The sun sets behind a mural of the late Freddie Gray in Baltimore. Though he would eventually symbolize a far more visible tragedy, his life also represents that of many young children in Baltimore who have been poisoned by lead paint. REUTERS/Bryan Woolston

Decades after the federal government banned consumer uses of lead paint, children are still being poisoned in their own homes.

One milligram of dust. That’s all the lead it takes to poison a child—the equivalent of three granules of sugar. Years before his death, Freddie Gray was found to have 35 micrograms of lead in his blood—seven times the amount that can impair brain development, according to the Centers for Disease Control and Prevention. Though Gray would eventually symbolize a far more visible tragedy, his life also represents that of many young children in Baltimore who have been devastatingly poisoned by lead paint. In fact, lead poisoning has become so common in Baltimore ghettos that local children are often referred to as “lead kids.”

For these children, exposure to dust caused by the chipping, flaking, or peeling of lead-based paint poses serious, and sometimes fatal, health risks. Among a host of other issues, lead poisoning can lead to permanent brain damage, which often results in learning disabilities and increased violent behavior. According to the Green & Healthy Homes Initiative, a national organization working to combat lead poisoning, children who have been poisoned are seven times more likely to drop out of school and six times more likely to end up in the juvenile justice system.

The home where Freddie Gray lived from 1992 to 1996 reads like a textbook description of lead infestation. Lead paint chips were strewn about the floor and strips of paint were peeling off the walls and windowsills. Door and window frames are common contributors to lead exposure, since the act of closing a door or opening a window can cause dust to build up and fumes to circulate. Still, only certain homes are at risk. When I ask Ruth Ann Norton, the president and CEO of the Green & Healthy Homes Initiative, why industrial communities are more prone to lead poisoning, she is quick to identify the culprit: age of housing.

A “toxic legacy”

Though the problem is entirely preventable, lead poisoning is still burdened by what Norton calls a “toxic legacy” dating back to the 1920s, when lead paint reached its peak use in the U.S. In 1951, Baltimore became the first city to ban the use of lead-based paint in homes. But it was not until 1978 that the federal government finally instituted a nationwide ban.

The problem was exacerbated in industrial cities during the late 20th century as the manufacturing industry declined and residents began to seek employment elsewhere. It was this period of job loss that compelled cities to ignore health concerns in an effort to hold on to existing residents. “In a city like St. Louis, Baltimore, or Detroit,” Norton says, “there was surplus housing, which became abandoned housing. What [industrial] cities did, which was a big mistake, is they lost their adherence to standards … The fear was that, if they enforced their housing codes, people would abandon their houses and leave.”

That logic turned out to be backwards. Not only are healthy, lead-free homes cheaper and easier to maintain, Norton says, but they are also more likely to attract investment and improve the safety of a neighborhood. And yet, with many of these contaminated homes still standing, lead poisoning is relatively unshakeable in industrial cities. Although Baltimore has achieved a 98 percent reduction in childhood lead poisoning since 1993, there are still 535,000 children between the ages of one and five being poisoned each year in the U.S.

Lead poisoning is even more endemic to poor black communities, which are less likely to be able to afford newer, lead-free homes than wealthier communities. According to a 2009 study, blood lead levels are highest among black children, who are three times more likely to have highly elevated blood-lead levels than white children. Children from poor families or who live in housing built before 1950 are also at high risk, the study found.

Who’s to blame?

Even after Freddie Gray’s stepfather Richard Shipley realized that their tenement in Sandtown-Winchester was infested with lead in the ‘90s, there was little that he or his family could do. A lead-paint inspector advised the family to move, Shipley told The Washington Post, but escaping a lead-infested home in Baltimore’s ghettos was like removing oneself from the fabric of the city itself.

Although Gray and his siblings filed a lawsuit in 2008 and received an undisclosed settlement in 2010, most lead lawsuits are not as successful. In reality, determining who is to blame for the enduring crisis of lead paint in the U.S. is a difficult task. Perhaps the most obvious offenders are the manufacturing companies, although courts have ruled that they are not legally responsible for lead paints produced and installed decades ago.

Then there are the landlords, who don’t always have residents’ best interests at heart. According to the Residential Lead-Based Paint Hazard Reduction Act of 1992, sellers and landlords are required to “disclose … the presence of any known lead-based paint, or any known lead-based paint hazards” and allow ten days for the buyer or renter to conduct a lead inspection (the inspection itself is not mandatory). Although he recognizes that not all landlords are irresponsible, David Fukuzawa, the managing director of The Kresge Foundation’s Health and Human Services Programs, says that many landlords “are abusing their position and privilege.” In turn, some tenants refrain from complaining to their landlords for fear of getting evicted, despite the fact that retaliatory eviction is illegal in most states.

