Morbidity and mortality levels were comparable between homeless and low-income adults; homeless children's slightly higher risk on some measures possibly reflects the impact of poverty and poor-quality, unstable housing.

Our findings demonstrate an increased risk of lead poisoning among immigrant children.

Although the incidence of lead poisoning has declined in the US, severe cases still occur. Physicians should be especially vigilant in certain at-risk populations including children who eat paint chips or soil, spend time outside the US (particularly in Pakistan), use imported products, or have developmental delays or sickle cell disease.

Successful public health media campaigns promote messages, increase awareness, engage the public, and encourage behavior change. Between 2004 and 2006, the Lead Poisoning Prevention Program of the New York City Department of Health and Mental Hygiene conducted a media campaign grounded in social learning theory and the social marketing model to increase parents' awareness of childhood lead poisoning, ways to protect their children, and property owners' legal responsibility to fix peeling lead paint safely, and increase awareness of regulatory changes and encourage enforcement of New York City's Local Law 1 of 2004. Campaign materials were focus group tested and the campaign was refined annually. The campaign ran city-wide and in targeted high-risk neighborhoods. Neighborhoods and media venue (bus, train, kiosk, and store) changed annually, based on population risk factors and venue availability. Exposure to the campaign, campaign-related knowledge, and behavior were assessed using pre- and postcampaign street intercept surveys. Results showed that campaign reached the targeted population, and had an impact on knowledge of lead poisoning prevention measures as evidenced by increased knowledge of lead paint exposures sources in one year and increased knowledge of preventive behaviors in another year; these improvements were observed for both genders and most ethnic, primary language, educational attainment, and age groups in each year. Lessons learned indicate that well-targeted media campaigns, designed with audience participation, can reach parents through various venues, and improve key knowledge areas. Evaluation challenges faced include high levels of knowledge at baseline, competing media messages, and balancing between program needs and evaluation design.

No abstract