Use of Geospatial Analysis for Assessing the Exposure and Risks of Elevated Blood Lead Levels among Children in Chicago City

Abstract

Lead (Pb) is a bluish-white, lustrous, soft, malleable, ductile, and poor electroconductive metal that has various uses to mankind. However, when this useful metal is absorbed by the body, various health effects are induced, often characterized as lead poisoning. In the United States, lead poisoning has decreased as a whole in recent years; however, it remains a major concern to children, still affecting 1 out of every 6 in Chicago. Therefore, the goal of this study is to evaluate the spatial distribution of aggregated children’s elevated Blood Lead Levels (BLLs) in Chicago’s neighborhoods as well as its relationship with the social-economic, behavioral, and cognitive factors. Geovisualization, geospatial pattern analysis, and spatially-resolved spatial modeling tools built in ArcGIS were used. Accordingly, a significant geographical control of the BLLs was detected such that lower BLLs were detected in the central, northern, far northern, and southwestern sides of the city, while the higher BLLs were detected in the western, southern, and southwestern sides of the city (i.e., I = 0.34, permutation 999, and p-value 0.001). This distribution has shown statistically significant associations (i.e., R2 = 40 – 54; and P < 0.05) with the social-economic, behavioral, and cognitive variables, indicating the likelihoods of incidences of violent crimes, poverty, and minority and lower students’ performances in the higher BLLs areas. However, it is not clear if these associations imply causations to the higher/lower BLLs or vice versa. Therefore, further studies would be critical to establish how much of these associations are the causations.

Full text

Use of Geospatial Analysis for Assessing the Exposure and Risks of Elevated
Blood Lead Levels among Children in Chicago City
Deidre White
A thesis submitted in partial fulfillment of the requirements for the
degree of Master of Arts in Geography with a Concentration in
Geographic Information Systems (GIS)
Chicago State University
2022

Elevated Blood Lead Level among Chicago Children White 2022
Page | 2
APPROVAL SHEET
We have examined this manuscript and verify that it meets the program and
University requirements for the degree of Master of Geography with Geographic
Information Systems (GIS) Concentration
Thesis Committee:
Dr. Tekleab Shibru Gala (Thesis Advisor) . Date
Associate Professor of Geomatics
Chicago State University
Dr. Daniel Block (Thesis Committee Member). Date
Professor of Geography
Chicago State University
Dr. Aynaz Lotfata (Thesis Committee Member). Date
Assistant Professor of Human Geography
Chicago State University

Elevated Blood Lead Level among Chicago Children White 2022
Page | 3
ABSTRACT
Lead (Pb) is a bluish-white, lustrous, soft, malleable, ductile, and poor
electroconductive metal that has various uses to mankind. However, when this
useful metal is absorbed by the body, various health effects are induced, often
characterized as lead poisoning. In the United States, lead poisoning has decreased
as a whole in recent years; however, it remains a major concern to children, still
affecting 1 out of every 6 in Chicago. Therefore, the goal of this study is to evaluate
the spatial distribution of aggregated children’s elevated Blood Lead Levels (BLLs)
in Chicago’s neighborhoods as well as its relationship with the social-economic,
behavioral, and cognitive factors. Geovisualization, geospatial pattern analysis, and
spatially-resolved spatial modeling tools built in ArcGIS were used. Accordingly, a
significant geographical control of the BLLs was detected such that lower BLLs were
detected in the central, northern, far northern, and southwestern sides of the city,
while the higher BLLs were detected in the western, southern, and southwestern
sides of the city (i.e., I = 0.34, permutation 999, and p-value 0.001). This distribution
has shown statistically significant associations (i.e., R2 = 40 – 54; and P < 0.05) with
the social-economic, behavioral, and cognitive variables, indicating the likelihoods
of incidences of violent crimes, poverty, and minority and lower students’
performances in the higher BLLs areas. However, it is not clear if these associations
imply causations to the higher/lower BLLs or vice versa. Therefore, further studies
would be critical to establish how much of these associations are the causations.
Keywords: Lead poisoning, Blood Lead Level (BLL), Crime, Chicago, Children, Spatial
analysis (GIS)

Elevated Blood Lead Level among Chicago Children White 2022
Page | 4
ACKNOWLEDGMENTS
I first must thank my thesis advisor & professor Dr. Tekleab Gala who
consistently steered me in the right direction and whose door was always open
whenever challenges came up with my thesis. I would also like to thank my advisor
& professor Dr. Block for his commitment to his students.
I acknowledge Sargent John Cleggett of Chicago Police department for his
time and assistance in identifying violent crimes within the data used for this thesis.
I give special thanks to my family and friends for the countless hours of
listening to me repeatedly.

Elevated Blood Lead Level among Chicago Children White 2022
Page | 5
TABLE OF CONTENTS
APPROVAL SHEET 2
ABSTRACT 3
ACKNOWLEDGMENTS 4
TABLE OF CONTENTS 5
LIST OF FIGURES 7
LIST OF TABLES 8
ABBREVIATIONS 9
CHAPTER 1: GENERAL INTRODUCTION 10
1.1. BACKGROUND OF LEAD POISONING 10
1.2 LEAD POISONING IN CHICAGO 122
1.3. RESEARCH GOAL AND OBJECTIVES 133
CHAPTER 2: LITERATURE REVIEW 155
2. 1. LEAD AND BENEFIT 155
2.2. HAZARDS OF LEAD POISONING 166
2.2.1. CRIMINAL BEHAVIOR .............................................................................................................. 177
2.2.2. ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD) ............................................................... 177
2.2.3. SOCIAL ECONOMIC IMPACT AND DISPARITIES ........................................................................... 1818
2.3. PATHWAYS 19
2.3.1. SOIL AND GARDENING ........................................................................................................... 1919
2.3.2. EMPLOYMENT ....................................................................................................................... 200
2.3.3. CHILDREN HANDS TO MOUTH ................................................................................................. 200
2.3.4. TOYS .................................................................................................................................... 211
2.3.5. SMELTER ............................................................................................................................... 211
2.4. GIS APPLICATION OF ELEVATED LEAD POISING ................................................................................ 222
2.4.1. CHOROPLETH MAPS ............................................................................................................... 222
2.4.2. SPATIAL AUTOCORRELATIONS .................................................................................................. 233
2.4.3. OVERLAY ANALYSIS ................................................................................................................ 244
2.4.4. SPATIAL RELATIONSHIP ........................................................................................................... 255
2.4.4.1. ORDINARY LEAST SQUARES (OLS) REGRESSION ....................................................................... 255
2.4.4.2. GEOGRAPHICALLY WEIGHTED REGRESSION (GWR) ................................................................... 266

Elevated Blood Lead Level among Chicago Children White 2022
Page | 6
CHAPTER 3: MATERIAL AND METHODOLOGY 2828
3.1. OVERVIEW OF THE STUDY AREA 28
3.2. DATA ACQUISITION AND DESCRIPTION 29
3.2.1. BLOOD LEAD LEVELS (BLLS), POVERTY RATE AND PER CAPITAL INCOME .......................................... 300
3.2.2. ILLINOIS STANDARDS ACHIEVEMENT TEST (ISAT) ........................................................................ 311
3.2.3. VIOLENT CRIME INCIDENCES ..................................................................................................... 311
3.2.4. PERCENT AFRICAN AMERICAN POPULATION ............................................................................... 322
3.2.5. HARDSHIP INDEX .................................................................................................................... 333
3.3. RESEARCH METHODOLOGY 344
3.3.1. SPATIAL ANALYSIS BLOOD LEAD LEVELS (BLLS) AMONG THE CHILDREN AGED 0 – 6 YEAR IN THE
NEIGHBORHOODS OF CHICAGO .......................................................................................................... 344
3.3.2. MODELLING SPATIAL ASSOCIATIONS OF BLL AMONG CHILDREN (I.E., 1 – 6 AGES) AND ASSOCIATED SOCIAL-
ECONOMIC, BEHAVIORAL, COGNITIVE FACTORS ..................................................................................... 366
3.3.3. VALIDATION METHODS .......................................................................................................... 387
CHAPTER 4: RESULT AND DISCUSSION 3939
4.1. BLOOD LEAD LEVELS (BLLS) AMONG THE CHILDREN AGED 0 – 6 YEAR AMONG THE CHICAGO
NEIGHBORHOODS 39
4.2. SPATIAL RELATIONSHIP OF ELEVATED LEAD BLOOD LEVEL AND CRIME OCCURRENCE RATE AND TEST SCORES
FOR THE CHICAGO NEIGHBORHOODS 422
4.3. ANALYZING THE SPATIAL RELATIONSHIPS OF ELEVATED LEAD BLOOD LEVELS AND SOCIOECONOMIC
CHARACTERISTICS OF THE CHICAGO NEIGHBORHOODS 455
CHAPTER 5: CONCLUSIONS AND RECOMMENDATIONS 4848
5.1. RESEARCH FINDINGS 48
5.2. RESEARCH SIGNIFICANCE 4949
5.3. RESEARCH LIMITATIONS 500
6. REFERENCES 532

Elevated Blood Lead Level among Chicago Children White 2022
Page | 7
LIST OF FIGURES
Figure 1: Ripple Effects of Elevated Lead Poisoning ............................................................. 11
Figure 2: The study area.................................................................................................................... 29
Figure 3: The 2017 data of elevated lead blood level among the children aged 0 – 6
year among community areas of Chicago .................................................................................. 41
Figure 4: Geographically Weighted Spatial Relationships of elevated lead blood level
and the crime occurrence and students’ test scores for the 77 community areas of
Chicago .................................................................................................................................................... 44
Figure 5: Geographically Weighted Spatial Relationships of elevated lead blood level:
a) percent African American population, b) economic hardship index, c) population’s
percent below poverty line, and d) household per Capital income of the community
areas of Chicago .................................................................................................................................... 47

Elevated Blood Lead Level among Chicago Children White 2022
Page | 8
LIST OF TABLES
Table 1: Relationships of blood lead level among the children and ISAT score and
Crime Occurrence ............................................................................................................................... 42
Table 2: Relationships of elevated lead blood level among the children and
socioeconomic characteristics ....................................................................................................... 45

