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The Alabama Childhood Lead Poisoning Prevention Program

2004 Strategic Plan for Lead Elimination

TABLE OF CONTENTS

I. INTRODUCTION............................................................................................1

II. MISSION STATEMENT ................................................................................1

III. BACKGROUND

1. What is the problem? .............................................................................2

2. How are children exposed to lead? ........................................................2

3. Who Is At Risk for Lead Poisoning? .....................................................3

4. Targeting At Risk Populations in Alabama ...........................................3

IV. PARTNERSHIPS.............................................................................................6

V. THE LEAD ELIMINATION PLAN FOR THE STATE OF ALABAMA

1. Surveillance and Analysis....................................................................11

2. Case Management ...............................................................................14

3. Primary Prevention: Child Health Education .....................................17

4. Primary Prevention: Hazard Reduction ...............................................22

APPENDIX A – Housing Data .....................................................................26

APPENDIX B—Census Data........................................................................28

APPENDIX C—Partnership Workgroup ...................................................40

ACRONYM LIST

ACES Alabama Cooperative Extension Services ACLPPP Alabama Childhood Lead Poisoning Prevention Program ADECA Alabama Department of Economic and Community Affairs ADEM Alabama Department of Environmental Management ADPH Alabama Department of Public Health BES Bureau of Environmental Services BLL Blood Lead Level CC Care Coordinator CDC Centers for Disease Control and Prevention CEU Continuing Education Unit DHR Department of Health and Human Resources EBLL Elevated Blood Lead Level EPSDT Early Periodic Screening Diagnostic Tool HCCA Healthy Child Care of Alabama HHLC Healthy Homes and Lead Hazard Control HUD U.S. Department of Housing and Urban Development JC CLPPP Jefferson County Childhood Lead Poisoning Prevention Program LIHEAP Low Income Home Energy Assistance Program µg/dL Micrograms per deciliter MC CLPPP Mobile County Childhood Lead Poisoning Prevention Program NEDS National Electronic Disease Surveillance System OSHA Occupational Safety and Health Administration PTA Parent Teacher Association SOPH School of Public Health WIC Women, Infants, and Children

The Alabama Childhood Lead Poisoning Prevention Program 2004 Strategic Plan for Lead Elimination

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I. INTRODUCTION

In 2004, the Alabama Childhood Lead Poisoning Prevention Project (ACLPPP)

established an advisory workgroup with the goal of developing a comprehensive state plan to

eliminate childhood lead poisoning by 2010. This workgroup brought together stakeholders

from organizations throughout Alabama for the purpose of implementing the Elimination Plan.

A facilitator guided the dialogue of these workgroups which met monthly to define problems, set

goals and objectives, determine activities with quantifiable means and timelines to measure

outcomes. The stakeholders involved in this workgroup were identified by the lead agency

(ACLPPP) and involved representatives from the following organizations: Alabama Department

of Public Health, the Alabama Medicaid Agency, Department of Children’s Affairs, University

of Alabama Birmingham School of Public Health, OSHA, Alabama Department of Economic

and Community Affairs, Alabama Cooperative Extension System, HUD, EPA and grassroots

organizations involved with lead poisoning prevention. This coalition utilizes the wide range of

expertise needed to develop and implement the goals and objectives of the strategic work plan.

For this strategic work plan, three subcommittees were formed: Surveillance, Screening

& Case Management, Primary Exposure Prevention, and Outreach/Education & Partnerships.

Federal, state and local representatives from the stakeholder organizations comprised these

subcommittees.

II. MISSION STATEMENT

The mission of the Alabama Childhood Lead Poisoning Prevention Project is to reduce the

statewide prevalence of elevated blood lead levels in children six years of age and less by 2010

from approximately five percent to less than one percent through extensive surveillance,

enhanced partnerships, targeted outreach, exposure prevention, and comprehensive case

management.


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III. BACKGROUND

What is the problem?

Childhood lead poisoning is the most preventable environmental health disease of young

children, yet an estimated 434,000 U.S. children one to five years of age have elevated blood

lead levels. Lead is a highly toxic heavy metal and a neurotoxin. Because lead poisoning most

often affects the central nervous system, it is most harmful to children less than six years of age.

Children’s organs, including the brain, begin developing during the fetal stage and continue to

develop through adolescence. Pregnant women and women of child-bearing age are also at

increased risk, because lead ingested by the mother can cross the placenta and affect the unborn

fetus. (http://www.aeclp.org/chil_ar/chil_ar_why_children.htm).

Lead poisoning can cause learning disabilities, behavioral problems, and, at very high

levels, seizures, coma, and even death (http://www.cdc.gov/nceh/lead/faq/about.htm). If a child

is exposed to neurotoxins such as lead, the resulting loss of intelligence or behavioral problems

can be irreversible. Because lead poisoning often occurs with no obvious symptoms, it

frequently goes unrecognized. The only way to diagnose lead poisoning is via blood lead levels.

Blood lead levels (BLLs) are considered elevated if they are over 10 µg/dL. Children’s

blood lead levels tend to increase rapidly from ages six to twelve months, and tend to peak at 18

to 24 months of age. Many studies point to a link between BLLs equal to or greater than 10

µg/dL and harmful health effects, in particular learning disabilities and behavior problems. The

Department of Health and Human Services’ Healthy People 2010 initiative has set a national

goal of eliminating BLLs equal to or greater than 10 µg/dL among children one to five years of

age by 2010.

How are children exposed to lead?

The primary source of lead exposure among U.S. children is in their residential

environment is lead-contaminated dust and soil from deteriorating lead-based paint. Before lead

was banned in 1978 from residential paint, it was often added as a stabilizing ingredient. Paint

contained even higher levels of lead prior to 1950. Therefore, older housing stock is the primary

source of lead-based paint. Intact paint is usually not a hazard; however, deteriorating lead-

based paint creates dust that is the primary source of exposure.


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The most common route of exposure for young children is through normal hand-to-mouth

behavior (e.g., thumb sucking, chewing on toys, eating food dropped on the floor, etc.) when

children come in contact with dust from deteriorating lead-based paint inside older homes and

around the soil outside the home. Children are also more exposed to lead dust in their

environment due to the fact that they spend significant amounts of time on the floor and ground.

As a result, they are more likely to come into contact with lead dust found in carpeting and soil.

Who Is At Risk for Lead Poisoning?

Although any child can potentially be poisoned by lead, children of some racial and

ethnic groups living in older housing are disproportionately affected by lead. For example, 22%

of black children and 13% of Mexican-American children living in housing built before 1946

have elevated blood lead levels compared with 6% of white children living in comparable types

of housing (http://www.cdc.gov/nceh/lead/faq/about.htm). Children enrolled in Medicaid have

three times the prevalence of elevated blood lead levels compared to non-Medicaid children.

With the increased recognition of existing health disparities in the United States, there

has been an emphasis on treatment and intervention. However, there is also a need to prevent

health disparities before the onset of injury, illness, or death.

http://www.preventioninstitute.org/thrive.html)

Targeting At-Risk Populations in Alabama

Since children are at highest risk for lead poisoning (especially those in low income

groups, living in older housing or belonging to certain minority groups) this population group

will be targeted for the Strategic Plan for Lead Elimination in Alabama. The Black Belt counties

of Alabama, named for the color of the soil which is thick, dark, and naturally rich was also the

part of the South where the slaves were most profitable. Today, over half the population in

Black Belt counties (lower central Alabama) is African American. It is also an area in dire need,

confronted with economic stagnation, declining population, and insufficient health care and

schools.


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Children

BLLs tend to peak at 18 to 24 months of age and 2.65% of Alabama’s population is aged

one to two years (see Appendix B). 8.12% of Alabama’s population is less than five years of

age.

Elevated Blood Lead Levels (EBLLs)

In 2003, 302 confirmed cases of childhood lead poisoning were reported.

Blood lead screening tests performed on children under six years old in Alabama that indicate

poisoning are reported to the health department for surveillance and case management. Children

with confirmed blood lead levels equal to or greater than 10 µg/dL are entered into the Alabama

case-management system and followed until case closure through the efforts of local health

departments as well as private clinics.

Housing

There are several ways that young children may be exposed to lead; the most common is

living in a housing unit built before 1950. Lead was present in residential paint until 1978 when

lead was banned in paint used in homes. However, paint used before 1950 contained even higher

levels of lead. In Alabama, the median year for houses built is 1975 (Appendix A). Thirteen

percent of houses were built before 1950 and 60% before 1979.

Poverty

Children under six living in poverty are at higher risk of lead poisoning than other

children. In Alabama, approximately 16% of the population lives in poverty (Appendix B). For

Alabama children less than five years of age, 11.88 % live in poverty (Appendix B). The total

number of children less than five years of age participating in the WIC program in FY1999 was

63,940 persons.

Minorities


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Children of certain racial/ethnic minority groups are at higher risk of lead poisoning than

other children. In 2000, the Alabama children aged one to two years old comprised 2.38 % of

the total white population, 3.16 % of the total black population, and 4.64 % of the total Hispanic

population (Appendix B). Of the traditional Black Belt counties in Alabama, six (Sumter,

Greene, Perry, Wilcox, Lowndes, Macon and Bullock) have over 65% nonwhite population in

the 2000 Census. In 1998, two-thirds of the state’s 62,025 newborns were white, and one-third

was of African American or other race. The number of live births to Hispanic Alabama residents

has increase more than four-fold in 10 years.


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IV. PARTNERSHIPS AND WORKGROUPS

ALABAMA DEPARTMENT OF PUBLIC HEALTH (ADPH)

The Alabama Childhood Lead Poisoning Prevention Program (ACLPPP)

The ACLPPP is the product of the collaborative efforts of the Alabama Department of

Public Health Bureaus of Family Health Services and the Centers for Disease Control &

Prevention (CDC). Their mission is to help every child in Alabama develop to their

maximum potential by promoting a lead free environment and healthy lifestyle. To

accomplish this mission ACLPPP provides public outreach and education, case

investigation, and case management services to help prevent further lead exposure in

Alabama’s children. ACLPPP has created partnerships with agencies to enact the goals and

objectives of the strategic plan for lead elimination (see Appendix C.) Targeted areas as

currently defined by Alabama Health Department: Pike, Jefferson, Mobile, Dallas, Wilcox,

Conecuh, Coffee Counties.

Alabama Perinatal Program

The mission of the Alabama Perinatal Program is to develop strategies that will reduce

infant morbidity and decrease the number of infant mortality.

Bureau of Environmental Services (BES)

A state-wide program authorized by Act No. 97-553, the Lead Reduction Act of 1997,

established the procedures to be followed for certification of contractors (or firms) that

perform lead-based paint inspections, risk assessments, and abatement activities in target

housing and child-occupied facilities. This program also requires that all persons engaged in

lead-based paint activities be properly trained, that training programs are accredited, and that

firms are certified; and that all lead-based paint activities in target housing and child-


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occupied facilities shall be performed by accredited individuals of certified firms according

to the prescribed work practice standards contained in these rules.

Healthy Child Care Alabama (HCCA)

HCCA is a program developed to support people who take care of other people’s

children. It was developed to promote health and safety to prevent injuries, and the risk of

illness in child care settings. HCCA also helps to coordinate community services to ensure

accessibility of medical care to children in need.

