State Category: Illinois

Peoria’s Efforts to Prevent and Respond to Childhood Lead Exposure

Background

In the early- to mid-2000s, Illinois had an estimated 81,000 children with elevated blood lead levels, among the highest in the nation. Several sources of lead exposure can impact children, but windows have the highest levels of lead paint and lead dust compared to any other building component.

Using a unique state-financed bond, the Comprehensive Lead Education, Reduction, and Window Replacement Program (Clear-Win) was enacted in 2007 to prevent poisonings and improve children’s health. Illinois declared that the primary purpose was “to assist residential property owners to reduce lead paint hazards through window replacement in pilot communities.” The program provides grants and loans for low-income properties to participate in a window replacement program. Clear-Win also fixes additional lead-based paint hazards and allows for other minor repairs.

The pilot was conducted in Peoria and in the Englewood and West Englewood neighborhoods of Chicago, communities selected by the state legislature that encompass rural and urban settings and, along with high rates of childhood lead poisoning, had a large quantity of homes built before 1940.

In addition to the program’s health and environmental benefits, it was also designed to support the state’s economy by training workers in lead-safe work practices and carpentry skills and creating market opportunities for Illinois window manufacturers, assemblers, and installers.

Clear-Win Program

The Illinois Department of Public Health administers the program in Peoria in partnership with:

  • The Peoria City/County Health Department is responsible for operating the program;
  • Two Illinois-based window manufacturers supply the replacement windows at a low bulk purchase price; and
  • Building contractors perform the installations.

A certified third party performs clearance testing on all projects by dust wipe sampling to make sure that cleanup has been done properly. If the dust levels are still too high, the contractor has to re-clean until reaching compliance.

Besides Clear-Win, the Peoria City/County Health Department has worked for more than 10 years to eliminate lead poisoning in children in recognition of the fact that three Peoria ZIP codes ranked in the top 10 urban ZIP codes in Illinois for the rate of elevated lead levels in children under age six.

One tool used by the Health Department is funding from the Department of Housing and Urban Development to create the Lead Hazard Control Program, which provides grants in targeted Peoria ZIP codes for lead mitigation in pre-1978 homes. Once children with lead poisoning are identified and the source is confirmed as household exposure, the grant helps to relocate families to lead-safe homes temporarily while lead hazards are removed.

Between January and August 2016, the lead-abatement program, currently funded by a three-year, $3 million federal grant, has helped the county clean up roughly 47 homes–with more than 700 made lead-safe over the past decade.

The Peoria City/County Health Department also has focused on educating families about the importance of lead testing, highlighting the need for children to be tested for lead poisoning at 9-12 months of age and again at 18-24 months of age.

Results

A recent study of 96 of the more than 400 households served by Clear-Win, including 49 in Peoria, that participated in the original Clear-Win initiative found that average lead dust declined by 44 percent and that, one year later, the levels remained substantially below what they were before the window replacements. Both children and adults pointed to health improvements, including fewer headaches, ear infections, and respiratory allergies for children and fewer cases of sinusitis and hay fever among adults.

Economic benefits were estimated at $5,912,219 compared with a cost of $3,451,841, resulting in a net monetary benefit of $2,460,378. A related evaluation shows that this includes energy saving benefits of $1.5 million, additional market value benefits of nearly $1.57 million, lead poisoning prevention health benefits of nearly $3.6 million, and tax benefits from job creation of $51,000.

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In August, 2017, the Health Impact Project, a collaboration between the Robert Wood Johnson Foundation (RWJF) and Pew Charitable Trusts released: Ten Policies to Prevent and Respond to Childhood Lead Exposure. The Trust for America’s Health (TFAH), National Center for Healthy Housing (NCHH), Urban Institute, Altarum Institute, Child Trends and many researchers and partners contributed to the report. TFAH and NCHH worked with Pew, RWJF and local advocates and officials to put together the above case study about lead poisoning and prevention initiatives.

The case study does not attempt to capture everything a location is doing on lead, but aims to highlight some of the important work.

Health Leads

Health Leads, operated by lay resource specialists and college student volunteers, is a collaborative comprised of partner hospitals, health systems, community health centers, and Federally Qualified Health Centers (FQHCs) working together to integrate basic resources such as access to food, heat, and other necessities into health care delivery. Operating via clinical settings since 1996, this initiative enables providers to prescribe solutions to patients helping them manage their disease and lives. The impact of Health Leads is two-fold. The program expands clinics’ capacity to secure nonmedical resources for patients— in 2013, 92 percent of patients identified that Health Leads helped them secure at least one resource they needed to be healthy. Additionally, Health Leads is producing a pipeline of new leaders—in 2013, nearly 70 percent of Health Leads graduates entered jobs or graduate study in the fields of health or poverty. Health Leads sustainability model utilizes earned revenue, national and local philanthropy, and in-kind contributions from volunteers and health care partners to fund its operation. To read more about this innovative program, see this brief summary [link].