Elevated Blood Lead Level among Chicago Children White 2022
Page | 9
ABBREVIATIONS
BLLs
Blood Lead Levels
WHO
World Health Organization
GIS
Geographical Information System
CDC
Disease Control and Prevention
ACCLPP
Advisory Committee on Childhood Lead Poisoning Prevention
Pb
Lead
ADHD
Attention deficit hyperactivity disorder
IQ
Intelligence Quotient
NTP
National Toxicology Program
GWR
Geographical Weighted Regression
OLS
Ordinary Least Square
ISAT
Illinois Standards Achievement Test

Elevated Blood Lead Level among Chicago Children White 2022
Page | 10
CHAPTER 1: GENERAL INTRODUCTION
1. Background of Lead Poisoning
Over the past 60 years, elevated BLLs have changed drastically. In 1960, the
standard was set at 60 deciliters. University of Pittsburgh psychiatrist Herbert L.
Needleman and others began observing “silent lead poisoning” in children with
BLLs below the establishment limit (Needleman et al., 1996). These studies revealed
these children had low IQ scores, attention problems, and antisocial tendencies. As
more and more reports of these deficits filtered in, the Center for Disease Control
and Prevention (CDC) lowered the BLL it deemed acceptable for children further
and further: In 1970, the amount was 40 micrograms per deciliter, and by 1991, it
was 10 micrograms per deciliter.
The CDC recently confirms there are no safe levels of elevated lead (Meyer et
al., 2003; Jones et al., 2009; Wheeler, & Brown, 2013). As of 2012, the CDC lowered
the testing standard BLL of 10 micrograms per deciliter to 5 micrograms per
deciliter. Lead poisoning occurs when lead or any of its salts are absorbed into the
body (Meyer, 2003). Damage to the body is irreversible, but treatment could
prevent further damage. Once ingested or inhaled, various systems within the body
are affected by lead, including the central nervous, cardiovascular, immunological,
endocrine (Advisory Committee on Childhood Lead Poisoning Prevention (ACCLPP)
2012), renal, and hepatic systems (Committee on Environmental Health, 2005).
Children being more susceptible to lead absorption can have a negative influence
with brain development and the nervous system. Long-term exposure in young

Elevated Blood Lead Level among Chicago Children White 2022
Page | 11
children could result in cognitive challenges, brain damage, and behavioral
problems that often lead to criminal activities (See Fig.1) (Tarrago, & Brown, 2017).
Figure 1: Ripple Effects of Elevated Lead Poisoning. (Source: Lead Safe
Illinois, Loyola University Chicago, accessed June 1, 2021)
Lead poisoning accounts for approximately 0.6% of the global burden of
disease (Sander et al., 2009; World Health Organization (WHO), 2010). In 2014 an
estimated 4 million children within the United States lived in homes that put them
at risk for cognitive and behavioral impairments due to exposure to environmental
lead (Adams, et al., 2014). Currently, pediatricians under the guidelines of the city of
Chicago are mandated to follow-up with children up to the age of 5 years old.
However, there is currently no other assistance required or provided beyond that
age.

Elevated Blood Lead Level among Chicago Children White 2022
Page | 12
1.2 Lead Poisoning in Chicago
In 2005, it was noted that Chicago lead the nation in the number of
children identified with lead poisoning. Spatially dependent environmental risk
factors for lead poisoning include residence or substantial time spent in a home or
location built before 1978 (Kim et al. 2008). Close to 87% of Chicago homes were
built before 1978, the year lead-based paint was outlawed. In a review of twenty-
three research articles using geographic information systems (GIS) to model
childhood lead poisoning from 1991 to 2012, the most commonly cited risk factor
was age of housing (Akkus & Ozdenerol 2014). After 40 years of banning the use of
lead-based paint, it continues to be a major issue in Chicago. Because the city has
such a sizable number of residents, the primary concerns are to promote health,
prevent disease, and reduce environmental hazards for all Chicagoans. Deteriorated
paint inside houses that contained lead was believed to be the main pathway of
exposure. The dynamics of long-term lead poisoning of children can affect their
lives well into adulthood; moreover, one of the effects could result in criminal
behavior.
Lead poisoning is an environmental hazard that can wreak havoc in young
children more so than adults. By the time a child is found with an elevated BLL, the
neurodevelopmental harm from the exposure may have already occurred (Sample,
2020). The elevation of lead in the blood stream became prevalent after the
industrial era; to this day, prevention has become an important focus in protecting
children from exposure to lead. This raises a major concern in larger cities like
Chicago. In Chicago, over 80,000 children had elevated lead poisoning between

Elevated Blood Lead Level among Chicago Children White 2022
Page | 13
1996 and 2001, and even today, though the numbers are lower, childhood lead
poisoning continues to be a serious problem. Although, lead poisoning rates have
decreased significantly, Chicago is still one of the top cities with the largest absolute
number of identified children with lead poisoning in the nation. The city of Chicago
by obligation under Illinois law (Illinois lead poisoning prevention Act) mandates
they conduct lead risk assessments. Therefore, this research attempts to review the
geographical distribution of children tested for and having elevated BLLs, reported
crimes, and schools with proven low-test scores in all seventy-seven neighborhoods
of Chicago. The hypothesis is that there are viable geographical controls as well as
correlations between elevated BLLs and criminal activities, low test scores, and
existing socio-economic disparities in Chicago neighborhoods.
3. Research Goal and Objectives
The main goal of this research is to investigate the geographical distribution
of elevated BLLs among Chicago’s 77 neighborhood areas, using the Exploratory
spatial data analysis (ESDA) toolsets in ArcGIS. Additionally, the study deployed GIS
toolsets for modeling, examining, and exploring the relationship between the
elevated lead poisoning and crime, on one hand, as well as the economic status in
each of Chicago’s communities, on the other.
Therefore, the specific objectives are:
1. Geo-visualization and spatial dependency or nonstationary of the
Blood Lead Levels (BLLs) among the children aged 0 – 6 years among
the community neighborhood areas of Chicago

Elevated Blood Lead Level among Chicago Children White 2022
Page | 14
2. Spatial Ordinary Least Squares (OLS) and Geographically weighted
(GW) regression for modeling, examining, and exploring the spatial
relationship of elevated BLLs and crime occurrence rate and test
scores for the Chicago neighborhoods
3. Spatial Ordinary Least Squares (OLS) and Geographically weighted
(GW) regression for modeling, examining, and exploring the Spatial
relationships of elevated BLLs and socioeconomic characteristics of
the Chicago neighborhoods
Geographic Information Systems (GIS), has proven to be extremely beneficial
in studying geographical distribution of such phenomena. Additionally, the spatial
regression modeling is established as a statistical method, and was used to examine
the relationship between two spatial variables: Explanatory Variables vs. Response
Variables.

Elevated Blood Lead Level among Chicago Children White 2022
Page | 15
CHAPTER 2: LITERATURE REVIEW
2. 1. Lead and Benefit
Lead (Pb) is a bluish-white lustrous metal with an atomic number of 82, one
of the 118 chemical elements. It is considered a heavy metal because of its density
as compared with other common materials. Native lead is rare in nature and usually
found in ore with zinc, silver, and copper (Lenntech, 2018). Its extraction also
contains these elements. Australia is among the major lead producers of the world,
accounting for 19% of its production, followed by the USA, China, Peru, and Canada.
The world Lead production amounts to 6 million tons a year, and there are
estimated reserves of 85 million tons worldwide, which is less than a 15-year
supply. Physically and chemically, Lead has properties of softness, high malleability,
ductility, and relatively poor electric conduction. These properties provide various
uses to mankind (Britannica, T. Editors of Encyclopaedia, 2020).
Lead was previously used for making pipes before it was officially banned
due to its adverse health effects. Still, Lead pipes bearing the insignia are used as
drains from the baths. Other Lead material such as Tetraethyl lead (PbEt4) was also
used in some grades of petrol (gasoline) before it was discarded on the ground of its
environmental hazards (Lenntech, 2018). Lead is a major constituent of lead acid
battery, and is applied as a coloring element in ceramic glazes, electrodes in the
process of electrolysis, and in the monitors of computer and television screens to
shield viewers from radiation. Lead can has also been used in sheeting, cables,
crystal glassware, ammunitions, bearings and weight in sport equipment (Lenntech,
2018).

Elevated Blood Lead Level among Chicago Children White 2022
Page | 16
2.2. Hazards of lead poisoning
Lead, which enters the human body mainly through eating foods, drinking
water, and breathing air, is one out of four metals that have the most damaging
effects on human health. The amount of Lead that enters through food accounts for
65% of the total, followed by water, which is 20% and air, which is 15% (Lenntech,
2018). Neuropsychological and biological studies find that sufficient exposure to
lead is associated with brain dysfunction (Sanders et al. 2009). Scientist have found
that lead exposure alters neurotransmitter and hormonal systems in ways that may
induce aggressive and violent behavior (Needleman et al. 1996). Childhood lead
poisoning, both acute and chronic, remains an enormous problem. Lead poisoning
accounts for approximately 0.6% of the global burden of disease (Sanders et al.
2009). According to published information from the Mayo Clinic, symptoms can be
hard to detect initially, and even people who seem healthy can have high blood
levels (Mayo Clinic, 2016). Once the body has accumulated dangerous amounts,
signs and symptoms will start to appear.
In general, lead impacts on human health can be summarized by the
following symptoms: disruption of the biosynthesis of haemoglobin and anaemia, a
rise in blood pressure, kidney damage, miscarriages and subtle abortions, and
disruption of the nervous systems. It can also cause brain damage, declined fertility
of men through sperm damage, diminished learning abilities and behavioral
disruptions of children, such as aggression, impulsive behavior, and hyperactivity
(Lenntech, 2018). Lead can also enter an unborn fetus through their mother’s
placenta and cause damage to the nervous system (Lenntech, 2018).

