-risk communities, remedy barriers to resources, ensure lead hazards are expeditiously removed from homes in vulnerable communities, and bolster local economic resilience.
Achieving equitable outcomes will require Oakland and Alameda County to align their joint eff orts
behind a geographically focused approach that ensures early and comprehensive action in the vulnerable neighborhoods experiencing high poverty, fewer resources, and greater exposure to health risks. Equity requires every program, policy, and investment to providesignifi cant and sustained
support to the people hurting most.1 Through thoughtful, whole-systems thinking that dedicates the majority of available funds to removing lead hazards from housing before children are poisoned in ways that meet priority community needs, Oakland and Alameda County can eliminate racial disparities in exposure to lead paint hazards, and reduce the severity and number of new cases of lead poisoning.
I have a case of a child who came two years ago as a refugee. His blood lead level was 8 μg/dL. We were able to figure out that the lead source may have been due to the eye makeup that they had been using since birth. e doctor recommended another blood lead test and six months later when it was tested, his blood lead level went up to 72 μg/dL. It was from the house this time.
Diep Tran, Alameda County Public Health Nurse2
2 Tram Nguyen, et al., Housing Habitability and Health: Oakland’s Hidden Crisis, Alameda County Public Health & Healthy Homes, April 2018, p. 13.
1 PolicyLink.
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Existing Racial Disparities in Oakland & Alameda County Socio-economic indicators, including education, neighborhood and physical environment, employment, social support networks, and access to health care, determine our health, well-being and life outcomes.
Inequities in key indicators of well-being disproportionately burden communities of color and low-income, low-wealth communities increasing their vulnerability to environmental hazards. Scoring and ranking census tracts is one helpful way to understand varying degrees of cumulative burden and compare the most burdened and least burdened communities. This report gathers data to defi ne
existing disparities and shed light on the conditions and lived experiences of the most burdened and marginalized communities within Oakland and Alameda County.
Methodology and Findings. E/J Solutions gathered data on 357 census tracts in Alameda County from various sources. We converted the results for each indicator into a scale of 0-10 then summed the scores for each indicator to create anOverall Burden Scorefor each census tract. To zero in on the most burdened communities, we isolated the top 25 most burdened census tracts overalland for each indicator. We identi fi
ed the share by race/ethnicity and compared Oakland to the remainder of Alameda County. We then averaged Oakland’s share of overall burden with its share of the most burdened census tracts as a way to identify Oakland’s equitable share of available lead paint settlement funds for Alameda County:60-70%. This also corresponds to the percentage of lead hazard cases reported to Alameda County between 2015-2020 that were located in Oakland.
Limitations. For brevity of reference this report defaults to the racial/ethnic categories of: (a)Black (b) Latinx (c) Asian and (d)White, which are the predominant racial categories in Alameda County census tracts. We acknowledge that this glosses over many distinctions within these categories and signifi
cantly smaller groups, such as Indigenous populations, Mixed Race, and Pacifi c Islander are not
well-highlighted. The overall racial burden scores highlighted above identify each census tract by its predominant demographic group, but the report also includes several demographic tables that identify all of the major racial/ethnic groups: Latinx, White, Black Asian, Pacifi c Islander and Other/Multiple. In
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many neighborhoods, such as4064 (Reservoir Hill/Manzanita), Oakland’s three largest racial ethnic groups are similar in size.
Shifting Demographics. Over the last two decades, signifi cant racial demographic shifts have resulted
in census tracts with higher lead risk that were until recently predominantly African American, such as Gaskill (4009), North Oakland: Bushrod and Santa Fe (4006 & 4007), Temescal 1 (4011), and Longfellow (4010) neighborhoods now being predominantly White. In addition, Latinx majorities in some census tracts grew. While African American and other Black residents may not be the predominant group, Oakland still remains home to a majority of Alameda County’s Black residents and this community remains a signifi
cant plurality in the most burdened neighborhoods.
Existing Equity Gaps
➔ Lack of proactive policies and programs to locate and abate lead paint hazards in at-risk housing.
