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Hidden hazards and screening policy: Predicting undetected lead exposure in Illinois

Author

Listed:
  • Abbasi, Ali
  • DiTraglia, Francis J.
  • Gazze, Ludovica
  • Pals, Bridget
Abstract
Lead exposure still threatens children’s health despite policies aiming to identify lead exposure sources. Some US states require de jure universal screening while others target screening, but little research examines the relative benefits of these approaches. We link lead tests for children born in Illinois between 2010 and 2014 to geocoded birth records and potential exposure sources. We train a random forest regression model that predicts children’s blood lead levels (BLLs) to estimate the geographic distribution of undetected lead poisoning. We use these estimates to compare de jure universal screening against targeted screening. Because no policy achieves perfect compliance, we analyze different incremental screening expansions. We estimate that 5,819 untested children had a BLL ≥5μg/dL, in addition to the 18,101 detected cases. 80% of these undetected cases should have been screened under the current policy. Model-based targeted screening can improve upon both the status quo and expanded universal screening.

Suggested Citation

  • Abbasi, Ali & DiTraglia, Francis J. & Gazze, Ludovica & Pals, Bridget, 2023. "Hidden hazards and screening policy: Predicting undetected lead exposure in Illinois," Journal of Health Economics, Elsevier, vol. 90(C).
    • Handle: RePEc:eee:jhecon:v:90:y:2023:i:c:s0167629623000607
    DOI: 10.1016/j.jhealeco.2023.102783
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    References listed on IDEAS

    as
    1. Stephen B. Billings & Kevin T. Schnepel, 2018. "Life after Lead: Effects of Early Interventions for Children Exposed to Lead," American Economic Journal: Applied Economics, American Economic Association, vol. 10(3), pages 315-344, July.
    2. Liran Einav & Amy Finkelstein & Tamar Oostrom & Abigail Ostriker & Heidi Williams, 2020. "Screening and Selection: The Case of Mammograms," American Economic Review, American Economic Association, vol. 110(12), pages 3836-3870, December.
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    6. Alex Hollingsworth & Ivan Rudik, 2021. "The Effect of Leaded Gasoline on Elderly Mortality: Evidence from Regulatory Exemptions," American Economic Journal: Economic Policy, American Economic Association, vol. 13(3), pages 345-373, August.
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    11. Hans Grönqvist & J. Peter Nilsson & Per-Olof Robling, 2020. "Understanding How Low Levels of Early Lead Exposure Affect Children’s Life Trajectories," Journal of Political Economy, University of Chicago Press, vol. 128(9), pages 3376-3433.
    12. Kim, Hyuncheol Bryant & Lee, Sun-mi, 2017. "When public health intervention is not successful: Cost sharing, crowd-out, and selection in Korea's National Cancer Screening Program," Journal of Health Economics, Elsevier, vol. 53(C), pages 100-116.
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    More about this item

    Keywords

    Lead poisoning; Environmental health; Screening; Machine learning;
    All these keywords.

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • D61 - Microeconomics - - Welfare Economics - - - Allocative Efficiency; Cost-Benefit Analysis

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