flint michigan water crisis research paper

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• 15 June 2021

Community–academic partnerships helped Flint through its water crisis

• E. Yvonne Lewis 0 &
• Richard C. Sadler 1

E. Yvonne Lewis is founder and chief executive of the National Center for African American Health Consciousness, Flint; co-community principal investigator at the Flint Center for Health Equity Solutions; co-director of the Healthy Flint Research Coordinating Center Community Core; and director of outreach, Genesee Health Plan, Flint, Michigan, USA.

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Richard C. Sadler is associate professor of public health at Michigan State University, Flint, Michigan, USA.

Flint in Michigan is infamous for its water crisis. From 2014, the state government decided to divert the city’s water supply through ageing pipes that contained lead, a neurotoxin, making many people unwell and leading to some deaths. Residents were left searching out water that was safe for drinking, washing and bathing. Nine public officials face criminal negligence charges around wilful neglect of duty and for allegedly concealing and misrepresenting data. A US$640-million class-action lawsuit is moving its way through the courts.

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Nature 594 , 326-329 (2021)

doi: https://doi.org/10.1038/d41586-021-01586-8

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A city and a water crisis: Flint, Michigan and the 1950/1960s water crisis

• Environmental Education
• Published: 03 September 2022
• Volume 13 , pages 14–22, ( 2023 )

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• Nicholas A. Timmerman   ORCID: orcid.org/0000-0002-2229-4068 1  

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The city of Flint and the Flint River has a long history of pollution, industrial waste, mismanagement of ecosystems, and issues of access to clean water that were significant factors in water management decisions for the city’s residents. In the 1950s and 1960s, the industrial and residential pollution control demands placed on the Flint River exceeded the river’s capacity. Particularly, the city needed to provide clean water to residents and an adequate flow rate to remove pollution from the very same water source. Many reasons emerged for the water crisis of the 1950s and 1960s, namely a rapid increase in population and demand for industrial growth, which taxed the city’s water and sewage infrastructure beyond its limits. During this era, city government took steps to increase pollution mitigation plans, increase river water flow rates, and develop reservoirs to store water reserves for use during high-demand seasons. One of the massive infrastructure plans included constructing a direct water pipeline to Lake Huron to provide Flint residents with an abundant clean water supply from one of the Great Lakes. Nonetheless, many plans enacted proved inadequate to address the immediate water emergency, and infrastructure plans such as constructing the water pipeline to Lake Huron failed to materialize, which could have prevented the Flint Water Crisis of the 2010s.

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Timmerman, N.A. A city and a water crisis: Flint, Michigan and the 1950/1960s water crisis. J Environ Stud Sci 13 , 14–22 (2023). https://doi.org/10.1007/s13412-022-00796-4

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The Psychosocial Effects of the Flint Water Crisis on School-Age Children

Lead poisoning has well-known impacts for the developing brain of young children, with a large literature documenting the negative effects of elevated blood lead levels on academic and behavioral outcomes. In April of 2014, the municipal water source in Flint, Michigan was changed, causing lead from aging pipes to leach into the city’s drinking water. In this study, we use Michigan’s universe of longitudinal, student-level education records, combined with home water service line inspection data containing the location of lead pipes, to empirically examine the effect of the Flint Water Crisis on educational outcomes of Flint public school children. We leverage parallel causal identification strategies, a between-district synthetic control analysis and a within-Flint difference-in-differences analysis, to separate out the direct health effects of lead exposure from the broad effects of living in a community experiencing a crisis. Our results highlight a less well-appreciated consequence of the Flint Water Crisis – namely, the psychosocial effects of the crisis on the educational outcomes of school-age children. These findings suggest that cost estimates which rely only on the negative impact of direct lead exposure substantially underestimate the overall societal cost of the crisis.

This work has been supported by the National Science Foundation Graduate Research Fellowship Program under Grant No. DGE-1656518 and by the Institute of Education Sciences under Grant No. R305B140009 and R305B170015. We are grateful to Sean Reardon, Carolyn Hoxby, Eric Bettinger, Ben Domingue, Jeremy Freese, Tom Dee, David Rehkopf, Eli Ben-Michael, Avi Feller, Jesse Rothstein, Emily Morton, Marissa Thompson, and Paula Lantz for helpful comments. We also wish to thank Jasmina Camo-Biogradlija, Kyle Kwaiser, Jonathan Hartman, Nicole Wagner, and the Education Policy Initiative staff for assisting with access to Michigan’s restricted-use educational data. This research used data structured and maintained by the MERI-Michigan Education Data Center (MEDC). MEDC data is modified for analysis purposes using rules governed by MEDC and are not identical to those data collected and maintained by the Michigan Department of Education (MDE) and/or Michigan’s Center for Educational Performance and Information (CEPI). Results, information, and opinions solely represent the analysis, information and opinions of the authors and are not endorsed by, or reflect the views or positions of, grantors, MDE and CEPI or any employee thereof. The views expressed herein are those of the authors and do not necessarily reflect the views of the National Bureau of Economic Research.

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The Flint Water Crisis

By: Marie McKendall, Nancy M. Levenburg

The city of Flint, Michigan, a previous hub for General Motors auto manufacturing, began to experience budget shortfalls in 2007. By 2011, the city was running a deficit of nearly $26 million, and…

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The city of Flint, Michigan, a previous hub for General Motors auto manufacturing, began to experience budget shortfalls in 2007. By 2011, the city was running a deficit of nearly $26 million, and the state assumed control of Flint through the appointment of an emergency manager. In 2014, immediately after state officials decided to begin sourcing Flint's tap water from the Flint River in order to save money, residents began complaining about the cost, color, and quality of their water. Over the next 18 months, residents reported suffering from various illnesses and an outbreak of Legionnaire's Disease occurred in the area. During this time, state officials continued to assure residents that their water was safe despite three water-boil advisories, the water rusting parts at General Motors' Flint engine plant, and the straightforward warnings from an EPA employee that an unsafe situation existed. Public pressure built as an ACLU reporter broke the story, an outside researcher's tests uncovered unsafe levels of lead in the water, and a Michigan State University pediatrician found elevated lead levels in children coinciding with the switch to Flint River water. In October of 2015, Flint switched back to sourcing water from Detroit; finally, in January of 2016, Michigan's Governor (Rick Snyder) declared a state of emergency and activated the Michigan National Guard to patrol the city and assist the American Red Cross with the distribution of bottled water and water filters. The citizens of Flint had been exposed to poisoned water for 18 months.

