The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #58930

Christen O'Haire, BA¹, Lynne M. Dansereau, MSPH¹, Peter Simon, MD MPH², and Patrick M. Vivier, MD, PhD¹. (1) Community Health, Brown University, Box G-A4, 97 Waterman Street, Providence, RI 02912, 401-863-9784, Christen_O'Haire@Brown.edu, (2) Rhode Island Department of Health, 3 Capitol Hill, Providence, RI 02908

Background: Lead poisoning is a serious, preventable, environmental health threat to children in the United States. Children enrolled in Medicaid are at a higher risk for lead poisoning.

Objectives: To compare the likelihood of lead screening and the risk of lead poisoning among Medicaid and commercially insured children enrolled in the same managed care organization.

Methods: We conducted a retrospective cohort analysis of 1823 Rhode Island children who turned 30 months of age between January 1, 2001 and December 31, 2001 and who were enrolled in the same managed care organization through either commercial insurance or through the state’s Medicaid program.

Results: Approximately 88 percent of all children were screened for lead poisoning at least once by 30 months of age. The proportion of children screened for lead poisoning did not differ by Medicaid (88.0 percent) and commercial (87.3 percent) insurance enrollment. Of the children screened for lead poisoning, 11.4 percent had an elevated blood lead level (> 10 ug/dL) on at least one test. Children enrolled in Medicaid (15.1 percent) were nearly three times as likely to have an elevated blood lead level as compared to commercial enrollees (5.3 percent).

Conclusions: In this state, where lead screening is recommended for all preschool children, a high proportion of Medicaid and commercially enrolled children received at least one lead screening by age 30 months. Medicaid enrolled children disproportionately bore the burden of lead poisoning as compared to commercially enrolled children.

Learning Objectives:

• Compare the likelihood of lead screening and the risk of lead poisoning among Medicaid and commercially enrolled children in the same managed care organization.

Keywords: Lead, Managed Care

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.