Flint Water Crisis Research Articles

Environmental Racism and the Contamination of Black Lives: A Literature Review

Exclusionary housing policies concentrate housing inequities, disproportionately exposing Black communities to environmental pollutants, and isolating them from essential health resources (Dimick et al. 2013). For this study, a literature review was conducted to explore how environmental racism has contaminated Black lives and to understand the policy failures that have perpetuated these inequities. Using case study methodology, this paper highlights three specific events to illustrate the contamination of Black lives: toxic wells in Dickinson County, Tennessee; coke plants in North Birmingham, Alabama; and the water crisis in Flint, Michigan. The central policy failures in these cases were delayed response, misinformation, weak enforcement of regulations, and inadequate solutions provided by environmental health officials. Future research should focus on the intersection of environmental hazards, community trust, and the effectiveness of prevention strategies in Black communities. Environmental health officials should focus on transparency, accountability, and equal protection for all lives.

Navigating Troubled Waters: Applying the IDEA Model to the Flint Water Crisis

This study examines the instructional crisis communication surrounding the water crisis in Flint, Michigan. Although pre-crisis government communications were widely criticized for their failure to adequately warn the public about dangerous levels of lead and other carcinogenic chemicals in Flint’s water, instructional messaging during the crisis has not received the same level of attention. This study employs qualitative content analysis to examine the website content from the EPA, U.S. Department of Health and Human Services, Michigan governor’s office, Genesee County Health Department, and Flint mayor’s office through the lens of the IDEA model during the height of the crisis. The instructional content published to these agencies’ websites fits within the IDEA model framework and serves as effective instructional communication about the health concerns facing residents. Explanation and action were most prominently featured across the content, although internalization strategies were also used to varying degrees. The content was distributed and widely shared across agency websites, especially at the federal and state level. Future areas of research include how semantic and rhetorical choices in message content and structure may enhance elements within the IDEA model and how using images can increase message effectiveness.

Credit Access and Mobility during the Flint Water Crisis

How do credit-constrained communities cope with the financial consequences of environmental crises? Beginning in April 2014, the residents of Flint, Michigan, were exposed to lead-contaminated water resulting from a series of governmental missteps. In this paper, we use the spatial distribution of lead and galvanized pipes in Flint to study the effect of the crisis on households’ financial health, including loan balances, repayment of outstanding debt, and Equifax Risk Scores, as well as on household mobility. We find that relatively more affected households, as measured by exposure to lead pipes, experienced a modest increase in the balance and frequency of past due loans. Equifax Risk Scores declined slightly on average, but more so at the bottom of the Risk Score distribution. In addition, we find that there was no effect on mobility out of the state or county, but that more affected households were more likely to move within the city when the crisis began, away from lead-pipe-dense areas.

Stories of Leadership, Good and Bad: Another Modest Proposal for Teaching Leadership in Law Schools

Stories of Leadership, Good and Bad: Another Modest Proposal for Teaching Leadership in Law Schools

Role of social connectedness in response to a public health crisis: The case study of the Flint water crisis

Role of social connectedness in response to a public health crisis: The case study of the Flint water crisis

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.

Building a “Stately Pleasure Dome”

The industrial heritage attraction known as AutoWorld, which opened in downtown Flint in July 1984, was intended to lure businesses and tourists to a struggling city. Yet just six months after opening, AutoWorld closed. This essay explores AutoWorld’s creation, its exhibits, and why audiences rejected it. I argue that this “half museum” and “half theme park” prioritized the auto industry’s agenda and white suburbanites over the needs of Flint residents. In doing so, I trace the connections between AutoWorld and the Flint Water Crisis, the origins of which are partially rooted in the subsidization of the auto industry’s expansion to the Flint suburbs. Because of misguided planning initiatives like AutoWorld, as well as the criminal enabling of the water crisis, the foundation of trust between Flint residents and those who operate the city’s institutions has been severely weakened.