What went wrong? What dysfunctions and conditions in federal and state organizations led to flawed decision making and catastrophic outcomes? The case provides a general overview of the city of Flint, events leading up to the Flint water crisis, information about the involved government agencies, and a chronology of the tap water sourcing decision. The case prompts readers to analyze and understand that a variety of factors, including multiple actors, ambiguities, corporate structures, and organizational complexities can combine to result in unethical decisions and outcomes.

Learning Objectives

Learning objectives include: (1) Describe the roles of various participants in a complex situation and recognize how those roles interacted in Flint; (2) Identify the kinds of rational and cognitive mistakes that can be made during a decision process; (3) Analyze how organizational culture and structure can influence the actions of employees in organizations; (4) Examine how flawed organizational systems and goals combined with human error can create a catastrophic outcome and offer suggestions for how a situation like Flint's water crisis could be avoided; (5) Hypothesize about the role of moral courage in their future business lives; and (6) Understand the concept, components, and consequences of environmental racism.

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Exploring what works, what doesn’t, and why.

The children of Flint, ten years later

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Dionna Brown calls herself a survivor of the Flint water crisis. Ten years ago, in April of 2014, the city switched its water supply to the Flint River. The move happened under an emergency manager, appointed by the state of Michigan to help the beleaguered city find its financial footing. But the river water was corrosive, awash with chloride from road salt runoff, and the city failed to add corrosion inhibitors to the water. Aging pipes began to leach iron and lead. The result was more than 100,000 residents being exposed to unsafe levels of lead in their drinking water.

Brown, then a junior in high school, remembers she needed to make a lot more effort to focus after the switch. “I was combining words and numbers a lot,” she says. “I had to work harder to just learn.” In 2018, a blood test revealed elevated levels of lead. Then came diagnoses of ADHD and dyslexia.

Brown didn’t let her learning challenges stop her: She graduated from Howard University and is on track to get a master’s degree next month. But like many Flint residents, she feels marked by the crisis. The most vulnerable people were and are children, thousands of whom live with the consequences of poor decisions made by politicians and health officials. Yet, some positive developments have emerged. Community members have fought court battles to force the replacement of lead pipes. A coalition of public agencies, grassroots groups, and nonprofits—backed by federal, state, and foundation funding—has spent years building a creative care network to buffer some of the worst outcomes of the water crisis.

Still, the people of Flint continue to deal with ongoing physical, mental, and emotional challenges. Rates of depression exceed national averages for both children and adults. And almost half of the parents enrolled in the Flint Registry , which tracks the health of over 21,000 people affected by the water crisis, said that their children were living with behavioral problems as of 2022. These included attention issues, aggression, depression, hyperactivity, and trouble adapting. Many of these issues are worsened by ongoing stress from the years of crisis.

Dionna Brown, 24, outside her father’s car wash in Flint, Michigan in March. Brown grew up in Flint but did not get tested for lead poisoning until 2018. She found out that she had elevated lead levels; she is also coping with ADHD and dyslexia.

Brown hugs her father, Dion Brown, Sr., after getting her car washed. Despite the struggles she experienced after Flint's water switch, she graduated from Howard University. Next month she expects to receive a master's degree in sociology from Wayne State University.

Brandon Gilleylen still remembers mud-colored water spouting from his faucet a few weeks after the ill-fated water switch. “It was just shocking to see,” says the Flint native.

Almost immediately, residents complained of the water’s foul taste and smell. Many began to lose hair and break out in skin rashes. Not long after Gilleylen’s tap water turned brown, the city announced a boil-water notice because Flint’s water was found to contain fecal coliform, a sign of disease-causing pathogens. Boil-water notices for additional issues came soon after. Gilleylen and his wife, parents of a one-year-old child, duly followed directions and boiled the water they used to cook, bathe, and make baby formula.

What they wouldn’t know until more than a year later was that lead had leached from corroded water pipes. Boiling the water essentially concentrated the lead, and about 100,000 Flint residents had already been exposed—including the Gilleylens’ baby. Brandon’s wife, Ashaley Hart-Gilleylen, says she was racked with worry about their little girl. “It was really, really tough mentally, wondering what happened to her and how she’s going to be affected,” she says.

Brandon Gilleylen remembers standing in line for bottled water and feeling an “apocalyptic” sense of dread. “When is the water going to run out? Are we going to have any water left?” he would think. “We’re stuck with brown water coming out our faucets, and nobody’s listening to what we all have to say.”

Officials ignored residents who said the water was making them sick and flat-out rejected scientific evidence. In September 2015, researchers from Virginia Polytechnic Institute and State University released results from a study of 252 Flint homes showing that 40 percent had water with elevated levels of lead, including one with levels twice what the Environmental Protection Agency (EPA) considers to be hazardous waste. Still, state officials denied there was a serious risk.

Later that month, doctors at the city’s Hurley Medical Center announced that the percentage of children with elevated blood lead levels had doubled since 2013. The state again dismissed the science; a spokesperson described the research as “unfortunate” and mounting concerns as “near-hysteria.” But one day later, the city of Flint issued a lead warning; a week later, Genesee County, which contains Flint, declared a public health emergency.

During a protest in April 2016, a Flint resident holds a jug of her fouled tap water, a bag containing hair she has lost, and a sign calling for Michigan Gov. Rick Snyder's resignation.

Photo: Jake May / The Flint Journal via AP, File

U.S. Surgeon General Vivek Murthy inspects a bottle of tap water from a Flint home during a visit in February 2016.

Photo: Jake May / The Flint Journal-MLive.com via AP

For families like the Gilleylens, a waiting game ensued: Would they start to see signs of lead poisoning in their children? As the Gilleylens’ daughter neared kindergarten, she began throwing violent temper tantrums, which her father says were well beyond the norm for a child her age, and which they attributed to the effects of the lead poisoning.

Ashaley Hart-Gilleylen was pregnant by the time the city switched back to Detroit water in October 2015. A few months later, she would miscarry. “I know it was something to do with the lead,” she says.

By January of this year, roughly 15 percent of kids in the Flint Registry had been diagnosed with anxiety and 10 percent with depression. (The national rates for kids of similar ages are 9.4 percent for anxiety and 4.4 percent for depression.) “We’re alarmed” but not surprised, says Nicole Jones, an epidemiologist at Michigan State University and the registry’s codirector. “The things that we’re seeing are things that we expected to be associated not only with exposure to lead, but exposure to the trauma of an environmental crisis.”