Elevated Blood Lead Level among Chicago Children White 2022
Page | 17
2.2.1. Criminal Behavior
Studies have linked elevated lead level with criminal behaviors (Stretesky &
Lynch 2004; Knapp, 2013; Winter & Sampson, 2017). According to a study
conducted by Knapp, (2013), by examining the hair of inmates convicted of violent
and property crimes, they attempted to assess whether these behaviors were linked
to variations in exposure to toxic substances, including lead. Additionally, Stretesky
and Lynch (2004) found that, despite the inmate’s age, socioeconomic status,
months institutionalized, and drug use history, hair-lead levels distinguished that, of
the two groups, violent offenders specifically were more likely than property
offenders to have elevated levels of hair-lead (Stretesky & Lynch 2004). Both
studies established links between elevated BLLs and violent crimes for Chicago
communities.
2.2.2. Attention Deficit Hyperactivity Disorder (ADHD)
The immediate health effect of concern in children is typically neurological. It
is important to remember that childhood lead poisoning can lead to health effects
later in life, including ADHD, delayed learning, and lower IQ. These effects can later
impact their school performance (Tarrago, & Brown, 2017; Geier et al, 2017). Data
from the National Toxicology Program (NTP) 2012 showed that the effect of
concurrent BLLs on IQ may be greater than currently believed. Lead inhibits the
bodies of growing children through the absorption of iron, zinc, and calcium—
minerals essential to proper brain and nerve development (Needleman, & Bellinger,
1991).

Elevated Blood Lead Level among Chicago Children White 2022
Page | 18
2.2.3. Social Economic Impact and Disparities
In the past, studies conducted by Needleman et al., (1996) have shown some
adverse Health outcomes are directly impacted by income levels. Where poverty
exists, disparities will also. This study looked at one important environmental
hazard: lead. It also attempted to identify some major concerns surrounding its
long-term effects and, through the use of Chicago maps, displaying which areas are
mostly affected in correlation with the economic statuses of those areas. There is a
greater likelihood of exposure in troubled neighborhoods, and life course
implications produce barriers for upward mobility (Reed, 2018). There is also
evidence suggesting that when minorities and the poor are not disproportionately
exposed to lead in the environment, they are still more likely than whites and the
affluent to suffer from the ill effects of lead (Reed, 2018). This is because the poor
and minorities have fewer contacts with physicians, and, when they do receive
treatment, they are more likely than the affluent to receive treatment that is
inadequate or incomplete.
Specifically looking at the case of lead poisoning, the resource-deprived are
less likely than those with resources to be screened and effectively treated for lead
poisoning (Reed, 2018). Moreover, the more affluent counties do a better job at
screening and treating lead poisoning than deprived neighborhoods. In addition,
poor diet and low psychological well-being, which are also associated with economic
deprivation, are two conditions thought to exacerbate the effects of lead poisoning
(Reed, 2018).

Elevated Blood Lead Level among Chicago Children White 2022
Page | 19
2.3. Pathways
2.3.1. Soil and Gardening
Lead in soil is increasingly considered a significant source of exposure,
especially for children engaging in hand-to-mouth contact through early methods of
mobility like crawling (Mielke and Reagan 1998). The positive relationship between
soil lead values and elevated blood level has been identified by several researchers
(Meilke et al. 1999; Johnson, & Bretsch, 2002). Studies demonstrating that BLLs in
children might be more related to this source than age or housing (Lanphear et al.
1998; Mielke and Reagan 1998). Meilke & Reagan (1998) found that at the census
tract level, soil lead is significantly associated with blood lead in New Orleans,
Louisiana. Spatial analysis of property-level soil lead tests has led to an
understanding of where lead exposure is greatest: nearer the foundation of the
home (termed the dripline) and the region closest to the street (Mielke 1994). The
spatial distribution of soil lead concentrations has been mapped for several cities
including Baltimore, Maryland (Mielke et al. 1983); New Orleans, Louisiana (Mielke
et al. 2013); Syracuse, New York (Johnson and Bretsch 2002); Indianapolis, Indiana
(Laidlaw et al., 2012); and Toledo, Ohio (Stewart et al. 2014). Results of these
studies demonstrate that soil lead concentrates in the center of cities (Mielke et al.
1983) and in older neighborhoods (Levin et al. 2008; Mielke, et al., 2011). For
example, a profile of soil lead in New Orleans demonstrated not only the variability
in soil lead from an urban center to the suburbs, but also how the pattern of soil lead
varied on individual properties along that continuum (Mielke 1994).

Elevated Blood Lead Level among Chicago Children White 2022
Page | 20
2.3.2. Employment
Employment is rarely considered when thinking about lead poisoning, unless
a person works in a hazardous job industry. There are service industry people that
are directly affected, such as: painters, battery workers, maintenance workers,
construction workers, and carpenters just to name a few. Lead inhalation, the most
common exposure route for construction employees, occurs from breathing in dust
or fumes that contain lead. Once lead is inhaled into the lungs, it goes quickly to
other parts of the body in the blood (Occupational Safety and Health Administration,
2007). These workers are potentially exposed daily at least eight hours a day. And
they aren't the only ones at a constant risk. Consider a person’s hobby is painting
houses. They are just as affected by lead as those in the aforementioned professions
(Tarrago, & Brown, 2017). The plumbing industry has been replacing the old
plumbing in homes with plastic instead of the galvanized steel piping previously
used. This will assist in keeping our water from being contaminated.
2.3.3. Children Hands to Mouth
The most common way children become contaminated with lead is by hand-
to-mouth contact. They are more likely to place their hands and other objects that
may carry lead dust into their mouth (Ko et al. 2007; Witzling, et al., 2010). A study
was done via video assessments of children’s touching and mouthing behaviors
during outdoor play in urban residential yards. The assessment consisted of thirty-
seven children. Their ages ranged from 1-5 years and they were observed for two
hours. The study focused on hand touches to the ground or other walking level

Elevated Blood Lead Level among Chicago Children White 2022
Page | 21
surfaces and the respective oral behaviors (Ko et al. 2007; Witzling, et al., 2010).
The conclusion of the test showed blood lead was directly correlated with log-
transformed rates of hand-in-mouth (Pearson’s correlation, r=0.564, n=22, P=0.006)
and object-in-mouth (Pearson’s correlation, r=0.482, n=22, P=0.023) behaviors (Ko
et al. 2007).
2.3.4. Toys
It was not until 2006 when the U.S. Consumer Products Safety Commission
announced a number of toys imported from China were contaminated with lead
paint. In 2007, more than 1.5 million “Thomas & Friends” wooden railway toys were
reportedly painted with lead. Mattel, one of the largest toy companies, recalled over
nine hundred thousand toys after discovering they were contaminated with lead
(Danger, 2008). Even by 2008, the magnitude of this problem had not been fully
determined and, hence, adequate methods for controlling the importation of
contaminated toys had not yet been established.
2.3.5. Smelter
Smelters are contaminated sites that were once metal industrial industries
and are now closed. The Environmental Protection Agency (EPA) listed this type of
site, as well as other contaminated industrial sites, as Superfund sites until 1980
(Switzer, & Bulan, 2002). These contaminated sites exist nationally due to
hazardous waste being dumped, left out in the open, or otherwise improperly
managed. These sites include manufacturing facilities, processing plants, landfills,
and mining sites (Switzer, & Bulan, 2002).

Elevated Blood Lead Level among Chicago Children White 2022
Page | 22
2.4. GIS application of elevated lead poising
Various studies have used Geographical Information Systems (GIS) to assess
the geographical distribution of elevated BLLs and their relationship to other risk
factors (Akkus, & Ozdenerol, 2014; Mielke et. al., 2011; Kunene, et al., 2017; Vasovic,
2020; White & Gala, 2022). The studies used overlay analysis of choropleth maps,
Spatial autocorrelations, spatial relationships, and geographically weighted
regressions (GWR).
2.4.1. Choropleth Maps
The choropleth maps are GIS mapping applied to quantitative data. The map
uses spatially aggregated data (e.g., blood lead level (micrograms of lead per
deciliter of blood, mg/dL) among children) in a given area, and displays them with
various symbology (shed scales or colors) to indicate varying values. Various studies
have used Choropleth maps to investigate or analyze the spatial distribution of lead
hazards in the human environment (Clune et al., 2011; Mateo-Tomás et al., 2016;
Peng et al., 2019). Clune et al., (2011) produced a global map of environmental lead
poisoning in children as an exercise to show exposure hotspots in regions around
the world, particularly where health is poor. Additionally, Mateo-Tomás et al.,
(2016) adopted choropleth maps to demonstrate the Spatio-temporal varying areas
of risk to lead exposure. Moreover, Peng et al., (2019) used Choropleth maps to
investigate the spatial distribution of lead contamination in soil and equipment dust
at children's playgrounds in Beijing, China.

Elevated Blood Lead Level among Chicago Children White 2022
Page | 23
2.4.2. Spatial autocorrelations
Spatial autocorrelation is a geostatistical tool of GIS used to depict if there is
a presence of statistically significant spatial patterns on the values of the variable
under consideration (e.g., blood lead levels (micrograms of lead per deciliter of
blood, mg/dL) among children). A positive spatial autocorrelation denotes the
spatial patterns in which variables with similar values are geographically
congregated, while a negative spatial autocorrelation denotes the patterns where
variables with dissimilar values are neighboring each other. A zero spatial
autocorrelation denotes the situation where values of the variable have no pattern
or are randomly distributed. The spatial autocorrelation uses global or local Moran
I indices to assess these patterns in the data.
Several studies have used spatial autocorrelation to investigate patterns in
the geographical distribution of elevated blood lead levels among children or other
health occurrences (e.g., Akkus, 2016; Kunene et al 2017; Xiao et al., 2018). Akkus,
(2016) spatial inquiry into childhood lead poising in Shelby County, TN and used the
Global (Moran’s I) and local spatial autocorrelations (Getis and Ord’s Gi), to find
geographic controls as well as local pockets of high at-risk areas. On the other hand,
Kunene et al., (2017) also deployed both global as well as location spatial
autocorrelation to understand the spatial pattern of the adult HIV/AIDS prevalence
rates and the risk factors in Sub-Saharan African countries. Similarly, Xiao et al.,
2018 used spatial autocorrelation for monitoring patterns in the data of heavy
metals (cadmium, lead, total arsenic, total chromium, and total mercury) in China

Elevated Blood Lead Level among Chicago Children White 2022
Page | 24
found varying levels of geographical controls on heavy metal contamination of the
rice field.
2.4.3. Overlay Analysis
Overlay analysis is a GIS operation that allows the comparisons of the
attribute and location information about multilayered GIS data representing
different themes. The analysis-which may include the operations such as but not
limited to, a spatial union, intersect, and subtract—is used for answering questions
related to spatial relationship, suitability modeling, and optimal site selection.
Various studies have used the overlay analysis of the spatial relationship of
childhood lead poisoning and other socio-economic and environmental factors
(Vaidyanathan et al., 2009; Miranda et al., 2011; Mielke et al., 2013). Reissman et al.,
(2001) established a strong relationship between the old housing and blood lead
levels, with overlay analysis, in Jefferson County, Kentucky, USA. Additionally,
Vaidyanathan et al., (2009) assessed the spatial relationship of the neighborhood at
risk for children subjected to lead exposure and neighborhood-level blood lead
testing of young children living in the city of Atlanta, Georgia, and found a strong
correlation. Moreover, Miranda et al., (2011) used a spatial overlay for analyzing the
relationship of the local airports and blood lead levels and found a significant
positive association with children living in six counties in North Carolina. Finally,
Mielke et al., (2013) deployed the GIS-based overlay analysis to evaluate the spatial
correlation between the New Orleans soil Pb and Children’s blood Pb and found a
statistically significant relationship.