➔ Insuffi
cient outreach, education, and blood lead testing in at-risk communities. Outreach to tenants must directly result in increased blood lead testing. ➔ Scattershot and racially inequitable implementation.
➔ Lack of coordination between overlapping jurisdictions. ➔ Disjointed and outdated data.
➔ Insuffi
cient program capacity.
➔ Misplaced blame due to the myth of “personal responsibility.” ➔ Mistrust resulting from poor community engagement.
➔ Inadequate protections and lack of enforcement of existing tenant protections for low-income tenants.
➔ Financial barriers to remediation for low-income homeowners and landlords. ➔ Missed opportunity to boost local economic resilience through development of a robust pipeline of RRP-certi fi
ed local businesses and contractors and workforce development programs that target at-risk individuals.
Recommended Actions
The City of Oakland and County of Alameda must address the factors that drive racially disparate lead poisoning impacts through holistic and proactive lead hazard abatement programming that prioritizes permanent lead rehabilitation in at-risk communities and simultaneously addresses multiple sources of lead alongside habitability and climate resilience needs. The following recommendations assume that the City and County will devote around 60-70% of Settlement Funds to the City of Oakland, with the entity that carries out the activity managing the necessary funds.
1. Improve ongoing ability to screen for and eliminate lead hazards through proactive approaches: (a) proactive inspections of rental properties dwellings and (b) lead-safe certifi
cation requirements for childcare facilities and schools.
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a. The City of Oakland willproactively inspect for all habitability issuesincluding lead paint hazards, beginning in priority census tractsand executing blanket coverage of at-risk dwellings block-by-block.
b. As inspections progress, City inspectors will carefully assess the number of temporary relocations needed and gather qualitative data about other signi fi cant burdens to the
neighborhood, such as road blockages or noise.
c. The City and County will prioritize lead-safe certifi cations for OUSD schools and childcare
facilities.
2. Prioritize abatement, testing, outreach, and education activities in high-risk areas and serving the populations most likely to live in high-risk dwellings. a. The City and County will utilize a geographically-phased approach in Oakland which begins in the overburdened census tracts that are most vulnerable to lead paint hazards. b. When lead paint hazards are found in homes where children reside, the City will immediately refer the case to the County for blood lead testing and other case management services.
c. The County will also receive reports of unsafe housing conditions in Oakland. The most effi
cient way to share this information with the City would be for the County to have direct access to the shared Equitable Lead Hazard Abatement Program database.
3. Ensure efficient
remedy of lead hazards and simultaneously address all habitability issues and all sources of lead in the places at-risk children spend time. a. The City and County will both provide lead hazard control. The Equitable Lead Hazard Abatement Program Specialist will monitor all e ff
orts in Oakland to ensure identifi
ed
hazards are remediated in a timely fashion.
b. The County will continue to operate its HUD-funded Lead Hazard Repair Program, but will immediately refer dwellings within Oakland that it cannot service to the City, for lead hazard control to be overseen by the Equitable Lead Hazard Abatement Program Specialist. c. The ELHAP specialist will coordinate with landowners/homeowners and schools to off er any
needed funding support for tenant relocation and lead hazard rehabilitation.
4. Ensure robust data collection; compile a database of all lead hazards identifi ed within the
City of Oakland and maintain comprehensive and up-to-date public records on lead hazards and rehabilitation and remediation eff
orts.
a. The City and County will enter every dwelling or other facility where habitability issues are found into a Equitable Lead Hazard Abatement Program database that is searchable and sortable by habitability issues, particularly lead.
b. ELHAP will not close a case until all habitability issues have been remedied. c. The ELHAP program will monitor and produce annual evaluations of the impacts of the program disaggregated by race/geographic proxy (census tract level preferred), which will be periodically reported to the public for transparency and community engagement.
