186939 GIS Technology and Lead Poisoning Prevention in Mississippi

Wednesday, October 29, 2008: 11:15 AM

Marinelle Payton, MD, PhD, MS, MPH , College of Public Service, School of Health Sciences, Jackson State University, Jackson, MS
Stevenson Paradeshi, BS , College of Science Engineering and Technology, Jackson State University, Jackson, MS
Childhood lead poisoning remains one of the most preventable environmental diseases affecting children, yet, despite substantial reduction, studies show that children remain at-risk. Unlike most states, Mississippi has yet to implement an effective Lead Poisoning Prevention Program to track elevated blood lead levels in children. According to CDC reports, in 2006, there were hundreds of children confirmed with elevated blood lead levels in Mississippi. Lead-based paint in older (pre-1950) housing remains a major exposure and may pose a threat to children. To implement a lead poisoning prevention program consistent with the goal of Healthy People 2010 in eliminating elevated blood lead levels in children, utilizing Geographic Information System (GIS) Technology, a study was conducted to determine at-risk areas in the 82 counties in Mississippi. We used GIS layers of 2000 census data to determine populated areas in the state, Group Block data to locate structures constructed before 1950, and EBLLs (elevated blood lead levels) data from CDC. The results revealed that all counties had pre-1950 structures, and that there was a higher prevalence rate of lead poisoning in the pre-1950 and older housing in comparison to post-1978 housing. This is the first study in the state of Mississippi to utilize GIS targeted screening to assess the risk of lead poisoning. This study has great public health significance in developing effective targeted screening programs to improve children's health and to implement policy development and evaluation to prevent childhood lead poisoning.

Learning Objectives:
Describe childhood lead poisoning in the state of Mississippi. Discuss the potential risk associated with childhood lead poisoning and pre-1950 homes and other dwellings in Mississippi. Recognize the usefulness of GIS Technology in identifying children at-risk for lead poisoning.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I originated the idea to perform the research, performed the research and wrote the abstract. Education: M.D. Boston University School of Medicine, Boston, MA (Doctor of Medicine) (Combined M.D – Ph.D. Degrees) Ph.D. Boston University School of Medicine, Boston, MA (Doctor of Philosophy/Neurological Science) M.S. Tennessee State University, Nashville, TN (Master of Science/Biology) M.P.H. Harvard School of Public Health, Boston, MA (Master of Public Health/Epidemiology) Certificate Environmental-Occupational Medicine Residency Harvard School of Public Health, Boston, MA Certificate Surgery/Medicine Residency, Boston University Affiliated Hospitals, Boston, MA NARRATIVE REPORT OF MAJOR RESEARCH: While originally engaged in clinical practice, as a physician with concurrent M.D.-Ph.D. qualifications in neurological science with specialty training in surgery, radiology, and environmental-occupational medicine, I devoted my professional preparation to an academic career in administration, teaching, research, and service to improve community health in the United States through public health intervention and preventive policies and practices. Over the last decade, my primary research interest has been to assess the risk of environmental-occupational exposure of neurotoxins on the brain and central nervous system as it relates to chronic disease in two susceptible populations, children and the elderly. The adverse health effects of the exposure of one neurotoxin, inorganic lead, that continues to pose a significant public health problem, has been the focus of most of my studies. I have spoken extensively on this topic, in particularly, at national and international meetings, and served as either principal investigator or co-principal investigator of these studies funded by the National Institutes of Health and Centers for Disease Control and Prevention. Because of my interest in preventive strategies, I originated one of the first community-based studies on childhood lead poisoning intervention and prevention in a high-risk community in Boston, MA. However, most of my work utilized the ongoing longitudinal Normative Aging Study (NAS) participants of the VA Outpatient Clinic, Boston, MA. These studies include the effect of environmental exposure of lead on biogenic amines, renal function, hemoglobin, hypertension, and cognition in the middle-aged and the elderly. Because of my interest in neurotoxicity, I originated the study of lead and cognitive function in the NAS to examine the effects of this neurotoxin on various cognitive outcome measures. I, also, established the collaboration with investigators of