Podcast Summary

Advancing Health – “From Toxic Paint to Safe Futures: Cleveland Clinic’s Bold Plan to End Lead Exposure”

Date: November 12, 2025
Host: Tom Hetterle, American Hospital Association
Guests:

• Vicki Johnson, Executive Vice President and Chief Community Officer, Cleveland Clinic
• Dr. Rupa Thakur, Pediatrician, Cleveland Clinic

Overview

This episode explores Cleveland Clinic's ambitious plan to eradicate lead exposure in Cleveland, focusing on the health risks—especially for children—posed by lead-based paint in older homes. Guests Vicki Johnson and Dr. Rupa Thakur discuss the historical origins of the problem, health impacts, their community-driven interventions, and the lessons learned for other health systems.

Key Discussion Points & Insights

Why Lead Exposure Still Plagues Cleveland

• Historical Context:

  • 90% of Cleveland homes were built before the 1978 ban on lead-based paint, making lead exposure a pervasive risk.
  • “This is our number one public health priority because…as the home deteriorates, it’s likely to poison those children living in the home.” – Vicki Johnson [01:21]

• Environmental Mechanics:

  • Lead paint deteriorates over high-friction areas (door frames, windows, decks), creating toxic dust that settles where children play; the danger is ever-present.
  • “As the paint chips or rubs off, it creates lead dust that then settles...and our little ones who are playing on those floors pick up that lead dust and either inhale or ingest it.” – Dr. Rupa Thakur [02:09]

Health Impacts – Why Prevention is Critical

• Child Development at Risk:
  • Effects are most severe in young children (ages 1–2), impairing brain and nervous system development even at low exposure levels.
  • Risks include slowed growth, learning and behavior problems, and lifelong health challenges.
  • “It can definitely prevent children from getting to their full potential.” – Dr. Rupa Thakur [02:49]
  • Adults are affected too, but impacts are less dramatic and different in nature [03:31].

Cleveland Clinic’s $55 Million Lead-Free Initiative

• Funding Allocation:
  • Dollars go directly to lead remediation in homes—removal and encapsulation.
  • Additional investments: workforce development, marketing, evaluation, and a special focus on making childcare centers lead-safe.
  • “Once we got involved in the coalition, we thought...little ones who go to childcare spend as much time during the week there as they do at home...we launched the Lead Safe Child Care Center initiative.” – Vicki Johnson [03:55]

Accessing Resources: Grants, Incentives, and Outreach

• How Residents Engage:

  • Grants and incentives are available for homeowners and landlords; education and outreach are key to raising awareness.
  • Engaging both homeowners and landlords requires tailored approaches, as many rentals are implicated.

• The Challenge:

  • Uptake of funds is slower than expected despite large resources.
  • “We thought...people would run in and take advantage of these resources...that is not the case.” – Vicki Johnson [08:58]

Making Homes Lead Safe vs. Lead Free

• Strategies:
  • Encapsulation: painting over with special paints and wrapping surfaces.
  • Replacement: tearing out and replacing hazardous areas for a permanent solution.
  • Approaches are decided based on condition and urgency; “lead safe” is the immediate goal, with “lead free” as the long-term vision.

Societal and Economic Benefits of Intervention

• Long-term Payback:
  • Study from Case Western Reserve shows every dollar spent can yield up to $220 in societal savings.
  • Preventing lead exposure reduces healthcare, unemployment, public benefit, and criminal justice system costs.
  • “Each dollar invested in lead poisoning prevention can have as much as $220 return on investment.” – Dr. Rupa Thakur [07:09]

Prevention Over Cure

• No Effective Reversal:
  • No cure exists for lead poisoning; prevention is the only effective path.
  • “As far as we know, there is no cure for lead poisoning once it’s happened.” – Dr. Rupa Thakur [08:17]

Lessons and Advice for Health Systems Nationwide

• Persistence and Partnerships:

  • Changing the situation is a long-term effort requiring resilience and ongoing education.
  • Coalition-driven, multi-sector partnerships are essential—over 400 organizations, thousands of members, combine policy, outreach, and practical action.

• Breaking Down Silos:

  • Data sharing and coordination across sectors (public health, clinical, housing) are critical to progress.
  • “A lot of that required breaking down barriers between all different silos...it takes a lot of people working together.” – Dr. Rupa Thakur [10:47]

• Public Messaging is Crucial:

  • Communication and education remain as important as technical solutions to drive participation and awareness.
  • “We’re still trying to educate the population on the danger of lead poisoning.” – Vicki Johnson [08:58]

Notable Quotes & Memorable Moments

• “This is our number one public health priority...as the home deteriorates, it’s likely to poison those children living in the home.”
  – Vicki Johnson [01:21]

• “As the paint chips or rubs off, it creates lead dust that then settles...and our little ones who are playing on those floors pick up that lead dust and either inhale or ingest it.”
  – Dr. Rupa Thakur [02:09]

• “Even the lowest levels of lead exposure can damage the brain and nervous system, can slow growth and development, and can lead to learning and behavior problems.”
  – Dr. Rupa Thakur [02:49]

• “Each dollar invested in lead poisoning prevention can have as much as $220 return on investment.”
  – Dr. Rupa Thakur [07:09]

• “As far as we know, there is no cure for lead poisoning once it’s happened.”
  – Dr. Rupa Thakur [08:17]

• “We thought...people would run in and take advantage of these resources...that is not the case.”
  – Vicki Johnson [08:58]

• “Breaking down barriers between all the different silos...it takes a lot of people working together.”
  – Dr. Rupa Thakur [10:47]

Timestamps for Key Segments

• [01:21] – Why Cleveland’s lead problem persists
• [02:09] – How children are exposed to lead in the home
• [02:49] – Health impacts & why prevention is essential
• [03:55] – Cleveland Clinic’s $55M commitment & strategies
• [05:56] – Lead-safe vs. lead-free remediation approaches
• [07:09] – Societal and financial benefits of prevention
• [08:17] – No cure for lead poisoning, only prevention
• [08:58] – Lessons learned on slow uptake and persistent barriers
• [10:47] – Importance of partnerships and information sharing

Takeaway

The Cleveland Clinic’s efforts reveal the complexity and urgency of addressing legacy lead exposure. The guests emphasize that while the technical solutions are known, persistent education, partnerships, and patient, sustained commitment are vital to seeing results—not just in Cleveland, but across the nation. Prevention, strong coalition-building, and public messaging remain the pillars of real progress against this overlooked public health crisis.