Women, Infants and Children (WIC)

The Special Supplemental Nutrition Program for Women, Infants, and Children, known

as WIC, is one of the nation’s most successful federally funded nutrition programs. The

program serves low and moderate income pregnant and breastfeeding women and women

who have just had a baby, infants, and children up to age years who are at nutritional risk.

The WIC program is administered in Alabama by ADPH through its Bureau of Family

Health Services.

ALABAMA DEPARTMENT OF CHILDREN’S AFFAIRS

The mission of the Alabama Department of Children's Affairs is to provide state

leadership to identify, analyze, streamline, and coordinate services for the 1.2 million

children throughout Alabama. This is accomplished through the divisions within the

Department of Children's Affairs which are Service Information & Evaluation, Service

Funding & Training, Service Coordination & Support, and Early Learning (Head Start &

Office of School Readiness.)

ALABAMA MEDICAID AGENCY


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Title XIX of the Social Security Act (SSA) is a program that provides medical assistance

for certain individuals and families with low income and resources. The program, known as

Medicaid, became law in 1965. Medicaid is the largest program providing medical and

health-related services to Alabama’s poorest people. In 2003, 906,000 individuals were

eligible for Medicaid benefits.

OSHA (OCCUPATIONAL SAFETY & HEALTH ADMINISTRATION)

OSHA's mission is to assure the safety and health of America's workers by setting and

enforcing standards; providing training, outreach, and education; establishing partnerships;

and encouraging continual improvement in workplace safety and health. This agency is

under the U.S. Department of Labor.

ENVIRONMENTAL PROTECTION AGENCY (EPA) OFFICE OF POLLUTION PREVENTION & TOXICS (OPPT)

OPPT has the primary responsibility for administering the Toxic Substances Control Act

(TSCA) and the Pollution Prevention Act of 1990. Among the goals of OPPT are promoting

risk reduction so as to minimize exposure to existing substances such as lead, asbestos,

dioxin, and polychlorinated biphenyls.

HUD (HOUSING AND URBAN DEVELOPMENT)

HUD's mission is to increase homeownership, support community development and

increase access to affordable housing free from discrimination. To fulfill this mission, HUD

will embrace high standards of ethics, management and accountability and forge new

partnerships--particularly with faith-based and community organizations--that leverage

resources and improve HUD's ability to be effective on the community level. With the

enactment of The Residential Lead-Based Paint Hazard Reduction Act of 1992, the Federal


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Government recognized modern scientific knowledge that childhood lead poisoning was

ubiquitous in America, caused primarily by lead-based paint hazards, and preventable. As a

part of the Act, in 1991, the Office of Healthy Homes and Lead Hazard Control was

established by HUD in order to bring together health and housing professionals in a

concerted effort to eliminate lead-based paint hazards in America's privately-owned and

low-income housing. The OHHLC is unique among federal agencies dealing with lead-

hazards, as the Office is staffed to bring lead health science to bear directly upon America's

housing.

ALABAMA COOPERATIVE EXTENSION SYSTEM (ACES)

The Alabama Cooperative Extension System, the primary outreach organization for the

land-grant mission of Alabama A&M University and Auburn University, delivers research-

based educational programs that enable people to improve their quality of life and economic

well-being.

ALABAMA DEPARTMENT OF ENVIRONMENTAL MANAGEMENT (ADEM)

ADEM administers all major federal environmental laws, including the Clean Air, Clean

Water and Safe Drinking Water acts and federal solid and hazardous waste laws. ADEM

assumes these responsibilities only after demonstration that state laws and regulations are at

least equivalent to federal standards and that the state has matching funds and personnel

available to administer the programs.

SAFE STATE ENVIRONMENTAL PROGRAMS

Safe State Environmental Programs helps individuals, schools, institutions, and

businesses to identify and manage lead-based paint hazards, asbestos, and indoor air


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hazards. The Alabama Department of Public Health requires Safe State accreditation to

perform lead-based paint inspections, risk assessments, project designs, and abatement

within the state. Training course accreditation is also required for training programs that

train lead-based paint abatement workers and supervisors, inspectors, risk assessors, and

project designers. Safe State Environmental Programs, through the University Testing

Service, also administers the EPA Lead-based Paint Certification Examinations. Safe State

is part of the College of Continuing Studies, University of Alabama.

UNIVERSITY OF ALABAMA AT BIRMINGHAM SCHOOL OF PUBLIC HEALTH

The Department of Maternal and Child Health focuses on promoting and enhancing the

health of children from birth to adulthood, their families and communities, with the goal of

improving the overall health status of this and future generations. The Department of

Environmental Health Sciences focuses on the biological mechanisms and consequences of

environmental and occupational hazards, as well as the prevention and containment of these

hazards.


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V. THE LEAD ELIMINATION PLAN FOR THE STATE OF ALABAMA

1. Surveillance & Analysis

Definition: The systematic collection, analysis, interpretation and dissemination of health data

on an ongoing basis to gain knowledge of the pattern of disease occurrence and potential in a

community in order to control and prevent disease in the community.

Goal: To monitor and track all blood lead levels of children aged less than 72 months old in

Alabama.

OBJECTIVE 1: To maintain a comprehensive database for all blood lead screening in

Alabama, including historical data.

Timeline: January 2006

Outcome: Continuously update (within 2 weeks) a database of all incident BLLs.

Input: Monthly input of all normal BLLs into database. Weekly input of all elevated

BLLs into database.

Output: Timely referrals for case management and environmental investigation

activities as well as for analysis.

Agencies: ADPH (ACLPPP, CCs), UAB (SOPH)

OBJECTIVE 2: To identify Target Populations whose children are at an inordinate risk for

elevated BLLs.


Outcome: To determine the risk factors (such as residential hazards, demographics, and

familial occupation) associated with elevated BLLs


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Input: Enter clinical, case management and housing data into database.

Output: Correlate BLLs with case management and housing data.

Agencies: ADPH (ACLPPP, CCs)

OBJECTIVE 3: To increase reporting of all BLLs to the health department.


Outcome: Non-reporting laboratories will begin reporting all BLLs. Increase to 90%

number of BLLs reported statewide.

Input: 1. Identify and contact laboratories not currently reporting BLLs and

encourage them to report all BLLs electronically.

2. Propose a regulation change to require reporting of all BLLs.

Output: Increase reporting of BLLs in a standardized electronic format.

Agencies: ADPH (ACLPPP) and Alabama Medicaid Agency.

OBJECTIVE 4: To report comprehensive and historical analyses of BLLs throughout the state.


Outcome: Use comprehensive database for analysis and evaluation.

Input: Migrate data from satellite databases into a central database.

Output Enter and track all BLL data throughout the state in a single database.

Agencies: ADPH (ACLPPP) and UAB (SOPH)

OBJECTIVE 5: To Target Areas and high-risk populations with low BLL screening rates.


Outcome: Produce annual reports to include:


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1. The incidence and prevalence rates of blood lead poisoning for Medicaid

eligibles.

2. The identity of under-screened Medicaid populations

3. The identity of populations with elevated BLLs

4. The screening rates of Target Areas and high-risk populations.

Input: Annual Medicaid data will be made available to ADPH for analysis.

Outputs: ADPH will analyze detailed Medicaid eligibility and claims data and develop

compliancy and screening rates annually.

Agencies: ADPH (ACLPPP), UAB (SOPH), Alabama Medicaid Agency

OBJECTIVE 6: To determine the risk of childhood blood lead poisoning due to association

with adult blood lead poisoning


Outcome: Annually, correlate via GIS analysis of addresses, the adult and childhood

blood lead levels

Input: Access the ADPH adult blood lead database

Output: Match adult blood lead address with childhood blood lead address

Agencies: ADPH (ACLPPP, Bureau of Epidemiology)

OBJECTIVE 7: To evaluate the progress and success of The Lead Elimination Plan for the

State of Alabama

Timeline: July 2006

Outcome: Produce annual workgroup reports


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Inputs: 1. Alabama Medicaid Agency submits annual eligibility and claims data by

end of year one.

2. ACLPPP will submit annual blood lead level, case and investigation data

reports by January 2006.

3. OSHA will submit a quarterly summary of lead occupation violation data

by January 2006.

4. HUD will submit a quarterly summary of activities related to ACLPPP

referrals as program feedback starting July 2005.

5. EPA and HUD will submit a quarterly summary of disclosure law

violations starting July 2005.

Output: A cross-agency annual report of workgroup activities is published.

Agencies: ADPH (ACLPPP), UAB (SOPH), Alabama Medicaid Agency, OSHA, HUD

(Alabama), EPA (Region IV)

OBJECTIVE 8: To use Web-based NEDSS-compliant database for data entry, tracking and

evaluation of blood lead data


Outcome: To enter and track incident data within database.

Input: Establish a component of Alabama’s NEDSS to receive blood lead levels.

Output: Transfer data from blood lead database into the Lead Program Area Module of

NEDSS.

Agencies: APDH (ACLPPP), UAB (SOPH)

2. Case Management


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Definition: Identifying an individual’s needs and problems and devising a method to meet those

appropriately and cost-effectively. Consultation with other health professionals and agencies

helps the person take advantage of appropriate treatments and procedures.

Goal: To assure proper follow-up for children with elevated blood lead levels.

OBJECTIVE 1: To employ and maintain a standard psycho-social case management protocol.

Timeline: April 2005 and ongoing

Outcome: 100% of the counties will have trained case managers available to provide

case management services to children with elevated BLLs.

Input: To provide quarterly training for case managers.

Output: All case managers for childhood lead poisoning cases will be trained

according to ACLPPP-Medicaid protocol.

Agencies: ADPH (ACLPPP), Alabama Medicaid

OBJECTIVE 2: Expand the use of the psycho-social case management system to sustain case

management provided to non-Medicaid clients.


Outcome: 50% of insurers will support case management services to non-Medicaid

clients.

Input: Contact private insurers and encourage them to provide case management

services.


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Output: Private Insurers provide case management for children with elevated BLLs

using the standard psycho-social case management protocol.

Agencies: ADPH (ACLPPP and BES, Alabama Medicaid Agency)

OBJECTIVE 3: Case management will be effective in lowering elevated BLLs to normal

levels.


Outcome: Annually, review and revise as necessary the psycho-social case management

and environmental investigation protocols to achieve lowering of BLLs.

Inputs: 1. Environmental investigation data will be tracked in the database.

2. Psycho-social case management data will be tracked in the database.

Output: Annually correlate psycho-social case management activities and

environmental investigation data with BLLs.

Agencies: ADPH (ACLPPP) and UAB (SOPH)

OBJECTIVE 4: Disclosure of Environmental Investigation reports results in increase in hazard

reduction activities


Outcome: Addresses of cases with identified lead hazards will undergo lead hazard

reduction activities

Input: Revise the current Environmental Lead Investigation Protocol to specify

disclosure responsibilities.


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Output: 1. Investigation reports specify corrective actions for family and homeowner

to reduce childhood exposure to identified hazards

2. Investigation reports disclosed to entities with ability to fund hazard

reduction activities.

Agencies: ADPH (ACLPPP and BES)

3. Primary Prevention — Child Health Education

Definition: Education that increases the awareness and favorably influences the attitudes and

knowledge relating to the improvement of health on a personal or community basis.