Elevated Blood Lead Level among Chicago Children White 2022
Page | 25
2.4.4. Spatial relationship
Spatial regression is a GIS technique of modeling, examining, and exploring
relationships between variables designated as dependent and independent
variables. In general, the spatial regression, however, does not indicate causation
between variables and therefore does not serve for prediction purposes. However, it
is used to describe the strength/weakness of the relationships, the direction of the
relationships (positive, negative, and zero), and the significance of the goodness of
fit between two variables.
Spatial data often do not fit the traditional assumptions of non-spatial
regression. These are normality (i.e., that for any fixed value of the independent
variable, the values of the dependent variable are normally distributed),
homoscedasticity (i.e., the variance of residual error is the same for any value of the
independent variable), and independence (i.e., observations are independent of each
other). Instead, spatial data are autocorrelated (i.e., the values of variables that are
near each other are more similar than those values of variables further away) and
nonstationary (i.e., the spatial patterns of the values of variables vary based on their
geographical location). The spatial lag model and spatial error model are introduced
into the spatial regression to account for these properties of spatial data. Two types
of spatial regression models, Ordinary Least Squares (OLS) regression and
Geographically weighted regression (GWR), are used.
2.4.4.1. Ordinary Least Squares (OLS) regression
Ordinary Least Squares (OLS) regression is a well-known simple regression
technique and is often used as a good starting point for all spatial regression

Elevated Blood Lead Level among Chicago Children White 2022
Page | 26
analysis. OLS is a global spatial regression model where a single equation of models
examines and explores the relationships in the entire dataset. Several studies have
used OLS for evaluating special relationships of blood lead levels among children
and its determinants (e.g., Boutwell et al.,2017; Fokum et al., 2017). For instance,
Boutwell et al., (2017) established the spatial association of aggregated blood lead
levels and specific indicators such as gun violence, homicide, and rape. The spatial
association was established using the spatial generalized linear mix model
(SGLMM). The model accounts for spatial dependent data not following Gaussian
distribution and found that aggregated blood lead level is a significant predictor of
violent crimes at the geographical scale of census tracts for the city of St. Louis MO.
Additionally, Fokum et al., (2017) estimated the prevalence and exposure of
children to lead poisoning in Illinois. Illinois law requires health providers to obtain
a blood lead test and assessment at least at the age of one and two years. Such tests
and assessments are required as evidence before a child attends licensed daycare,
kindergarten, or school. And this blood lead level among children is used to analyze
the prevalence of childhood lead poisoning in Illinois.
2.4.4.2. Geographically weighted regression (GWR)
Geographically weighted regression (GWR) is a spatial regression technique,
whose utility for spatial has increased in recent years. It provides a local model of
spatially varying relationships among variables by fitting a regression equation to
every location in the dataset. And therefore, GWR is a more reliable and powerful
model of examining and estimating spatial linear relationships, should it be used
properly. Although GWR application to blood lead levels and its determinants is

Elevated Blood Lead Level among Chicago Children White 2022
Page | 27
limited, several studies have used it for modeling spatial-resolved relationships in
the dataset concerning social and health services (e.g., Vasovic, 2020; Holmes, 2021;
White & Gala, 2022). To investigate the controls of spatial disparity of
unemployment in Chicago, Vasovic (2020) used GWR, to model spatially varying
relationships of neighborhood race/crime and unemployment. Similarly, Holmes,
(2021) used GWR to examine settlement patterns of older African Americans in
Chicagoland and relations with the patterns of African Americans of all ages and
older Americans of all races in Chicagoland.

Elevated Blood Lead Level among Chicago Children White 2022
Page | 28
Chapter 3: MATERIAL AND METHODOLOGY
3.1. Overview of the Study Area
The city of Chicago covers just over two hundred and thirty-one square
miles, approximately five hundred and seventy feet above sea level. It is situated
along the shore of Lake Michigan the 5th largest body of fresh water in the world.
The city was incorporated as a city in 1837 and currently has a population that
amounts to over two million people and has the third largest school system in the
United States, educating over three hundred and fifty thousand students a year.
Chicago is sectioned into seventy-seven different neighborhood community
areas. The community areas of Chicago were defined by University of Chicago’s
social science research committee for the city’s statistical and planning purposes.
Neighborhood community areas are a geographical scale at which various socio-
economic, demographic, and environmental statistical data are traditionally
aggregated and widely used by the city to assist the local and regional urban
planning. The city is also divided into 9 districts: central, north, far north, northwest,
west, southwest, far southwest, south, and far south sides. These districts are
generally classified along Chicago’s racially segregated fault lines.

Elevated Blood Lead Level among Chicago Children White 2022
Page | 29
Figure 2: The study area
3.2. Data Acquisition and Description
This study deployed the data of blood lead level among children aged 0 – 6 in
Chicago and compared it to students’ performances on state wide test scores and
crime occurrence rates. Additionally, it used data of a percentage of the African
American population, people below poverty level, per capital incomes, and values of
Hardship index. This data aggregated to conduct the analysis at the scale of

Elevated Blood Lead Level among Chicago Children White 2022
Page | 30
neighborhood community areas in Chicago. Although the data analyses were
conducted at the scale of Chicago neighborhoods, the results were presented and
interpreted at the scale of these districts so as to discuss the BLLs values among
Chicago children and associated social-economic, behavioral, and cognitive factors
in the context of socio-environmental justice.
3.2.1. Blood lead levels (BLLs), Poverty rate and Per Capital Income
The blood lead levels (BLLs), people below poverty level, and per capital
incomes were obtained from Chicago Health Atlas
(https://www.chicagohealthatlas.org/). The BLLs, which measured in micrograms
of lead per deciliter of blood (mg/dL), is listed under the category of the
environmental health. It is a measurement of an elevated blood lead level among the
children aged 0 – 6 in Chicago, with corresponding 95% confidence intervals, by
Chicago community area, for 2017. On the other hand, the per capital income and
poverty rates are listed under the income category of the socio-economic factors
and are found aggregated at the scale of neighborhood community areas of Chicago.
The Per capital income is the average income earned by individuals, whereas
poverty rate is the ratio of the number of people whose income falls below the
poverty line. The poverty line is a threshold nationally defined as when a household
income for a family of four earns less than $26,200 per annum. In general, the city of
Chicago and the Chicago Department of Health together prepared the Chicago
Health Atlas data for better understanding and monitoring, and for solutions for
improved Chicago health and well-being.

Elevated Blood Lead Level among Chicago Children White 2022
Page | 31
3.2.2. Illinois Standards Achievement Test (ISAT)
The data of Illinois Standards Achievement Test (ISAT) for the city of Chicago
was obtained from Chicago public schools (https://www.cps.edu/about/district-
data/metrics/assessment-reports/ ). The ISAT data is used for assessing the
learning standards of the Illinois students and aggregated by schools in the city. It
consists of the students’ assessment of math, reading, and writing tests, and
reported the percentage of students who are exceeding the standards needed. It is
expressed in the percentile ranks, which range from as low as 1 to the maximum of
99%, with 50% denoting a school’s average performance. The school aggregated
performance ranks of the 2013/14 school year for math, reading, and writing tests
were averaged to get estimates of the overall ISAT scores of schools in the city. The
school performances were averaged across the community areas in preparation for
further analysis.
3.2.3. Violent crime Incidences
Data for crime incidence report is created by the research & development
division of the Chicago Police and was obtained from the city of Chicago data portal
(https://data.cityofchicago.org/). The crime data is prepared by Chicago police
department’s Citizen Law Enforcement Analysis and Reporting (CLEAR) system. In
total, a spreadsheet containing incidences of 265,268 crimes was downloaded of
which 56,725 were violent crimes. Violent crimes are, generally, offenses committed
against a person. According to the state of Illinois, violent crimes include incidences
of battery, robbery, burglary, arson, child abuse and endangerment, homicide,

Elevated Blood Lead Level among Chicago Children White 2022
Page | 32
kidnapping, rape, assaults, and offenses. Violent crime data conatins coordinate
points for the locations where the crimes were committed. The add XY event data
tool of ArcGIS is used for geocoding the point data and mapping. Finally, the point-
based violent crime data was joined with the base-map of neighborhood community
area map, by using spatial join, and presented a spatially-resolved summary of the
number of crimes committed per each neighborhood in the city.
3.2.4. Percent African American Population
The percent African American population data of 2017 was obtained from
the US census bureau data portal (https://www.census.gov/programs-
surveys/acs/data.html). The data is collected by the American Community Survey
(ACS), which gathers demographic data used for monitoring and conducting public
services planning. The data is available at many geographic aggregate levels
depending on the survey frequency. This study used 5-years of ACS survey data,
which presents demographic (i.e., ancestry, citizenship, educational attainment,
income, language proficiency, migration, disability, employment, and housing
characteristic) data at a scale of census tract. Parallel census tracts boundary data of
Chicago, to which the tabular demographic data is joined, was obtained from
Topologically Integrated Geographic Encoding and Referencing (TIGER) Line
Shapefiles data (https://www.census.gov/geographies/mapping-files.html). The
two data are joined using common primary keys of the attribute tables. Once the
demographic data is joined, the population data was aggregated to the scale of
Chicago community neighborhood area. Percent African American population is a