the ongoing study of cognitive function in the NAS and administered the battery of neuropsychological tests to the participants of this study. This study of lead and cognitive function contributed to the successful funding of two research grants, "Lead Exposure, Accumulation in Bone, and Cognitive Toxicity" and "Lead Biomarkers, Aging, and Chronic Disease." One of my publications, "Relations of Bone and Blood Lead to Cognitive Function: The VA Normative Aging Study," was the first epidemiological study to report that higher levels of blood and bone (tibia) lead were significantly associated with poorer performance on various parameters of cognitive function in the elderly. Presently, lead poisoning continues to be one of my major research interests, as it remains one of the most pervasive preventable environmental diseases in the nation. Although studies have shown a significant association between lead exposure and various outcome measures in the United States, little is known about the exposure to lead in Mississippi. As Mississippi ranks high on health disparities, it is possible that a large number of its population is suffering from diseases associated with exposure to hazardous chemicals such as lead. To this end, I conduct research utilizing GIS technology to assess the risk for lead poisoning in Mississippi (this research has been accepted for national presentations). As the Chair (and Founding Member) of the Mississippi State Childhood Lead Poisoning Advisory Board and Chair of its Education Subcommittee, I have assisted the state in developing and writing its first Childhood Lead Poisoning Prevention Guidance and the Mississippi State Lead Poisoning Elimination Plan (in collaboration with the Centers for Disease Control and Prevention). In addition, I originated many service activities such as Town Hall Meetings on lead poisoning prevention and an annual conference series on Eliminating Health Disparities. My overarching research goal is consistent with that of Healthy People 2010/20 to identify, address, reduce, and ultimately eliminate the disproportionate impact of exposures to environmental toxins in susceptible populations. MAJOR RESEARCH FUNDING INFORMATION: 1988-1990 National Research Service Award Department of Epidemiology, Harvard School of Public Health National Institute of Environmental Health Sciences National Institutes of Health 1991-1993 Principal Investigator Clinical Environmental Medicine Fellowship Award Community Lead Exposure: Childhood Intervention/Prevention Agency for Toxic Substance Disease Registry ($52,000) Centers for Disease Control and Prevention Specific Aim: To assess the environmental exposure of lead in children (a community-based intervention prevention study). 1992 -1995 Investigator Superfund Project 3 ($429,752) Epidemiology of Lead, Diet and Blood Pressure Superfund Toxic Substances: Exposure and Disease ($9,966,856 – all projects) Specific Aim: To assess the environmental exposure and behavioral factors which contribute to biomarkers of various accumulated heavy metals. 1991-1996 National Institute of Environmental Health Sciences, National Institutes of Health Research Grant ($312,092) Epidemiology of Lead, Blood Pressure, Neurologic and Renal Function ($2,078,209 - total award) Specific Aim: To elucidate the inter relationship between accumulated lead burden measure by the K-X-Ray Fluorescence, blood lead levels, dietary calcium, and blood pressure. 1996-1997 Principal Investigator Alfred L. Frechette Award in Public Health Childhood Lead Poisoning Prevention Massachusetts Health Research Institute ($30,000) Specific Aim: To develop a childhood lead poisoning prevention and intervention program. 1995-2000 Co-Principal Investigator Superfund Grant Project 4 ($1,468,207) Lead Exposure, Accumulation in Bone, and Cognitive Toxicity in Elderly Men and Women Superfund Toxic Substances: Exposure and Disease ($12,202,028 – all projects) National Institute of Environmental Health Sciences National Institutes of Health Specific Aim: To assess and understand the risk to human health from toxic substances in the environment. The assessment of exposure – bone lead exposure and biomarkers–bone lead kinetics with respect to the bone changes associated with age. 1996-2001 Co-Investigator Lead Biomarkers, Aging and Chronic Disease ($2,818,784- requested funds) National Institute of Environmental Health Sciences National Institutes of Health Specific Aim: Studies of lead in the NAS and NHS to examine the cross-sectional and prospective relationships of lead dose to kidney function, cognitive performance and serum uric acid; and to test the hypothesis regarding the prospective relationship and modification of baseline lead data to changes in kidney function, lead toxicity by markers of bone resorption. 