Goal: Decrease in elevated BLLs due to an increase in lead safe behaviors and screening.

OBJECTIVE 1: Children will be assessed for risk of lead poisoning by health care providers

and screened for blood lead poisoning accordingly.

Timeline: April 2006

Outcome: Health care providers will determine child’s risk and screen for blood lead

poisoning according to protocol.

Input: 1. Provide printed educational materials (such as provider packets, Medicaid

newsletter, and county fact sheets) to under-screening health care

providers.

2. Provide CEUs to health care providers in Target Areas regarding risk

determination and screening


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Output: 1. Health care providers will be educated regarding risk determination and

importance of screening via mass mail out to 50% EPSDT providers in

Target Areas.

2. Conduct site visit with three EPSDT providers in Target Areas per month.

Agencies: ADPH (ACLPPP), UAB (SOPH) and Alabama Medicaid

OBJECTIVE 2: Families will be informed through childcare providers of the risk factors for

lead poisoning and the importance of screening.


Outcome: Childcare providers will educate children and families regarding lead safe

behaviors and the importance of screening.

Input: 1. Provide childcare providers in Target Areas with CEUs regarding lead

safe behaviors and the importance of screening.

2. Provide materials to AARP regarding lead safe behaviors and the

importance of screening.

3. Provide faith-based childcare centers in Target Areas with materials

regarding lead safe behaviors and the importance of screening.

Output: Childcare providers (both regulated and faith-based facilities and

grandparents) encourage lead safe behaviors for children.

Agencies: ADPH (ACLPPP), DHR


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OBJECTIVE 3: A decrease in elevated BLLs in children due to primary prevention activities

targeting mothers of newborns


Outcome: The mothers of newborns in Target Areas will be educated regarding lead safe

behaviors and the importance of screening.

Input: Collaborate with the State Perinatal Program Regional Coordinator’s to

develop childhood lead poisoning prevention message for mothers of

newborns.

Output: Hospital’s take-home packet for mothers of newborns in Target Areas will

include childhood lead poisoning prevention education

Agencies: ADPH (ACLPPP, Perinatal Program)

OBJECTIVE 4: A decrease in elevated BLLs in children due to primary prevention activities

targeting families of WIC participants.

Timeline: November 2008

Outcome: WIC staff refers participants who have not received a blood lead screen for a

blood lead screen and provide additional nutritional education to families of

participants with a documented diagnosis of blood lead poisoning.

Input: 1. WIC staff will ask families of participants aged 12 months and greater

whether participant has received a blood lead screen.

2. Review current nutrition education tool and revise as necessary.


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Output: 1. WIC staff will refer participants aged 12 months and greater who have not

received a blood lead screen to obtain a blood lead screen.

2. Collaboration between WIC and ACLPPP staff will ensure a nutrition

education tool will contain pertinent information and current

recommendations for children with lead poisoning.

Agencies: ADPH (WIC, ACLPPP)

OBJECTIVE 5: A decrease in elevated BLLs due to additional health education outreach

through collaboration with other agencies


Outcome: Additional partners will incorporate childhood lead poisoning prevention

education as part of comprehensive childhood education programs.

Input: Seek potential partners to further reinforce childhood lead poisoning

prevention health education outreach efforts.

Output: Development of partnerships with agencies such as HCCA, Office of School

Readiness, Children’s Affairs, PTA, DHR, State Child Nutrition, Alabama

Partnership for Children, Immunization Division. ACES

Agencies: ADPH (ACLPPP)

OBJECTIVE 6: A decrease in elevated BLLs due to the implementation of lead safe behaviors

by families in Target Areas.


Outcome: Increased public awareness via public service announcements and other health

education activities regarding lead poisoning risks.


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Input: Review public health lead poisoning messages.

Output: Refine and develop “key messages” (such as lead dust control) that will be

used as the core outreach education for the public. Potential outlets include

paint retailers, restaurant flyers, utility bill inserts and mass media.

Agencies: ADPH (ACLPPP), HUD, EPA

OBJECTIVE 7: Community leaders and public and private stakeholders will have access to

information regarding elimination goals and activities at a centralized Web

site.


Outcome: To have an online clearinghouse of lead education materials and information

regarding the Elimination Plan and it’s progress.

Input: 1. Collect childhood lead poisoning prevention health education materials

2. Compile annual progress reports.

Output: Post materials, Workgroup reports and The Lead Elimination Plan online.


OBJECTIVE 8: Other state agencies serving at-risk populations will support childhood lead

poisoning elimination efforts


Outcome: Increased number of agencies through out the state that collaborate with

childhood lead poisoning preventive activities.


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Input: Identify additional agencies (such as DHR, Headstart, Success by 6, DRS,

CRS, Department of Education, YMCA, Goodtimes, Refugee Clinics, etc.)

that serving at-risk populations

Output: Educate agencies regarding their potential role in eliminating childhood lead

poisoning.


4. Primary Prevention — Hazard Reduction

Definition: To of any hazard that reduces or eliminates the threat of causing childhood lead

poisoning.

Goal: A decrease in elevated BLLs in children due to a reduction in exposure to lead hazards.

OBJECTIVE 1: Decreased exposure of children to occupational lead hazards.


Outcome: Results of environmental investigations determine fewer indications of

childhood lead exposure to occupational lead hazards.

Input: ADPH reports to OSHA suspected occupation-related childhood lead cases.

Output: OSHA investigates referrals, issuing appropriate citations or penalties to

responsible and exposing employers, and monitors compliance activities in

accordance with OSHA regulations.

Agencies: ADPH (ACLPPP), OSHA


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OBJECTIVE 2: Decreased exposure of children to residential lead-based paint hazards.


Outcome Sellers, landlords and remodelers will comply with federal disclosure laws.

Input: 1. ADPH forwards to EPA addresses with known lead hazards.

2. EPA promotes awareness thru outreach and compliance assistance of the

disclosure laws.

Output: EPA monitors compliance and enforces Section 1018 disclosure rules that

may result in civil penalties or abatement.

Agencies: ADPH (ACLPPP), EPA, ACES

OBJECTIVE 3: Decreased exposure of children to consumer products containing lead hazards.


Outcome: Families, providers and retailers become educated regarding lead exposure

from consumer products.

Input: ADPH reviews and monitors consumer product reports.

Output: Customized health education messages that include reports of lead exposure in

new consumer products.

Agencies: ADPH

OBJECTIVE 4: A decrease in elevated BLLs in children exposed to lead-based paint hazards

in public housing and HUD-assisted housing.


Outcome: Public housing and HUD-assisted housing will not be a significant point

exposure of lead hazards to children.


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Input: ADPH forwards to HUD identified lead hazards in public housing and HUD-

assisted and recommends corrective measures to reduce or eliminate

residential lead hazards.

Output: 1. HUD will reduce residential lead hazards.

2. Secure lead-safe housing for children with elevated BLLs.

Agencies: ADPH (ACLPPP), HUD

OBJECTIVE 5: A decrease in elevated BLLs in children due to decreased exposure to

residential lead hazards in residences undergoing renovation.


Outcome: Residences having undergone renovation will not be a significant source of

lead hazard exposure.

Input: 1. Train remodelers in Target Areas regarding lead safe work practices.

2. Distribute material to remodelers (thru agents such as building permit

agencies, technical/trade schools, remodeling associations, painters

unions, and historical societies

Output: Remodelers employ lead safe work practices when renovation activities

disturb lead hazards

Agencies: ADPH (ACLPPP), OSHA

OBJECTIVE 6: A decrease in elevated BLLs in children as a result of/through increased

regulation of lead hazards.


Outcome: Lead protective policies enacted and enforced in Target Areas


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Input: 1. Contact and educate political leaders regarding the need for protective

policies (such as tenant rights, tax breaks, code regulations, and lead-safe

certification of property)

2. Provide sample legislation and data that support the need.

Output: Lead protective policies proposed in communities within target areas.

Agencies: ADPH (ACLPPP), local jurisdictions (such as community-based

organizations, league of municipalities, and association of county

commissioners.)

OBJECTIVE 7: A reduction in residential lead hazards.


Outcome: Homes identified with residential lead hazards are safely reduced

Input: 1. Identity and seek funding resources to reduce residential lead hazards

2. Identify likely recipients in Target Areas of these funds.

3. Provide child lead data that supports the need for funds and the referral

mechanism to put funds to use to reduce residential lead hazards.

Output: Organizations secure funds to reduce residential lead hazards.