CommunityRX: Connecting Health Care to Self-Care

CommunityRX is a new, patient-centered health information technology system that transforms the quality of information about and access to self-care resources, especially in lower-income communities. Through this technology, patients are provided with a personalized HealtheRX referral list for self-care resources to access once they leave the clinical setting. To date, more than 950+ health care professionals have been trained to deliver HealtheRx to over 45,000 patients; 20 clinical sites have implemented this technology; and more than 250 Chicago Public School students and 100 science-oriented college students are employed by CommunityRX to map the health assets in the community. CommunityRX was developed in 2012 and is funded by a Centers for Medicare & Medicaid Services Innovation Award. To read more about this innovative program, see this brief summary [link].

Improving the Health of Communities by Increasing Access to Affordable, Locally Grown Foods

BY MICHEL NISCHAN, CEO and Founder, Wholesome Wave

When my son was diagnosed with type 1 diabetes, I became painfully aware of the direct connection between food and health. As a chef, this realization caused me to transform the way I fed my family and customers. Fresh, nutrient-dense, locally grown foods became the foundation for the type of diet that would give my son and restaurant guests the best long-term health.

Quickly, though, I recognized that not every family can afford to purchase healthy foods. As a result, I founded Wholesome Wave in 2007.

Wholesome Wave is a 501(c)(3) nonprofit dedicated to making healthy, locally and regionally grown food affordable to everyone, regardless of income. We work collaboratively with underserved communities, nonprofits, farmers, farmers’ markets, healthcare providers, and government entities to form networks that improve health, increase fruit and vegetable consumption and generate revenue for small and mid-sized farms.

Double Value Coupon Program

In 2008, we launched the Double Value Coupon Program (DVCP), a network of more than 50 nutrition incentive programs operated at 305 farmers markets in 24 states and DC. The program provides customers with a monetary incentive when they spend their federal nutrition benefits at participating farmers markets. The incentive matches the amount spent and can be used to purchase healthy, fresh, locally grown fruits and vegetables.

Farmers and farmers’ markets benefit from this approach, and have been key allies as we work towards federal and local policy change.  In 2013, federal nutrition benefits and DVCP incentives accounted for $2.45 million in sales at farmers’ markets.

Communities also see an increase in economic activity.  The $2.45 million spent at local farmers’ markets creates a significant ripple effect. In addition to the dollars spent at markets, almost one-third of DVCP consumers said they planned to spend an average of nearly $30 at nearby businesses on market day, resulting in more than $1 million spent at local businesses. We also see that the demographics of market participants are more diverse – our approach breaks down social barriers and allows consumers who receive federal benefits to be seen as critical participants in local economies.

Equally as important, people are eating healthier. Our 2011 Diet and Behavior Shopping Study indicated 90 percent of DVCP consumers increased or greatly increased their consumption of fresh fruit and vegetables – a behavior change that continues well after market season ends.

Today, the program reaches more than 35,800 participants and their families and impacts more than 3,500 farmers. Combined with the new Food Insecurity Nutrition Incentives Program in the latest Farm Bill, this approach is now being scaled up with $100 million allocated for nutrition incentives over five years.

Fruit and Vegetable Prescription Program

We developed the Fruit and Vegetable Prescription Program (FVRx) to measure health outcomes linked to fruit and vegetable consumption. The four to six month program is designed to provide assistance to overweight and obese children who are affected by diet-related diseases such as type 2 diabetes. In 2013, the program impacted 1,288 children and adults in 5 states and DC. Nearly two-thirds of the participants are enrolled in SNAP and roughly a quarter receive WIC benefits.

The model works within the normal doctor-patient relationship.  During the visit, the doctor writes a prescription for produce that the patient’s family can redeem at participating farmers’ markets. The prescription includes at least one serving of produce per day for each patient and each family member – i.e., a family of four would receive $28 per week to spend on produce. In addition to the prescription, there are follow-up monthly meetings with the practitioner and a nutritionist to provide guidance and support for healthy eating, and to measure fruit and vegetable consumption.  Other medical follow-ups are performed, including tracking body mass index (BMI).

FVRx improves the health of participants. Forty-two percent of child participants saw a decrease in their BMI and 55 percent of participants increased their fruit and vegetable consumption by an average of two cups. In addition, families reported a significant increase in household food security.

Each dollar invested in the program provides healthier foods for participants, boosts income for small and mid-sized farms and supports the overall health of the community. As with the DVCP, there are benefits for producers and communities.  In 2012 alone, FVRx brought in $120,000 in additional revenue for the 26 participating markets.

In less than seven years, Wholesome Wave has extended its reach to 25 states and DC and is working with more than 60 community-based organizations, community healthcare centers in six states, two hospital systems, and many others. Our work proves that increasing access to affordable healthy food is a powerful social equalizer, health improver, economic driver and community builder.

Wholesome Wave is working to change the world we eat in. As the number of on-the-ground partners increases, we get closer to a more equitable food system for everyone.  This means healthier citizens and communities, and a more vibrant economy nationwide.