2001- 2003 Principal Investigator Institute of Epidemiology and Health Services Research ($951,478) Department of Public Health, School of Public Health Jackson State University Centers for Disease Control and Prevention Specific Aim: To establish and build the infrastructure of the Institute of Epidemiology and Health Services Research in the Department of Public Health, Jackson State University. Built the School’s first research infrastructure, the Institute of Epidemiology and Health Services Research that has provided the foundation for meeting public health program/school accreditation criteria for research. Established a state-of-the-art Surveillance Laboratory to develop data repositories. 2002- Environmental Health and Bioterriorism Task Force National Mdical Association Department of Health and Human Services Specific Aim: Studying the impact of bioterriorism on minority communities; accessing and developing training and curricula on environmental health and bioterriorism. 2003- Principal Investigator Institute of Epidemiology and Health Services Research ($1,131,679). Department of Public Health, School of Public Health Jackson State University Centers for Disease Control and Prevention Specific Aim: Research to address rural and urban problems in Mississippi (to identify, address and eliminate health disparities). 2003-2004 Principal Investigator Road Map to Eliminating Health Disparities ($121,038) Centers for Disease Control and Prevention Specific Aim: To develop a roadmap that will help to eliminate health disparities in Mississippi. 2003 – 2007 Director Planning and Evaluation Core. Excellence in Partnerships for Community Outreach, Research on Health Disparities and Training (“Project Export”). Center for Excellence in Minority Health National Institutes of Health. Pursued opportunities to establish EXPORT Center Grant for the Jackson State University Department/School of Public Health – attended workshop in 2002 (Dallas, TX) to develop project cores – awarded $4,500,000 for four yrs. Pursued opportunity to establish EXPORT Grant for the Jackson State University Department of Public Health – attended workshops on developing the EXPORT Center. Specific Aims: Community outreach, research on health disparities and training. 2003 – 2004 Principal Investigator Partnership to Address Asthma Prevention in the Lower Mississippi Delta. Planning Grant ($15,000 ) Centers for Disease Control and Prevention/Association of Schools of Public Health Specific Aim: To study asthma triggers. 2003 – 2004 Principal Investigator From Haircuts and Soap Operas to Health Disparities Planning Grant ($20,869) Centers for Disease Control and Prevention/Association of Schools of Public Health Specific Aim: To develop health education programs to prevent disease in underserved populations. 2004 Co-Project Director Consortium of African American Public Health Programs. A multi-site, multi-state applied research project on nutrition and obesity. Specific Aim: To develop and implement nutrition, education and physical activity programs to prevent the prevalence of obesity in underserved populations. 2005 Co- Investigator BodyLove Project - A collaboration with the University of Alabama School of Public Health. Specific Aim: To promote health education via radio shows. 2005 Principal Investigator Post Katrina Activities. To sponsor the Fourth Annual Conference on Eliminating Health Disparities in Mississippi: From Research to Action, Institute of Epidemiology and Health Services Research, Jackson State University, Jackson, MS ($40,000). National Institute of Mental Health, National Institutes of Health. Specific Aim: To sponsor the Fourth Annual Conference on Eliminating Health Disparities in Mississippi/post-katrina activites: From Research to Action, Institute of Epidemiology and Health Services Research, Jackson State University, Jackson, MS. 2006 - Principal Investigator Delta Health Initiative Project. A partnership of a $25,000,000 award to the Delta Health Alliance ($1,001,000). The Office of Rural Health and Policy, Department of Health and Human Services. Specific Aim: To eliminate health disparities in the Mississippi Delta. Projects are on obesity, HIV/AIDS, stroke, and data surveillance of health services. 2006 - 2008 Principal Investigator Center for Excellence in Minority Health (“Project EXPORT” - Excellence in Partnerships for Community Outreach, Research on Health Disparities and Training) ($4,560,000). National Center of Minority Health and Health Disparities, National Institutes of Health Specific Aim: To reduce and ultimately eliminate health disparities in minorities. 2006 - 2007 Principal Investigator Utilizing National Library Resources to Eliminate Health Disparities in HIV/AIDS ($20,000) National Library of Medicine, National Institutes of Health. Specific Aim: To eliminate health disparities in HIV/AIDS by increasing health literacy of students and community residents in the Jackson Metropolitan Area through using the National Library of Medicine online resources; and to house two National Library of Medicine Work Stations in the Health Sciences Library. 