Agencies: ADPH (ACLPPP), HUD, Safe State and ACES


26

APPENDIX A Housing Data

Note: Black Belt counties are shaded

A l a b a m a H o u s i n g D a t aM e d ia n Y e a r B u i l t

A u ta u g a 1 , 2 1 5 7 % 7 , 6 5 4 4 3 % 8 , 8 6 9 5 0 % 1 9 8 0B a ld w in 4 , 9 8 6 7 % 2 2 , 2 2 9 3 0 % 2 7 , 2 1 5 3 7 % 1 9 8 6B a r b o u r 1 , 7 8 4 1 4 % 4 , 9 6 0 4 0 % 6 , 7 4 4 5 4 % 1 9 7 8B ib b 1 , 2 7 7 1 5 % 3 , 2 1 8 3 9 % 4 , 4 9 5 5 4 % 1 9 7 8B lo u n t 2 , 3 2 1 1 1 % 8 , 5 9 7 4 1 % 1 0 , 9 1 8 5 2 % 1 9 7 9B u l lo c k 6 8 2 1 4 % 2 , 0 5 8 4 4 % 2 , 7 4 0 5 8 % 1 9 7 7B u t le r 1 , 9 3 6 1 9 % 4 , 0 2 4 4 0 % 5 , 9 6 0 6 0 % 1 9 7 4C a lh o u n 8 , 6 7 6 1 7 % 2 5 , 4 3 5 5 0 % 3 4 , 1 1 1 6 6 % 1 9 7 2C h a m b e r s 4 , 2 0 1 2 6 % 7 , 1 9 7 4 4 % 1 1 , 3 9 8 7 0 % 1 9 6 8C h e r o k e e 1 , 3 3 0 9 % 4 , 9 8 6 3 6 % 6 , 3 1 6 4 5 % 1 9 8 2C h i l t o n 2 , 3 3 2 1 3 % 7 , 6 4 8 4 3 % 9 , 9 8 0 5 7 % 1 9 7 7C h o c ta w 7 7 8 1 0 % 3 , 8 3 5 4 9 % 4 , 6 1 3 5 9 % 1 9 7 6C la r k e 1 , 7 1 0 1 4 % 5 , 5 8 9 4 4 % 7 , 2 9 9 5 8 % 1 9 7 5C la y 1 , 2 6 6 1 9 % 2 , 8 4 8 4 3 % 4 , 1 1 4 6 2 % 1 9 7 3C le b u r n e 9 4 8 1 5 % 2 , 8 3 3 4 6 % 3 , 7 8 1 6 1 % 1 9 7 4C o f f e e 2 , 1 4 2 1 1 % 9 , 6 4 0 4 9 % 1 1 , 7 8 2 5 9 % 1 9 7 5C o lb e r t 4 , 0 3 3 1 6 % 1 2 , 4 7 9 5 0 % 1 6 , 5 1 2 6 6 % 1 9 7 1C o n e c u h 1 , 3 4 7 1 9 % 3 , 0 0 3 4 1 % 4 , 3 5 0 6 0 % 1 9 7 5C o o s a 8 8 9 1 4 % 2 , 6 9 7 4 4 % 3 , 5 8 6 5 8 % 1 9 7 6C o v in g t o n 3 , 8 3 7 2 1 % 8 , 6 9 8 4 7 % 1 2 , 5 3 5 6 7 % 1 9 7 1C r e n s h a w 1 , 3 8 8 2 1 % 2 , 7 2 9 4 1 % 4 , 1 1 7 6 2 % 1 9 7 3C u l lm a n 4 , 3 2 3 1 2 % 1 4 , 6 6 9 4 2 % 1 8 , 9 9 2 5 4 % 1 9 7 8D a le 1 , 9 9 9 9 % 1 0 , 9 7 1 5 0 % 1 2 , 9 7 0 6 0 % 1 9 7 6D a l la s 3 , 5 9 3 1 8 % 1 0 , 7 7 7 5 3 % 1 4 , 3 7 0 7 0 % 1 9 7 1D e K a lb 4 , 7 1 6 1 7 % 1 1 , 3 7 1 4 1 % 1 6 , 0 8 7 5 7 % 1 9 7 6E lm o r e 2 , 5 1 9 1 0 % 9 , 8 6 0 3 8 % 1 2 , 3 7 9 4 8 % 1 9 8 1E s c a m b ia 2 , 3 2 6 1 4 % 8 , 0 7 0 4 9 % 1 0 , 3 9 6 6 3 % 1 9 7 4E t o w a h 1 0 , 1 6 5 2 2 % 2 2 , 8 5 4 5 0 % 3 3 , 0 1 9 7 2 % 1 9 6 8F a y e t t e 1 , 4 6 9 1 7 % 4 , 0 3 4 4 8 % 5 , 5 0 3 6 5 % 1 9 7 3F r a n k l in 1 , 9 9 8 1 5 % 6 , 8 8 6 5 0 % 8 , 8 8 4 6 5 % 1 9 7 3G e n e v a 2 , 0 2 8 1 7 % 5 , 6 3 8 4 7 % 7 , 6 6 6 6 3 % 1 9 7 4G r e e n e 4 9 4 1 0 % 2 , 4 5 9 4 8 % 2 , 9 5 3 5 8 % 1 9 7 7H a le 1 , 1 5 6 1 5 % 2 , 9 1 5 3 8 % 4 , 0 7 1 5 2 % 1 9 7 9H e n r y 1 , 2 1 6 1 5 % 3 , 6 4 4 4 5 % 4 , 8 6 0 6 0 % 1 9 7 6H o u s to n 3 , 5 9 1 9 % 1 9 , 2 0 1 4 9 % 2 2 , 7 9 2 5 8 % 1 9 7 7J a c k s o n 3 , 0 1 2 1 2 % 1 1 , 2 6 0 4 7 % 1 4 , 2 7 2 5 9 % 1 9 7 6J e f f e r s o n 5 5 , 4 9 7 1 9 % 1 5 7 , 5 1 1 5 5 % 2 1 3 , 0 0 8 7 4 % 1 9 6 8L a m a r 1 , 2 5 9 1 7 % 3 , 4 3 5 4 6 % 4 , 6 9 4 6 2 % 1 9 7 5L a u d e r d a le 5 , 3 6 5 1 3 % 2 0 , 0 5 5 5 0 % 2 5 , 4 2 0 6 3 % 1 9 7 4L a w r e n c e 1 , 4 7 7 1 0 % 6 , 7 1 5 4 5 % 8 , 1 9 2 5 5 % 1 9 7 8L e e 3 , 2 3 5 6 % 1 8 , 7 0 7 3 7 % 2 1 , 9 4 2 4 4 % 1 9 8 3L im e s t o n e 2 , 7 6 5 1 0 % 1 0 , 3 7 6 3 9 % 1 3 , 1 4 1 4 9 % 1 9 8 1L o w n d e s 6 6 5 1 1 % 2 , 3 9 9 4 1 % 3 , 0 6 4 5 3 % 1 9 7 9M a c o n 1 , 5 2 8 1 4 % 5 , 3 4 2 5 0 % 6 , 8 7 0 6 5 % 1 9 7 4M a d is o n 6 , 6 9 6 6 % 5 5 , 5 3 3 4 6 % 6 2 , 2 2 9 5 2 % 1 9 7 9M a r e n g o 1 , 3 4 0 1 3 % 4 , 5 9 7 4 5 % 5 , 9 3 7 5 9 % 1 9 7 5M a r io n 1 , 7 2 5 1 2 % 6 , 9 7 4 4 8 % 8 , 6 9 9 6 0 % 1 9 7 6M a r s h a l l 4 , 0 3 8 1 1 % 1 6 , 5 1 8 4 5 % 2 0 , 5 5 6 5 7 % 1 9 7 7M o b i le 2 2 , 4 5 8 1 4 % 9 1 , 1 1 2 5 5 % 1 1 3 , 5 7 0 6 9 % 1 9 7 2M o n r o e 1 , 4 7 9 1 3 % 5 , 0 9 1 4 5 % 6 , 5 7 0 5 8 % 1 9 7 7M o n t g o m e r y 1 3 , 7 7 8 1 4 % 4 8 , 8 3 3 5 1 % 6 2 , 6 1 1 6 6 % 1 9 7 3M o r g a n 4 , 5 9 6 1 0 % 2 2 , 3 5 7 4 7 % 2 6 , 9 5 3 5 7 % 1 9 7 7P e r r y 7 2 8 1 3 % 2 , 6 6 0 4 9 % 3 , 3 8 8 6 3 % 1 9 7 5P ic k e n s 1 , 3 8 6 1 5 % 4 , 3 3 9 4 6 % 5 , 7 2 5 6 0 % 1 9 7 5P ik e 2 , 0 2 4 1 4 % 5 , 9 4 5 4 3 % 7 , 9 6 9 5 7 % 1 9 7 7R a n d o lp h 2 , 2 2 4 2 2 % 4 , 0 5 0 3 9 % 6 , 2 7 4 6 1 % 1 9 7 3R u s s e l l 2 , 9 3 3 1 3 % 1 1 , 5 6 3 5 1 % 1 4 , 4 9 6 6 3 % 1 9 7 3S h e lb y 2 , 7 9 0 5 % 1 5 , 4 5 4 2 6 % 1 8 , 2 4 4 3 1 % 1 9 8 7S t . C la i r 2 , 9 8 6 1 1 % 9 , 5 6 6 3 5 % 1 2 , 5 5 2 4 6 % 1 9 8 2S u m te r 8 7 6 1 3 % 3 , 0 1 5 4 3 % 3 , 8 9 1 5 6 % 1 9 7 7T a l la d e g a 5 , 8 5 9 1 7 % 1 4 , 6 6 8 4 3 % 2 0 , 5 2 7 6 0 % 1 9 7 5T a l la p o o s a 3 , 4 8 3 1 7 % 8 , 8 1 6 4 3 % 1 2 , 2 9 9 6 0 % 1 9 7 5T u s c a lo o s a 7 , 4 4 0 1 0 % 3 2 , 2 5 5 4 5 % 3 9 , 6 9 5 5 6 % 1 9 7 7W a lk e r 4 , 8 9 0 1 5 % 1 4 , 4 9 7 4 5 % 1 9 , 3 8 7 6 0 % 1 9 7 6W a s h in g t o n 8 1 7 1 0 % 3 , 6 3 1 4 5 % 4 , 4 4 8 5 5 % 1 9 7 8W i lc o x 7 3 6 1 2 % 2 , 7 8 6 4 5 % 3 , 5 2 2 5 7 % 1 9 7 7W in s t o n 1 , 2 1 4 1 0 % 5 , 7 0 6 4 6 % 6 , 9 2 0 5 5 % 1 9 7 8

T o t a l s 2 6 1 , 9 7 0 1 3 % 9 1 1 , 4 7 2 4 6 % 1 , 1 7 3 , 4 4 2 6 0 % 1 9 7 5

B u i l t b e f o r e 1 9 5 0 B u i l t B e t w e e n 1 9 5 0 a n d B u i l t B e f o r e 1 9 7 9


27

APPENDIX B

Census Data

Note: Black Belt counties are shaded

Total Population by Race/Ethnicity and County

Total Population White Black Hispanic Other

Autauga 34,823 79.74% 7,428 17.01% 610 1.40% 810 1.85% Baldwin 120,868 86.08% 14,357 10.22% 2,466 1.76% 2,724 1.94% Barbour 14,788 50.93% 13,369 46.04% 478 1.65% 403 1.39% Bibb 15,870 76.20% 4,584 22.01% 210 1.01% 162 0.78% Blount 46,999 92.11% 598 1.17% 2,718 5.33% 709 1.39% Bullock 2,764 23.60% 8,486 72.44% 322 2.75% 142 1.21% Butler 12,429 58.08% 8,671 40.52% 143 0.67% 156 0.73% Calhoun 87,598 78.04% 20,725 18.46% 1,753 1.56% 2,173 1.94% Chambers 22,111 60.44% 13,872 37.92% 280 0.77% 320 0.87% Cherokee 22,164 92.40% 1,327 5.53% 204 0.85% 293 1.22% Chilton 33,897 85.61% 4,131 10.43% 1,152 2.91% 413 1.04% Choctaw 8,724 54.79% 6,985 43.87% 107 0.67% 106 0.67% Clarke 15,519 55.69% 11,918 42.77% 180 0.65% 250 0.90% Clay 11,616 81.49% 2,219 15.57% 253 1.77% 166 1.16% Cleburne 13,235 93.71% 521 3.69% 198 1.40% 169 1.20% Coffee 32,971 75.60% 7,950 18.23% 1,183 2.71% 1,511 3.46% Colbert 44,470 80.88% 9,096 16.54% 618 1.12% 800 1.45% Conecuh 7,760 55.08% 6,091 43.23% 102 0.72% 136 0.97% Coosa 7,742 63.45% 4,147 33.99% 158 1.29% 155 1.27% Covington 32,247 85.69% 4,618 12.27% 292 0.78% 474 1.26% Crenshaw 10,042 73.49% 3,369 24.65% 87 0.64% 167 1.22% Cullman 73,940 95.43% 726 0.94% 1,688 2.18% 1,129 1.46% Dale 35,771 72.81% 9,902 20.16% 1,642 3.34% 1,814 3.69% Dallas 16,417 35.41% 29,201 62.98% 290 0.63% 457 0.99% DeKalb 58,436 90.67% 1,064 1.65% 3,578 5.55% 1,374 2.13% Elmore 50,376 76.47% 13,505 20.50% 805 1.22% 1,188 1.80% Escambia 24,575 63.93% 11,799 30.69% 379 0.99% 1,687 4.39% Etowah 84,919 82.08% 15,120 14.61% 1,763 1.70% 1,657 1.60% Fayette 15,994 86.48% 2,199 11.89% 152 0.82% 150 0.81% Franklin 27,268 87.33% 1,307 4.19% 2,316 7.42% 332 1.06% Geneva 22,181 86.09% 2,725 10.58% 453 1.76% 405 1.57% Greene 1,898 19.03% 7,964 79.85% 58 0.58% 54 0.54% Hale 6,803 39.59% 10,074 58.62% 157 0.91% 151 0.88% Henry 10,647 65.28% 5,247 32.17% 249 1.53% 167 1.02% Houston 64,312 72.43% 21,703 24.44% 1,122 1.26% 1,650 1.86% Jackson 49,200 91.24% 2,002 3.71% 610 1.13% 2,114 3.92% Jefferson 379,707 57.35% 259,623 39.22% 10,284 1.55% 12,433 1.88% Lamar 13,695 86.11% 1,899 11.94% 207 1.30% 103 0.65% Lauderdale 77,240 87.81% 8,624 9.80% 894 1.02% 1,208 1.37% Lawrence 26,899 77.29% 4,613 13.25% 367 1.05% 2,924 8.40% Lee 84,298 73.24% 25,954 22.55% 1,645 1.43% 3,195 2.78% Limestone 54,142 82.44% 8,703 13.25% 1,740 2.65% 1,091 1.66% Lowndes 3,464 25.71% 9,841 73.04% 85 0.63% 83 0.62% Macon 3,331 13.82% 20,298 84.21% 173 0.72% 303 1.26% Madison 196,496 71.01% 62,602 22.62% 5,226 1.89% 12,376 4.47%


