Lead Wars: The Politics of Science and the Fate of America’s Children by Gerald Markowitz, David Rosner (review)

Lead Wars: The Politics of Science and the Fate of America’s Children is the definitive history of childhood lead poisoning in the United States. In it, historians Gerald Markowitz and David Rosner untangle several important story lines. First is the prevalence of childhood lead poisoning and its devastating health impacts on children, particularly in low-income and African American communities, which are disproportionately affected. Second is the scientific and political debate of what to do about lead poisoning. Third is the ethical and legal morass of the Kennedy Krieger/Johns Hopkins case in Baltimore in the 1990s. Each of these strands itself is significant, but what is particularly important is that this book uses a vast archive to untangle the complicated web of factors into a compelling narrative that is disturbing and important.

First, the prevalence of childhood lead poisoning remains a major public health issue. In 2012, more that 250,000 children still suffer from it, despite major gains in lead reduction, as lead was taken out of gasoline and paint in the latter half of the twentieth century (lead also enters the environment from insecticides and smelting and fabricating processes). Lead exposure causes major physiological and neurological damage. Children with low levels of lead have been shown to have higher rates of behavioral problems, hyperactivity, and problems with impulse control, lower IQs, and higher rates of arrests.

Second, the 1960s saw major community activism around childhood lead poisoning by social justice groups and radical organizations, ranging from the Harlem Park Neighborhood Organization in Baltimore to the Young Lords and the Black Panthers. At the same time, public health advocates and doctors like J. Julian Chisolm, Jane Lin-Fu, and Herbert Needleman conducted important research, wrote reports, and sounded the clarion call about the problems of low-level lead exposure.

As Markowitz and Rosner demonstrate, the sad story of lead is emblematic of larger debates about public health as a field, since lead poisoning challenges paradigms of what constituted health and disease—in terms of dosage effects and solutions. They take us into meetings at health associations and hearings at regulatory agencies and walk us through legal arguments of paint companies and landlords who fought their liability in both historical and contemporary terms.

While remaining laser-focused on childhood lead poisoning, the authors also explain the larger political and ideological contexts for what became one of the most notorious recent legal and ethical cases involving public health research. In 2001, the Court of Appeals in Maryland ruled in favor of two African American children and their families against the Kennedy Krieger Institute (KKI), a children’s clinic and research center at Johns Hopkins. The KKI conducted a six-year study of childhood lead exposure, designed to find the cheapest way to reduce the lead exposure, although elimination is best for children’s health. The study recruited children to live in homes where researchers knew there was lead, which the court compared to the worst violations of health research in the twentieth century—Nazi research and the Tuskegee syphilis study. Markowitz and Rosner do a remarkable job of discussing this case from all perspectives and situating it within the Reagan-era political moment that saw the demands for landlord abatement of lead as politically unfeasible.

Markowitz and Rosner are coauthors of Deceit and Denial: The Deadly Politics of Industrial Pollution, the definitive histories of silicosis, and now a book on lead. Their work is meticulously researched, and the histories they recount move from the home to the clinic, government agency, courtroom, and media. What makes their work particularly important is that they have the intellectual architecture to explain why their story matters to those who are not already passionate about children’s health in general or lead poisoning specifically. Their ultimate argument is to show what the contested politics...