Thursday, January 10, 2013

You've Never Heard Of This Public Health Victory

  By  xaxnar

Over at Mother Jones, Kevin Drum has a cover story that spotlights how a critical public health action years ago is having a much bigger payback than anyone realized at the time. America's Real Criminal Element: Lead details the links between lead in gasoline and crime. It's already stirring up some ripples around the blogosphere.

   America's rate of crime is at a 50 year low. Drum has been watching this for a while and puts together some studies that strongly correlate this with the history of use of tetraethyl lead in gasoline and its eventual removal, along with new medical studies that have examined the pretty nasty things lead does to the human nervous system. The short version is, the rise in crime that began in the 60's and peaked in the early 90s was in large part driven by chronic exposure to lead in gasoline via air pollution.

The Case Against Lead

  Before anyone starts yelling "Correlation is not causation", Drum specifically addresses that in several ways. He doesn't claim lead was the only factor - things like the crack epidemic and changes in policing and imprisonment strategies can't be entirely dismissed. But - and this is a big but - the correlation of lead use in gasoline after World War II and it's eventual abandonment in the 70s correlates very closely with crime rates with a roughly 20 year lag. In other words, kids growing up exposed to lead in the air around them suffered damage to their brains and nervous systems that translated into crime when they became adults.

   There are several natural 'experiments' that strongly suggest the amount of lead being used in gasoline is strongly linked to crime. The correlation is seen in countries around the world where leaded gas was available. Lead wasn't discontinued uniformly in the U.S. - states that had a rapid decline in lead use saw a comparable decline in crime, and vice versa. The association of crime with big cities matches up with the greater concentration of vehicles in big cities. More lead in the air, more crime. Absent leaded gas, the rates between big and smaller cities are now roughly the same level.

Just How Bad Is It - and How Does It Do the Damage?

I strongly recommend reading the entire piece - it has some fascinating information with links.

     As to the mechanisms by which lead has such toxic effects,

...Neurological research is demonstrating that lead's effects are even more appalling, more permanent, and appear at far lower levels than we ever thought. For starters, it turns out that childhood lead exposure at nearly any level can seriously and permanently reduce IQ. Blood lead levels are measured in micrograms per deciliter, and levels once believed safe—65 μg/dL, then 25, then 15, then 10—are now known to cause serious damage. The EPA now says flatly that there is "no demonstrated safe concentration of lead in blood," and it turns out that even levels under 10 μg/dL can reduce IQ by as much as seven points. An estimated 2.5 percent of children nationwide have lead levels above 5 μg/dL.
emphasis added

     Here's the real kicker:

So lead is a double whammy: It impairs specific parts of the brain responsible for executive functions and it impairs the communication channels between these parts of the brain. For children like the ones in the Cincinnati study, who were mostly inner-city kids with plenty of strikes against them already, lead exposure was, in Cecil's words, an "additional kick in the gut." And one more thing: Although both sexes are affected by lead, the neurological impact turns out to be greater among boys than girls.

    Other recent studies link even minuscule blood lead levels with attention deficit/hyperactivity disorder. Even at concentrations well below those usually considered safe—levels still common today—lead increases the odds of kids developing ADHD.

    In other words, as Reyes summarized the evidence in her paper, even moderately high levels of lead exposure are associated with aggressivity, impulsivity, ADHD, and lower IQ. And right there, you've practically defined the profile of a violent young offender.

emphasis added

    Lead was phased out of gasoline because of concerns over neurotoxicity and because it poisoned the catalytic convertors that came into use in the 1970's to reduce air pollution. It was eventually banned. (wikipedia history here) Who knew the EPA could be more effective at fighting crime than the FBI or Rudy Giuliani? (Atrios has a snarky observation on what else it might explain.)

Larger Implications

        Drum notes that the legacy of lead is still having toxic effects. We have a whole generation or more of people who grew up convinced that cities are hotbeds of violent crime - and not without reason given what we now know. That's changing but the paranoid stereotypes are still very much in effect out in the heartland and in certain political circles.