28

Marengo 10,582 46.95% 11,581 51.38% 219 0.97% 157 0.70% Marion 29,387 94.15% 1,131 3.62% 360 1.15% 336 1.08% Marshall 75,081 91.30% 1,194 1.45% 4,656 5.66% 1,300 1.58% Mobile 249,763 62.47% 132,845 33.22% 4,887 1.22% 12,348 3.09% Monroe 13,962 57.40% 9,683 39.81% 190 0.78% 489 2.01% Montgomery 107,858 48.26% 108,146 48.39% 2,665 1.19% 4,841 2.17% Morgan 92,584 83.36% 12,383 11.15% 3,645 3.28% 2,452 2.21% Perry 3,642 30.71% 8,057 67.93% 102 0.86% 60 0.51% Pickens 11,676 55.74% 8,940 42.68% 147 0.70% 186 0.89% Pike 17,790 60.09% 10,766 36.37% 365 1.23% 684 2.31% Randolph 16,940 75.69% 4,949 22.11% 272 1.22% 219 0.98% Russell 27,925 56.12% 20,217 40.63% 744 1.50% 870 1.75% Shelby 126,951 88.60% 10,570 7.38% 2,910 2.03% 2,862 2.00% St. Clair 57,917 89.46% 5,253 8.11% 686 1.06% 886 1.37% Sumter 3,813 25.77% 10,718 72.43% 165 1.12% 102 0.69% Talladega 53,399 66.48% 25,206 31.38% 812 1.01% 904 1.13% Tallapoosa 30,342 73.16% 10,488 25.29% 242 0.58% 403 0.97% Tuscaloosa 111,367 67.55% 48,135 29.19% 2,130 1.29% 3,243 1.97% Walker 64,855 91.72% 4,323 6.11% 607 0.86% 928 1.31% Washington 11,673 64.50% 4,818 26.62% 160 0.88% 1,446 7.99% Wilcox 3,611 27.39% 9,423 71.48% 97 0.74% 52 0.39% Winston 24,055 96.83% 93 0.37% 372 1.50% 323 1.30%

Totals 3,125,819 70.29% 1,150,076 25.86% 75,830 1.71% 95,375 2.14%


29

Population 1 to 2 Years of Age by Race/Ethnicity

Population 1 to 2-Years Old White Black Hispanic Other Total Autauga 924 2.65% 242 3.26% 21 3.44% 30 3.70% 1,217 2.79%Baldwin 2,678 2.22% 469 3.27% 103 4.18% 115 4.22% 3,365 2.40%Barbour 297 2.01% 399 2.98% 18 3.77% 12 2.98% 726 2.50%Bibb 415 2.61% 131 2.86% 8 3.81% 7 4.32% 561 2.69%Blount 1,195 2.54% 11 1.84% 157 5.78% 19 2.68% 1,382 2.71%Bullock 53 1.92% 233 2.75% 7 2.17% 5 3.52% 298 2.54%Butler 235 1.89% 270 3.11% 4 2.80% 5 3.21% 514 2.40%Calhoun 2,008 2.29% 645 3.11% 72 4.11% 84 3.87% 2,809 2.50%Chambers 492 2.23% 454 3.27% 14 5.00% 11 3.44% 971 2.65%Cherokee 513 2.31% 38 2.86% 14 6.86% 10 3.41% 575 2.40%Chilton 908 2.68% 134 3.24% 42 3.65% 17 4.12% 1,101 2.78%Choctaw 225 2.58% 190 2.72% 0 0.00% 6 5.66% 421 2.64%Clarke 399 2.57% 408 3.42% 10 5.56% 16 6.40% 833 2.99%Clay 299 2.57% 57 2.57% 8 3.16% 5 3.01% 369 2.59%Cleburne 318 2.40% 12 2.30% 8 4.04% 5 2.96% 343 2.43%Coffee 729 2.21% 243 3.06% 51 4.31% 54 3.57% 1,077 2.47%Colbert 995 2.24% 260 2.86% 33 5.34% 49 6.13% 1,337 2.43%Conecuh 165 2.13% 168 2.76% 3 2.94% 5 3.68% 341 2.42%Coosa 192 2.48% 97 2.34% 11 6.96% 2 1.29% 302 2.48%Covington 681 2.11% 157 3.40% 12 4.11% 19 4.01% 869 2.31%Crenshaw 222 2.21% 83 2.46% 5 5.75% 11 6.59% 321 2.35%Cullman 1,764 2.39% 21 2.89% 92 5.45% 41 3.63% 1,918 2.48%Dale 907 2.54% 376 3.80% 107 6.52% 87 4.80% 1,477 3.01%Dallas 312 1.90% 1,099 3.76% 10 3.45% 19 4.16% 1,440 3.11%DeKalb 1,439 2.46% 45 4.23% 206 5.76% 38 2.77% 1,728 2.68%Elmore 1,304 2.59% 375 2.78% 30 3.73% 49 4.12% 1,758 2.67%Escambia 536 2.18% 314 2.66% 14 3.69% 56 3.32% 920 2.39%Etowah 2,061 2.43% 483 3.19% 93 5.28% 71 4.28% 2,708 2.62%Fayette 365 2.28% 57 2.59% 9 5.92% 12 8.00% 443 2.40%Franklin 635 2.33% 32 2.45% 115 4.97% 20 6.02% 802 2.57%Geneva 505 2.28% 63 2.31% 17 3.75% 14 3.46% 599 2.32%Greene 39 2.05% 271 3.40% 0 0.00% 2 3.70% 312 3.13%Hale 180 2.65% 350 3.47% 5 3.18% 12 7.95% 547 3.18%Henry 242 2.27% 158 3.01% 10 4.02% 8 4.79% 418 2.56%Houston 1,491 2.32% 738 3.40% 49 4.37% 77 4.67% 2,355 2.65%Jackson 1,159 2.36% 60 3.00% 38 6.23% 62 2.93% 1,319 2.45%Jefferson 8,303 2.19% 8,119 3.13% 438 4.26% 492 3.96% 17,352 2.62%Lamar 297 2.17% 51 2.69% 9 4.35% 8 7.77% 365 2.30%Lauderdale 1,743 2.26% 248 2.88% 55 6.15% 60 4.97% 2,106 2.39%Lawrence 718 2.67% 101 2.19% 21 5.72% 78 2.67% 918 2.64%Lee 1,880 2.23% 783 3.02% 47 2.86% 126 3.94% 2,836 2.46%Limestone 1,378 2.55% 244 2.80% 110 6.32% 33 3.02% 1,765 2.69%Lowndes 97 2.80% 300 3.05% 3 3.53% 1 1.20% 401 2.98%Macon 60 1.80% 530 2.61% 6 3.47% 7 2.31% 603 2.50%


30

Continued Population 1 to 2-Years Old White Black Hispanic Other Total Madison 4,939 2.51% 1,950 3.11% 208 3.98% 468 3.78% 7,565 2.73%Marengo 253 2.39% 338 2.92% 8 3.65% 7 4.46% 606 2.69%Marion 678 2.31% 30 2.65% 22 6.11% 14 4.17% 744 2.38%Marshall 1,780 2.37% 43 3.60% 315 6.77% 56 4.31% 2,194 2.67%Mobile 6,399 2.56% 4,748 3.57% 174 3.56% 463 3.75% 11,784 2.95%Monroe 386 2.76% 321 3.32% 7 3.68% 24 4.91% 738 3.03%Montgomery 2,338 2.17% 3,492 3.23% 89 3.34% 189 3.90% 6,108 2.73%Morgan 2,256 2.44% 391 3.16% 188 5.16% 102 4.16% 2,937 2.64%Perry 74 2.03% 284 3.52% 6 5.88% 5 8.33% 369 3.11%Pickens 245 2.10% 275 3.08% 7 4.76% 11 5.91% 538 2.57%Pike 387 2.18% 328 3.05% 26 7.12% 34 4.97% 775 2.62%Randolph 402 2.37% 143 2.89% 14 5.15% 14 6.39% 573 2.56%Russell 701 2.51% 593 2.93% 25 3.36% 44 5.06% 1,363 2.74%Shelby 3,762 2.96% 311 2.94% 133 4.57% 115 4.02% 4,321 3.02%St. Clair 1,515 2.62% 111 2.11% 32 4.66% 36 4.06% 1,694 2.62%Sumter 81 2.12% 323 3.01% 9 5.45% 2 1.96% 415 2.80%Talladega 1,208 2.26% 723 2.87% 28 3.45% 44 4.87% 2,003 2.49%Tallapoosa 617 2.03% 345 3.29% 9 3.72% 11 2.73% 982 2.37%Tuscaloosa 2,486 2.23% 1,511 3.14% 74 3.47% 106 3.27% 4,177 2.53%Walker 1,592 2.45% 128 2.96% 28 4.61% 44 4.74% 1,792 2.53%Washington 308 2.64% 149 3.09% 4 2.50% 63 4.36% 524 2.90%Wilcox 99 2.74% 293 3.11% 5 5.15% 1 1.92% 398 3.02%Winston 541 2.25% 0 0.00% 23 6.18% 12 3.72% 576 2.32%