Elevated Blood Lead Level among Chicago Children White 2022
Page | 33
quotient of African American population to the total population of the community
areas.
3.2.5. Hardship Index
The hardship index is a measure that is used for comparing the socio-
economic conditions by combining six social and economic variables (Nathan, &
Adams, 1976; Wilson, et al., 2017). These are unemployment rate (i.e., percent of
unemployed population over 16 years of age), educational achievement (ratio of
population ages 25 or above without high school diploma), and per capita income
(i.e., individual income per annum). It also includes dependency ratio (the
proportion of population below age 18 and above 64), crowded housing (percentage
of the housing units where more than a person live in a room), and poverty (i.e.,
proportion of the population below designated state’s poverty level). The 2017 ACS
data of these variables aggregated at the scale of neighborhood community areas of
Chicago were obtained from the Chicago Health Atlas
(https://www.chicagohealthatlas.org/). The hardship index is calculated by
standardizing the socio-economic variables (e.g., unemployment rate) using the
following equation.
X = ((Y-Ymin) / (Ymax—Ymin)) * 100
Where, X = standardized unemployment rate of the neighborhood community areas
of Chicago
Y = the unemployment rate of the neighborhood community areas
Ymin = the value of the minimum unemployment rate of all neighborhood
community areas of Chicago

Elevated Blood Lead Level among Chicago Children White 2022
Page | 34
Ymax = the value of the maximum unemployment rate of all neighborhood
community areas of Chicago
The final hardship index is the average of the standard values of the six socio-
economic variables considered. The index has a value ranging between 0 and 100.
Zero represents neighborhoods experiencing the least socioeconomic hardship,
while 100 represents neighborhoods experiencing with a stressful socioeconomic
hardship.
3.3. Research Methodology
3.3.1. Spatial Analysis Blood Lead Levels (BLLs) among the children aged 0 – 6
year in the neighborhoods of Chicago
The spatial analysis of the BLLs of the children in the urban neighborhood of
Chicago was conducted via geovisual and geostatistical spatial pattern analysis
(Kunene, 2016; Kunene, et al., 2018; Hunley III, 2019). The geovisual analysis works
by visually interpreting the spatial distribution of the values of aggregated BLLs (i.e.,
deciliter of blood (mg/dL)) after the data that is being displayed as a choropleth
map on the Arcmap. The interpretation was done in such a way that the data is
classified into five categories around the city’s, state’s, and national average.
On the other hand, the geostatistical spatial pattern analysis was conducted
using global as well as local Moran’s I statistics, both built in a spatial statistics
toolbox in ArcGIS. The Global Moran’s I is a statistical tool used for measuring the
tendency that proximate urban neighborhoods are having similar, dissimilar, and

Elevated Blood Lead Level among Chicago Children White 2022
Page | 35
random values of the BLLs. The statistics of Global Moran’s I index (Anselin, 1995;
Hunley, & Gala, 2020) is estimated by:
    

 


󰇡  



 󰇢

 (1)
Where: I is the Moran’s I statistics, Xi is the values of the BLLs among the
children of urban neighborhoods i, Xj are the values of the BLLs among the children
of urban neighborhoods j, Wi,j are the spatial weights that determines the
relationship between urban neighborhoods i and j, and n is equal to the total
number of urban neighborhoods. The statistical significance of the spatial pattern is
established by comparing the observed Moran’s I statistics with expected Moran’s I,
which is random distribution. The Expected Moran’s I ( is given by:
󰇛󰇜 
 (2)
The local Moran’s I statistics, conversely, is a measure of local hot or cold
spots of the BLLs values of the children among Chicago neighborhoods. Hotspots are
areas where clusters of higher values of BLLs are detected, while coldspots are
localities where clusters of lower BLLs values are detected. The statistical tool
deployed to measure the local Moran’s Ii statistics is Anselin Local Moran's (Ii)
(Anselin, 1995; Mitchell, 2005; Hunley, & Gala, 2020), and is expressed as:





 󰇛
󰇜 (3)
Where: Xi is values of the BLLs among the children for urban neighborhoods,
i is the mean of the aggregated values of the BLLs among the children of Chicago

Elevated Blood Lead Level among Chicago Children White 2022
Page | 36
city, and Wi,j, is spatial weight between neighborhoods i and j and is a standard
deviation of the values of the neighborhoods BLLs given by:



 (4)
The standard deviation is a measure of the standardized variation of the values of
the BLLs among the children for urban neighborhoods from its mean.
3.3.2. Modelling Spatial Associations of BLL among Children (i.e., 1 – 6 ages)
and associated social-economic, behavioral, cognitive factors
The spatial associations of the BLLs and risk factors were conducted globally
using a simple spatial regression model as well as locally by deploying a
Geographical Weighted Regression (GWR) model (Kunene, 2016; Kunene, et al.,
2018). The simple spatial regression is an extension of a regular Ordinary Least
Square (OLS) regression, which involved the creation of spatial weight structure.
The spatial weight defined the structure to account for the non-stationarity in the
data, i.e. a situation where mean and variance are dependent on the location and
distance between neighborhoods. Finally, the global model predicted
neighborhoods’ aggregated BLL among children of Chicago as influenced by values
of social-economic, behavioral, and cognitive factors.
On the other hand, geographically weighted regression (GWR) establishes
local regression that would help predict values of BLL as a condition by each
associated factor. GWR works based on a simple idea that models of local goodness-
of-fit are developed from subsets of values of the BLLs and factors scanned with a
moving window. The number of neighborhoods considered for the estimation is

Elevated Blood Lead Level among Chicago Children White 2022
Page | 37
contingent on the size of the moving window (i.e., Kernel type, Bandwidth method,
Distance, and Number of neighbors’ parameters). This model also accounts a
nonstationary while estimating the unbiased slope, and intercept for the goodness-
of-fit. The equation to estimate the dependent BLL among children Vj from set of n
social-economic, behavioral, and cognitive factors Zi, for a neighborhood pi is locally
given by Böhner, & Bechtel, (2018) as follows:


 (5)



 

 



 

 


 

  (6)
 

 

 





 


 

  (7)
Where: aj is the intercept, j is the beta coefficient, and ɛj is the error term of
the regression equation. The observed values Vi are weighted by Wij indicating the
spatial weights for the input data of the target neighborhood Pi.
Simply, spatial weights are often estimated by giving a weight of 1 for the
neighborhoods that fall within the spatial kernel and 0 for those outside. However,
in this study, the adaptive kernel, i.e. Gaussian weighting scheme, the weight
assigned to the neighbor decreases when distances are applied. The adaptive kernel
(Gaussian) is given by:
 
󰇡
󰇢 (8)

Elevated Blood Lead Level among Chicago Children White 2022
Page | 38
Where: Wij are weights of the neighborhood areas in Chicago with respect to
the target neighborhood Pi , and di,j are neighborhoods distances from the target,
and b is “bandwidth”.
3.3.3. Validation Methods
The Spatial Autocorrelation and Hot Spot Analysis (i.e., Getis-Ord Gi* statistics) of
the BLLs among the children were verified by the values of the Moran’s I Index and
corresponding p-value. Generally, while +1 Moran's Index value indicates spatial
clustering of the aggregated data of BLLs value, the index value near -1.0 indicates
the spatial dispersion, and the 0-index value depicts spatial randomness. P-values
(i.e., α < 0.05) ascertain the statistical significance of the observed patterns of
dispersion or cluster in the distribution of BLLs among the neighborhoods of
Chicago.
On the other hands, various indices were deployed to evaluate performances
of the Simple spatial and geographically weighted regressions. The regression
models were implemented to establish association between BLLs among the
children and associated social-economic, behavioral, and cognitive factors.
Generally, the indices validated the associations in terms of strengths, directions
and their statistical significances. While the relative strengths of the associations
were evaluated with coefficient of determination (R2), the directions were validated
by the positivity or negativity of the β-coefficient and statistical significances
denoted against by the P-values (i.e., α < 0.05).

Elevated Blood Lead Level among Chicago Children White 2022
Page | 39
CHAPTER 4: RESULT AND DISCUSSION
4.1. Blood Lead Levels (BLLs) among the children aged 0 – 6 year among
the Chicago neighborhoods
Figure 3 evaluated the spatial patterns and distribution (a), geographic
controls of these spatial patterns and distribution (b), and spatial clustering of
similar values of elevated BLLs (c). Accordingly, the BLLs among children aged 0 – 6
year for Chicago ranges between 0 – 7.90 micrograms of lead per deciliter of blood
(mg/dL). The citywide average BLLs among children is µ = 1.9 mg/dL ± σ = 1.85.
According to Illinois Department of Public Health (2007), this is higher than the
average national (i.e., 1.6 mg/dL) as well as the Illinois State’s (i.e., (i.e., 1.3 mg/dL)
BLLs among children age 0 – 6.
The spatial patterns of the BLLs among children is distributed in such a way
that lower levels are found in the central, northern, far northern, and southwestern
sides of the city while the higher values are found in the western, southern and
southwestern sides of the city. Further analysis was conducted to see if there are
significant overall geographical controls within the spatial patterns of the BLLs
among children in Chicago (i.e., Figure 3b). Accordingly, the global spatial
autocorrelation (i.e., Moran’s I statistics) analysis found significant positive Moran’s
I (i.e., I = 0.34, permutation 999, and p-value 0.001). The outcome is an indicative of
the BLLs value’s non- dispersions and non- randomness among children in the
neighborhoods of Chicago city. On the other hand, the positive Moran’s I coefficient
suggests the spatial clustering of the similar values (i.e., high or low) of the BLLs
values.

