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Childhood lead poisoning (LP) has been an entrenched public health issue in the U.S. for over 200 years, and remains tied instrinsically to race and class. While Black children suffer the highest blood lead levels, LP’s highest exposure rates exist in poor neighborhoods with older housing and higher rates of street crime. Although these places are often targeted for urban renewal/gentrification, there exists no city-scaled analysis of gentrification, LP, and crime. Drawing from critical theories, public health, and ethnographic work, I explore how changes in a neighborhood’s demographics and built environment impact LP and street crime. My mixed-methods research challenges the self-termed “pragmatic” public health researchers and municipal policymakers who view gentrification as a means to reduce/eliminate LP and street crime. Instead, I argue that gentrification can only exacerbate LP and crime--potentially reducing LP in marginalized intra-city regions yet predominantly for incoming gentrifiers, who subsequently displace long-term residents into more disadvantaged areas.