A recent study points to the wider impact of the water crisis. Test scores in math dropped for 3rd through 8th graders across Flint following the crisis, while the number of K–12 students with special education needs rose by eight percent. The results showed little variation between kids living in homes with lead service lines and those without. Sam Trejo, a Princeton University sociologist and lead author of the study, says the findings point to the Flint water crisis “not just as the tragic events that led some kids to be exposed to more lead in their water … but instead as a broader kind of emergent crisis that affected an entire city.”

Trejo’s study is consistent with other research documenting how Flint remains caught up in the water crisis, with one in four residents suffering from post-traumatic stress disorder and struggling with ongoing physical health issues. Many still feel betrayed by local and state leadership.

Adults in the registry have fared even worse than kids when it comes to mental health, with more than a third diagnosed with depression. In addition, the data show many adults have chronic conditions like high blood pressure, which can be caused by lead exposure.

“The community response was to wrap our children and families with goodness. What we’ve learned is that despite all the good stuff that we’ve been able to put in place, people continue to struggle.” Mona Hanna-Attisha, pediatrician

It’s an overcast Sunday in January on the Northside of Flint, but it’s warm inside the spacious sanctuary at Christ Fellowship Missionary Baptist Church. Rev. Allen C. Overton steps into the pulpit and begins his sermon. The pastor’s rolling baritone turns somber as he touches on the water crisis. “It’s a catastrophic tragedy that, 10 years later, I’m still on conference calls with my attorneys because every lead line has not been removed in this city.” Shouts of “Yes!” and “That’s right” ring out from the pews.

Back in the fall of 2014, Overton was watching television when General Motors announced it would stop using Flint water; the company was concerned that high levels of chloride could corrode its machinery. It would eventually come out that the failure to add corrosion inhibitors to the river water resulted not only in lead contamination but also in a reduction in chlorine levels, allowing other contaminants to flourish, including  E. coli  and  Legionella  bacteria. When more chlorine was added to fight bacteria, a buildup of trihalomethanes—disinfection byproducts linked to cancer—became yet another problem. At the time, though, state officials assured residents that even so, the water was acceptable for human consumption. Overton was shocked, and thought, “We got a problem.”

Rev. Allen C. Overton sits inside Flint's Christ Fellowship Missionary Baptist Church in March.

Overton was a spokesperson for Concerned Pastors for Social Action, a Flint-area coalition of ministers. He began calling city and state offices to ask what was going on; he was repeatedly told the water was safe to drink. In 2016, Concerned Pastors became part of a group that brought a lawsuit against the city of Flint and the state of Michigan, which led to a settlement that included a commitment to replace all of the city’s lead and galvanized steel pipes.

Such pipes represent much of Flint’s infrastructure, given that Flint’s housing stock was largely in place by the late 1950s, says Richard Sadler, a medical geographer at Michigan State’s College of Human Medicine. Sadler led a 2017 study which mapped clusters of homes whose residents had high blood lead levels; one such cluster was located just a few blocks away from Overton’s church. Concerned Pastors has been back to court several times to force action, as Flint missed multiple court-ordered deadlines to replace its aging pipes. The city claims that 95 percent of the work is done, and now that the Biden Administration has set aside money to address the issue nationally, Overton feels optimistic. “I’m trusting and believing that the city administration is going to get it done this year,” he says.

Concerned Pastors is just one of the local groups that has rallied for Flint since the crisis began 10 years ago. Many local churches and nonprofits sprang into action, and groups like the Red Cross organized small armies of volunteers to staff water drives handing out bottled water to residents and to deliver clean water and fresh food to people who were homebound.

After-school programs, healthy-foods initiatives, and community health centers worked in tandem to stitch together a safety net for distressed families. The Genesee Health System, a public entity providing mental health services, used funds from a settlement to create what is now the Children’s Integrated Services Assessment Clinic , which tests local children for lead exposure and carries out neuropsychological assessments of children. Meanwhile, the Pediatric Public Health Initiative (PPHI), created by Michigan State and Hurley Children’s Hospital, targets care to focus on lessening the impacts of the water crisis through community programs, advocacy, training, and evaluation.

“The community response was to wrap our children and families with goodness,” says Mona Hanna-Attisha, the pediatrician whose announcement about the sharp jump in kids’ lead levels back in 2015 finally got officials to acknowledge the crisis. And yet, she says, the people of Flint continue to face enormous socioeconomic challenges. Hanna-Attisha is associate dean for public health at Michigan State’s College of Human Medicine and director of the PPHI. “What we’ve learned,” she says, “is that despite all the good stuff that we’ve been able to put in place, people continue to struggle.”

Flint pediatrician and whistleblower Mona Hanna-Attisha speaks to a crowd of over 100 people during a launch event for the Flint Registry, set up to track lead exposure, in 2018.

Photo: Bronte Wittpenn / The Flint Journal-MLive.com via AP

Hanna-Attisha is leading a new program called Rx Kids , which gives $1,500 prenatal cash payments to pregnant women in Flint and $500 per month for babies during their first year of life. The program launched in January with funding from a host of public and private sources. “We’re doing something that hasn’t been done before—we’re prescribing away poverty,” Hanna-Attisha says.

The task is daunting: The University of Michigan reports that nearly 70 percent of Flint kids still grow up in poverty. And almost half of registry adults say they have difficulty covering the cost of housing and food. Good nutrition is especially crucial, as calcium, iron, and vitamin C reduce the body’s absorption of lead.

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A decade after the crisis, some lessons are clear, Hanna-Attisha says, citing, among others, a need “to invest in prevention, to invest in public health, to address inequities, and to respect science … and not have to rely on children to be resilient to overcome insurmountable challenges.”

Shaketta Brooks worries about those challenges. She and her nine-year-old son, sunny-natured and with a bright smile, are at the Flint Public Library, where they've been taking turns reading aloud from a book on Martin Luther King, Jr.

Her son was born premature just four months after Flint’s water switch. When women are exposed to lead before or during pregnancy, their risk of giving birth prematurely increases, as does the risk of miscarriage and having a low-birth-weight baby.