Elevated Blood Lead Level among Chicago Children White 2022
Page | 40
Furthermore, the Local Moran's statistic is conducted to analyze spatially-
resolved locations where significant spatial clustering is present. Accordingly, the
Local Moran's statistic found areas of significant clustering of higher values of the
BLLs among children as well as low values (i.e., p-value = 0.05; See Figure 3c).
Accordingly, neighborhoods in the south, far southwest, southwest and far south
sides of Chicago have shown significant clustering of higher values of the BLLs
among children (i.e., p-value = 0.05; Figure 3c). These sides of the city are areas
known for their predominant residence of minority (i.e., Blacks and Hispanic
American) population. On the other hand, neighborhoods in the central, north, and
far north sides of Chicago have shown significant clustering of lower amounts of
higher values of the BLLs among children (Figure 3c).
The geographical controls of the BLLs among children consists of studies
conducted in Texas (Yu, 2016), in Greater Flint, Michigan (Hanna-Attisha et al.,
2016), in Baltimore Maryland (Wheeler et al., 2019), and in Kabwe, Zambia (Moonga
et al., 2021). It is also consistent with reported dynamics among various
demographic groups in the state. In Illinois, although the state average is lower, the
levels among African American and Hispanic children are reported to roughly two to
three times the elevated BLLs among white children (Fokum et al., 2017).

Elevated Blood Lead Level among Chicago Children White 2022
Page | 41
Figure 3: The 2017 data of elevated BLLs among the children aged 0 – 6 year among
community areas of Chicago: a) spatial distribution; b) statistical evaluation of global
spatial controls and c) statistical evaluation of local spatial controls.

Elevated Blood Lead Level among Chicago Children White 2022
Page | 42
4.2. Spatial relationship of elevated lead blood level and crime occurrence rate
and test scores for the Chicago neighborhoods
The spatial associations were established between the BLLs, the crime occurrence
rate, and students’ ISAT test scores, (Figure 4 and Table 1). Accordingly, significant
associations were found between the BLLs and average ISAT scores (i.e., P-value < 0.05)
and crime occurrence rate (per 1000 residents) (i.e., P-value < 0.05). Additionally, with the
R2 of 40% and 53% for the average ISAT scores and crime occurrences rate, respectively,
the associations were demonstrably strong. However, while the relation with the average
ISAT scores is negative (B- coefficient = -0.08), the one with the crime occurrence rate is
positive (B- coefficient = 0.007), indicating in the values of BLLs is associated with higher
incidences of violent crimes and students’ poor academic performances.
Table 1 Relationships of blood lead level among the children and ISAT score and Crime Occurrence
Rate
Variables
Strength
(R2)
Direction of the
relationship
(B- coefficient)
Local Variability
(Sigma)
Significance of
the relationship
(P-value)
Crime
Occurrence
Rate
0.53
0.007
1.103
0.000
Average ISAT Score
0.40
-0.08
1.607
0.000
However, such relations are locally variable across the city (Figure 4). Accordingly,
the local association (i.e., R2) of the BLLs among children and crime occurrence rates (per
1000 residents) ranged between R2 of 20% and 88% (i.e., moderate to very strong
associations). Moderate associations (R2 = 16% - 36%) observed in the neighborhoods of
the north, far northern, and far southern sides of the city; whereas a very strong

Elevated Blood Lead Level among Chicago Children White 2022
Page | 43
association (R2 > 67%) were established in the southwest and far southwest sides.
Similarly, the local association (i.e., R2) of the BLLs among children and averaged ISAT
scores ranged between R2 of 5% and 47% (i.e., weak to moderate associations). The weak
association was observed in the neighborhood of Chatham, in the far south side of Chicago,
while the moderate associations (i.e., R2 = 16% - 36%) dominated the west and northwest
sides. The types and significances of the associations found in this study were consistent
with studies elsewhere (Zhang et al., 2013; Sauve-Syed, 2017; Boutwell et al., 2017; Winter
& Sampson, 2017). For example, Zhang et al., 2013 established the association of elevated
BLLs of children younger than 6 years old with poor academic achievement in Detroit, MI;
whereas Boutwell et al. (2017) found that BLLs are statistically significant predictors of
violent crime in St. Louis City, MO.

Elevated Blood Lead Level among Chicago Children White 2022
Page | 44
Figure 4: Geographically Weighted Spatial Relationships of elevated BLLs and the crime
occurrence and students’ test scores for the 77 community areas of Chicago

Elevated Blood Lead Level among Chicago Children White 2022
Page | 45
4.3. Analyzing the Spatial relationships of elevated lead blood levels and
socioeconomic characteristics of the Chicago neighborhoods
Figure 5 investigated the controls of demographic and socio-economic variables on
the BLLs among children. Accordingly, variables such as percent African American
population, population below the poverty line, household’s income, and the hardship index
were considered. Statistically, significant associations of the BLLs and the above-mentioned
variables were detected (i.e., P < 0.05), although the direction and the strength of the
associations varies from variable to variable. The highest associations were found with
percent population below the poverty line (i.e., R2 = 54%), followed by the hardship index
(i.e., R2 = 47%; strong relation) and household per capital income (i.e., R2 = 42%). The
association of the BLLs and demographic variables, particularly percent African population,
was relatively the least (i.e., R2 = 40%). Similarly, while the relationships with percent
African American population, below poverty lines, and the hardship index were positive,
with household income, the relationship was negative. Low household incomes are
associated with higher values of the BLLs among children in Chicago.
Table 2: Relationships of elevated BLLs among the children and socioeconomic
characteristics
Variables
Strength
(R2)
Direction of the
relationship
(B- coefficient)
Local
Variability
(Sigma)
Significance of
the relationship
(P-value)
Below poverty
0.54
0.11
1.4
0.000
Hardship Index
0.50
0.04
1.4
0.000
Percent African
American
0.40
0.02
1.6
0.000
Per Capital
Income
0.42
-0.0006
1.5
0.000

Elevated Blood Lead Level among Chicago Children White 2022
Page | 46
Figure 5 shows spatially-resolved strength of the associations of BLLs and selected
demographic and socioeconomic variables using geographically weighted spatial
regression analysis. For example, the strength of local association (i.e., R2) of the BLLs
among children and demographic characteristics (i.e., percent African American
population) ranged between R2 of 2% and 65% (i.e., very weak to strong associations).
Generally strong associations (R2 = 37% - 66%) were detected in the neighborhoods of the
northwestern, west, southwest, and far southwestern sides of the city; while very weak and
weak associations (R2 = 2% - 16%) were detected in the central, south, and far south sides.
On the other hand, local association (i.e., R2) of socio-economic characteristics (i.e.,
aggregated household income) and the BLLs among children ranged between R2 of 4% and
73% (i.e., very weak to very strong associations). The very strong associations (R2 = 37% -
66%) were detected in the neighborhoods of the north and far north sides of the city, while
very weak and weak associations (R2 = 2% - 16%) were detected in the far south sides.
The local associations of other socioeconomic variables (i.e., economic hardship index and
percent population below poverty lines) were less variable (i.e., S.D. = 0.036 and 0.0001
respectively). In general, strong associations (i.e., 36% - 66%) were found throughout the
neighborhoods of Chicago city.

Elevated Blood Lead Level among Chicago Children White 2022
Page | 47
Figure 5: Geographically Weighted Spatial Relationships of elevated BLLs: a) percent
African American population, b) economic hardship index, c) population’s percent below
poverty line, and d) household per Capital income of the community areas of Chicago.
The associations of BLLs and demographic and socioeconomic variables aggregated
at the neighborhoods of Chicago city corroborates findings elsewhere (Morales et al., 2005;
Sadler et al., 2017; Kim et al., 2018). Morales et al., 2005 reported the demographic and
socioeconomic factors associated with the BLLs among Mexican-American children and
adolescents in the United States, while Sadler et al., (2017) also documented BLLs
associated with the oldest house age and poorest housing condition in Flint, MI. On the
other hand, Kim et al., (2018) has shown a low socio-economic status associated with high
BLLs among Korean children, although the underlying mechanism is not known.

Elevated Blood Lead Level among Chicago Children White 2022
Page | 48
CHAPTER 5: CONCLUSIONS AND RECOMMENDATIONS
5.1. Research Findings
This study aimed at evaluating the spatial distribution of children’s elevated BLLs in
Chicago’s 77 community areas. Additionally, it was aimed at the spatial associations of BLL
among children (i.e., 1 – 6 ages) and the social-economic, behavioral, and cognitive factors.
The following research findings are reported.
1. Spatial patterns of the BLLs among children of Chicago are distributed in such a way
that lower levels are found in the central, northern, far northern, and southwestern
sides of the city, while the higher values are found in the western, southern, and
southwestern sides of the city. Further analysis was conducted to see if there are
significant overall geographical controls of the spatial patterns of the BLLs among
children in Chicago. Accordingly, the global spatial autocorrelation (i.e., Moran’s I
statistics) analysis found significant positive Moran’s I (i.e., I = 0.34, permutation 999,
and p-value 0.001).
2. The associations of BLLs in children with students’ learning performances and
neighborhoods’ record on criminal activities were established. Significant
associations were found between the Chicago neighborhoods’ average ISAT
performances and the BLL (i.e., P-value < 0.05). Similarly, significant association was
also observed between neighborhood BLLs and the crime occurrence rate (per 1000
residents) and (i.e., P-value < 0.05). Higher strength of association was found with the
crime occurrence rate (i.e., R2 = 53%) vis-à-vis the average ISAT score (i.e., R2 = 40%).
However, while the association with the average ISAT scores is negative, the

Elevated Blood Lead Level among Chicago Children White 2022
Page | 49
association with the crime occurrence rate is positive, indicating that higher values of
aggregated BLLs among children living in Chicago neighborhoods signifies the
likelihoods of higher criminal activity occurrences and poor students’ performances in
learning.
3. Additionally, the association of the BLL among children and of Chicago neighborhoods’
demographic and socio-economic variables (i.e., percent African American population,
population below poverty line, household’s income, and hardship index) were also
investigated. Statistically, significant associations ranged between R2 = 40 and R2 = 54
were detected (i.e., P < 0.05). Similarly, while the associations with percent African
American, percent population below the poverty lines, and the hardship index were
positive, household income was negative; this indicates that neighborhoods with
aggregated higher BLLs imply the likelihood of poorer and blacker Chicago
neighborhoods.
5.2. Research Significance
This research is significant in assessing Children lead poisoning among Chicago
neighborhoods. As of 2012, the CDC lowered the testing standard BLLs of 10 micrograms
per deciliter to 5 micrograms per deciliter, and currently states there are no safe levels of
lead in blood. Lead poisoning occurs when lead or any of its salts are absorbed into the
body. Long-term exposure in young children could result in mental retardation, brain
damage, and behavioral problems such as criminal activities. Therefore, pediatricians
under the guidelines of the city of Chicago are mandated to follow-up with children up to
the age of 6 years old, and currently provide no other assistance beyond that age.

