How Children Became a City’s Lead Detectors

Milwaukee parent Domininck Tompkins has lived in rental units with lead hazards for many years.
(Darren Hauck for The Hechinger Report)

In Milwaukee, a child’s blood test is too often the first housing inspection.

Milwaukee—When a doctor told Domininck Tompkins that her 1-year-old’s lead level was too high, she immediately suspected her child was being poisoned at their home, a poorly maintained rental with chipping paint.

A few weeks later, when her landlord pulled up in her truck to collect the rent, Tompkins told the woman about a letter from the city confirming that lead detected in her daughter’s body posed significant health risks for the girl. Tompkins recalled that the landlord uttered just three words as she rolled up her window: “I don’t care.”

After that, Tompkins said, the landlord always sent someone else to collect the rent.

In the decade since, Tompkins has moved several times and been homeless twice. Most of her rentals have included unaddressed lead paint, lead dust, and other hazards, she said. Tompkins now has three daughters—11, 7, and 2—with another on the way, and her oldest daughters have struggled with developmental delays and behavioral challenges that doctors say likely stem at least partly from lead poisoning.

Yet Tompkins—who tested high for lead herself as a child—has felt powerless to secure her family a lead-free home. Milwaukee, like countless other cities, lacks any requirements that most rentals get inspected for lead. Landlords too often ignore complaints without consequence, just as Tompkins’s ultimately did.

As the persistent lead problem in Milwaukee rental homes underscores, there’s a long-overlooked connection between tenants’ rights and the health and well-being of young kids. High lead levels, for instance, are associated with developmental delays and conditions like attention deficit hyperactivity disorder and learning disabilities. A Milwaukee-based study found that even low levels of lead are associated with poorer third-grade academic performance. This held true even when controlling for other factors, such as mothers’ income levels or children who were born prematurely.

In their conclusion, the authors stressed the importance of home lead abatement efforts to strengthen the academic performance of Milwaukee’s children. Yet, for untold numbers of renters, those abatement efforts come too late—if they come at all.

Children are the “lead detectors,” people here often say, since city officials typically only intervene with landlords after a young child tests high for the toxin. Though no amount of lead exposure is considered safe, the federal government established a blood lead “reference value” of 3.5 micrograms per deciliter to flag children with lead levels that are higher than most. In Milwaukee, when a child under the age of 6 tests above 3.5, the City gets notified and follows up with the family.

But it’s usually only for kids who test at 10 micrograms or above that the city will get deeply involved: assigning a nurse to the child; investigating to find the source of the exposure (which usually turns out to be the home, despite a well-publicized school lead crisis last year); and, in many instances, pushing for lead abatement work, like replacing windows, covering furnaces, or demolishing a garage.

Last year, the city oversaw 250 of these renovations for clients who were mostly between the ages of 1 and 3—the largest number of abatement projects in years. City officials would love to see this number continue to grow: More than 2,000 kids under 6 in the Milwaukee area tested high for lead in 2025. Most of these cases were in rentals, said Tyler Weber, the city’s deputy commissioner of environmental health. The city wound up using federal grants and city dollars to foot the bill for much of the work—because the landlords wouldn’t pay, and the city is severely limited in terms of how much it can fine recalcitrant homeowners.

“Sometimes we have to throw money at the property even if the landlord is going to benefit,” Weber said. “Do you hate the landlord more than you love the child? That’s often the situation we are stuck in.”

Nearly 60 percent of Milwaukee households rent rather than own, a percentage that rises significantly for low-income Milwaukeeans. In his landmark book Evicted: Poverty and Profit in the American City, sociologist Matthew Desmond immersed himself in the lives of struggling Milwaukee renters and their sometimes cutthroat landlords, making a persuasive argument that evictions—there are more than 12,000 eviction filings a year in Milwaukee County, which has a population of just over 900,000—are a leading cause of poverty, not just a consequence of it.

