Journal of public health management and practice : JPHMP · 2026
A Return-On-Investment Analysis for Lead Poisoning Case Management in New York City.
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Goldwater Jason C, Harris Yael M, Neustrom Kyle W, Sedlar Slavenka, Ehrlich Jacqueline, Faciano Andrew
Аннотация
OBJECTIVES: To evaluate the return on investment (ROI) and social return on investment (SROI) of childhood lead poisoning case management in New York City by quantifying direct cost savings and long-term societal benefits associated with intervention among children with elevated blood lead levels.
DESIGN: Mixed-methods economic modeling study estimating ROI and SROI using program cost data, published outcome valuations, and sensitivity analyses for 1462 high-risk NYC children.
SETTING: New York City Department of Health-led lead poisoning case management program serving high-risk children in urban housing.
PARTICIPANTS: One thousand four hundred sixty two New York City children with blood lead levels ≥10 μg/dL who received case management and environmental inspections.
INTERVENTION: Public health nurse-led case management, including home inspections, lead hazard remediation coordination, medical monitoring, and family support services.
MAIN OUTCOME MEASURE: ROI and SROI, including avoided medical, education, productivity, justice, and quality-of-life costs.
RESULTS: Baseline ROI was 1.34 ($2.34 saved per $1 invested); SROI was 26.37, reflecting more than $98 million in lifetime societal benefits for the full cohort of 1462 children.
CONCLUSIONS: Lead poisoning case management generates substantial economic and societal returns, supporting sustained investment as a high-impact, equity-focused public health strategy.
DESIGN: Mixed-methods economic modeling study estimating ROI and SROI using program cost data, published outcome valuations, and sensitivity analyses for 1462 high-risk NYC children.
SETTING: New York City Department of Health-led lead poisoning case management program serving high-risk children in urban housing.
PARTICIPANTS: One thousand four hundred sixty two New York City children with blood lead levels ≥10 μg/dL who received case management and environmental inspections.
INTERVENTION: Public health nurse-led case management, including home inspections, lead hazard remediation coordination, medical monitoring, and family support services.
MAIN OUTCOME MEASURE: ROI and SROI, including avoided medical, education, productivity, justice, and quality-of-life costs.
RESULTS: Baseline ROI was 1.34 ($2.34 saved per $1 invested); SROI was 26.37, reflecting more than $98 million in lifetime societal benefits for the full cohort of 1462 children.
CONCLUSIONS: Lead poisoning case management generates substantial economic and societal returns, supporting sustained investment as a high-impact, equity-focused public health strategy.