251037 An innovative law enforcement strategy through health and housing collaboration: The Philadelphia Lead Court

Tuesday, November 1, 2011: 2:30 PM

Carla Campbell, MD, MS , Department of Environmental and Occupational Health, Drexel School of Public Health, Philadelphia, PA
Curtis E. Cummings, MD, MPH , Department of Environmental and Occupational Health, Drexel University School of Public Health, Philadelphia, PA
Edward Gracely, PhD , Department of Epidemiology and Biostatistics, Drexel School of Public Health, Philadelphia, PA
Peter Palermo, MS , Philadelphia Department of Public Health, Philadelphia, PA
George Gould, JD , Community Legal Services of Philadelphia, Philadelphia, PA
Objectives: This study was designed to determine if the Philadelphia Lead Court was effective as an innovative law enforcement strategy in enforcing the existing city health code when property owners had not responded to orders from the Philadelphia Department of Public Health (PDPH) to remediate lead hazards found in the homes of children with elevated blood lead levels (BLLs). Methods: A quantitative assessment reviewed PDPH of cases from 1998-2002 (the Pre-Court Period) and from 2003-2008 (the Court Period). Compliance rates for each era were compared using a chi-square analysis. Time to compliance was determined by using Kaplan-Meier curves to look at the months until compliance, and a log-rank test compared them. The trends for BLLs of resident children will be examined for the period after compliance is achieved. Qualitative data was analyzed for trends and key themes among 15 key participants in the Lead Court process. Results: A total of 4207 unique properties from the health department records were analyzed. Within one year of the initial failed property inspection 6.6 % of the pre-Court and 72.6% of the Court cases had achieved compliance; p<.0001. The mean number of months to compliance was 50.1 (95% CI=49.3-51.0) months in the pre-Court era and 21.4 (95% CI= 20.1-22.8) months in the Court era; p<0.001. During interviews with Court participants, the responses indicated agreement that the court was very effective, with pre-Court enforcement strategies not effective. Conclusions: Lead Court is proven to be very effective, whereas the pre-court strategies were not effective. With Lead Court, most properties were remediated within one year of the initial failed inspection, and the mean number of months to compliance was less than half. This model of a specialized court could be replicated in other cities with similar problems of housing with lead hazards or difficulties in code enforcement.

Learning Areas:
Environmental health sciences
Public health or related public policy
Public health or related research

Learning Objectives:
1. Explain how housing and health code violations can lead to lead exposure and lead poisoning of young children. 2. Describe how a specialized court system can be created and utilized to carry out health code enforcement.

Keywords: Environmental Exposures, Child Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have worked in childhood lead poisoning prevention for years and was the Principal Investigator on the study for the abstract being submitted.
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.