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5. Prioritize the needs of vulnerable and overburdened tenants, landlords and homeowners. a. The City will actively enforce existing tenant protections to prevent eviction and displacement.
b. The City and County will minimizefinancial
burdens by increasing the amount offinancial
support
available to low-income homeowners who may be undergoingfinancial hardship—
both owner-occupied dwellings and landlords providing a ff ordable housing— to fund
rehabilitation and repair activities, including grants or zero-interest loans, in order to ensure that lead hazards are abated in a timely fashion.
c. The City will support low-income landlords who provide aff ordable housing by making funds
available to enable them to follow through on their obligation under Oakland City Ordinance Section 8.22.800 to provide temporary relocation assistance for tenants.
6. Bolster local economic resilience.
a. ELHAP should support workforce development to increase high-road, union-wage, family-sustaining jobs creation in partnership with the Oakland Workforce Development Board and the Cypress Mandela Training Center, and off
er job-placement support post
certifi
cation.
b. The City will increase Renovation, Repair, and Painting training and certi fi cation
opportunities for existing small local businesses through targeted outreach to businesses registered to do business in Oakland, particularly those owned by people of color. c. The City and County will collaborate to provide wraparound services to small local businesses located in at-risk neighborhoods.
7. Increase targeted public education eff
orts in vulnerable communities.
a. Focusing on at-risk areas, the County should make education about lead hazards, remediation, and lead testing more widespread and accessible through popular education and translation of lead outreach materials into additional languages. b. The City will collaborate with the County to develop and carry out eff ective outreach to
hard-to-reach populations, including through partnerships with local community-based organizations that are active on the ground.
c. The County will ensure that outreach eff
orts translate directly into increased blood lead
testing.
8. Ensure meaningful community participation and oversight of lead poisoning prevention eff
orts.
a. The City and County will ensure equitable governance, community oversight, and transparency by building in ongoing collaboration with a ff ected communities .
Well-intentioned policies may nevertheless have unintended negative consequences if the most impacted community members are not part of the process. Unintended consequences include increasedfinancial
hardship, unfair stigmatization, failing to identify
children / households with lead risks, and prolonged exposure to lead.
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b. Prioritize impacted community needs in all phases of policy development, treating their lived experience and input with the same level of consideration given to other highly-credible types of data and information.
c. Make lead risk data available to families, policymakers, and other stakeholders who need information about sources of exposure, such as property-specifi c information on leaded
drinking water pipes and lead in the water, dust, paint, and soil at or near homes, schools, and child care facilities.
d. Increase the number of community representatives on the Joint Powers Authority Board.
9. Generate additional funding to support ongoing lead remediation systems.
Conclusion
In addition to improving quality of life and the quality of the housing stock, Oakland and Alameda County can realize multiple cascading public health, safety, environmental, social, and economic benefi
ts by creating and fully funding an equitable lead hazard abatement program. Researchers have found that eradicating lead paint hazards from older homes where children from low-income families reside would provide a return of approximately $1.39 in future benefi ts per dollar invested.
Dedicated funding for an equitable lead hazard abatement program would protect young children from accruing high levels of untreated lead poisoning, which can cause brain damage, anti-social, erratic, or violent behavior, and limit their future economic livelihood. Lowering exposure to lead paint hazards will increase students’ academic performance, supporting higher attendance, graduation rates, and success later in life. Furthermore, Oakland can bolster economic and community resilience by ensuring more Oakland residents are gainfully employed in rehabilitating Oakland’s housing stock and adapting to climate change, addressing lead paint hazards, alongside mold, asbestos, weatherization for energy e ffi
ciency, and solar and electrifi
cation projects. As lead poisoning,
unemployment, housing insecurity, and houselessness decrease, so too will criminalized behavior, addressing multiple root causes of insecurity and signifi cantly increasing public safety forall Oakland
residents.
