We have been rightfully outraged by the lead poisoning of children in Flint, Michigan — an outrage that one health expert called “state-sponsored child abuse.”

But lead poisoning goes far beyond Flint, and in many parts of America seems to be even worse.

“Lead in Flint is the tip of the iceberg,” notes Dr. Richard J. Jackson, former director of the National Center for Environmental Health at the Centers for Disease Control and Prevention. “Flint is a teachable moment for America.”

In Flint, 4.9 percent of children tested for lead turned out to have elevated levels. That’s inexcusable. But in 2014 in New York state outside of New York City, the figure was 6.7 percent. In Pennsylvania, 8.5 percent. On the west side of Detroit, one-fifth of the children tested in 2014 had lead poisoning. In Iowa for 2012, the most recent year available, an astonishing 32 percent of children tested had elevated lead levels. (I calculated most of these numbers from CDC data.)

Across America, 535,000 children ages 1 through 5 suffer lead poisoning, by CDC estimates.

“We are indeed all Flint,” says Dr. Philip Landrigan, a professor of preventive medicine at the Icahn School of Medicine at Mount Sinai. “Lead poisoning continues to be a silent epidemic in the United States.”

None of this diminishes the tragedy of Flint, which is particularly horrifying because it was delivered by the government through the municipal water system even as state officials scoffed at the local outcry. In any case, data collection is poor, so we don’t have a good handle on the scale of the problem either in Flint or elsewhere: Take comparisons with a grain of salt. But it’s clear that this lead poisoning is not one city’s catastrophe but a nation’s — and the world’s, since the situation is even worse in some low-income countries.

Some 24 million homes in America have deteriorated lead paint, of which occupants are often unaware. If a toddler regularly breathes lead-contaminated dust, or sucks a finger that has touched the dust, that child may suffer lifelong brain damage.

Yet anti-lead programs have been dismantled in recent years because in 2012 Congress slashed the funding for lead programs at the CDC by 93 percent. After an outcry, some money was restored, but even now these lead programs have only a bit more than half the funding they once had.

Lead poisoning is an old problem: An Australian doctor, Lockhart Gibson, diagnosed the first case in 1904.

Then in 1943, a doctor in Boston encountered a young boy who had tried to stab his teacher, and remembered that the same boy had suffered lead poisoning years earlier. Researchers soon found that early exposure to lead impairs brain development and is strongly associated with later violent or criminal behavior.

Yet the lead industry ferociously fought attempts at regulation. It wasn’t until the 1970s and ’80s that lead was largely removed from gasoline, and until 2008 that a regulation reduced lead in paint to a reasonable level. Millions of children continue to suffer brain impairment because of the greed of the lead industry.

The removal of lead from gasoline was a triumph of public health. One scholarly article estimated that this raised the IQ of the average American child by between 2 and 5 points.

Today the continuing poisoning of half a million American children is tolerated partly because the victims often are low-income children of color.

In Baltimore, I met a 2-year-old boy named Malachi who couldn’t speak, apparently because of lead poisoning. When Congress slashed funding for lead programs, it helped poison kids like Malachi — and 50 years from now his capacity will still be constrained because of the failures of Congress.

A first step is to restore funding and to improve lead poisoning screening. When a child tests positive, a public health team should be dispatched to find the source and eliminate it.

“Every urban area has lead,” notes Dr. Leana Wen, health commissioner of Baltimore. Speaking of efforts to reduce lead poisoning, she said, “If there’s something we can do that will result in improved educational outcomes and reduced violence in the community, why don’t we do it?”

Let’s recognize the catastrophe in Flint as a wake-up call to address not just one city’s lead-poisoning tragedy, but America’s.


Nicholas Kristof is a New York Times columnist.

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