ST. JOSEPH, Missouri – On a sunny November afternoon in this historic city, birthplace of the Pony Express and death spot of Jesse James, Lauranda Mignery watched her son Kadin, 2, dig in their front yard. As he played, she scolded him for putting his fingers in his mouth.

In explanation, she pointed to the peeling paint on her old house. Kadin, she said, has been diagnosed with lead poisoning.

He has lots of company: Within 15 blocks of his house, at least 120 small children have been poisoned since 2010, making the neighborhood among the most toxic in Missouri, Reuters found as part of an analysis of childhood lead testing results across the country. In St. Joseph, even a local pediatrician’s children were poisoned.

Last year, the city of Flint, Michigan, burst into the world spotlight after its children were exposed to lead in drinking water and some were poisoned. In the year after Flint switched to corrosive river water that leached lead from old pipes, 5 percent of the children screened there had high blood lead levels.

Flint is no aberration. In fact, it doesn’t even rank among the most dangerous lead hotspots in America.

In all, Reuters found nearly 3,000 areas with recently recorded lead poisoning rates at least double those in Flint during the peak of that city’s contamination crisis. And more than 1,100 of these communities had a rate of elevated blood tests at least four times higher.

The poisoned places on this map stretch from Warren, Pennsylvania, a town on the Allegheny River where 36 percent of children tested had high lead levels, to a zip code on Goat Island, Texas, where a quarter of tests showed poisoning. In some pockets of Baltimore, Cleveland and Philadelphia, where lead poisoning has spanned generations, the rate of elevated tests over the last decade was 40 to 50 percent.

Like Flint, many of these localities are plagued by legacy lead: crumbling paint, plumbing, or industrial waste left behind. Unlike Flint, many have received little attention or funding to combat poisoning.

To identify these locations, Reuters examined neighborhood-level blood testing results, most of which have not been previously disclosed. The data, obtained from state health departments and the U.S. Centers for Disease Control and Prevention, tracks poisoning rates among children tested in each location.

The resulting portrait provides a granular look at places where decades-long U.S. efforts to stamp out lead poisoning have fallen short.

“The disparities you’ve found between different areas have stark implications,” said Dr. Helen Egger, chair of Child and Adolescent Psychiatry at NYU Langone Medical Center’s Child Study Center. “Where lead poisoning remains common, many children will have developmental delays and start out behind all the rest.”

In children up to age 6, the CDC threshold for an elevated blood lead level is 5 micrograms per deciliter. Any child who tests high warrants a public health response, the agency says; even a slight elevation can reduce IQ and stunt development.

Nationwide, the CDC estimates that 2.5 percent of small children have elevated levels. In the communities identified by this analysis, a far higher rate of children who got tested had lead poisoning. In most cases, the local data covers a 5- or 10-year period through 2015.

Reporters visited several of the trouble spots: a neighborhood with many rundown homes in South Bend, Indiana; a rural mining town in Missouri’s Lead Belt; the economically depressed North Side of Milwaukee. In each location, it was easy to find people whose lives have been impacted by lead exposure. While poverty remains a potent predictor of lead poisoning, the victims span the American spectrum – poor and rich, rural and urban, black and white.

MAPPING LEAD HAZARDS

Most U.S. states disclose data on the percentage of child blood tests that show elevated levels of lead. Yet this data, often for statewide or county-wide populations, is too broad to identify neighborhoods where children face the greatest risk.

Instead, Reuters sought testing data at the neighborhood level, in census tracts or zip code areas, submitting records requests to all 50 states.

U.S. census tracts are small county subdivisions that average about 4,000 residents apiece. Zip codes have average populations of 7,500. In each area, a relatively small number of children are screened for lead poisoning each year.

Reuters found 2,606 census tracts, and another 278 zip code areas, with a prevalence of lead poisoning at least twice Flint’s rate.

The test results allow for local analysis, pinpointing neighborhoods whose lead poisoning problems may be obscured in broader surveys.

For example: Across Maryland, 2 percent of childhood lead tests were high in recent years, just a small fraction of the rate in the worst-affected Baltimore tracts. In Flint, while 5 percent of children citywide recently tested with high blood lead levels, the highest rate has been in the downtown zip code, where about 11 percent tested high from 2005 to 2015.

“I hope this data spurs questions from the public to community leaders who can make changes,” said epidemiologist Robert Walker, co-chair of the CDC’s Lead Content Work Group, which analyzes lead poisoning nationwide. “I would think that it would turn some heads.”

The findings, Walker said, will help inform the public about risks in their own neighborhoods and allow health officials to seek lead abatement grants in the most dangerous spots.

There isn’t much federal help available. Congress recently directed $170 million in aid to Flint. That’s 10 times the CDC’s budget for assisting states with lead poisoning this year.

Looking for lead

Since the 1970s, U.S. efforts to eradicate childhood lead poisoning have made remarkable progress. But the advances have been uneven. Legacy lead – in paint, plumbing, yards, well-water or even playgrounds – means that kids in many neighborhoods remain at a disproportionately high risk of poisoning.

Reuters conducted a nationwide analysis of childhood blood lead testing data at the neighborhood level. This map will allow you to see what the local prevalence of elevated lead tests has been in the 21 states where we obtained census tract or zip code level data. The CDC estimates that nationwide, around 2.5% of children ages 0-6 have an elevated lead level, defined as 5 micrograms/deciliter or higher. Among small children tested in Flint, Michigan during the peak of that city’s lead contamination crisis, 5% had elevated levels, or double the average. In many neighborhoods – census tracts or zip code areas – across the country, a far higher rate of children have tested high in recent years.

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