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1.INTRODUCTION
Across the United States there are deeply entrenched inequities drawn along racial lines. Both historically and in the present day, racial discrimination has been perpetuatedde jurethrough federally and locally sanctioned practices. These systemic policies and practices cumulatively impacthealth outcomes, lived experiences, and life expectancy. Across almost every socio-economic indicator, Black, Indigenous, Latinx and other non-White communities fare the worst, resulting in poor quality of life and shortened life expectancy.3 The racialincome and wealth gapis enormous: African Americans earn 60% of the average White income and own only 5% of the wealth, a disparity which analysts estimate cost the U.S. about $2.4 trillion in 2014.4 Nationally, in 2015,racial health disparitieswere found to “cost the [national] economy an estimated $245 billion in excess health care expenditures, illness-related lost productivity, and premature deaths.”5 Although Oakland is one of the most racially
diverse cities in the country, it has a long history of systemic racial and economic discrimination.
Within the City of Oakland and the broader context
of Alameda County, there are extreme disparities
between neighborhoods and across numerous key
determinants of well-being, including access to a
clean environment, healthy food, recreational and
open space, educational achievement, living wage
employment, and decent housing.
Exposure to lead paint and lead poisoning are
among the inequitable outcomes facing
low-income communities and Latinx, Black,
immigrant, and refugee communities in the City of
Oakland and Alameda County. Several years ago,
Oakland’s O ffi
ce of Planning, Building &
Neighborhood Preservation estimated that medical
services, special education, disabilities, and lost
wages due to lead poisoning, cost city residents
upwards of $150 million each year.6
Figure 1. County of Alameda Lead Outreach Poster
6 City of Oakland Offi
ce of Planning, Building & Neighborhood Preservation,Proposed Program Design for Proactive Code Enforcement Operations.
5 Ibid.; John Z. Ayanian, MD, The Costs of Racial Disparities in Health Care, Harvard Business Review, October 10, 2015. 4 PolicyLink, Racial Equity Impact Assessments.
3 City of Oakland Department of Race & Equity, Oakland Equity Indicators: Measuring Change Toward Greater Equity in Oakland, 2018.
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1.1. Racial Equity Assessment of Lead Paint Hazards in Oakland & Alameda County
As systemic institutional practices have placed certain groups in harm’s way, each institution must play a part in reversing inequitable outcomes. Unless equitable considerations are infused into every aspect of policy design and implementation, even well-intended policy interventions may inadvertently exacerbate inequality, with costly results. Policymakers are now seeking out viable methodologies, programs, and policies that can remedy entrenched harms.
Oakland Municipal Code section 2.29.170 specifi
es that “the City of Oakland will intentionally integrate, on a Citywide basis, the principle of ‘fair and just’ in all the City does in order toachieve equitable opportunities for all people and communities.”7 Section 2.29.170 defi nes inequitable outcomes as
“diff
erences in well-being that disadvantage one individual or group in favor of another” and acknowledges that the “diff
erences are systematic, patterned, unfair andcan be changed. Inequities are not random; they are caused by past and current decisions, systems of power and privilege, policies and the implementation of those policies.” The Department of Race and Equity’sRacial Equity Implementation Guide provides a roadmap for City departments to follow in developing racially equitable policies.
Following DRE’s roadmap, E/J Solutions conducted an independent review of existing research and quantitative data from several public sources, including research and data shared by Alameda County Public Health Department’s Healthy Homes Department, which has been working in lead poisoning prevention for several decades. The REIA identifi
es racial inequities that will be exacerbated if not
directly addressed and actions that can be taken to advance equity and meaningfully impact outcomes in the low income communities and Latinx, Black, Indigenous, immigrant, and refugee communities in Oakland and Alameda County experiencing high poverty rates and greater exposure to health risks.
1. Census tract by census tract comparison of the disparities facing a) low-income and b) non-White communities in Oakland and Alameda County that lead to increased vulnerability to lead poisoning;
2. Methodologies for prioritizing high-risk populations and neighborhoods;
3. Identifi
cation of equity gaps in present-day lead poisoning prevention eff orts: the agencies,
programs, and protocols related to discovery and remediation or abatement of lead paint hazards; and
4. Description of equitable program elements, including data gathering data to monitor and evaluate program implementation and ensure equity goals are met.
