Eliminating Disparities in Children's Lead Exposure: An Unfinished Job.

Abstract

<b>Objectives.</b> To examine trends in blood lead levels (BLLs) among US children aged 5 years or younger using national and state data. <b>Methods.</b> We analyzed 2011 to 2023 National Health and Nutrition Examination Survey (NHANES) data by year and available demographic characteristics. We report geometric means, the prevalence of BLLs of 3.5 micrograms per deciliter or above and 5.0 micrograms per deciliter or above, and linear trends. In addition, we summarize 2017 to 2023 surveillance data from 7 states. <b>Results.</b> National BLLs continue to decline. In 2021 to 2023, geometric mean BLLs and the prevalence of BLLs of 3.5 micrograms per deciliter or above were lower for all groups than in previous years. Small recent NHANES sample sizes and limited state-level subgroup data constrained detailed analyses. However, state-level data revealed disparities by geography, race, and ethnicity. <b>Conclusions.</b> National data indicate decreasing BLLs among children and elimination of racial disparities, but state and local BLL data unmask ongoing disparities. <b>Public Health Implications.</b> To better describe childhood lead exposures, NHANES should increase its sample size, oversample high-risk populations, and release timely data, and states should expand surveillance and risk factors and make data publicly available. Together, the data assessed here provide benchmarks to target prevention efforts and warn of emerging risks. (<i>Am J Public Health</i>. 2026;116(9): 1343-1351. https://doi.org/10.2105/AJPH.2026.308468).