Brooks's son spent months in the neonatal intensive care unit at a local hospital. “They said he was underdeveloped,” she says, and he needed a blood transfusion. Children exposed to lead in the womb can suffer damage to the brain and nervous system, which can cause learning and behavior problems later on. He is among the more than 20 percent of kids with special-education or early-intervention plans in the Flint Registry .

Shaketta Brooks embraces her nine-year-old son on the Genesee Valley Trail in March. Brooks says she often walked here in 2014, the year the water crisis began.

Brooks and her son walk in their neighborhood in Flint.

Lead can be particularly harmful to young children, due to rapid growth of their bodies and brains. Because lead can damage the central nervous system, “it affects their cognition, it affects their learning, it affects their attention,” notes Jones, the Michigan State epidemiologist.

Brooks says her son can be hyperactive, so she signs him up for sports like basketball and boxing for exercise. But she’s “on eggshells” watching him run because of his asthma, another condition that can be linked to lead exposure.

Jones understands the fear: Lead exposure, she says, “is a lifelong concern."

On a quiet morning in a wooded corner of the city, the Flint River flowed serenely past Buick City, an old General Motors site, on its bendy route north toward Saginaw Bay. Marcell Simmons, 23, kayaks the river every summer. As a paddle guide for the Flint River Watershed Coalition, he educates people about the wildlife and plants that surround the river: bald eagles, great blue herons, and vegetation like water lilies and cattails, which Simmons eats from time to time just to prove to other paddlers these plants are edible.

He tries to foster respect for the river. “It was straight-up love for the city,” Simmons says about why he wanted the job. Barely a teen in 2014, he didn’t escape the fallout of the crisis. After the switch to Flint River water, his school performance took a hit. “I was a whole lot sharper prior to the water crisis,” says Simmons, who struggles with attention issues. “I don't know if it’s ADHD or if it’s lead,” he says, “so I just work with it.” A decade later, he’s still furious about what happened. “You can’t help but to be enraged,” he says.

In January, Simmons testified virtually at an EPA hearing to gather comments for a plan to strengthen the Lead and Copper Rule , the 1991 law regulating lead levels in drinking water. The EPA had proposed lowering the remedial action level from 15 to 10 parts per billion (a part per billion is roughly the equivalent of one drop in 500 barrels of water). Simmons spoke in favor of the change. “We are the United States of America,” he said, in a tone of disbelief. “Children, right now, are having developmental issues that started from the day they were born.”

"I was a whole lot sharper prior to the water crisis,” says Marcell Simmons, a clean water activist in Flint, Michigan. A decade later, he’s still furious about what happened. “You can’t help but to be enraged.”

Dionna Brown also spoke at the hearing. “No amount of lead in drinking water is deemed safe,” she said. Brown came from a middle-class family and didn’t use the services being offered in Flint. “I have to work harder to get what I want,” she says. “It's not okay that I have to work harder, but there’s nothing I can’t do if I put my mind to it.”

While in college, Brown became involved with the nonprofit Young, Gifted & Green, where she now works to eliminate lead in communities like Flint. She says the water crisis helped open her eyes to historic environmental injustice. “This is the history of America,” she says. “ We see where the power plants are located, where the trash incinerators are, where all these environmental hazards are placed—they’re placed in Black, brown, and low-income areas.”

Besides wide-scale lead exposure, the crisis also sparked a deadly outbreak of Legionnaires’ disease, which sickened dozens and took the lives of at least 12 people. Nine public officials, including emergency managers appointed by the state, were criminally charged for their roles in the disaster. None were convicted and, last year, all remaining charges were dismissed.

The crisis was an injustice on many fronts, says Debra Furr-Holden, dean of the New York University School of Global Public Health. Furr-Holden lived in Flint as a child and worked as a public health researcher at Michigan State during the crisis. Indeed, if Flint were not a poor, majority-Black city, she says, the water crisis might never have happened. “This tolerance for water that the government knew was not potable being allowed to flow out of people’s taps—we just don’t believe this would have ever happened in an East Lansing or Lansing or Grand Rapids,” she says, calling the crisis an outright “act of environmental racism.”

The full health effects of the water crisis on the children of Flint won’t be known for another 10 to 15 years, Furr-Holden notes. “We already know what lead does in the body … what lead does to the brain,” she says. “Can we overcome that with intervention? Yes, but we won’t know how well we did until these kids reach adolescence and young adulthood.”

Furr-Holden credits the assessment clinic, the Pediatric Public Health Initiative, and the replacement of lead service lines as critical to the recovery. Another key is the state’s expansion of Medicaid for children in Flint who will need years of support, she says, to address the ongoing health effects and psychological trauma from the disaster.

The people of Flint carry on. Shaketta Brooks volunteers with the National Parents Union, devoted to the rights of minority and low-income parents. “It’s part of the healing for me,” she says.

Marcell Simmons attends community college and plans to pursue a career in communications. He says he’s eager to kayak the river once the weather warms. Dionna Brown says she plans to go to law school in 2026. “I’m a child of the Flint water crisis,” she says. “I’m the example that Flint kids are successful and can be successful, even though so many people doubted us.”

The Gilleylen family welcomed another child in 2017. They say their daughter’s behavior has improved some, and she thrives as a young athlete. They’re now planning to buy their first home, outside the city limits.

This story was supported by the USC Annenberg Center for Health Journalism’s 2023 Impact Fund for Reporting on Health Equity and Health Systems .

Top image: Marcell Simmons, a watershed guide and clean water activist, at the Flint River near downtown Flint in March.

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• Healthy Flint Research Coordinating Center The Healthy Flint Research Coordinating Center (HFRCC) is a collaboration with the Flint Community, UM-Flint, UM-Ann Arbor, and MSU. more info... less info... Working to aid Flint recovery and rebuild from the water crisis by: • Assisting in coordination, dissemination, and building synergy in research efforts in Flint. • Facilitating community and academic partnerships through workshops. • Utilizing a community managed ethics board review (CERB) of proposals. • Creating a data repository to share data that can aid the creation of a healthy Flint and lessen redundant research. Opendataflint.org • Offering Community-Driven Research Day. • Increasing community voice with structured community dialogues. • Including a broad coordinated cross-section of Flint stakeholders.
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• "Flint Water Crisis: Data-Driven Risk Assessment via Residential Water Testing" Article presented at Data for Good Exchange 2016, reports on researcher's data model that predicts locations in Flint to have lead contaminated water. [September 2016] more info... less info... Abernethy, J., Anderson, C., Dai, C., Farahi, A., Nguyen, L., Rauh, A., . . . Yang, S. (2016, September 30). Flint water crisis: Data-driven risk assessment via residential water testing. In Data For Good Exchange 2016. Retrieved October 7, 2016, from https://arxiv.org/abs/1610.00580 doi:arXiv:1610.00580

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Flint Water Crisis Exposed Children to Elevated Lead Levels

T he water crisis in Flint, Michigan, has led to a significant rise in the exposure of children to harmful lead levels, according to new research from Cornell University. This crisis began in 2014 when the city’s water supply was switched from Lake Huron to the Flint River as a cost-saving measure. The corrosive water from the Flint River was not adequately treated to prevent lead leaching from old pipes, leading to contaminated drinking water.