Totals 74,405 2.38% 36,349 3.16% 3,519 4.64% 3,725 3.91% 117,998 2.65%


31

Population Living in Poverty by Race/Ethnicity

Population Living In Poverty White Black Hispanic Other Total Autauga 2,428 51.25% 2,133 45.02% 122 0.28% 153 3.23% 4,738Baldwin 9,766 69.67% 3,616 25.80% 501 0.36% 397 2.83% 14,018Barbour 1,808 25.71% 5,032 71.56% 240 0.91% 58 0.82% 7,032Bibb 2,249 54.97% 1,803 44.07% 30 0.15% 29 0.71% 4,091Blount 5,340 90.05% 99 1.67% 732 1.45% 143 2.41% 5,930Bullock 273 8.02% 3,132 91.98% 61 0.60% 0 0.00% 3,405Butler 1,409 27.07% 3,755 72.14% 65 0.31% 37 0.71% 5,205Calhoun 11,024 62.30% 6,111 34.54% 401 0.37% 434 2.45% 17,695Chambers 2,066 33.68% 3,996 65.15% 43 0.12% 58 0.95% 6,134Cherokee 3,302 89.92% 243 6.62% 74 0.31% 71 1.93% 3,672Chilton 4,397 71.47% 1,430 23.24% 423 1.08% 106 1.72% 6,152Choctaw 1,192 30.90% 2,584 66.98% 7 0.04% 48 1.24% 3,858Clarke 1,363 21.96% 4,771 76.86% 54 0.20% 72 1.16% 6,207Clay 1,527 63.84% 822 34.36% 59 0.42% 31 1.30% 2,392Cleburne 1,716 87.86% 161 8.24% 33 0.24% 43 2.20% 1,953Coffee 3,280 52.19% 2,774 44.14% 147 0.34% 172 2.74% 6,285Colbert 4,967 65.42% 2,476 32.61% 148 0.27% 128 1.69% 7,592Conecuh 1,226 32.97% 2,444 65.72% 26 0.19% 43 1.16% 3,719Coosa 690 39.20% 1,058 60.11% 17 0.14% 12 0.68% 1,760Covington 5,098 74.55% 1,591 23.27% 147 0.40% 103 1.51% 6,838Crenshaw 1,643 55.43% 1,292 43.59% 16 0.12% 20 0.67% 2,964Cullman 9,344 94.05% 158 1.59% 522 0.68% 284 2.86% 9,935Dale 3,857 54.02% 2,924 40.95% 233 0.49% 253 3.54% 7,140Dallas 1,532 10.76% 12,597 88.44% 68 0.15% 95 0.67% 14,243DeKalb 8,730 89.16% 290 2.96% 823 1.29% 381 3.89% 9,791Elmore 2,978 48.13% 3,107 50.22% 79 0.13% 73 1.18% 6,187Escambia 3,067 40.47% 4,038 53.28% 28 0.08% 457 6.03% 7,579Etowah 10,200 64.00% 4,887 30.66% 499 0.49% 576 3.61% 15,938Fayette 2,535 80.63% 538 17.11% 29 0.16% 39 1.24% 3,144Franklin 4,688 80.63% 489 8.41% 692 2.25% 120 2.06% 5,814Geneva 3,461 69.08% 1,331 26.57% 148 0.58% 158 3.15% 5,010Greene 174 5.13% 3,216 94.84% 37 0.37% 1 0.03% 3,391Hale 653 14.41% 3,779 83.40% 33 0.20% 56 1.24% 4,531Henry 1,103 35.93% 1,857 60.49% 164 1.02% 79 2.57% 3,070Houston 6,260 47.62% 6,480 49.29% 315 0.36% 257 1.95% 13,146Jackson 6,294 86.30% 667 9.15% 77 0.14% 296 4.06% 7,293Jefferson 26,412 27.61% 65,859 68.84% 2,554 0.39% 2,105 2.20% 95,674Lamar 2,006 79.57% 419 16.62% 47 0.30% 51 2.02% 2,521Lauderdale 9,288 74.65% 2,799 22.50% 253 0.29% 219 1.76% 12,442Lawrence 3,636 68.98% 1,196 22.69% 31 0.09% 424 8.04% 5,271Lee 16,131 66.88% 7,149 29.64% 417 0.38% 641 2.66% 24,119Limestone 5,245 67.49% 1,876 24.14% 650 1.03% 208 2.68% 7,771Lowndes 404 9.60% 3,798 90.24% 10 0.07% 7 0.17% 4,209Macon 425 5.95% 6,634 92.93% 33 0.15% 69 0.97% 7,139


32

Continued Population Living In Poverty White Black Hispanic Other Total Madison 13,973 49.19% 12,745 44.86% 776 0.29% 1,327 4.67% 28,408Marengo 744 12.82% 4,925 84.84% 51 0.23% 85 1.46% 5,805Marion 4,415 93.32% 231 4.88% 64 0.21% 58 1.23% 4,731Marshall 10,490 88.19% 301 2.53% 1,277 1.57% 400 3.36% 11,895Mobile 24,206 33.37% 45,092 62.15% 803 0.20% 2,982 4.11% 72,549Monroe 1,397 27.23% 3,633 70.80% 0 0.00% 99 1.93% 5,131Montgomery 5,577 15.15% 30,495 82.85% 269 0.13% 652 1.77% 36,809Morgan 8,871 65.83% 3,554 26.37% 1,219 1.11% 492 3.65% 13,476Perry 396 9.84% 3,571 88.70% 61 0.54% 39 0.97% 4,026Pickens 1,414 27.40% 3,723 72.14% 11 0.05% 23 0.45% 5,161Pike 2,384 36.33% 4,043 61.61% 148 0.52% 130 1.98% 6,562Randolph 2,373 64.22% 1,238 33.50% 152 0.70% 75 2.03% 3,695Russell 3,878 39.80% 5,552 56.98% 97 0.20% 247 2.54% 9,743Shelby 6,412 71.79% 1,954 21.88% 609 0.43% 267 2.99% 8,932St. Clair 5,992 79.01% 1,370 18.06% 50 0.08% 185 2.44% 7,584Sumter 573 10.21% 5,004 89.18% 90 0.62% 29 0.52% 5,611Talladega 6,397 47.38% 6,893 51.06% 59 0.08% 195 1.44% 13,501Tallapoosa 3,204 47.74% 3,421 50.98% 11 0.03% 77 1.15% 6,711Tuscaloosa 12,563 47.17% 12,964 48.68% 467 0.30% 881 3.31% 26,633Walker 9,812 85.49% 1,435 12.50% 182 0.26% 190 1.66% 11,478Washington 1,318 39.59% 1,680 50.47% 51 0.28% 331 9.94% 3,329Wilcox 438 8.53% 4,682 91.21% 9 0.07% 13 0.25% 5,133Winston 3,926 93.57% 61 1.45% 131 0.54% 107 2.55% 4,196

Totals 325,940 46.69% 345,978 49.56% 17,675 2.53% 17,891 2.56% 698,097


33

Total Population Living in Poverty by Race/Ethnicity

Population of Racial Class Living In Poverty White Black Hispanic Other Total Autauga 2,428 6.99% 2,133 28.86% 122 30.96% 153 13.95% 4,738 10.92%Baldwin 9,766 8.08% 3,616 26.76% 501 21.55% 397 13.06% 14,018 10.15%Barbour 1,808 13.04% 5,032 42.48% 240 51.28% 58 23.11% 7,032 26.80%Bibb 2,249 14.41% 1,803 45.37% 30 16.57% 29 15.10% 4,091 20.61%Blount 5,340 11.22% 99 17.58% 732 28.01% 143 16.61% 5,930 11.74%Bullock 273 10.76% 3,132 41.65% 61 18.21% 0 0.00% 3,405 33.48%Butler 1,409 11.50% 3,755 42.79% 65 55.08% 37 34.26% 5,205 24.62%Calhoun 11,024 12.62% 6,111 31.09% 401 21.30% 434 19.40% 17,695 16.11%Chambers 2,066 9.42% 3,996 29.01% 43 16.17% 58 24.47% 6,134 17.04%Cherokee 3,302 15.00% 243 19.47% 74 33.33% 71 28.06% 3,672 15.56%Chilton 4,397 12.97% 1,430 34.49% 423 41.92% 106 16.80% 6,152 15.70%Choctaw 1,192 13.65% 2,584 37.88% 7 4.86% 48 37.21% 3,858 24.51%Clarke 1,363 8.82% 4,771 40.44% 54 31.21% 72 32.88% 6,207 22.59%Clay 1,527 13.35% 822 35.60% 59 28.50% 31 19.62% 2,392 17.11%Cleburne 1,716 13.01% 161 32.39% 33 20.63% 43 18.45% 1,953 13.95%Coffee 3,280 9.82% 2,774 36.04% 147 13.67% 172 12.39% 6,285 14.70%Colbert 4,967 11.18% 2,476 27.09% 148 28.41% 128 18.85% 7,592 13.96%Conecuh 1,226 15.85% 2,444 39.85% 26 39.39% 43 50.00% 3,719 26.59%Coosa 690 9.03% 1,058 26.19% 17 42.50% 12 11.54% 1,760 14.93%Covington 5,098 15.95% 1,591 35.92% 147 39.20% 103 19.54% 6,838 18.45%Crenshaw 1,643 16.50% 1,292 38.82% 16 14.95% 20 28.99% 2,964 22.11%Cullman 9,344 12.70% 158 21.21% 522 33.48% 284 17.92% 9,935 13.00%Dale 3,857 10.97% 2,924 29.94% 233 16.52% 253 13.96% 7,140 15.09%Dallas 1,532 9.40% 12,597 43.34% 68 30.36% 95 20.17% 14,243 31.05%DeKalb 8,730 14.79% 290 28.68% 823 24.36% 381 21.24% 9,791 15.39%Elmore 2,978 6.11% 3,107 30.03% 79 11.21% 73 7.03% 6,187 10.24%Escambia 3,067 12.80% 4,038 38.61% 28 7.12% 457 25.42% 7,579 20.87%Etowah 10,200 12.12% 4,887 34.22% 499 31.09% 576 26.19% 15,938 15.70%Fayette 2,535 16.07% 538 25.21% 29 33.72% 39 20.86% 3,144 17.32%Franklin 4,688 16.93% 489 38.17% 692 31.10% 120 25.32% 5,814 18.89%Geneva 3,461 15.64% 1,331 45.29% 148 46.39% 158 46.20% 5,010 19.62%Greene 174 9.28% 3,216 40.29% 37 66.07% 1 3.03% 3,391 34.28%Hale 653 9.76% 3,779 37.95% 33 25.98% 56 51.85% 4,531 26.88%Henry 1,103 10.32% 1,857 36.14% 164 53.42% 79 54.48% 3,070 19.06%Houston 6,260 9.72% 6,480 30.51% 315 32.47% 257 15.39% 13,146 15.00%Jackson 6,294 12.82% 667 31.91% 77 13.32% 296 14.81% 7,293 13.67%

Jefferson 26,412 7.00% 65,859 26.01% 2,554 24.89% 2,10

5 16.24% 95,674 14.77%Lamar 2,006 14.75% 419 22.92% 47 35.88% 51 29.65% 2,521 16.09%Lauderdale 9,288 12.19% 2,799 33.33% 253 30.89% 219 16.65% 12,442 14.43%Lawrence 3,636 13.55% 1,196 26.14% 31 13.48% 424 13.74% 5,271 15.25%Lee 16,131 19.77% 7,149 28.64% 417 22.11% 641 19.28% 24,119 21.81%Limestone 5,245 9.84% 1,876 24.11% 650 46.16% 208 17.42% 7,771 12.35%Lowndes 404 11.53% 3,798 38.60% 10 9.17% 7 15.22% 4,209 31.37%Macon 425 13.36% 6,634 36.41% 33 22.60% 69 21.43% 7,139 32.84%


