Identifying Jurisdictions at Risk of Containing Housing Units With Deteriorated Paint: Results and Targeting Implications for the US Department of Housing and Urban Development

CONTEXT: The US Department of Housing and Urban Development provides millions in annual funding to make low-income housing lead safe, but funds are limited relative to need. To adequately target efforts, local program administrators must identify neighborhoods that are the most “at risk” of residential lead exposure; however, no federal agency currently provides a public data set for this use. OBJECTIVES: To examine pre-1980 households with large areas of deteriorated paint, a significant and common predictor of lead dust, and identify high-risk jurisdictions. To highlight the potential use of a newly available data set for strategic lead poisoning prevention and targeting. DESIGN: Microdata from the 2011 American Housing Survey and the 2009-2013 American Community Survey were used to develop a household-level predicted risk metric that identifies housing units at risk of containing large areas of deteriorated paint. Predicted risk, defined as the mean predicted percentage of occupied housing units at risk of containing deteriorated paint within a given jurisdiction, was summarized by state, county, and tract. SETTING: National, all occupied housing units. PARTICIPANTS: Occupied housing units summarized by household (n = 9 363 000), census tract (n = 72 235), county (n = 3143), and state (n = 51). MAIN OUTCOME MEASURE: Housing units built prior to 1980 with a large area of deteriorated paint. RESULTS: New York, Rhode Island, New Jersey, Massachusetts, and Pennsylvania had the highest predicted percentage of at-risk households (range: 2.52%-2.90%). County-level and tract-level estimates are the most useful when examining a predefined jurisdiction; New York state was presented as a case study. County-level quartile risk scores revealed Albany as an at-risk jurisdiction. Tract-level quartile risk scores further identified at-risk neighborhoods in northeastern Albany. CONCLUSIONS: Findings can help housing and health policy makers identify and target geographic areas with a high probability of households at risk of potential exposure to deteriorated lead-based paint.