Trust

The water crisis in Flint, Mich., happened more than six years ago, but it seems like it will take a generation or more for customer confidence in the area to be restored. Flint is a case study of what happens when nonwater professionals like emergency city managers or state officials make technical decisions based on financial drivers; in Flint, leadership went even further by ignoring the pleas of concerned community members. It's here—when its voices were ignored by so many trusted institutions—that the public's trust was lost. Communities care about their local water supply challenges, affordability issues, and potential health threats, and they trust that the water industry will address and resolve any issues before they disrupt normal services. In the water industry, it is especially hard to rebuild a community's trust if it is ever broken. But what does it take for a utility to earn back trust that is lost? If we look at other communities, we see the answer is competency, transparency, and better representation. The answer is also money, and in Flint's case, that includes a recent US$600 million settlement with the state, with most of the money being dedicated to addressing the health and education needs of children affected by lead. While Flint's problems began in spring 2014, in a 2013 article in Journal AWWA, I wrote, “Transparency helps gain the trust of stakeholders, and public involvement and collaboration can increase the overall community benefits of addressing the costs of system stewardship.” This wasn't forward-thinking, this was the thinking of the day—and that thinking is still true. Communities need to understand the systems that serve them and be involved in decisions that affect their health and livelihoods. But once a path is determined, they need to let the standards and norms of the water industry drive implementation, operation, and management—with the understanding that they will be heard if there are problems. Ongoing community engagement and outreach across income and racial demographics ensures all stakeholders understand their water systems and share responsibility for their protection. AWWA understands that utilities need to instill trust in the communities they serve, and recently the association expanded its strategic plan to specifically mention strengthening public trust. Moving forward, AWWA will expand its efforts to help utilities better connect with the communities that rely on the water industry's expertise to deliver safe, reliable water. This month's Journal AWWA features a range of topics, including examples of how utilities have responded to the challenges of PFAS, cyanotoxins, lead service lines, and more. Please consider sharing your perspectives and experiences to improve the water industry by writing me at journaleditor@awwa.org.

P81 Family planning and the Flint water crisis

Objectives: In 2014, officials in Flint, Michigan changed the city’s water source to reduce costs, exposing residents to legionella, lead, and other bacteria. We sought to understand the impacts of water contamination on residents’ reproductive health outcomes and decision-making.

The pervasive threat of lead (Pb) in drinking water: Unmasking and pursuing scientific factors that govern lead release.

The Flint water crisis raised questions about the factors resulting in unacceptable soluble lead concentrations in the city’s drinking water. Although water treatment strategies, failure to follow regulations, and unethical behavior were all factors, knowledge deficits at the intersection of several scientific fields also contributed to the crisis. Pursuit of opportunities to address unresolved scientific questions can help avert future lead poisoning disasters. Such advances will enable scientifically based, data-driven risk assessments that inform decisions involving drinking water systems. In this way, managers and decision makers can anticipate, monitor, and prevent future lead in water crises.

Interactive Effects of Copper Pipe, Stagnation, Corrosion Control, and Disinfectant Residual Influenced Reduction of Legionella pneumophila during Simulations of the Flint Water Crisis.

Flint, MI experienced two outbreaks of Legionnaires’ Disease (LD) during the summers of 2014 and 2015, coinciding with use of Flint River as a drinking water source without corrosion control. Using simulated distribution systems (SDSs) followed by stagnant simulated premise (i.e., building) plumbing reactors (SPPRs) containing cross-linked polyethylene (PEX) or copper pipe, we reproduced trends in water chemistry and Legionella proliferation observed in the field when Flint River versus Detroit water were used before, during, and after the outbreak. Specifically, due to high chlorine demand in the SDSs, SPPRs with treated Flint River water were chlorine deficient and had elevated L. pneumophila numbers in the PEX condition. SPPRs with Detroit water, which had lower chlorine demand and higher residual chlorine, lost all culturable L. pneumophila within two months. L. pneumophila also diminished more rapidly with time in Flint River SPPRs with copper pipe, presumably due to the bacteriostatic properties of elevated copper concentrations caused by lack of corrosion control and stagnation. This study confirms hypothesized mechanisms by which the switch in water chemistry, pipe materials, and different flow patterns in Flint premise plumbing may have contributed to observed LD outbreak patterns.