Elevated Blood Lead Level among Chicago Children White 2022
Page | 50
This study examined some major concerns surrounding its long-term effects and
their relation with the social-economic, behavioral, and cognitive factors. The motivation
for this focus is to review the number of children tested for and showing elevated BLLs
with the number of reported crimes and schools with proven low-test scores. The
dynamics of long-term lead poisoning of children can affect their lives well into adulthood;
moreover, one of the effects could result in criminal behavior. There are significant
correlations revealed by using spatial analyses between elevated blood lead poisoning with
high crime areas, and low-test scores within the schools among low poverty communities
of Chicago. Deteriorated paint containing lead in houses was believed to be the main
pathway of lead exposure. However, after 40 years of banning the use of lead-based paint,
it continues to be a major issue in Chicago. Having such a sizable number of residents, the
concern is to promote health, prevent disease, and reduce environmental hazards for all
Chicagoans.
5.3. Research Limitations
Although, this research was significant in identifying the long-term effects of lead
poisoning, it has the following limitations:
 Although the exploratory spatial data analysis toolsets in ArcGIS have been effective
in investigating the geographical controls of elevated BLLs in Chicagoland, they also
have some limitations. First, the hotspot areas do not necessarily mean the cluster of
the highest values of elevated BLLs and, hence, can be misleading (Levine, 2013).
The hotspots were, instead, indicating neighborhoods of the higher values relative
to surrounding neighborhoods with the lower values. Secondly, both global and

Elevated Blood Lead Level among Chicago Children White 2022
Page | 51
local Moran I have substantial type I errors since the significant test of spatial
clustering is generally weak (Levine, 2013). The phenomenon is often allowing
many neighborhoods in Chicagoland to show statistically significant hotspot areas.
Reducing the search radius may reduce the size of type I errors and, thereby, the
number of significant hotspot neighborhoods in Chicagoland; however, with
irregular sizes of the neighborhood areas, a small search radius could make the
community areas not have the surrounding neighborhoods to compare with.
 Again, even though the spatial regression models are effective tools in accounting
for spatial dependency and nonstationary, while establishing relationships between
elevated BLLs and social-economic, behavioral, and cognitive factors, they also have
limitations. First, the algorithm of GWR is computationally intensive and, therefore,
it takes a long time to run (Mitchell, 2012). Secondly, this tool, like other regression
tools, is affected by the presence of multicollinearity in the data. Multicollinearity,
which is common among spatially clustered explanatory variables, is the situation,
in multivariate regression, where two or more involved explanatory variables are
showing strong correlation and, hence, their values to the model are redundant
(Wheeler, Tiefelsdorf, 2005).
 Tracking the children - City officials can mandate laws to alter health outcomes of
children that have been affected by elevated BLLs. To this date the parents of the
children that have tested positive for elevated BLLs do not receive any additional
follow-ups or structural assistance with preventive measures beyond the age of five.
These findings are based on children who have been tested for BLLs without
tracking its cognitive and behavioral impacts. Such follow-up longitudinal studies

Elevated Blood Lead Level among Chicago Children White 2022
Page | 52
could shed a better light in understanding locally applicable determinants or risk
factors of the observed elevated BLLs among children in Chicago neighborhoods.
 This research depicted strong associations of the BLLs and the social-economic,
behavioral, and cognitive characteristics of neighborhoods of Chicago city. However,
the associations cannot be translated into causations such that the percent African
American population, population below the poverty line, household’s income, and
the hardship index are considered responsible for elevated BLLs or vice versa.
Further studies will be critical to establish how much of these associations are the
causations.

Elevated Blood Lead Level among Chicago Children White 2022
Page | 53
6. REFERENCES
Adams, D. A., Jajosky, R. A., Ajani, U., Kriseman, J., Sharp, P., Onwen, D. H., ... & Abellera, J. P.
(2012). Centers for Disease Control and Prevention (CDC) 2014. Summary of notifiable
diseases—United States, 1-121.
Advisory Committee on Childhood Lead Poisoning Prevention (ACCLPP) (2012). Low Level
Lead Exposure Harms Children: A Renewed Call for Primary Prevention. Accessed
from: http://www.cdc.gov/nceh/lead/ACCLPP/Final_Document_030712.pdf.
Akkus, C., & Ozdenerol, E. (2014). Exploring childhood lead exposure through GIS: a review
of the recent literature. International Journal of Environmental Research and Public
Health, 11(6), 6314-6334.
Akkus, C. (2016). A Spatial Inquiry into Childhood Lead Poisoning in Shelby County, Tennessee.
Anselin, L. (1995). Local indicators of spatial association—LISA. Geographical analysis,
27(2), 93-115.
Böhner, J., & Bechtel, B. (2018). GIS in climatology and meteorology. In Comprehensive
geographic information systems (pp. 196-235). Elsevier.
Britannica, T. Editors of Encyclopaedia (2020, January 9). Lead. Encyclopedia Britannica.
https://www.britannica.com/science/lead-chemical-element
Boutwell, B. B., Nelson, E. J., Qian, Z., Vaughn, M. G., Wright, J. P., Beaver, K. M., ... &
Rosenfeld, R. (2017). Aggregate-level lead exposure, gun violence, homicide, and
rape. PloS one, 12(11), e0187953.
Clune, A. L., Falk, H., & Riederer, A. M. (2011). Mapping global environmental lead poisoning
in children. Journal of Health and Pollution, 1(2), 14-23.

Elevated Blood Lead Level among Chicago Children White 2022
Page | 54
Committee on Environmental Health. (2005). Lead exposure in children: prevention,
detection, and management. Pediatrics, 116(4), 1036-1046.
Danger, K. I. (2008). The year of the recall–An examination of children’s product recalls in
2007 and the implications for child safety.
Fokum, F. D., Shahidullah, M., Jorgensen, E., & Binns, H. (2017). “Prevalence and Elimination
of Childhood Lead Poisoning in Illinois, 1996–2012”. In Applied Demography and
Public Health in the 21st Century (pp. 221-236). Springer, Cham.
Geier, D. A., Kern, J. K., & Geier, M. R. (2017). Blood lead levels and learning disabilities: a
cross-sectional study of the 2003–2004 National health and nutrition examination
survey (NHANES). International journal of environmental research and public health,
14(10), 1202
Hanna-Attisha, M., LaChance, J., Sadler, R. C., & Champney Schnepp, A. (2016). Elevated
blood lead levels in children associated with the Flint drinking water crisis: a spatial
analysis of risk and public health response. American journal of public health,
106(2), 283-290.
Holmes, A. (2021). Spatial Modeling of Naturally Occurring Retirement African Americans’
Communities in Chicagoland (Doctoral dissertation, Chicago State University).
Hunley III, R. (2019). The Great Migration? African American Population Growth And Decline
In The Chicago Metropolitan Area (Doctoral dissertation, Chicago State University).
Hunley, R., & T. Gala, (2020). Spatial Patterns of African-American Population and
Movement in Chicagoland. SSRG International Journal of Geoinformatics and
Geological Science 7(2), 28-36.

Elevated Blood Lead Level among Chicago Children White 2022
Page | 55
Illinois Department of Public Health (2007) Children Enrolled in the Department of
Healthcare and Family Services (HFS) Medical Programs Tested for Blood Lead
Poisoning; State and Community Based, Illinois Lead Program, June 2007
Johnson, D. L., & Bretsch, J. K. (2002). Soil lead and children’s blood lead levels in Syracuse,
NY, USA. Environmental Geochemistry and Health, 24(4), 375-385.
Jones, R. L., Homa, D. M., Meyer, P. A., Brody, D. J., Caldwell, K. L., Pirkle, J. L., & Brown, M. J.
(2009). Trends in blood lead levels and blood lead testing among US children aged 1
to 5 years, 1988–2004. Pediatrics, 123(3), e376-e385.
Knapp, A. (2013). How lead caused America’s violent crime epidemic. Forbes. Com, 22.
Kim, E., Kwon, H. J., Ha, M., Lim, J., Lim, M. H., Yoo, S. J., & Paik, K. C. (2018). How does low
socioeconomic status increase blood lead levels in Korean children?. International
journal of environmental research and public health, 15(7), 1488.
Ko, S., Schaefer, P. D., Vicario, C. M., & Binns, H. J. (2007). Relationships of video
assessments of touching and mouthing behaviors during outdoor play in urban
residential yards to parental perceptions of child behaviors and blood lead
levels. Journal of exposure science & environmental epidemiology, 17(1), 47-57.
Kunene, N. R. (2016). Scaling up Spatiotemporal dynamics of HIV/AIDS Prevalence in sub-
Saharan Africa (Doctoral dissertation, Chicago State University).
Kunene, N., Gella, M., & Gala, T. (2017). Geographic controls of adult HIV/AIDS prevalence
and their determinants for Sub-Saharan Africa countries. American Journal of Public
Health, 5(4), 130-137.

Elevated Blood Lead Level among Chicago Children White 2022
Page | 56
Kunene, N., Ebomoyi, W., & Gala, T. S. (2018). Scaling-up spatiotemporal dynamics of
HIV/AIDS prevalence rates of Sub-Saharan African countries. International Journal
of Medical Engineering and Informatics, 10(1), 1-15.
Laidlaw, M. A., Zahran, S., Mielke, H. W., Taylor, M. P., & Filippelli, G. M. (2012). Re-
suspension of lead contaminated urban soil as a dominant source of atmospheric
lead in Birmingham, Chicago, Detroit and Pittsburgh, USA. Atmospheric
Environment, 49, 302-310.
Lanphear, B. P., Burgoon, D. A., Rust, S. W., Eberly, S., & Galke, W. (1998). Environmental
exposures to lead and urban children's blood lead levels. Environmental Research,
76(2), 120-130.
Lead Safe Illinois (2021) Ripple Effects of Childhood Lead Poisoning: Healthy Homes &
Healthy Communities Initiative: Loyola University Chicago," Loyola University:
Loyola University Chicago, accessed June 1, 2021,
https://www.luc.edu/healthyhomes/leadsafeillinois/leadfacts/rippleeffectsofchild
hoodleadpoisoning/
Levin, R., Brown, M. J., Kashtock, M. E., Jacobs, D. E., Whelan, E. A., Rodman, J., ... & Sinks, T.
(2008). Lead exposures in US children, 2008: implications for
prevention. Environmental health perspectives, 116(10), 1285-1293.
Levine, N. (2013). Hot spot analysis of zones. N Levine, CrimeStat: Spatial Statistics Program
for the Analysis of Crime Incident Locations, Version, 4, 242960-242995.
Lenntech, (2018) Water Treatment and Purification. Lenntech. Retrieved from
https://www.lenntech.com/periodic/elements/pb.htm#ixzz5EHutcM2p).