34

Population of Racial Class Living In Poverty White Black Hispanic Other Total Madison 13,973 7.10% 12,745 22.09% 776 14.42% 1,327 10.30% 28,408 10.55%Marengo 744 7.06% 4,925 42.63% 51 25.12% 85 38.99% 5,805 25.90%Marion 4,415 15.23% 231 28.03% 64 18.34% 58 17.52% 4,731 15.64%Marshall 10,490 13.75% 301 32.51% 1,277 30.54% 400 24.62% 11,895 14.66%Mobile 24,206 9.80% 45,092 34.40% 803 18.77% 2,982 23.45% 72,549 18.51%Monroe 1,397 10.10% 3,633 37.52% 0 0.00% 99 20.00% 5,131 21.32%Montgomery 5,577 5.32% 30,495 29.78% 269 12.27% 652 14.90% 36,809 17.34%Morgan 8,871 9.50% 3,554 30.15% 1,219 33.77% 492 15.66% 13,476 12.29%Perry 396 11.73% 3,571 45.46% 61 40.94% 39 30.00% 4,026 35.36%Pickens 1,414 12.11% 3,723 41.99% 11 13.41% 23 15.75% 5,161 24.91%Pike 2,384 13.75% 4,043 38.73% 148 51.21% 130 20.28% 6,562 23.07%Randolph 2,373 14.25% 1,238 26.90% 152 38.68% 75 21.25% 3,695 17.01%Russell 3,878 14.12% 5,552 27.97% 97 13.88% 247 19.31% 9,743 19.90%Shelby 6,412 5.05% 1,954 18.75% 609 21.60% 267 9.82% 8,932 6.31%St. Clair 5,992 10.46% 1,370 30.63% 50 11.90% 185 22.00% 7,584 12.08%Sumter 573 15.44% 5,004 46.91% 90 51.72% 29 33.33% 5,611 38.70%Talladega 6,397 12.21% 6,893 29.69% 59 15.09% 195 20.55% 13,501 17.61%Tallapoosa 3,204 10.75% 3,421 33.14% 11 6.79% 77 21.39% 6,711 16.56%Tuscaloosa 12,563 11.72% 12,964 28.95% 467 24.21% 881 24.21% 26,633 17.02%Walker 9,812 15.34% 1,435 32.62% 182 28.00% 190 19.53% 11,478 16.50%Washington 1,318 11.30% 1,680 33.76% 51 57.95% 331 24.04% 3,329 18.48%Wilcox 438 12.42% 4,682 50.45% 9 33.33% 13 30.23% 5,133 39.94%Winston 3,926 16.53% 61 69.32% 131 34.66% 107 25.97% 4,196 17.14%

Totals 325,940 10.51% 345,978 31.28% 17,675 25.05% 17,891 17.82% 698,097 16.10%


35

Total Population less than 5 Years of Age by Race/Ethnicity

Total Population �5-Years White Black Hispanic Other Total Autauga 2,891 8.32% 737 9.97% 30 7.61% 115 0.27% 3,753 8.65%Baldwin 8,450 6.99% 1,210 8.95% 231 9.94% 381 0.28% 10,102 7.31%Barbour 932 6.72% 1,254 10.59% 51 10.90% 8 0.03% 2,208 8.41%Bibb 1,301 8.33% 325 8.18% 29 16.02% 11 0.06% 1,647 8.30%Blount 3,812 8.01% 48 8.53% 579 22.16% 57 0.11% 4,297 8.51%Bullock 147 5.80% 744 9.89% 23 6.87% 0 0.00% 891 8.76%Butler 788 6.43% 827 9.42% 4 3.39% 26 0.12% 1,641 7.76%Calhoun 6,166 7.06% 1,752 8.91% 246 13.06% 280 0.25% 8,301 7.56%Chambers 1,558 7.10% 1,310 9.51% 21 7.89% 78 0.22% 2,966 8.24%Cherokee 1,564 7.10% 98 7.85% 35 15.77% 57 0.24% 1,740 7.37%Chilton 2,752 8.11% 355 8.56% 149 14.77% 50 0.13% 3,212 8.20%Choctaw 644 7.37% 578 8.47% 3 2.08% 30 0.19% 1,260 8.01%Clarke 1,170 7.58% 1,308 11.09% 18 10.40% 7 0.03% 2,488 9.05%Clay 863 7.55% 208 9.01% 14 6.76% 10 0.07% 1,081 7.73%Cleburne 1,028 7.79% 9 1.81% 27 16.88% 26 0.19% 1,063 7.59%Coffee 2,325 6.96% 754 9.80% 79 7.35% 110 0.26% 3,218 7.52%Colbert 3,114 7.01% 790 8.64% 77 14.78% 95 0.17% 4,032 7.41%Conecuh 504 6.51% 557 9.08% 6 9.09% 13 0.09% 1,074 7.68%Coosa 609 7.97% 297 7.35% 13 32.50% 0 0.00% 906 7.69%Covington 2,119 6.63% 461 10.41% 71 18.93% 30 0.08% 2,642 7.13%Crenshaw 681 6.84% 261 7.84% 30 28.04% 13 0.10% 977 7.29%Cullman 5,445 7.40% 57 7.65% 230 14.75% 158 0.21% 5,712 7.47%Dale 2,811 8.00% 1,142 11.69% 296 20.99% 324 0.68% 4,414 9.33%Dallas 893 5.48% 3,148 10.83% 47 20.98% 55 0.12% 4,115 8.97%DeKalb 4,706 7.97% 106 10.48% 587 17.37% 151 0.24% 5,231 8.22%Elmore 3,841 7.88% 1,049 10.14% 65 9.22% 67 0.11% 4,995 8.27%Escambia 1,661 6.93% 951 9.09% 57 14.50% 191 0.53% 2,817 7.76%Etowah 6,063 7.20% 1,418 9.93% 273 17.01% 400 0.39% 8,053 7.93%Fayette 1,118 7.09% 179 8.39% 0 0.00% 29 0.16% 1,327 7.31%Franklin 1,874 6.77% 135 10.54% 274 12.31% 47 0.15% 2,249 7.31%Geneva 1,416 6.40% 256 8.71% 46 14.42% 20 0.08% 1,718 6.73%Greene 90 4.80% 819 10.26% 5 8.93% 0 0.00% 909 9.19%Hale 475 7.10% 1,074 10.78% 19 14.96% 23 0.14% 1,613 9.57%Henry 793 7.42% 424 8.25% 67 21.82% 30 0.19% 1,274 7.91%Houston 4,773 7.41% 2,250 10.59% 146 15.05% 178 0.20% 7,248 8.27%Jackson 3,680 7.49% 225 10.77% 83 14.36% 206 0.39% 4,119 7.72%Jefferson 25,245 6.69% 23,489 9.28% 1,356 13.21% 1,592 0.25% 50,894 7.86%Lamar 920 6.76% 128 7.00% 18 13.74% 33 0.21% 1,083 6.91%Lauderdale 5,178 6.80% 759 9.04% 99 12.09% 175 0.20% 6,168 7.15%Lawrence 2,007 7.48% 375 8.19% 32 13.91% 253 0.73% 2,646 7.66%Lee 5,882 7.21% 2,326 9.32% 141 7.48% 381 0.34% 8,608 7.78%Limestone 4,079 7.65% 744 9.56% 248 17.61% 178 0.28% 5,173 8.22%Lowndes 241 6.88% 901 9.16% 25 22.94% 2 0.01% 1,151 8.58%Macon 188 5.91% 1,534 8.42% 26 17.81% 30 0.14% 1,752 8.06%


36

Total Population �5-Years White Black Hispanic Other Total Madison 14,815 7.52% 5,722 9.92% 523 9.72% 1,438 0.53% 22,213 8.25%Marengo 759 7.20% 1,024 8.86% 19 9.36% 53 0.24% 1,836 8.19%Marion 2,054 7.08% 86 10.44% 32 9.17% 34 0.11% 2,186 7.23%Marshall 6,037 7.91% 74 7.99% 718 17.17% 197 0.24% 6,700 8.26%Mobile 18,826 7.62% 14,235 10.86% 502 11.73% 1,527 0.39% 34,787 8.87%Monroe 1,140 8.24% 985 10.17% 12 11.21% 37 0.15% 2,177 9.04%Montgomery 7,315 6.98% 10,485 10.24% 187 8.53% 489 0.23% 18,391 8.66%Morgan 7,051 7.55% 1,198 10.16% 535 14.82% 434 0.40% 8,883 8.10%Perry 224 6.64% 923 11.75% 7 4.70% 10 0.09% 1,157 10.16%Pickens 806 6.91% 893 10.07% 4 4.88% 18 0.09% 1,724 8.32%Pike 1,231 7.10% 1,008 9.66% 49 16.96% 60 0.21% 2,299 8.08%Randolph 1,246 7.48% 409 8.89% 53 13.49% 27 0.12% 1,686 7.76%Russell 2,127 7.75% 1,856 9.35% 101 14.45% 183 0.37% 4,213 8.61%Shelby 11,334 8.92% 1,048 10.06% 372 13.19% 332 0.23% 12,881 9.10%St. Clair 4,636 8.09% 326 7.29% 52 12.38% 117 0.19% 5,106 8.13%Sumter 230 6.20% 988 9.26% 29 16.67% 4 0.03% 1,227 8.46%Talladega 3,719 7.10% 2,207 9.51% 50 12.79% 143 0.19% 6,075 7.93%Tallapoosa 1,942 6.51% 1,028 9.96% 51 31.48% 73 0.18% 3,051 7.53%Tuscaloosa 7,413 6.92% 4,673 10.43% 190 9.85% 246 0.16% 12,467 7.97%Walker 4,647 7.27% 449 10.21% 91 14.00% 77 0.11% 5,207 7.48%Washington 955 8.19% 522 10.49% 0 0.00% 191 1.06% 1,668 9.26%Wilcox 279 7.91% 948 10.22% 8 29.63% 1 0.01% 1,228 9.56%Winston 1,766 7.44% 5 5.68% 62 16.40% 40 0.16% 1,855 7.58%