As Milwaukee’s lead crisis shows, the conditions that allow evictions to flourish can cause lasting harm to young children as well.

Over 10 percent of tested children in 51 of the county’s census tracts between 2018 and 2021 turned up positive for lead poisoning. In six tracts, over 20 percent of children were poisoned, more than eight times the national average. People of all ages can be affected, but young children are particularly vulnerable: Their brains are developing rapidly, while hand-to-mouth behaviors increase the likelihood that they will ingest lead.

While most cases of lead poisoning in Milwaukee are treated through outpatient case management, once or twice a month a child becomes so sickened that they need to be hospitalized for therapy to prevent permanent neurological damage, coma, and, in rare cases, death.

For Shyquetta McElroy, the alarm was raised early. At her eldest son’s six-week checkup, McElroy learned that his lead level was too high. Breastfeeding at the time, she left with instructions only to up her vitamin D intake.

By the end of kindergarten, her son’s lead level—at almost 10 micrograms—was as high as it had ever been, and McElroy began to understand how deeply lead poisoning had affected her son. The boy’s teachers told her in a meeting that he needed to repeat the year. He didn’t meet milestones that most of his peers did: using the toilet consistently, writing the first letter of his name, following instructions.

That meeting was a turning point for McElroy. She told her landlord, who agreed to spend more than $20,000 on lead abatement, maxing out her credit to put in new walls, windows, and, in some sections of the house, new floors. She also gutted and redid the attic. “She immediately went in and got it fixed,” McElroy said.

The reason for the too-rare cooperation: The landlord was McElroy’s mom.

McElroy quickly discovered that many landlords were not nearly as generous, including the owner of the steeply discounted Section 8 rental she moved to after leaving her mother’s apartment. “Being in a position where you are low-income and don’t have the money to change your situation, you got to go with what you can,” she said.

Decades ago, in cities like Baltimore, Cleveland, and Milwaukee, what had once been a rich man’s paint became largely a poor person’s problem. Coinciding with redlining, white flight, and urban disinvestment, scores of stately homes finished with lead paint in the first half of the 20th century were converted into multifamily rental units that often housed lower-income tenants.

For some time, Milwaukee was actually at the forefront when it came to protecting families like McElroy’s from lead. In 1991, the city updated its lead ordinances to require abatement work in rentals if a child was exposed to lead hazards, even in the absence of a positive blood test. “We regularly took owners to court and fined them,” said Amy Murphy, lead manager for Milwaukee’s health department from 1992 to 2006.

In 1999, the city started a pilot rental inspection project that required 1,000 homes in two high-risk areas to be brought up to an established standard of lead safety within one year. “That ordinance shifted the balance of power between property owners and tenants,” Murphy said. And owners, unsurprisingly, “didn’t want to be legislated.”

After a few years, Milwaukee landlords convinced the city to stop requiring the abatement work, insisting that they would collaborate to ensure that a steady stream of landlords did it voluntarily, with financial incentives. Not long after that, Murphy left the city health department, citing growing dysfunction and poor leadership—and the city’s once-ambitious lead abatement efforts went into free fall. Ultimately, the health commissioner was forced to resign after his department failed to notify thousands of families that their children had elevated blood levels.

At the same time, Wisconsin legislators empowered landlords on several issues, turning lead removal into a more private matter that hinged on a homeowner’s willingness to take action—and, some would argue, their morality. State laws have long made it easier for landlords in Wisconsin to evict tenants than in many other states, particularly those on either coast. Then just over a decade ago, lawmakers made it virtually impossible for communities to proactively police most landlords when it comes to lead.

In 2015, the Wisconsin State Legislature passed a law, supported by landlords and the state builders’ associations, prohibiting cities and towns from creating rental inspection programs. This left Milwaukee with no way of ensuring that most rentals would be safe for families and young kids before they moved in.