In the study, titled “Child Lead Screening Behaviors and Health Outcomes Following the Flint Water Crisis,” researchers revealed that one in four children who were screened had elevated blood lead levels — a rate much higher than the national average. The team found that despite lead screenings being free of charge, Flint’s children were under-screened, with only 77% of nearly 250 children surveyed having been tested since the crisis began. This figure is below the desired rate of at least 90% following such a public health emergency.

Jerel Ezell, the lead author of the study and a Flint native, underscored the gravity of the situation. “Our methods allow us to say that there was a substantial uptick in negative health outcomes among Flint children following the water crisis,” he stated. The symptoms associated with elevated lead exposure included learning delays, hyperactivity, emotional agitation, and skin rashes. Furthermore, the study highlighted that Black and low-income children faced higher rates of such conditions.

The research also indicated that long-term community distrust and health concerns persist years after the crisis began. More than 90% of children reportedly drank bottled water, which could lead to additional health issues due to the lack of nutrients and fluoride, increasing their risk for dental problems.

Ezell’s research emphasizes the need for ongoing monitoring of health risks potentially linked to the water crisis and addresses systemic factors that limited screening. He pointed out that the underwhelming screening rates could be attributed to parental distrust, logistical barriers, or a failure of officials to effectively communicate the need for these tests. “When government and health care institutions don’t have real skin in the game and aren’t made to be accountable, you have to build confidence and strengthen resources to help communities protect themselves,” he said.

Relevant articles:

– Water crisis increased Flint children’s lead exposure , cornell.edu

– Conducting evaluations of evidence that are transparent, timely and can lead to health-protective actions , National Institutes of Health (NIH) (.gov)

– What ACEs/PCEs do you have? , acestoohigh.com

– Physical interventions to interrupt or reduce the spread of respiratory viruses , National Institutes of Health (NIH) (.gov)

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Community–academic partnerships helped Flint through its water crisis

E. yvonne lewis.

founder and chief executive of the National Center for African American Health Consciousness, Flint; co-community principal investigator at the Flint Center for Health Equity Solutions; co-director of the Healthy Flint Research Coordinating Center Community Core; and director of outreach, Genesee Health Plan, Flint, Michigan, USA

Richard C. Sadler

Associate professor of public health at Michigan State University, Flint, Michigan, USA

A city that faced a public-health emergency shows how collaborations with neighbourhood advocates can advance health equity.

Graphical Abstract

Residents of Flint, Michigan, attended community blood-testing events in 2016 after lead contamination was found in the city’s water supply.

BRETT CARLSEN/GETTY

Flint in Michigan is infamous for its water crisis. From 2014, the state government decided to divert the city’s water supply through ageing pipes that contained lead, a neurotoxin, making many people unwell and leading to some deaths. Residents were left searching out water that was safe for drinking, washing and bathing. Nine public officials face criminal negligence charges around wilful neglect of duty and for allegedly concealing and misrepresenting data. A US$640-million class-action lawsuit is moving its way through the courts.

But Flint should be known for more than its public-health tragedy. Accounts of the crisis often cast pioneering scientists and physicians as lone heroes, assuming that those who documented the lead in the water and blood of Flint’s residents were the ones who brought officials to account. That assumption erases the work of community activists who got academics to look for lead and its damaging health effects in the first place. Flint is a working example of how community members and academics can collaborate on problems – such as how to collect data or develop robust models of health risks and injustices – and on finding solutions.

Flint’s water crisis came to light because of strong research partnerships between activists, academics and other specialists. These partnerships continue to advance work that matters to the community. Efforts include identifying neighbourhood conditions (including crime levels, asthma rates and access to healthy food) and assessing projects to improve them. It requires a commitment that research does not just end up in a thesis or paper, but becomes information that is useful to community members.

Here’s one example. The Genesee Health Plan is a non-profit benefit programme that provides basic health-care coverage to uninsured residents of Genesee County, which includes Flint. It was established in 2001 and is supported by property taxes. One of us (E.Y.L.) helped to provide the other (R.C.S.) with data from a sample of Genesee Health Plan enrollees to produce maps of chronic conditions. One map showed the health plan’s wide adoption in our community, and officials used it to advocate for voter support when the tax measure was renewed in 2018. This partnership was possible only because of the connections already formed between E.Y.L., who is a community organizer, and R.C.S., a geographer and public-health specialist at Michigan State University (MSU) in Flint.

Long-standing efforts to ensure Flint community members have a voice in research have gained momentum. One tangible result was the creation of the Healthy Flint Research Coordinating Center in 2016. To form the centre, E.Y.L. and another Flint resident representing community organizations joined up with six researchers – two each at MSU, the University of Michigan in Ann Arbor and the University of Michigan–Flint. It works to minimize redundant research, maximize creation of new community–academic partnerships and ensure that research receives a community ethics review.

Also established in 2016 to support equitable community–academic partnerships was the Flint Center for Health Equity Solutions, funded by the US National Institutes of Health (NIH). E.Y.L. is the centre’s overall community principal investigator. Each of its four divisions and two research projects is co-directed by a community member and an academic. The divisions are: methodology (which R.C.S. directs); dissemination and implementation sciences; administrative; and consortium partners. A programme within the centre – in which people with substance-use disorders are coached by their peers – has expanded and is now supported by additional external funding.

Here, we distil how we’ve made community-based research work, and provide lessons others might use.

Distinct challenges

Each of us experienced different challenges before we formed our community partnership, which might offer some pointers for others considering such collaborations. To that end, here, we relate our stories individually.

R.C.S. writes:

I grew up in Flint, and joined MSU as a faculty member in 2015. I knew that the kind of community-focused work I was most passionate about makes it harder to rack up the publications and citations required to progress in most academic institutions, which often treat these as a proxy for high-quality research.