This REIA will guide the City of Oakland in partnering with Alameda County to ensure that joint eff orts
result in equitable discovery and abatement of lead hazards and dramatically reduce present-day racial disparities in lead poisonings. The REIA’s approach and recommendations are particularly aligned with Alameda County’s “Housing Habitability and Health: Oakland’s Hidden Crisis” published in April 2018 as 7 City of Oakland Municipal Code Section 2.29.170.
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well as the lead equity recommendations developed by lead policy experts during the Equity Analysis of Lead Policies Consensus Conference held in November 2018.
Only by directing a lion’s share of any available funds toward addressing the deeply entrenched barriers that have hindered progress toward total remediation of lead hazards will vulnerable communities no longer be systematically exposed to lead hazards and receive the resources necessary to thrive.8 This equitable goal provides an opportunity for transformative approaches that shun the status quo and dismantle and reverse the policies and practices that exacerbate inequitable outcomes.
The framework is centered on actualizing the equity principle of healthy housing as acommunity asset in which local and regional governments should invest for the benefi t of the greater good. The
numerous benefi
ts associated with closing racial equity gaps and increasing access to healthy housing include:
➔ Effi
cient and effective resource allocation that reduces intransigent problems more quickly;9 ➔ Reversing legacies of discrimination;
➔ Making access to aff
ordable and habitable housing a human right;
➔ Improving public health, safety and quality of life;
➔ Boosting Oakland and Alameda County’s tax base and desirability as places to live.
1.2. Lead Paint Lawsuit & Settlement Agreement
In July 2019, Santa Clara, Alameda, Los Angeles, Monterey, San Mateo, Solano, and Ventura Counties along with the City and County of San Francisco, and the Cities of Oakland and San Diego, entered into a landmark $305 million Settlement Agreement with Sherwin-Williams Co., ConAgra Grocery Products Co. and NL Industries Inc., lead paint manufacturers who knowingly sold a harmful product in accordance with “industry standards.” Alameda County and the City of Oakland are the only two parties to the Settlement Agreement with overlapping jurisdiction and shared responsibility to reduce child lead poisoning in Oakland.
Under the Lead Settlement Memorandum of Understanding, Alameda County and the City of Oakland will jointly receive 10% of the settlement abatement funds to be paid out over seven years (approximately $24 million). The abatement funds were allocated by averaging percentages of pre-1978 housing stock and pre-1951 housing stock. The funds will be “distributed to the County of Alameda to be held in a trust account in the County of Alameda treasury until the County of Alameda and the City of Oakland come to a joint agreement on the ultimate disposition of the funds.” The settlement funds may be used to address public health hazards, bodily injury, personal injuries, and property damage related to lead paint. Such eff
orts may include but are not limited to developing
or enhancing “programs that abate lead from housing, particularly housing occupied by low-income individuals;” providing “services to individuals, particularly children who have been exposed to lead 9 Oakland-Berkeley-Alameda County Continuum of Care, Centering Racial Equity in Homeless System Design, January 2021, p. 3.
8 Human Impact Partners, Achieving Equity in Lead Poisoning Prevention Policy Making: Proceedings from a Consensus Conference, November 2018, p. 12.
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paint; and educating the public “about the hazards caused by lead paint, and the best means of avoiding exposure to and remediating the harms caused by lead paint, including the availability of funding for lead abatement.”
1.3. Alameda County’s Proposal: Lead-Safe Alameda County: 2030 Along with overlapping jurisdiction, the City of Oakland and Alameda County have shared responsibility to reduce child lead poisoning and can work in partnership as both have existing programs that provide lead abatement services. “The County of Alameda and the cities of Alameda, Berkeley, Emeryville, and Oakland have worked together for 27 years . . . to address the multi-faceted problems presented by lead-based paint and other lead hazards in our communities.”10 Alameda County proposes a ten-year plan for primarily ramping up existing lead poisoning prevention activities in Oakland and Alameda County, utilizing over two million annually of the settlement funds under a comprehensive, coordinated plan, MOU, and a jointly-approved spending framework. The Lead Abatement Joint Powers Authority would provide oversight and the Plan would be rati fi ed
through adoption by both the Alameda County Board of Supervisors and Oakland City Council. City and County activities will “complement and support each other” and both jurisdictions can leverage existing programs and seek out additional funding to enhance services and fi ll gaps.