Elevated Blood Lead Level among Chicago Children White 2022
Page | 57
Mateo-Tomás, P., Olea, P. P., Jiménez-Moreno, M., Camarero, P. R., Sánchez-Barbudo, I. S.,
Rodríguez Martín-Doimeadios, R. C., & Mateo, R. (2016). Mapping the spatio-temporal
risk of lead exposure in apex species for more effective mitigation. Proceedings of the
Royal Society B: Biological Sciences, 283(1835), 20160662.
Meyer, P. A., Pivetz, T., Dignam, T. A., Homa, D. M., Schoonover, J., Brody, D., & Centers for
Disease Control and Prevention. (2003). Surveillance for elevated blood lead levels
among children-United States, 1997-2001. Morbidity and Mortality Weekly Report
CDC Surveillance Summaries, 52(10).
Mielke, H. W., Anderson, J. C., Berry, K. J., Mielke, P. W., Chaney, R. L., & Leech, M. (1983).
Lead concentrations in inner-city soils as a factor in the child lead
problem. American Journal of Public Health, 73(12), 1366-1369.
Mielke, H. W. (1994). Lead in New Orleans soils: new images of an urban
environment. Environmental Geochemistry and Health, 16(3-4), 123-128.
Mielke, H. W., & Reagan, P. L. (1998). Soil is an important pathway of human lead exposure.
Environmental health perspectives, 106(suppl 1), 217-229.
Mielke, H. W., Covington, T. P., Mielke Jr, P. W., Wolman, F. J., Powell, E. T., & Gonzales, C. R.
(2011). Soil intervention as a strategy for lead exposure prevention: The New
Orleans lead-safe childcare playground project. Environmental Pollution, 159(8-9),
2071-2077.
Mielke, H. W., Gonzales, C. R., Powell, E. T., & Mielke, P. W. (2013). Environmental and
health disparities in residential communities of New Orleans: The need for soil lead
intervention to advance primary prevention. Environment international, 51, 73-81.

Elevated Blood Lead Level among Chicago Children White 2022
Page | 58
Miranda, M. L., Anthopolos, R., & Hastings, D. (2011). A geospatial analysis of the effects of
aviation gasoline on childhood blood lead levels. Environmental Health
Perspectives, 119(10), 1513-1516.
Mitchell A. (2012). ESRI Guide to GIS Analysis, Volume 2: Spatial Measurements and
Statistics. New York: ESRI Press.
Morales, L. S., Gutierrez, P., & Escarce, J. J. (2005). Demographic and socioeconomic factors
associated with blood lead levels among Mexican-American children and
adolescents in the United States. Public health reports, 120(4), 448-454.
Moonga, G., Chisola, M., Berger, U., Nowak, D., Yabe, J., Nakata, H., ... & Bose-O'Reilly, S.
(2021). Geospatial approach to investigate spatial clustering and hotspots of blood
lead levels in children within Kabwe, Zambia. medRxiv.
Nathan, R. P., & Adams, C. (1976). Understanding central city hardship. Political Science
Quarterly, 91(1), 47-62.
Needleman, H. L., & Bellinger, D. (1991). The health effects of low-level exposure to lead.
Annual review of public health, 12(1), 111-140.
Needleman, H. L., Riess, J. A., Tobin, M. J., Biesecker, G. E., & Greenhouse, J. B. (1996). Bone
lead levels and delinquent behavior. Jama, 275(5), 363-369.
Occupational Safety and Health Administration (2007) Regulatory review 29 CFR 1926.62
Lead in Construction: Accessed from https://www.osha.gov/laws-
regs/lookback/lead-construction-review
Peng, T., O'Connor, D., Zhao, B., Jin, Y., Zhang, Y., Tian, L., ... & Hou, D. (2019). Spatial
distribution of lead contamination in soil and equipment dust at children's
playgrounds in Beijing, China. Environmental Pollution, 245, 363-370.

Elevated Blood Lead Level among Chicago Children White 2022
Page | 59
Reed, H. (2018). Indiana's Public Health is in Jeopardy: Lessons to Learn from Toxic
Chemical Contamination in East Chicago. Ind. Health L. Rev., 15, 109.
Reissman, D. B., Staley, F., Curtis, G. B., & Kaufmann, R. B. (2001). Use of geographic
information system technology to aid Health Department decision making about
childhood lead poisoning prevention activities. Environmental Health
Perspectives, 109(1), 89-94.
Sadler, R. C., LaChance, J., & Hanna-Attisha, M. (2017). Social and built environmental
correlates of predicted blood lead levels in the Flint water crisis. American journal of
public health, 107(5), 763-769.
Sample, A. Jennifer (2020) Childhood lead Poisoning: Management. UpToDate, last
modified May 6, 2020, accessed from
https://www.uptodate.com/contents/childhood-lead-poisoning-
management?topicRef=6493&source=see_link.
Sanders, T., Liu, Y., Buchner, V., & Tchounwou, P. B. (2009). Neurotoxic effects and
biomarkers of lead exposure: a review. Reviews on environmental health, 24(1), 15.
Sauve-Syed, K. (2017). Lead exposure and student performance: A study of Flint schools.
Unpublished manuscript, Department of Economics, Syracuse University, Syracuse,
NY.
Stewart, L. R., Farver, J. R., Gorsevski, P. V., & Miner, J. G. (2014). Spatial prediction of blood
lead levels in children in Toledo, OH using fuzzy sets and the site-specific IEUBK
model. Applied geochemistry, 45, 120-129.
Stretesky, P. B., & Lynch, M. J. (2004). The relationship between lead and crime. Journal of
Health and Social Behavior, 45(2), 214-229.

Elevated Blood Lead Level among Chicago Children White 2022
Page | 60
Switzer, C. S., & Bulan, L. A. (2002). CERCLA: comprehensive environmental response,
compensation, and liability act (Superfund). American Bar Association.
Tarrago, O., & Brown, M. J. (2017). Case studies in environmental medicine (CSEM) lead
toxicity. Agency for toxic substances and disease registry.
Yu, Q. (2016). Spatial statistical analysis of childhood blood lead exposure in Texas.
Vaidyanathan, A., Staley, F., Shire, J., Muthukumar, S., Kennedy, C., Meyer, P. A., & Brown, M.
J. (2009). Screening for lead poisoning: a geospatial approach to determine testing of
children in at-risk neighborhoods. The Journal of pediatrics, 154(3), 409-414.
Vasovic, S. (2020). Spatial Analysis of Unemployment Disparities in Chicago (Doctoral
dissertation, Chicago State University).
Wheeler, D., & Tiefelsdorf, M. (2005). Multicollinearity and correlation among local
regression coefficients in geographically weighted regression. Journal of
Geographical Systems, 7(2), 161-187.
Wheeler, W., & Brown, M. J. (2013). Blood lead levels in children aged 1–5 years—United
States, 1999–2010. MMWR. Morbidity and mortality weekly report, 62(13), 245.
Wheeler, D. C., Raman, S., Jones, R. M., Schootman, M., & Nelson, E. J. (2019). Bayesian
deprivation index models for explaining variation in elevated blood lead levels
among children in Maryland. Spatial and spatio-temporal epidemiology, 30, 100286.
White, D., & Gala, T. (2022). Environmental Injustice? Disparities in the Exposure to
Environmental Lead Poisoning and Risks among Children in the Chicago
Neighborhoods. American Journal of Public Health, 10(3), 124-133
Wilson, M; Tailor, A & Linares, A (2017) Chicago Community Area Economic Hardship Index
(2017), Great Cities Institute, University of Illinois Chicago.

Elevated Blood Lead Level among Chicago Children White 2022
Page | 61
Winter, A. S., & Sampson, R. J. (2017). From lead exposure in early childhood to adolescent
health: A Chicago birth cohort. American journal of public health, 107(9), 1496-1501.
Witzling, L., Wander, M., & Phillips, E. (2010). Testing and educating on urban soil lead: A
case of Chicago community gardens. Journal of Agriculture, Food Systems, and
Community Development, 1(2), 167-185.
World Health Organization. (2010). Childhood lead poisoning. June 9, 2021 Accessed from
https://www.who.int/ceh/publications/leadguidance.pdf
Xiao, G., Hu, Y., Li, N., & Yang, D. (2018). Spatial autocorrelation analysis of monitoring data
of heavy metals in rice in China. Food Control, 89, 32-37.
Zhang, N., Baker, H. W., Tufts, M., Raymond, R. E., Salihu, H., & Elliott, M. R. (2013). Early
childhood lead exposure and academic achievement: evidence from Detroit public
schools, 2008–2010. American journal of public health, 103(3), e72-e77.

ProQuest Number:
INFORMATION TO ALL USERS
The quality and completeness of this reproduction is dependent on the quality
and completeness of the copy made available to ProQuest.
Distributed by ProQuest LLC ( ).
Copyright of the Dissertation is held by the Author unless otherwise noted.
This work may be used in accordance with the terms of the Creative Commons license
or other rights statement, as indicated in the copyright statement or in the metadata
associated with this work. Unless otherwise specified in the copyright statement
or the metadata, all rights are reserved by the copyright holder.
This work is protected against unauthorized copying under Title 17,
United States Code and other applicable copyright laws.
Microform Edition where available © ProQuest LLC. No reproduction or digitization
of the Microform Edition is authorized without permission of ProQuest LLC.
ProQuest LLC
789 East Eisenhower Parkway
P.O. Box 1346
Ann Arbor, MI 48106 - 1346 USA
29061024
2022