2006 - Co – Investigator, BodyLove Radio Show on Diabetes Partnership with the University of Alabama School of Public Health at Birmingham, Alabama. 2007 - 2010 Principal Investigator Fighting Obesity in Mississippi ($90,000) National Child Health and Development National Institutes of Health. Specific aim is to establish an annual health workshop series on diabetes and obesity (diabesity) to assess change in unhealthy lifestyle behaviors, and identify community health needs. Selected Publications: Payton M, Hu H, Sparrow D, Young JB, Landsberg L, Weiss ST. Relation between Blood Lead and Urinary Biogenic Amines in Community-exposed Men. Am J Epidemiol 1993;138:815-25. Wantanabe H, Hu H, Payton M, Korrick S, Rotnitzky A. Correlates of Bone and Blood Lead Levels in Carpenters. AM J Ind Med 1994;26:255-64. Hu H, Wantanabe H, Payton M, Korrick S, Rotnitzky A. The Relationship Between Bone Lead and Hemoglobin. JAMA 1994;272:1512-17. Payton M, Hu H, Sparrow D, Weiss ST. Low-level Lead Exposure and Renal Function in the Normative Aging Study. Am J Epidemiol 1994;140:821-829. Payton M, Riggs K, Spiro R, Weiss ST, Hu H. Low-Level Lead Exposure and Cognitive Function in the Elderly. Am J Epidemiol 1995;6(4):S43. Payton M, Riggs K, Spiro A, Weiss ST, Hu H. Lead Exposure and Cognitive Function in Aging Men. Am J Epidemiol 1996;143(11):S44. Hu H, Aro A, Payton M, Korrick S, Sparrow D, Weiss STW, Rotnitzky A. The Relationship of Bone and Blood Lead to Hypertension: The Normative Aging Study. JAMA 1996;275(15):1171-1176. Hu H, Payton M, Korrick S, Sparrow D, Weiss STW, Rotnitzky A. Determinants of Bone and Blood Lead Levels among Community-Exposed Middle-Aged to Elderly Men: The Normative Aging Study. Am J Epidemiol 1996;144:749-59. Payton M, Riggs K, Spiro R, Weiss ST, Hu H. Relations of Bone and Blood Lead to Cognitive Function: The VA Normative Aging Study. Neurotoxicol Teratol 1998;20:19-27. Payton, M. (ed.) Forward, Special Edition of the Researcher: An Interdisciplinary Journal, Jackson State University, 2003;19 (1). Payton M, Mawson A. (eds.) Introduction, Special Edition of the Researcher: An Interdisciplinary Journal, Jackson State University, 2005;20 (2). Payton, M, Williams, V., Okojie, F. The National Alumni AIDS Prevention Project Strategies for Capacity Building, Researcher: An Interdisciplinary Journal, Jackson State University, 2004-05;19 (4): 60-65. Payton, M, et al. The Arizona African American Health Information System: A Linked Network Service, Researcher: An Interdisciplinary Journal, Jackson State University, 2004-05;19 (4): 32-39. Payton, M and Mawson A (eds.) Special Edition of the Researcher: An Interdisciplinary Journal, Jackson State University, 2005;20 (2). Younis M, Payton M, Celeicj Y, Younies H. A Review of Implications of informational Asymmetry and Principal-Agent Relationship, The Journal of Public Budgeting, Accounting and Financial Management, (submitted for publication). Risisky D, Hogan VK, Kane M, Burt B, Dove C, Payton M. Concept Mapping as a Tool to Engage a Community in Health Disparity Identification. Ethnicity and Disease 2008;18:77-83. Berget RJ, Reynolds CF, Ricci EM, Quinn SC, Mawson AR, Payton M, Thomas SB. A Plan to facilitate the Early Career Development of Minority Scholars in the Health Sciences. Health and Social Policy (accepted). Jacobs B, Mawson AR, Payton M, Guignard JC. Myth and Reality Concerning the Public Health Impact of Disasters: The Case of Hurricane Katrina. Myth and Reality Concerning the Public Health Impact of Disasters: The Case of Hurricane Katrina. Public Health Reports 2008; 123(5). Proceedings of Meetings Payton M. The Epidemiology of Lead, Diet, and Blood Pressure. In: Proceedings of Symposium on Environmental Health Sciences and Toxicology. Atlanta: National Institutes of Health and Clark Atlanta University, 1991. Hu H, Kim R, Payton M, Korrick S, Sparrow D, Weiss ST. The relationship of bone and blood lead to hypertension: further analyses of the normative aging study data. Proceedings of the 1996 Pacific Basin Conference on Hazardous Waste, Nov 4-8, 1996. East-West Center: Honolulu. Editor Payton M. Guest Editor, The Researcher: An Interdisciplinary Journal. Jackson State University. A Special Edition by the Institute of Epidemiology and Health Services Research. 2003;Vol. XIX (No. 1). Payton M and Mawson A. Guest Editors, The Researcher: An Interdisciplinary Journal. Jackson State University. A Special Edition by the Institute of Epidemiology and Health Services Research. 2005;Vol. XX (No. 2). Bronner YL, Payton M, Rodney P, Washington WN. Editors, Health Disparities? Not in My Community. Model programs for improving health outcomes FalkonQuest Publishing, Encino, CA, 2006.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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