Alameda County initially proposed to spend no less than 34% of settlement funds in Oakland, with the possibility for that percentage to rise to 42% “based upon community needs assessment.” After early discussions about this REIA’s fi
ndings, Alameda County now proposes to spend no less than 60% of settlement funds in Oakland.
1.4. Lead Paint
Lead (atomic symbolPb) is a naturally occurring, “soft, grayish metal with poisonous salts.”11 This toxic metal is relatively easy to find
and extract, and especially useful for industrial purposes. It is non-biodegradable, durable yet malleable, resistant to certain levels of corrosion, and helps reduce long-term water damage.12 These properties make lead a widely-used commercial additive. Tetraethyl lead was added to gasoline in 1921 to help reduce engine knocking and wear and tear. Almost immediately, industry workers started to become extremely ill, and some lost their lives. “At Dupont's manufacturing plant in New Jersey, it was particularly bad — eight workers died between 1923 and 1925.”13 At one time or another, lead has been used in gasoline, paint, solder, water pipes, and cosmetics, as well as other products. Despite this widespread use, lead is an extremely potent toxin; exposure to lead is extremely dangerous to human health and well-being, and isparticularly harmful to young children (0-6 years old).
13 Clair Patterson And The Age Of The Earth, History of Lead Use in America, publish.illinois.edu. 12 California State Auditor, Childhood Lead Levels: Millions of Children Have Not Received Required Testing for Lead Poisoning, January 2020, p. 5; see also Traci Pedersen, “Facts About Lead,” Live Science, October 6, 2016. 11 Concept Page, “Lead,” Harvard Catalyst Profi
les (“atomic number 82, atomic weight 207.19”).
10 Alameda County Community Development Agency, Healthy Homes Department, Lead-Safe Alameda County: 2030, p. 6.
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Although corporations in the lead paint industry were well aware of lead’s toxicity and its risks to public health by the early 20th century, the federal government did not ban use of leaded paint until 1978. It is possible for any home built before 1978 to have lead paint, although the older the home, the more likely it is to have several layers of decaying lead paint. Lead paint manufacturers were also aware that lead paint “powders and chalks” “soon after it is applied” and produces lead dust after a couple of years. Sales of lead paint peaked in 1922, began decreasing in the 1920s and early 1930s and by 1944, use of lead paint for residential interiors had declined to a low level.14 In addition to lead paint hazards, nearly all homes built before the 1980s also have lead solder connecting to copper pipes. Leaded gasoline was not fully banned for all on-road vehicles until 1996, and the fallout from those tailpipe emissions still contaminates outdoor soil. 15 The aviation fuel “avgas” and industrial batteries still contain lead and some cosmetics and toys have been found to contain lead.16 After the lead paint ban was enacted, there was little systemic action to remove the lead paint that remained on the interior and exterior surfaces of dwellings and other buildings. In essence, the national emergency was swept under the rug. Due to this inaction, and the fact that lead does not degrade once it is in the environment,lead paint has remained a pressing public health issue that disproportionately aff
ects low-income, low-wealth communities and Latinx, Black, immigrant, 16 Ibid.
15 Nathan McClintock, Assessing Soil Lead Contamination at Multiple Scales in Oakland, California: Implications for Urban Agriculture and Environmental Justice.
14 See People v. Conagra Grocery Products Company, (2017) 17 Cal.App.5th 51.
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and refugee communities. While blood lead levels in the general U.S. population have declined steadily, there continues to be a high prevalence of low-level lead exposure among the general population, including pregnant women.17
1.5. Lead Poisoning
Lead is an extremely powerful neurotoxicant, which “can aff ect almost every organ and system in the
body” and the brain (central nervous system) is the most sensitive, particularly in young children.
