Safe and Healthy Homes

In 2004, 5.1% of 109,110 Chicago children tested had an elevated blood lead level (BLL, defined as ≥10 μg/dL); particular areas had highest prevalence with elevated BLLs, including 10.6% of children in Chicago’s west side and 7.9% of children living in south side neighborhoods. Over the past decade the prevalence of elevated BLLs among Chicago children has decreased markedly. However, such efforts are not sufficient for Chicago to meet the Healthy People 2010 goal of elimination of childhood lead poisoning. Additionally, recent research has determined negative health effects of lead at even very low levels. Reducing the potential for exposure to lead and fostering the primary prevention of elevated BLLs among Chicago children will require application of innovative strategies to reach families with young children and address lead hazards when children are very young. Chicago is a prime location for application of programs that focus on primary prevention of lead exposures through addressing housing-related concerns. An estimated 59% of Chicago homes were built before 1950 and, thus, are at high risk for having a lead paint hazard. Chicago has existing programs to address lead hazards, including programs for identification and repair of lead hazards in housing and Lead Safe Work Practices (LSWP) training conducted by the Chicago Department of Public Health (CDPH). These programs can support an increased capacity.

The goals of the project are to:
1) implement systems in primary care medical practices located in high-risk Chicago neighborhoods that will facilitate routine identification of families of infants and young children with high likelihood for exposures to lead hazards;
2) connect willing families to a community agency through which they will receive additional information lead; and
3) increase number of requests for preventive home inspection and increase participation in CDPH sponsored LSWP trainings.

The following objectives will allow us to accomplish these goals:
1) develop the Safe & Healthy Homes (S&HH) Program, including: "
a) a S&HH fax which parents (primarily those with children <2 years) or pregnant women can complete during medical visits to request information about lead from a community agency
b) content of educational encounters from community agency to parents that will personalize lead risks to home characteristics, and provide information on opportunities for lead education, LSWP training, and programs to evaluate and address their housing needs
2) engage 8 primary care practices to participate in the S&HH Program
3) facilitate the implementation of systems at these primary care offices to promote the submission of S&HH Faxes to the community agency
4) provide education to parents identified through submitted faxes through mail, e-mail, and telephone contacts and at lead education group sessions and home visits
5) foster and promote preventive home inspections by CDPH, participation in CDPH-sponsored LSWP trainings, and participation in other programs that evaluate and address lead hazards
6) evaluate the impact of this primary prevention approach by determining the number of lead inspections for preventive evaluations in targeted areas and the number of individuals referred by the project who complete LSWP training.


The activities of this project will be accomplished in the following manner:
1) culturally-appropriate project materials and procedures with be developed through the partnering agencies and translated into Spanish
2) medical practices will be engaged in the project and each practice will determine a team to address systems changes necessary to implement the S&HH Fax
3) staff members at medical practices will receive lead education and have practice systems change efforts fostered and coordinated by an experienced facilitator throughout the project
4) parents identified on S&HH faxes submitted by the practices will receive follow-up from the community agency within 2 weeks of the receipt of the fax with information provided personalized to their home and neighborhood
5) parents will be invited to attend a lead education parent sessions, or receive a home visit if they have heightened concerns and request in-person education, and will be invited to attend CDPH sponsored LSWP trainings and participate in other programs, as appropriate;
6) number of inspections for lead by the CDPH for program participants will be monitored by accessing, which contains current, updated home inspection data for Chicago; other outcome data will be collected by reports from the CDPH.

Anticipated outcomes of the program:
1) 8 primary care practices will receive training and apply the S&HH Fax in their practices
2) Personalized educational materials will be mailed to an estimated 5,920 parents
3) Additional follow-up will be provided by telephone to 1,184 parents; through home visits to 148 parents and in Lead Education group sessions for 340 parents
4) 511 families will request and receive a lead inspection from CDPH (property owners must repair lead hazards if found, as mandated by city ordinance)
5) 80 individuals will be trained at CDPH LSWP trainings

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