Robert J Karp
Disparities in developmental outcomes in similarly lead-poisoned children have been recognized for at least 85 years. Genetic and epigenetic factors, gender differences, birth order, and other elements in seemingly similar environments affect how children in the same family with similar levels of blood lead will experience their poisoning. Evaluating differences among children in tandem with identification, integration, and expansion of available resources within a bioecological system will enable clinicians to provide more specific and thus more effective interventions. These can be achieved within a community-based medical home that includes lead poisoning prevention, abatement, and enforcement of regulations at all levels. Lead poisoning is nested in poverty, which requires attention through public policies.