Although the state lifted the ban two years later, the law continues to make it prohibitively difficult for towns and cities to perform meaningful rental inspections of the duplexes and single-family homes where city officials say most of the lead problem persists. For instance, it outlaws rental licensing programs that would make it easier to establish and enforce minimal maintenance standards, and it sets severe limits on communities’ ability to recoup inspection fees or fine homeowners.

Wisconsin law also heavily curtails local governments from conducting preemptive code enforcement, meaning renters typically must make a complaint to get a violation addressed. “Many tenants don’t know to do that,” said Kevin Solomon, senior associate organizer with Common Ground, a nonprofit advocacy group in Milwaukee that works on issues including tenants’ rights. He added that renters also fear retaliation, citing a case last fall when a Milwaukee landlord was charged with killing his tenant, allegedly because the victim had complained to the city about code violations. “Many also call and call, but stop because it doesn’t make a difference—in part because the fines/fees are so low,” Solomon wrote in an e-mail.

The state does have a statute allowing for rent abatements when unaddressed conditions are found that are hazardous to tenants’ health, but the process can be bureaucratic, time-consuming, and limited to a small fraction of rent—if tenants even know it exists at all. And renters who make the mistake of withholding too much rent, let alone all of it, can find themselves in eviction court.

By the time Tompkins’s oldest daughter started school, she and her family had had enough of paying for a dilapidated rental that she feared had poisoned her child. Lead test after test came back positive.

When the girl was a toddler, childcare teachers told Tompkins that her daughter needed early intervention services because she was missing developmental milestones related to speech and walking. At first, the mother resisted, determined to help her child on her own. But when the teachers brought it up a second time, Tompkins agreed, and the girl has received extra support and special education services ever since.

In 2019, the family owed some back rent but was, according to Tompkins, paying it off. She told her landlord that the family planned to move, frustrated by years of inaction on lead abatement and other repairs. The landlord took steps to evict them.

Without any notice, sheriff’s deputies showed up one frigid morning shortly before Christmas 2019. Tompkins was in the shower, and she barely had time to get dressed before the entire family—including her partner, two children, her mother and her sister—was forced to the street.

“They put us out in the dead of winter,” she said. “My kids had no shoes on their feet.” It wasn’t lost on her that the antagonistic relationship with her landlord began when Tompkins complained about lead.

Tompkins was homeless for several months and sent her two kids and mother to live with relatives in Arizona. The next rental they found also had code violations, and it eventually burned to the ground because of electrical issues. The family was homeless again.

They found their current rental on a quiet street, with chipping paint covering the façade, porch, and interior. Several months ago, the owner agreed to pay for lead remediation, starting with tearing down the porch. But the contractor wanted more money than the landlord was willing to pay, and little of the work got done, according to Tompkins.

All three of her children have at different points tested high for lead, and Tompkins tries to manage the situation as best she can. She regularly attends Cooking with COLE (Coalition on Lead Emergency) sessions at a nearby church, where caregivers learn how to mitigate lead risks by cooking with filtered water, feeding children certain healthy foods, sealing off chipping paint and conducting regular cleaning with wet wipes. COLE also coaches families in how to talk with pediatricians about lead and negotiate with schools to get appropriate special education supports.

But the struggle to secure a lead-free home has left Tompkins frustrated. Her 7-year-old has behavioral challenges in school, and a doctor once said that her 2-year-old might need early intervention to address developmental delays. “It’s about these kids’ safety—lead affects them more than the rest of us,” Tompkins said.

McElroy’s challenges in Milwaukee’s rental market ultimately inspired her to work as a family advocate and organizer at COLE, where she supports parents like Tompkins. For the last two years, she has served as the organization’s executive director.

Over the years, McElroy built up enough resources through a home childcare business and her work at COLE that she could afford to be a bit more choosy about where she lived.