In these cases, many citizens feel that the federal government has a responsibility to step in. “As a country, we need to figure out what it is that we want,” says Baltimore Health Commissioner Leana Wen. “If we decide that this is an issue we cannot tolerate any longer, we have to make lead paint abatement a requirement.” Still, Fukuzawa finds that the issue is best tackled on a municipal level. “The solution is going to look a little bit different in every community,” he says. “What it looks like in Detroit is different than what it looks like in south L.A.”

While approaches may differ from city to city, places like Detroit and Baltimore are excellent examples of municipal governments that have united their communities over a shared concern about lead paint. “Not seeing our residents as problems, but rather as solutions to our problems—that is a big element of why our work [in Baltimore] has been so successful,” Wen tells CityLab. In particular, she notes, Baltimore has excelled at developing public-private partnerships and working toward a common goal of universal lead screening for children ages one and two. Unfortunately, the city’s home investigations are not frequent enough to address many cases of lead poisoning—even in a state like Maryland, which has the strongest lead laws in the country. The city also lacks an easily accessible point-of-care testing system that could simultaneously diagnose and treat lead victims.

Limits to funding

Another major roadblock to eradicating childhood lead poisoning—particularly in industrial cities—is lack of funding. According to a new report released this month by the Center for American Progress, the CDC’s Childhood Lead Poisoning Prevention program has been hard hit by budget cuts, in turn limiting the program to 29 states and the District of Columbia. These limitations are concerning, since the CDC has singular access to information about when and where lead poisoning occurs. Without an extensive CDC prevention program, it becomes difficult for major government agencies like the U.S. Department of Housing and Urban Development (HUD) to decide where to allocate funds.

Just last week, HUD released $52.6 million in grants to remove lead hazards from over 2,800 low-income households. But even with these grants in place, current funds are not enough to eliminate lead poisoning in the U.S. Nearly two decades ago, President Bill Clinton’s Task Force on Environmental Health Risks and Safety Risks to Children determined that HUD would require a minimum budget of $230 million a year to protect children from lead poisoning. This funding would allow HUD's Office of Lead Hazard Control and Healthy Homes to provide additional lead screenings and prevent lead exposure in low-income households and those with children below age six. With this budget, Norton estimates, the U.S. could reasonably expect to end childhood lead poisoning as a major public health problem in five years.

Even so, not all government officials support efforts to reduce lead poisoning. Last August, Kenneth Holt, Maryland’s Secretary of Housing and Community Development, sparked controversy when he conjectured that mothers might intentionally poison their children with lead in exchange for free housing. While addressing an audience at the Maryland Association of Counties summer convention, Holt floated the idea of weakening Maryland’s lead paint laws to prevent residents from taking advantage.

And yet a 2009 study from the Economic Policy Institute found that taxpayers actually receive a $17-$221 return on investment for every dollar invested in controlling lead hazards. The reason is simple: Keeping children safe from lead hazards can prevent future health issues, reduce criminal activity, limit the number of kids who end up in special education programs, and improve individual IQs and lifetime earnings—all of which reduce stress on the economy. “There is no other public health program in the country that has that kind of dollar return,” Norton says.

But Fukuzawa is careful to note that “we can’t subsidize our way out of this problem.” In all likelihood, permanently eradicating lead poisoning from the U.S. will require the full cooperation of both local communities and national entities.

Beyond industrial cities

While aging industrial cities are the most vulnerable to lead poisoning, no city is exempt from the hazardous history of lead paint. Even small towns and rural communities are at risk. In addition to major industrial cities, the Green & Healthy Homes Initiative has worked to eliminate lead poisoning in a number of locations nationwide, including southern cities like Austin, San Antonio, and Atlanta and places like Marin County, California.

And yet, because states monitor the number of children with lead poisoning on a volunteer basis in exchange for CDC funding, not all states have signed up for the challenge. As a result, many citywide lead problems go unnoticed. As of earlier this year, only 26 states had reported recent data on blood lead levels to the CDC, and another 13 states had not reported any data. In Baltimore and beyond, children like Freddie Gray suffer every day from an illness not only lacking in visibility and awareness, but in the information required to make a difference.

In reality, investing in the reduction of lead poisoning is meaningful on a number of levels. “The poisoning of our children is a health issue, but it’s also a civil justice issue and an economic development issue,” Wen says. “It ties into everything else in our city.”

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