Totals 227,349 5.24% 108,464 2.50% 9,523 0.22% 11,651 0.27% 351,785 8.12%


37

Population � 5 years of Racial Class Living in Poverty

Population � 5-years of Racial Class Living In Poverty White Black Hispanic Other Total Autauga 207 0.60% 255 3.45% 10 2.54% 14 1.28% 486 10.26%Baldwin 1,008 0.83% 417 3.09% 77 3.31% 114 3.75% 1,561 11.14%Barbour 237 1.71% 758 6.40% 36 7.69% 0 0.00% 1,004 14.28%Bibb 283 1.81% 215 5.41% 8 4.42% 0 0.00% 498 12.17%Blount 450 0.95% 24 4.26% 134 5.13% 13 1.51% 551 9.29%Bullock 32 1.26% 514 6.84% 23 6.87% 0 0.00% 546 16.04%Butler 90 0.73% 435 4.96% 4 3.39% 0 0.00% 525 10.09%Calhoun 1,150 1.32% 883 4.49% 91 4.83% 77 3.44% 2,158 12.20%Chambers 120 0.55% 553 4.01% 15 5.64% 24 10.13% 706 11.51%Cherokee 280 1.27% 21 1.68% 28 12.61% 25 9.88% 347 9.45%Chilton 478 1.41% 197 4.75% 47 4.66% 4 0.63% 693 11.26%Choctaw 189 2.16% 306 4.49% 0 0.00% 23 17.83% 526 13.63%Clarke 96 0.62% 679 5.76% 0 0.00% 0 0.00% 775 12.49%Clay 128 1.12% 97 4.20% 0 0.00% 0 0.00% 225 9.41%Cleburne 161 1.22% 9 1.81% 0 0.00% 0 0.00% 170 8.70%Coffee 332 0.99% 441 5.73% 27 2.51% 25 1.80% 816 12.98%Colbert 475 1.07% 318 3.48% 28 5.37% 21 3.09% 814 10.72%Conecuh 124 1.60% 304 4.96% 6 9.09% 13 15.12% 441 11.86%Coosa 36 0.47% 104 2.57% 6 15.00% 0 0.00% 140 7.95%Covington 388 1.21% 294 6.64% 28 7.47% 16 3.04% 719 10.51%Crenshaw 165 1.66% 136 4.09% 4 3.74% 9 13.04% 316 10.66%Cullman 835 1.13% 14 1.88% 99 6.35% 29 1.83% 907 9.13%Dale 402 1.14% 586 6.00% 72 5.11% 66 3.64% 1,087 15.22%Dallas 141 0.87% 1,916 6.59% 25 11.16% 38 8.07% 2,114 14.84%DeKalb 913 1.55% 30 2.97% 196 5.80% 55 3.07% 1,058 10.81%Elmore 324 0.66% 438 4.23% 25 3.55% 4 0.39% 771 12.46%Escambia 261 1.09% 427 4.08% 2 0.51% 71 3.95% 762 10.05%Etowah 1,137 1.35% 657 4.60% 70 4.36% 179 8.14% 2,024 12.70%Fayette 233 1.48% 44 2.06% 0 0.00% 12 6.42% 290 9.22%Franklin 433 1.56% 80 6.25% 149 6.70% 9 1.90% 622 10.70%Geneva 296 1.34% 156 5.31% 33 10.34% 15 4.39% 487 9.72%Greene 10 0.53% 425 5.32% 3 5.36% 0 0.00% 435 12.83%Hale 34 0.51% 575 5.77% 4 3.15% 15 13.89% 650 14.35%Henry 69 0.65% 234 4.55% 40 13.03% 30 20.69% 333 10.85%Houston 753 1.17% 1,003 4.72% 74 7.63% 41 2.46% 1,808 13.75%Jackson 670 1.36% 119 5.69% 26 4.50% 70 3.50% 859 11.78%Jefferson 2,054 0.54% 8,896 3.51% 534 5.20% 285 2.20% 11,454 11.97%Lamar 205 1.51% 47 2.57% 2 1.53% 19 11.05% 271 10.75%Lauderdale 855 1.12% 306 3.64% 27 3.30% 60 4.56% 1,246 10.01%Lawrence 251 0.94% 114 2.49% 2 0.87% 57 1.85% 424 8.04%Lee 589 0.72% 855 3.43% 26 1.38% 64 1.92% 1,527 6.33%Limestone 662 1.24% 237 3.05% 165 11.72% 22 1.84% 1,045 13.45%Lowndes 20 0.57% 515 5.23% 2 1.83% 2 4.35% 537 12.76%Macon 19 0.60% 780 4.28% 6 4.11% 0 0.00% 799 11.19%


38

Total Population �5-Years Living in Poverty White Black Hispanic Other Total Madison 1,436 5.05% 2,130 7.50% 132 0.46% 190 0.67% 3,823 13.46%Marengo 84 1.45% 575 9.91% 0 0.00% 24 0.41% 683 11.77%Marion 396 8.37% 18 0.38% 7 0.15% 5 0.11% 425 8.98%Marshall 1,174 9.87% 24 0.20% 201 1.69% 69 0.58% 1,353 11.37%Mobile 2,385 3.29% 7,498 10.34% 115 0.16% 514 0.71% 10,431 14.38%Monroe 158 3.08% 441 8.59% 0 0.00% 4 0.08% 605 11.79%Montgomery 359 0.98% 4,340 11.79% 32 0.09% 92 0.25% 4,807 13.06%Morgan 918 6.81% 548 4.07% 216 1.60% 113 0.84% 1,681 12.47%Perry 16 0.40% 509 12.64% 3 0.07% 7 0.17% 532 13.21%Pickens 137 2.65% 482 9.34% 1 0.02% 4 0.08% 623 12.07%Pike 232 3.54% 614 9.36% 41 0.62% 14 0.21% 860 13.11%Randolph 254 6.87% 114 3.09% 29 0.78% 3 0.08% 373 10.09%Russell 434 4.45% 713 7.32% 0 0.00% 51 0.52% 1,212 12.44%Shelby 533 5.97% 302 3.38% 90 1.01% 11 0.12% 871 9.75%St. Clair 510 6.72% 136 1.79% 9 0.12% 67 0.88% 721 9.51%Sumter 27 0.48% 569 10.14% 17 0.30% 0 0.00% 596 10.62%Talladega 606 4.49% 1,059 7.84% 6 0.04% 34 0.25% 1,705 12.63%Tallapoosa 318 4.74% 448 6.68% 0 0.00% 21 0.31% 787 11.73%Tuscaloosa 626 2.35% 2,081 7.81% 71 0.27% 32 0.12% 2,790 10.48%Walker 906 7.89% 239 2.08% 37 0.32% 21 0.18% 1,179 10.27%Washington 132 3.97% 174 5.23% 0 0.00% 46 1.38% 352 10.57%Wilcox 26 0.51% 535 10.42% 8 0.16% 0 0.00% 561 10.93%Winston 384 9.15% 0 0.00% 27 0.64% 24 0.57% 417 9.94%

Totals 29,646 4.25% 48,963 7.01% 3,196 0.46% 2,867 0.41% 82,914 11.88%


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APPENDIX C

PARTNERSHIP WORKGROUP TEAM

Advisory Subcommittee

ADPH Family Health Services Thomas M. Miller, M.D., Director 201 Monroe Street, Suite 1350 Montgomery, AL 36104

334-206-2940 [email protected] Alabama Medicaid Agency John Searcy, M.D. P.O. Box 5624 Montgomery, AL 36103-5624 334 242-5619 [email protected]

ADPH Women, Infants and Children Wendy Blackmon 201 Monroe Street, Suite 1350 Montgomery, AL 36104 334-206-5333 [email protected]

ADPH Perinatal Program Gene Hamrick 201 Monroe Street, Suite 1350 Montgomery, AL 36104 334-206-2928 [email protected]

Mobile County Health Department Environmental Health Kelley Micher 251 N. Bayou Street

Mobile, AL 36652-2867 251-690-8846

[email protected]

ADECA LIHEAP Willie Whitehead P.O. Box 5690 Montgomery, AL 36103-5690 334-242-5365 [email protected] University of Alabama at Birmingham Terry Wall MTC 201 1600 Seventh Avenue South Birmingham, AL 35233 205-939-9585 [email protected] Tuskegee University National Center for Bioethics in Research & Health Care Dr. Pamela Foster Drew Hall Room 106 Tuskegee, AL- 36088 334-727-4699 [email protected] ADPH Office of Primary Care and Rural Health Gwen Lipscomb 201 Monroe Street, Suite 710 Montgomery, AL 36104 334-206-5432 [email protected] Facilitator


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Auburn University College of Business Stan Harris 415 W. Magnolia Avenue Auburn, AL 36849 334-844-6519 [email protected] Workgroup ADPH ACLPPP Christopher Sellers 201 Monroe Street, Suite 1350 Montgomery, AL 36104 334-206-2789 [email protected] ADPH Bureau of Clinical Laboratories Norma Vance 8140 AUM Drive Montgomery, AL 36130 334-260-3494 [email protected]

ADPH Bureau of Family Health Services Charlena Freeman 201 Monroe Street, Suite 1350 Montgomery, AL 36104 334-206-2973 [email protected] Alabama Cooperative Extension System Environmental Health Laura Booth 214 Extension Hall Auburn University, AL 36849-5631 334-844-5638 [email protected]

Jefferson County Department of Public Health JC CLPPP Susan Martin Box 2648 Birmingham, AL 35202-2648 205-930-1082 [email protected]

ADPH Primary Care & Rural Health Julia Hayes 201 Monroe Street Montgomery, AL 36104 334-206-3812 [email protected] ADPH Bureau of Environmental Services Sal Gray 201 Monroe Street, Suite 1250 Montgomery, AL 36104 334-206-5373 [email protected] Alabama Medicaid Agency Brenda Vaughn EPSDT P.O. Box 5624 Montgomery, AL 36103-5624 334 242-5582 [email protected] Alabama Housing Finance Authority Barbara Wallace 2000 Interstate Park Drive Montgomery, Alabama 36109 334-244-9200 [email protected]


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ADPH ACLPPP Cindy Ashley 201 Monroe Street, Suite 1350 Montgomery, AL 36104 334-206-2966 [email protected] Citizens' Lead Education and Poisoning Prevention Lynn Battle Wildwood Pkwy, Suite 108 Mail Box 363 Birmingham, AL 35211 205-780-8077 [email protected] Department of Children’s Affairs Linda Hampton 201 Monroe Street, Suite 1670 Montgomery, Alabama 36130 334 223-0502 [email protected] ADPH Family Health Services Dianne Sims 201 Monroe Street, Suite 1350 Montgomery, AL 36104 334-206-2920 [email protected]

ADPH Perinatal Program Abbey Snead 201 Monroe Street, Suite 1350 Montgomery, AL 36104 334-286-2830 [email protected]

ADPH Healthy Childcare Sharis Lemay 201 Monroe Street, Suite 1350 Montgomery, AL 36104 334-206-2965 [email protected]

UAB School of Public Health Center for Community Health Linda Goodson Ryals Public Health Bldg. RPHB 514 1530 3rd Avenue South Birmingham, AL 35294-0022 205-975-8381 [email protected]

Mobile County Environmental and Lead Coalition Leevones Dubose 2500 Second Avenue Mobile, AL 36617 251-457-6867 [email protected]

University of Alabama Department of Public Health Program for Rural Services and Research Pam Baker 20 Research Drive, Suite 104 Tuscaloosa, AL 35487-0372 205-348-8124 [email protected]

Mobile County Health Department MC CLPPP Tara R. Mosley 251 N. Bayou Street Mobile, AL 36652-2867 251-690-8885 [email protected]


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ADECA Kit Gallup 401 Adams Avenue P.O. Box 5690 Montgomery, AL 36103-5690 334-353-0988 [email protected]

ADPH Public Information Division Arrol Sheehan 201 Monroe Street, Suite 900 Montgomery, AL 36104 334-206-5510 [email protected]

OSHA Sanchez Roberto Vestavia Village 2047 Canyon Road Birmingham, Alabama 35216-1981 205 731-1534 [email protected]

HUD Cynthia Yarborough Medical Forum Building 950 22nd Street North – Suite 900 Birmingham, Alabama 35203 205-731-2617 [email protected] OSHA Ken Atha Mobile Area 3737 Government Blvd, Suite 100 Mobile, AL 36693-4309 251- 441-6131

EPA Region IV Mrs. Andrea Price-Lippitt 61 Forsythe Street NW Atlanta, GA 30303 404-562-8983 [email protected]

EPA Region IV Patricia Livingston 62 Forsythe Street NW Atlanta, GA 30303 404 562 9171

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