Humans are poisoned when theybreathe in or ingest the lead, which circulates through the blood, leading to elevated blood lead levels, and is distributed to the brain, liver, kidney, and bones. Teeth and bones store the lead where it accumulates over time. Exposure to lead presents a dire threat to public health, well-being, and children’s growth, education, development, and life outcomes.
Table 1: Terminology & Abbreviations
Lead Pb
Blood Lead Level BLL or PbB
Elevated Blood Lead Level EBLL
Micrograms per deciliter
Unit of measurement for blood lead levels
μg/dL
Although there are a number of sources of lead hazards,the main and most important method of exposure for children is ingestion of lead paint dust and chips.18 Lead paint in homes is a major contributor to blood lead levels because the lead content in lead-based paint is high, while most other sources only contain trace amounts of lead. A well-maintained surface with lead-based paint does not pose a hazard. However, as lead paint ages, it chalks, peels, or chips, creating hazardous conditions when old buildings fall into disrepair or are renovated improperly. Deteriorating lead paint, especially on surfaces that rub together, such as sliding windows, contaminates indoor dust and outdoor soil.
Lead-based paint and lead paint con aminated dust are the most widespread and hazardous sources of lead exposure for young children in the United S ates.
Center for Disease Control
Low-income communities and Latinx, Black, immigrant, and refugee communities “face disparate risk from older, poor-quality housing.” 19 Children younger than six are especially vulnerable to lead poisoning and its harmful eff
ects— due to their increasing mobility (crawling, putting their hands in 19 Housing Habitability and Health: Oakland’s Hidden Crisisat p. 6. 18 David Norris, Jillian Olinger, and Mary McKay, The Weight of Lead — Part I: How Contaminated Houses Are Poisoning the Poor, ChangeLab Solutions, January 2018.
17 Motao Zhu et al., Maternal low-level lead exposure and fetal growth, Environmental Health Perspectives, vol. 118,10 (2010) (In 2003–2004, “the mean PbB among women 18–49 years of age was 1.2 μg/dL, with a 95th percentile of 2.6 μg/dL.”)
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their mouths) and early stage of development. Lead-contaminated environments can cause a young child’s blood lead concentrations to increase rapidly between the ages of six and 12 months, with the rapid rise peaking between 18 months and 36 months of age. Young children can also absorb lead more effi
ciently than adults, are less likely to eliminate it through their waste once it has entered their bodies, and are more susceptible to its negative health eff ects. Lead remains harmful to children over
the age of six, adults, and the elderly, and can harm the reproductive system.
Millions of women
of child-bearing age
have lead stored in
their bones due to
exposure as
children. Lead
stored in a pregnant
mother’s bones is
released during
pregnancy,
exposing the
developing fetus to
lead poisoning.
Studies have linked
slightly elevated
maternal blood lead
levels (5 -10 μg/dL)
to reproductive
problems such as
reduced fetal
growth and low birthweight, and highly elevated maternal PbB (≥ 10 μg/dL) doubles the risk of harm to the baby.20 Even lead exposure that ends well before pregnancy can lead to reduced birth weight or developmental issues.21 Lead contamination begins in the second trimester of pregnancy, increases during the third trimester “when the baby is growing rapidly and incorporates nutrients and toxins from its mother,” and continues to accumulate after birth during the baby’s fi rst year.22 Lead may also
leach into breastmilk, further exposing newborns to lead poisoning even before they are able to crawl about and ingest any hazards in their environment.
The Center for Disease Control and Prevention (CDC) now defi nes an elevated blood lead level as5
μg/dL and states thatno level of lead exposure is safe.23 Indeed, for young children, blood lead levels below 5 μg/dL can harm normal development patterns, and impair nervous system development, 23 Center for Disease Control and Prevention, Blood Lead Levels in Children(“This value [5 μg/dL] is based on the U.S. population of children ages 1-5 years who are in the highest 2.5 percent of children when tested for lead in their blood.”) 22 Leigh Hopper, Lead contamination found in baby teeth of children living near Exide battery plant, USC News, May 6, 2019. 21 World Health Organization, Lead Poisoning and Health (“Because lead is known to delay physical and mental development in babies, lead poisoning is a likely contributor to babies born with low birth weight”). 20 Maternal low-level lead exposure and fetal growth.