When she had to move last winter, McElroy grilled prospective landlords about lead hazards and brought her own testing device when she toured homes. Her assertiveness slowed down the hunt for a new place to live, she said: “There were probably four that turned me down where I knew it had something to do with the questions that I asked about lead.”

In a city where many parents can’t afford to ask questions, McElroy would love to see the city enact greater accountability for landlords. “As it is, the landlord can come up with any reason why this couldn’t be done,” she said. “The loopholes are bigger for the landlords and very, very narrow for the tenants.”

Most cities are, like Milwaukee, reactive rather than proactive when it comes to lead poisoning and kids. But a growing number of communities inspect rentals for lead hazards.

Rochester, a city of just over 200,000 in New York, has built one of the most extensive rental inspection programs in the country. For over 20 years, every registered rental unit in the city has received a visual inspection for deteriorating paint every three to six years. In high-risk areas where most of the childhood lead poisoning cases occur, many rentals also get dust wipe testing for lead. Any home that fails either type of inspection must pay to get reinspected before it can be rented out.

While lead poisoning is still a real threat in Rochester, the numbers have improved: Between 2000 and 2016, the rate of children testing with elevated levels dropped 85 percent.

“What Rochester is doing should be the norm,” said Murphy, who has continued to work on the issue nationally, including for the National Center for Healthy Housing.

This year, an inspection program modeled on Rochester’s was expanded to more than 20 cities across the state. Unlike Wisconsin, New York law does not severely restrict local efforts to build out rental inspection programs or code enforcement. New York tenants also benefit from a host of laws and regulations that give them more power than the average tenant in Wisconsin, including everything from increased protections and longer timelines in the eviction process to classifying illegal eviction as a crime.

All of this gives New York tenants more wiggle room to negotiate with landlords on a host of issues, including lead.

The tide may be starting to turn for renters in Milwaukee. A new tenant union, Tenants United, was formed just six months ago under the auspices of Common Ground to lobby on rent prices, unsafe conditions in rentals and other issues. Tenants United partnered with the Milwaukee city attorney in the spring to sue Highgrove Holdings, one of the city’s largest out-of-state landlords and the subject of countless lead hazard complaints, arguing that Highgrove had become a nuisance to its tenants and the entire city.

A plan to replace all lead service lines, a source of water contamination, is underway. And both Milwaukee’s health department and the city attorney are primed to take more action on lead hazards in homes. The city has seen a slight uptick in landlords paying for abatement work because of stepped-up enforcement over the last few years.

But at the end of 2026, the city will lose the federal pandemic-era American Rescue Plan Act funds that have been paying for much of its lead abatement efforts. Weber said he thinks the city can make up most of the shortfall through a grant from the US Department of Housing and Urban Development; that money comes with more restrictions, however, including a stricter cap on how much can be spent on each house.

And the state laws blocking rental inspections, preemptive code enforcement and meaningful fines remain impediments to change. So, too, are the eviction laws. When a child has been poisoned by lead, “Mom and Dad are devastated. They are angry,” Weber said. “They say, ‘Why would I continue paying rent?’ But there’s no protections, and they can be evicted.” He snapped a finger.

McElroy and Tompkins know the stakes. McElroy’s eldest has not tested high for lead since he was about 6, but the teenager still struggles with the effects of the poisoning.

The 19-year-old, who recently finished high school, has a hard time retaining information and grapples with vision and hearing problems that physicians say are likely lingering effects of the lead. “You can lower the lead level, but they never lose the damage,” McElroy said.

Tompkins’s oldest daughters also continue to experience developmental and cognitive delays that affect both their academics and behavior. She hopes that her fourth daughter, due in July, never has to live in a lead-contaminated home. The new landlord at her house has committed to extensive abatement and renovation, including a new porch and windows and replacement walls and floors in some rooms.

The renovation work will likely force the family to move out temporarily. But Tompkins is cautiously optimistic that at least the work will finally get done. “It’s a big project he has to do,” she said. “So one step at a time.”