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Denver Boulevard sits on San Antonio’s southeast side, intersecting with neighborhoods in the second city council district. While primarily residential, two churches and two taquerías accompany the small lawns and chain-linked fences. Its houses are distinctly decorated for Fiesta and the Spurs. However, Denver is remarkable for a different reason.
The City of San Antonio’s Green and Healthy Homes initiative (GHH) has helped remove lead-based paint from 12 homes on Denver Boulevard for families with children under 6 years old since 2005. Peeling and cracking of lead paint creates dust that young children breathe and flakes that they may ingest.
Luis Pesina is a homeowner in the area. He explained that his house is over 100 years old and was part of the renovation program.
“They came in and repainted and replaced all the windows, and found lead on the ground within one foot from the house.”
When asked whether he knew about the health risks of lead-based paint prior to the renovation, Pesina said that he did not. “I started reading on it, but by then my kids were grown and gone,” he recalled.
According to the Centers for Disease Control and Prevention, lead in the home increases a child’s risk for numerous long-term health issues. Exposure for children can cause damage to the brain and nervous system, slowed growth and development, behavior and learning problems, as well as difficulty hearing and speaking.
In San Antonio, old housing stock is concentrated in the neighborhoods immediately north, south, and east of downtown. According to the Bexar County Health Collaborative, many such homes were built in the 1930s and 1940s. Since nearly 42 percent of Bexar county homes were constructed before 1978 – and are therefore likely to contain lead-based paint because it had not yet been outlawed by Congress – there are wide sections of San Antonio that require lead-based paint removal.
According to data obtained from an open records request to the City of San Antonio, the GHH has served 1,073 units across the city since 2005. The program, which serves families who live in pre-1978 housing and earn 80 percent or below the area median income, is funded by a grant from the Department of Housing and Urban Development (HUD). San Antonio’s Neighborhood and Housing Services Department (NHSD) estimates that over 2,685 children have been spared from exposure to lead over that period.
Jennifer Buxton, the housing production manager, said that the program has removed lead-based paint from 134 units in the East Side Promise Zone since 2016 and hopes to reach 200 by 2020. A “promise zone” is a federal designation the Obama administration created to leverage community resources toward revitalization.
Barriers to Abatement
Community reluctance is the most common barrier to removing lead paint. Families are reluctant for many reasons: they are often unaware of the detrimental health complications from lead, the benefits of paint removal to a child’s health accrue over a long period of time, and mistrust in government is prevalent. Unfortunately, Buxton explained, these factors mean that the families who are the most at risk are the least likely to apply for assistance.
“Families have to be willing to answer their doors and do a lot of documentation in the program,” Buxton lamented.
The application process requires identification documents, three months of pay stubs from everyone in the household that is employed, six months of bank statements, a tax return, copies of public assistance or retirement checks, and even divorce decrees if applicable.
The city has two main strategies to drive applications. It contracts with the nonprofit Family Service Association to knock on doors in communities at risk. The department also reaches families who use adjacent city services like Pre-K 4 SA.
Rita Espinoza, chief of epidemiology at the San Antonio Metropolitan Health District, explained that if a child enrolled in the city’s preschool program is found to have an elevated blood lead level (BLL), the program would aim to connect with the child’s family.
“There are several reasons why people might not want to trust government agencies or people on campaigns from the city,” said Beto DeLeon, a community organizer who works on environmental justice with the Southwest Workers Union.
DeLeon referenced instances when San Antonio Water System (SAWS) representatives were accompanied by police on routine leak repair trips and a history of exploitation of Latino and Black communities in San Antonio.
San Antonio in Context
The distribution of childhood exposure to lead largely follows other city health patterns. Housing stock quality is one social determinant of health, and poorer zip codes with old buildings and the remnants of redlining leave children more at risk.
Espinoza stated that 2.4 percent of children between zero and 5 years old in San Antonio have elevated BLLs, while the national average is 2.5 percent.
When asked how concerned parents and other residents of San Antonio should be, Espinoza said it depends on where a family lives. She recommends parents have their children tested regularly and highlighted the need for education about lead exposure.
In 2016, the U.S. had around 3,000 areas with lead poisoning rates at least double those of Flint, Michigan. In comparison to communities like Cleveland, Baltimore, South Bend, and many others with old housing stock, San Antonio’s rates of exposure remain quite low.
Nevertheless, there is no safe BLL for children. The CDC considers 5 µg/dL (micrograms per deciliter) to be the “reference level” at which public health action should be initiated, but negative impacts come at nearly all levels. In the past 30 years, the CDC has significantly lowered its reference level as a result of successful regulations such as the removal of lead from paint and gasoline.
The map above depicts the Texas Department of State Health Services’ (DSHS) most recent BLL data for children in Bexar County zip codes ages zero to 15.
“Texas law requires reporting of blood lead tests, elevated and non-elevated, for children younger than 15 years of age. Physicians, laboratories, hospitals, clinics, and other healthcare facilities must report all blood lead tests to the Texas Child Lead Registry,” said Lara Anton, a spokesperson for the DSHS, in an email.
Anton noted that the department conducts follow-up actions based on the CDC’s reference level if needed. “These activities include contacting parents, providers and conducting environmental lead investigations when appropriate,” she said. However, Buxton did not recall the GHH communicating with the state to determine candidates for lead-based paint abatement.
While the distribution of lead exposure largely follows health patterns like life expectancy, the causes in each neighborhood are the result of many factors. Air quality, the impacts of climate change, and lack of quality health care generate divergent outcomes. According to the Bexar County Health collaborative, there is a drastic disparity in life expectancy in the region as a result. Near east side and near west side residents have a life expectancy of 70 to 74 years while residents in the far northwest and southeast sections of Bexar county can expect to live to 90.
Dr. Alfred Montoya, a medical anthropologist and professor in Trinity University’s Department of Sociology and Anthropology, explained that contaminated soil dumping in some areas is another factor that may contribute to lead poisoning. Montoya mentioned the Alamodome construction process which risked exposing lead and other toxins from underground. In 1993, the city rushed to open the $197 million Alamodome and dumped nearly 500,000 cubic yards of contaminated soil in low-income areas.
As recently as 2013, the city ignored the recommendations of geoscientists who concluded that construction for the convention center would move 150,000 cubic yards of contaminated soil across from the San Antonio food bank.
Although the homeowners we spoke to on Denver Boulevard did not know of the harms that result from lead-based paint for their children, they quickly learned of the importance to address the problem.
“A lot of folks are aware that something is not right,” DeLeon said, referencing his experience educating residents about environmental justice with the Southwest Workers Union. “There are a lot of different reasons that our homes and environments can make us sick, so people have that wisdom and they’re looking for the origins and then to build solutions from that.”