       We have theories of policing based on zero tolerance and other strategies that may no longer apply and may not have been effective in the first place. We have a huge prison industrial complex dedicated to locking up people - one that may have been overbuilt. Drum notes criminologists so far have largely ignored the lead hypothesis. He attributes it to a bias towards looking for sociological reasons to explain crime. Medical/environmental explanations are not on their radar. (Plus, the roughly 20 year lag between exposure and effects makes the connection less than obvious.)

       In short, we have a whole structure of social, institutional, legal, and political assumptions built up to address a problem it turns out we didn't fully understand at the time - and a lot of them are still in effect even though it turns out they weren't quite the right answers. To move forward is going to require recognition of those facts and the ability to rethink our previous solutions. That's not a strength of our current political system these days.

It's Not Over

   Drum closes with an important point. Lead may no longer be in our gasoline, but there's plenty of it that ended up in the soil, and there's still plenty of it left in old paint as well. People who live in cities where there was heavy lead exposure are still at risk from this toxic legacy. Lead in the soil doesn't stay there as Drum notes. It gets blown around with the wind, gets tracked into houses and kids play in it. Buy an old house with lead paint, you can poison yourself fixing it up. Lead may be lurking in your plumbing. (A companion article by Sarah Zhang spells out what to look for.)

     We still have a lot of cleaning up to do. Drum estimates it would take roughly $20 billion a year for at least 2 decades to clean up the lead that's lurking out there. But - and here's the key - he figures the resulting reduction in crime, the improvements in health, the reduction in damage to the brains of those now being exposed, well let me quote him again:

Put this all together and the benefits of lead cleanup could be in the neighborhood of $200 billion per year. In other words, an annual investment of $20 billion for 20 years could produce returns of 10-to-1 every single year for decades to come. Those are returns that Wall Street hedge funds can only dream of.


Lead abatement isn't cheap, but the return on investment is mind-blowing.

   Or else, as Drum notes, we can just continue to let kids grow up exposed to lead and spend $20 billion a year to lock them up in new prisons up once they reach 20 years of age.

Some Additional Thoughts

     To expand a bit on some of the larger implications of Drum's reporting, this is the kind of example that really makes the case for a strong public sector to protect the public interest.

       The original reason for the phasing out of leaded gasoline was because of the growing need to improve air quality by reducing emissions from cars. Many people alive today have never experienced how bad smog used to routinely get in our major cities - and it's still a problem in some areas. The auto industry resisted, and there was the usual griping about government regulation making things more expensive. According to the wikipedia article, the tetraethyl lead industry fought it like mad and sued those who first started sounding the warnings about the dangers of lead in gasoline.

     If what Drum is reporting holds up - and it will doubtless draw a lot of attacks from the usual suspects - it turns out government action to address one problem has helped with another we didn't fully appreciate at the time. It was a policy based on the best science of the time - not ideology, not some idle faith in free markets - that put catalytic convertors on cars and took lead out of gasoline. The science of today is confirming it was the right decision, even better than we knew. Far from costing us money, it has saved us a tremendous amount, and saved countless lives as well. The private sector didn't do that; government did.

    The downside to all of this is that the current anti-government, anti-regulation, anti-science, pro-business fanaticism crippling our government does not bode well for further rational action. There is zero chance the Republican Party as it currently is will allow any effective action to address the far greater challenge of climate change (or anything else for that matter). The immense concentration of wealth that has taken place in the intervening years also means the private interests that benefit from inaction have even more resources to protect their interests against the larger interests of the public.

   With all that, the case the Kevin Drum has put together is a pretty clear demonstration that we CAN use the power of government and the public sector to solve our problems. The removal of lead from gasoline turns out to be a bigger victory in the war for the public interest than we knew at the time. The war continues - but we can win if we keep fighting. Read the whole thing and decide for yourself. And keeping checking back with Kevin Drum. He promises additional material at his blog.

Originally posted to xaxnar on Thu Jan 03, 2013