I still worked to hit those markers, publishing more than 50 papers in 6 years. I secured several grants from agencies that fund research that has community value – including agencies in the NIH, the US Centers for Disease Control and Prevention (CDC) and the Michigan Department of Health and Human Services. My focus was on work that mattered to the community, and I didn’t worry whether journals had high impact factors or huge name recognition.

The community-engaged philosophy of the College of Human Medicine at MSU – where I gained tenure this year – made it more open to alternative metrics, such as volunteering on local non-profit committees, conducting community-based mapping and talking about research at local meetings. The key was to frame my academic output on a longer time scale than that of publications – long enough to see meaningful change.

E.Y.L. writes:

As an African American female community activist of decades’ standing, I worried about being physically mistreated, emotionally abused and misrepresented by research institutions. On one occasion before I moved to Flint, I remarked that some physicians’ descriptions of pregnant African American women as unconcerned with or unwilling to take care of their own needs did not reflect people in my community. I was asked about my academic credentials and then ignored for the rest of the conversation. I experienced this often during the water crisis: community members were touted as being great citizen scientists, until there was disagreement with the ‘real scientists’. Then we were marginalized and told we lacked the necessary degrees to provide input.

As community members, we also see our ideas appropriated. For instance, during a discussion at one national meeting, I made a distinction – on the basis of my own experience – between projects that were faith-based (driven by religious principles) and those that were faith-placed (using spaces such as churches). The following year, a researcher presented data based on this model without acknowledging me as the inspiration. I felt dishonoured, discouraged and demotivated. I now ask academic partners to give attribution for my ideas. Knowing the norms – and what credit to request – has helped me immeasurably.

Joint challenges

One of the biggest barriers to community participation is language. Words can have different meanings in different contexts – for instance, the phrase ‘those people’ can be highly offensive in many situations. When community members hear terms such as public engagement, they assume that ‘public’ refers to a broad, mixed group of individuals, such as those who might go to a public event. Yet academics often use the term to mean targeted outreach to specific groups of people – faith leaders, patient groups or policymakers, say. And to help navigate excessive jargon in the early stages of Flint’s partnerships, one group developed a glossary of acronyms such as NIH and CDC.

Importantly, everyone involved must take time to understand the culture and unique characteristics of the groups within communities. Not all Black communities are the same, for instance, and none is homogeneous. The heterogeneity among people’s levels of income, education and health insurance must be kept in mind in communications. Research materials written in English for a ‘general audience’ might not be appropriate – strong cultural dialects and a lack of access to information need to be considered.

Funding norms can also become a barrier to sustaining long-term relationships. Grants that last only one, two or five years are insufficient to address many community concerns. Too many communities have experienced projects for which funding ends and researchers move on, leaving unfinished work. Without sustained effort, the situation can revert to being the same or worse than it was before the project began. This is partly why community-engaged work is so important: researchers committed to the cause will continue as partners long after the funding is gone. And if grants from typical funders run out, academics will find other sources of support for community partners – such as by maintaining relationships with local philanthropies. (In Flint, such support has come from the C. S. Mott Foundation and Community Foundation of Greater Flint.)

Researchers often come to communities with a prepared study design, seeking approval rather than input – even when input could improve a study. Researchers assessing campaigns to promote healthy eating might include a control group that receives nothing, whereas the treatment group receives a suite of services and vouchers. This creates a perception of unfairness that can warp a study and discourage participation. Too often, researchers treat community partners who point out such risks as a barrier to progress, rather than as a liaison to a robust study. That attitude undermines future interactions. Establishing realistic expectations is one way to mitigate this issue.

Researchers might also offer to provide training in work that is already under way. For example, Flint has a crime-reduction programme in which residents proactively assess whether street lights are working and maintain vacant properties. Proposals that disregard what is already in place are wasteful and cause resentment. At one point, a team of researchers approached us to implement a healthy-eating project, not realizing that the Flint community had helped to develop the recipe book on which it was based. The Healthy Flint Research Coordinating Center now maintains an index of projects to discourage redundant work (one of R.C.S.’s tasks).

Before and especially during the water crisis, a string of ‘helicopter researchers’ from outside Flint came to study topics from environmental issues to violence. Community members were asked to fill out surveys, or learnt through informal chatter about researchers who wanted records about emergency hospitalizations. But data and insights were not brought back to the community. Many residents felt used and dismissed. The coordinating centre now works with researchers so their results can be applied to inform and improve the community where data were collected.

Interactions are generative: when academic researchers dismiss community ideas, take them without credit, bristle at valid input, ‘introduce’ programmes that are already in progress or focus more on producing papers than on helping communities, residents will expect the same of other researchers. Even those with the best of intentions can be rebuffed or face distrust, something R.C.S. was attuned to when he began his transition from Flint community member to academic.

Nurture relationships

Ideally, interactions become constructive feedback loops. In 2018, E.Y.L. provided health-plan data to R.C.S.. The resulting analysis using a geographic information system (GIS) showed, for the first time, that the centre of Flint was an asthma hotspot (see ‘ Asthma hotspots in Flint ’). This pattern correlates with historical sites of car factories and lead contamination in the soil (M. A. S. Laidlaw et al. Int. J. Environ. Res. Public Health 13 , 358; 2016). R.C.S. explored how best to show those patterns in ways that would be interpretable and helpful to community members. These results have informed targeted outreach activities, such as developing tailored materials based on local landmarks and identifying specific neighbourhoods, churches or community groups where the materials can be distributed.

Community–academic partnerships strengthened during Flint’s water crisis continue to bear fruit, such as revealing high rates of asthma in some areas. This helps to direct interventions such as mobile health units.

None of this would have happened without the partnership and trust we had built. The university needed access to health-plan data. Health-plan officials had to trust researchers to answer relevant questions, honour patient confidentiality and provide insight to accomplish the plan’s goal.

As the value of such analysis became clear, community members were eager for more. Most neighbourhood and community groups come together to solve a specific, immediate problem, not to form a self-sustaining, long-lasting organization, so they rarely consider mechanisms for collecting long-term data. Flint now sees community members approaching researchers; they seek to evaluate programmes that they’ve put into place. They want data to support the fact that they do good work and to show which efforts are most effective. A true partnership has been achieved.

