The Iowa Department of Public Health (IDPH) is requesting $858,246 from the Centers for Disease? Control and Prevention (CDC) in this competing continuation application to fund the 15th year of? the Iowa Childhood Lead Poisoning Prevention Program (Iowa CLPPP). IDPH will provide? $516,629 in matching funds, which exceeds the requirement that the applicant provide $1 in? matching funds for each $2 of requested federal funds. In this project, IDPH is establishing? community-based CLPPPs in rural and urban areas throughout Iowa with the eventual result of? local CLPPP services being available in all counties in the state. This funding would not supplant? current state and local funding, but would be used in addition to current funding to upgrade and? increase total state and local program efforts.? The number of children tested for lead poisoning in Iowa has increased steadily from 25,778 in 1997? to 47,372 in 2004. The number of children with confirmed elevated blood lead levels has ranged? from 1,019 to 1,376 per year. In some cases, the number of children with confirmed elevated blood? lead levels has increased as the number of children tested has increased. Based on current? surveillance data, IDPH predicts that 2,796 of Iowa?s 227,062 children will have confirmed elevated? blood lead levels in calendar year 2006.? Pre-1950 Housing? According to CDC guidance on lead screening, ?Housing built before 1950 poses the greatest risk? for lead exposure because it is much more likely to contain lead-based paint than is newer housing. .? . . The focus should be on poor children and children of racial/ethnic minority groups because? generally they are at higher risk than other children.? (Screening Young Children for Lead Poisoning:? Guidance for State and Local Public Health Officials, CDC, November 1997) Housing data from the 2000? census show that 39.3 percent (483,849 units) of the housing in Iowa was built before 1950. This is? substantially greater than the national average of 22.3 percent. Iowa ranks fifth among the states in? the percentage of housing built before 1950. The number of pre-1950 housing units per county? ranges from 1,413 to 42,467. The percentage of pre-1950 housing per county ranges from 18? percent to 61 percent.? Minority and Hispanic Population? Iowa's combined minority and Hispanic population is 7.8 percent. The combined minority and? Hispanic population ranges from 0.7 to 23.3 percent and from 60 to 34,933 residents per county.? According to 2000 census data, the rate of poverty in Iowa children under the age of 6 years is 12.9? percent. By county, the number of children in poverty ranges from 36 to 3,947, and the poverty rate? ranges from 4.5 to 27.2 percent. (Source: 2000 Census)? High-risk Populations? In the cohort population of children born in 2000 who were enrolled in Medicaid for at least one? month, 65.7 percent have received at least one blood lead test, and 4.6 percent have confirmed? elevated blood lead levels. For non-Medicaid children, 66.2 percent have received at least one blood? lead test, and 1.45 percent have confirmed elevated blood lead levels. In another cohort, the? children born in 2000 who participate in the Special Supplemental Nutrition Program for Women,? Infants, and Children (WIC) program, 77.6 percent have received at least one blood lead test, and? 4.6 percent have confirmed elevated blood lead levels. These data demonstrate that children who? have been covered by Medicaid or WIC are at high risk for lead poisoning.? Local CLPPPs? A CLPPP should include the following activities: promoting screening, case management of leadpoisoned? children, education and outreach, data management, and developing strategic partnerships? within the community. In Iowa, a local CLPPP is one where these activities are carried out in an? area ranging in size from one to seven counties by one or more local agencies. In the last 14 years,? IDPH has established local CLPPPs in rural and urban areas throughout Iowa with the goal of? having comprehensive local CLPPP services available in each of Iowa?s 99 counties. Iowa's local? CLPPPs are based on agencies of county governments because most public health and? environmental health activities are carried out at the county level, even in Iowa's largest cities. In? Fiscal Year 2007, 29 local CLPPPs will provide complete CLPPP services to 74 of Iowa?s 99? counties. IDPH is seeking state resources to expand local CLPPP coverage to all of Iowa?s 99? counties. The implementation of the activities contained in this proposal will allow IDPH to? continue the development of the Iowa CLPPP.? Iowa?s lead-poisoned children are widely dispersed throughout Iowa and are not concentrated in a? few urban counties; 40.7 percent are estimated to be in Iowa?s 9 metropolitan counties, 21.2 percent? are estimated to be in Iowa?s 15 micropolitan counties, and 38.1 percent are estimated to be in? Iowa?s 75 rural counties. These data show that IDPH must carry out childhood lead poisoning? prevention efforts in each of the 99 counties to achieve the goal of eliminating childhood lead? poisoning in Iowa. IDPH proposes to do this by allocating resources to local CLPPPs in amounts? that are proportional to their share of the estimated confirmed lead-poisoned children in Iowa.? IDPH will use a similar method to allocate its staff efforts in non-CLPPP counties.? Integrated Lead Program? IDPH has chosen to integrate lead poisoning prevention activities funded by CDC and by the? Environmental Protection Agency (EPA) into a single lead poisoning prevention program.? Although the CDC and EPA programs emphasize different activities, the goals of the CDC and? EPA programs are similar -- to eliminate childhood lead poisoning in Iowa. Public and professional? health education and communication are part of both the CDC and EPA lead poisoning prevention? programs. IDPH believes that the integration of these activities and requiring each staff person to? participate in both the CDC and the EPA program provides the most efficient and effective use of? staff time. Since each staff member is fully trained in both CDC and EPA activities, Iowa citizens? can get the answer to virtually any question about lead poisoning from any staff member.? IDPH is requesting $858,246 from the Centers for Disease Control and Prevention (CDC) in this? competing continuation application and will provide $516,629 in matching funds. With these funds,? IDPH proposes to continue the expansion of the Iowa CLPPP and its efforts to eliminate childhood? lead poisoning in Iowa by 2010.