Environmental / Justice Solutions | 17
resulting in permanent brain damage, learning disabilities, speech and language defi ciencies, attention
defi
cit hyperactivity disorder, and aggression. Many of the health impacts are irreversible, causing lifelong debilitation, including delinquency, and antisocial behaviors. Health care providers do not treat lead poisoning “until the child’s blood lead level is above 4.5 μg/dL because the medicines also remove other good things in the body like potassium and calcium, creating a serious imbalance.”24 Table 2. Increasing Harmful Eff
ects of Lead Poisoning25
BLL (μg/dL) Potential Health Impacts Services Available Below 4.5 Harm to Brain/Central Nervous System
● Reduced IQ
● Attention Defi
cit Hyperactivity
Disorder (ADHD, inability to pay
attention).
The American Academy of Pediatrics has
found that “one in fi
ve cases of attention
defi
cit/hyperactivity disorder among U.S.
children has been attributed to lead
exposure,” limiting their prospects for
academic achievement and reducing their
productivity later in life.
Tested Children: Health care providers
will assess nutrition, consider lead
exposure risk, and provide counsel on
identifi
ed risk factors.
Untested Children: High likelihood of
EBLL going undetected due to absence
of other health impacts and systematic
lack of testing.
4.5 - 9.4 Damaged Hearing
Similarly to ADHD, a child’s undiagnosed
hearing loss due to undiagnosed lead
poisoning could lead to severe disciplinary
consequences.
Tested Children: Health care providers
will retest in 1-3 months, test for iron
suffi
ciency, and the local prevention
program provides outreach and
education.
Untested Children: High likelihood of
EBLL going undetected due to absence
of other health impacts and systematic
lack of testing.
9.5 - 14.4 Behavioral Disorders (aggressive,
destructive or delinquent behaviors)
Tested Children: Health care providers
will retest in 1-3 months. If at this level
for two tests at least 30 days apart, the
local prevention program provides “full
case management services.”
Untested Children: High likelihood of
EBLL going undetected due to absence
of other health impacts and systematic
lack of testing.
25 Childhood Lead Levels: Millions of Children Have Not Received Required Testing for Lead Poisoningat p. 6. 24 Housing Habitability and Health: Oakland’s Hidden Crisisat p. 13.
Environmental / Justice Solutions | 18
14.5 - 69.4 Harm to Cardiovascular System(high blood
pressure)
Harm to Immune System
Anemia
Vitamin D Defi
ciency
Impaired Tooth & Bone Development
Tested Children: Full case management
services with increasing frequency of
testing. Hospitalization and chemical
treatment to reduce BLLs after BLL
reaches 44.5. Test kidney function.
Untested Children: Severe physical
impacts will likely result in medical
attention.
Above 69.5 Seizures
Comas
Death
Tested Children: Hospitalization and
chemical treatment to reduce BLLs
after BLL reaches 44.5. Test kidney
function.
Untested Children: Severe physical
impacts will likely result in medical
attention.
According to the City of Pasadena’s Public Health Department, a very small amount of lead can cause lead poisoning, “just enough lead to equal one granule of sugar each day over a period of time will raise a child’s blood lead level enough to require treatment.”26 Because of lead’s bioaccumulative nature, most cases of lead poisoning are caused by this type of chronic exposure to low-doses of lead, or slow lead poisoningas lead accumulates in the body over time.27 A child with lead poisoningmay not seem sick, but some children may have stomach problems, trouble sleeping, less energy than normal or may have problems concentrating. For children, slow lead poisoning may presentprimarily as learning and behavioral issues; in teens and young adults, it may be associated with increased school dropout rates and aggressive behavior. Thus, “despite the very real and measurable impacts of lead poisoning on children, their families, and society at large, children who are lead poisoned often exhibit few or no obvious symptoms at the time when intervention is most eff ective: when the
child is young.”28