The partnership represents many works in progress, far beyond what we describe here. There are still conflicts, miscommunication and lost opportunities. But we now know how to set ourselves up for success as projects emerge.

The most important ingredient in making collaborations work is commitment: to producing research that is relevant, and to understanding many angles and perspectives. This means spending less time and attention on conventional metrics, such as published papers, journal impact factors and procured grants, and much more on nurturing relationships. In true community-based partnerships, a paper is incomplete without a link back to the local community.

Although our experiences are specific to Flint, community–academic partnerships that focus on research that is relevant to policy are essential worldwide. Regions in the Rust Belt of North America, Eastern Europe and east Asia have all experienced population decline and economic problems. More will soon do so. Exploring solutions is of benefit both to researchers and to communities when they work together.

A medical assistant checks for the presence of lead in blood samples as part of a community campaign in Flint, Michigan.

JIM WEST/ALAMY

A local church in Flint was set up as a water distribution center because lead contamination had made the public supply unsafe.

TOM WILLIAMS/CQ ROLL CALL

The authors declare no competing interests.

Contributor Information

E. Yvonne Lewis, founder and chief executive of the National Center for African American Health Consciousness, Flint; co-community principal investigator at the Flint Center for Health Equity Solutions; co-director of the Healthy Flint Research Coordinating Center Community Core; and director of outreach, Genesee Health Plan, Flint, Michigan, USA.

Richard C. Sadler, Associate professor of public health at Michigan State University, Flint, Michigan, USA.

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How victims of the Flint water crisis helped protect abortion rights in Michigan | Opinion

By: Melissa Mays

This op-ed originally appeared in The Detroit Free Press on 05/16/24

Ten years ago, the life of every Flint resident took a perilous turn when the city, under the control of a state-appointed emergency manager, began using the Flint River as its municipal water source. 

Along with all the well-documented suffering, hardship and trauma we’ve experienced because of that fateful decision, there have been positive ripple effects we could never have foreseen flowing from our long and relentless fight for safe, affordable water.  

Those include protecting abortion rights for all Michiganders, and enabling victims of an unemployment benefits debacle to sue the state, and collect. Both of which I knew nothing about until last week, when I joined a panel discussion to commemorate the 10-year anniversary of the water crisis hosted by one of Flint’s most steadfast allies, the ACLU of Michigan. 

Flint water crisis lawsuit created legal precedent  

In 2016, I became the lead plaintiff in Mays v. Snyder, a lawsuit I and others brought against the state and some individuals in an attempt to gain some compensation for all the harm done to Flint residents.  

But there was a huge obstacle we had to clear: Because of governmental immunity laws and the vast protection they provide, the odds were stacked against us being able to get a judge’s OK to even proceed with the case.  

Fortunately, our legal team had two constitutional law experts – Julie Hurwitz and the late Bill Goodman – who devised an innovative approach that relied on “due process right to bodily integrity” in the Michigan constitution to overcome claims of governmental immunity. 

We prevailed because the courts rightly saw that the city pumping poisoned water into our homes denied Flint residents that fundamental right. Allowed to move forward, the case recently settled for more than $620 million, with 80% going to children who were harmed. But the "bodily integrity" ruling so crucial to our case, I learned, has had much broader impact. 

Read Full op-ed on freep.com

Flint resident and activist Melissa Mays is founder of the group Water You Fighting For and Flint Rising operations manager. 

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How victims of the Flint water crisis helped protect abortion rights in Michigan | Opinion

Ten years ago, the life of every Flint resident took a perilous turn when the city, under the control of a state-appointed emergency manager, began using the Flint River as its municipal water source.

Along with all the well-documented suffering, hardship and trauma we’ve experienced because of that fateful decision, there have been positive ripple effects we could never have foreseen flowing from our long and relentless fight for safe, affordable water.

Those include protecting abortion rights for all Michiganders, and enabling victims of an unemployment benefits debacle to sue the state, and collect. Both of which I knew nothing about until last week, when I joined a panel discussion to commemorate the 10-year anniversary of the water crisis hosted by one of Flint’s most steadfast allies, the ACLU of Michigan.

Flint water crisis lawsuit created legal precedent

In 2016, I became the lead plaintiff in Mays v. Snyder, a lawsuit I and others brought against the state and some individuals in an attempt to gain some compensation for all the harm done to Flint residents.

But there was a huge obstacle we had to clear: Because of governmental immunity laws and the vast protection they provide, the odds were stacked against us being able to get a judge’s OK to even proceed with the case.

Fortunately, our legal team had two constitutional law experts – Julie Hurwitz and the late Bill Goodman – who devised an innovative approach that relied on “due process right to bodily integrity” in the Michigan constitution to overcome claims of governmental immunity.

We prevailed because the courts rightly saw that the city pumping poisoned water into our homes denied Flint residents that fundamental right. Allowed to move forward, the case recently settled for more than $620 million, with 80% going to children who were harmed. But the "bodily integrity" ruling so crucial to our case, I learned, has had much broader impact.

(Unfortunately, the U.S. Department of Justice has, so far, continued to ignore the constitutional violations the EPA also was responsible for perpetuating. Instead, government lawyers are clinging to an ongoing claim of governmental immunity in the class action lawsuit we filed against the EPA.)

Court ruling aided Michigan abortion rights fight

I was happy to join the ACLU’s panel discussion. The ACLU came to our assistance when few were listening to the claims that something was terribly wrong with our water, and they’ve been fighting alongside us ever since.

As the discussion wrapped up, we mused about how difficult it can be to predict the ripple effect success can bring.

When we conducted the largest citizen-led study of tap water ever undertaken, we had no idea that effort would result in the issue of lead contamination receiving worldwide attention and igniting far-flung efforts to address the hazard, with lead pipe replacement programs going on in cities and schools across the nation.

A fellow panelist, ACLU of Michigan Deputy Legal Director Bonsitu Kitaba, told me something I’d been completely unaware of. She described how the decision in Mays v. Snyder played a pivotal role in the ACLU’s successful efforts to protect abortion rights in Michigan.

Kitaba explained that the ruling in our 2016 case was the first to affirm bodily autonomy as a right under the state constitution. Fast forward to 2022, when the ACLU of Michigan and Planned Parenthood of Michigan sued the state over its archaic 1931 abortion ban law. That lawsuit’s aim was to preserve the state constitutional right to abortion before the U.S. Supreme Court imminent decision to overturn Roe v. Wade.

The case was before the Michigan Court of Claims, where Judge Elizabeth Gleicher, using the reasoning in the Mays decision, found that the Michigan Constitution protected the right to abortion through the right to bodily integrity. That allowed the judge to issue a permanent injunction forbidding the state from enforcing Michigan's 1931 abortion ban and preserving access to this critical health care in Michigan after Roe fell.

I sat there, speechless. As a woman, reproductive rights are especially near and dear to my heart. To hear that our struggle helped protect those rights was overwhelming. Making it reverberate even more was the fact that the city’s use of the Flint River had, in a way, deprived many people who wanted to have children from doing so — as the Detroit Free Press previously reported , lead in the water had a significant negative impact on pregnancies:

“Fertility rates decreased by 12% among Flint women, and fetal death rates increased by 58%, after April 2014, according to research by assistant professors and health economists David Slusky at Kansas University and Daniel Grossman at West Virginia University.”

Anyone can join the fight for justice

So yes, Kitaba’s news blew me away. Then, another ACLU attorney pointed out that a written opinion by the former Chief Justice of the Michigan Supreme Court in our case was also successfully used in another hugely important class action against the state.

In Bauserman v. Unemployment Insurance Agency, the thousands of people wrongfully accused of unemployment fraud and denied unemployment insurance tried to sue the state because of its use of a flawed computer system. The state’s attorneys tried to argue that people were not even entitled to sue the State of Michigan to get compensation for wrongs like this. Lawyers at the ACLU and elsewhere relied on the chief justice’s opinion in our case to convince the Supreme Court to say — for the first time ever — that in most cases, Michiganders can sue their own government for compensation when the government violates rights guaranteed to them by the Michigan constitution.

Clearly, the impact of our efforts has indeed been, happily, far-reaching.

But what is the lesson in all this?

For me, it’s that you don’t have to be an expert to engage in the fight for social and economic justice. I knew little about water treatment, constitutional law or how to be an organizer before the disaster hit. I was a working mom who educated myself, then began educating and organizing others in an effort to right a terrible wrong.

You can do the same.

Flint resident and activist Melissa Mays is founder of the group Water You Fighting For and  Flint Rising operations manager. Submit a letter to the editor at freep.com/letters and we may publish it online or in print.

This article originally appeared on Detroit Free Press: Flint's water crisis case set precedent for abortion rights protection

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CD rates today, May 18, 2024 (best account provides 5.15% APY)

If you’re searching for today’s best CD rates, we’ve narrowed down some of the top offers. Learn more about CD rates today.

Vanguard 'nickel-and-dimes Grandma' after 49 years without junk fees

Vanguard has long had a reputation for eschewing the random fees asset managers are known for. But as our contributing columnist Allan Sloan notes, the company has started charging what he calls chintzy fees.

What is a student credit card and how do you pick one?

Learn how to choose a student card by evaluating the available rates, terms, rewards, and bonus offers.

The best portable power station for 2024 to help you prep for storms, blackouts and emergencies

Suitable for homes, apartments, RVs and more, these backup batteries are a modern must-have.

Deadly mpox outbreak abroad is a 'global threat,' CDC warns. Here's what to know.

The CDC is ramping up surveillance for mpox in the U.S., as a deadlier form of the disease spreads rapidly through the Democratic Republic of the Congo.

Adobe comes after indie game emulator Delta for copying its logo

After Apple loosened its App Store guidelines to permit game emulators, the retro game emulator Delta -- an app 10 years in the making -- hit the top of the App Store's charts. Delta's game emulator was built by developer Riley Testut, who had begun his experiments in this space by figuring out how to load games onto graphing calculators, before turning to iOS.

K-pop group NewJeans is at the center of messy feud: What to know

Breaking down the ongoing K-pop drama between ADOR CEO Min and Hybe.

Ben Affleck and Jennifer Lopez: What we know — and what we don't — amid rumors they're splitting

Is Ben Affleck and Jennifer Lopez's marriage over? There are a lot of rumors floating around about their union. Here's what we know.

The 27 best Walmart deals to shop this weekend — save up to 75% on early Memorial Day sales, summer essentials and more

Ready for your pre-summer perusal: A massive patio umbrella for over half off, a 65-inch Hisense smart TV for under $500 and a Keurig hot/iced coffeemaker for nearly $70 off.

New Yahoo News/YouGov poll shows why Biden-Trump rematch is still neck and neck

Right now, neither candidate is strong enough to capitalize on his opponent's flaws.

The best REI Anniversary Sale flash deals - 50% off on down jackets for the whole family and tents

REI's biggest sale of the year includes Flash Deals of 50% off on outdoor and camping essentials like down jackets for the whole family, down vests, and tents.

Surface Pro 10 for Business review: A safe upgrade for IT workers

The Surface Pro 10 for Business is basically just a chip upgrade over the previous model, but it’s still a thin, light and well-designed Windows tablet.

Driving 2024 Chevy Traverse, BMW X5 M Competition, Fiat 500e | Autoblog Podcast #832

This week's Autoblog Podcast covers the new Chevy Traverse, BMW X5 Competition, Fiat 500e, and EV news regarding Tesla, the Biden Administration and Toyota

LeBron James reportedly won't leave Lakers to join Bronny with another NBA team

LeBron James reportedly wouldn't join an NBA team who drafts his son Bronny. Previously, LeBron has said he wants to play his final season with his son.

Apple is said to be working on a 'significantly thinner' iPhone

The iPhone could be going the way of the iPad Pro by becoming much thinner next year. However, you'll may have to pay quite a lot for this rumored slender model, which may replace the Plus in the annual iPhone lineup.

OpenAI created a team to control 'superintelligent' AI — then let it wither, source says

OpenAI's Superalignment team, responsible for developing ways to govern and steer "superintelligent" AI systems, was promised 20% of the company's compute resources, according to a person from that team. It had the ambitious goal of solving the core technical challenges of controlling superintelligent AI in the next four years.

90th Anniversary Edition signals end of Jaguar F-Pace in Europe

Jaguar is sending off the F-Pace in global markets with a limited-edition model called 90th Anniversary Edition.

2024 Tight end rankings for fantasy football

The Yahoo Fantasy football analysts reveal their first tight end rankings for the 2024 NFL season.

2024 Wide Receiver rankings for fantasy football

The Yahoo Fantasy football analysts reveal their first wide receiver rankings for the 2024 NFL season.