Retrospective blood lead assessment from archived clotted erythrocyte fraction in a cohort of lead-exposed mother-child dyads

Exposure to lead (Pb) is linked to a host of adverse health effects. Recent revelations of unmonitored exposures to hazardous levels of lead as seen in the Flint Water Crisis have manifested a need for evaluating biological samples, other than regularly prepared whole blood, for biomonitoring of lead exposure. Here, we present a method utilizing clotted erythrocyte fraction samples, which are commonly archived along with serum (or plasma) in biorepositories, to predict whole blood lead levels to allow for retrospective assessments of environmental exposure to lead. Whole blood and clotted erythrocyte fraction samples were collected from 91 participants in the Airborne Exposure to Semivolatile Organic Pollutants (AESOP) cohort study of mother-child dyads. Clotted erythrocyte fraction samples were prepared either using microwave assisted acid digestion or alkaline dilution and subsequently analyzed for lead using Inductively-couple plasma-mass spectrometry (ICP-MS). Simultaneously withdrawn whole blood samples were also analyzed. A strong linear relationship was observed between lead in whole blood and clotted erythrocyte fraction with Pearson correlation coefficients (r) of 0.90, and 0.89 (p < 0.001) for acid digestion and alkaline dilution, respectively. Slopes and intercepts from simple linear regression models of the two clotted erythrocyte fraction methods were not found to be significantly different (p > 0.05) when compared to the standard blood lead assay method. Modeled blood lead predicted from clotted erythrocyte fraction was evaluated at a test threshold of 3 μg/dL was found to have diagnostic sensitivity of 88% and specificity of 100%. Results from this study demonstrate clotted erythrocyte fraction samples are a viable alternative biological sample for retrospective public health surveillance of environmental exposure to lead.

Seeing the “Unseeable,” A Student-Led Activity to Identify Metals in Drinking Water

Municipal drinking water, regulated by the Environmental Protection Agency via the Safe Drinking Water act, has long been assumed to be contaminant-free. However, crises related to drinking water have emerged, most notably the “Flint Water Crisis” in Flint, MI, where high levels of lead (Pb) were detected in the area’s water. Much of the water-sampling data collected in Flint was obtained by “Citizen Scientists” working closely with a team of researchers at Virginia Tech, who used the analytical technique of Inductively Coupled Plasma Mass Spectrometry (ICP-MS) to quantify metal ions present in the water. Inspired by these efforts, we developed adaptable public water testing outreach efforts, led by students in Baltimore city (Middle School, High School, and College), to test the city’s drinking water. These “student-scientists” read news and scientific articles to understand the public health impact of lead in drinking water and the analytical approaches scientists use to detect metal ions in water. The students then developed a written “water collection protocol” and sought participation from colleagues (other students, faculty, and staff) who collected their home drinking water to be tested. The student scientists prepared and analyzed samples for lead (Pb) as well as copper (Cu), iron (Fe), and zinc (Zn) metal ions commonly found in drinking water, to be tested via ICP-MS. Data were then plotted onto a map of Baltimore City, with the metal levels indicated for each Zip code. This outreach event connects science to real-life news events while teaching analytical methodology and can be tailored to students at various stages of their education.

Stress, Coping, Resilience and Trust during the Flint Water Crisis

In 2014, government officials in the City of Flint, Michigan switched the municipal water source from the Detroit Water System (water source: Lake Huron) to the Flint River. During this time, an estimated 102,000 Flint residents were potentially exposed to multiple chemical (e.g., lead) and biological threats (e.g., Legionella). After the switch to water sourced from the Flint River, Flint residents consistently reported concerns over water quality while also experiencing rashes, hair loss, and other health problems, including anxiety and depression. This study 1) reports on the Flint Water Crisis and its subsequent impact on residents’ stress, coping, resilience and trust and 2) describes a process methodology that trained, hired and deployed Flint residents as members of a multidisciplinary research team. A random sample of 320 Flint residents underwent household-based interviews to assess their health and mental health needs. Concomitantly, household water samples were obtained and residents were connected to known resources based on interview responses relative to need. This study found that declines in health and mental health status were correlated with increased stressors (i.e., fatigue, financial concern, anxiety), coping and less resilience or the capacity to recover. Perceived trust in government officials was significantly lower after the water crisis. While the water crisis generated numerous stressors, the event also galvanized community competence to engage in solution-focused coping and other adaptive capacities. By assessing and building upon Flint residents’ resilience, community resource specialists, identified and subsequently strengthened city residents’ ability to survive devastating challenges.

Flint, Michigan, and the Politics of Safe Drinking Water in the United States

Flint’s drinking water crisis has brought renewed⸺and needed⸺attention to the importance of safe drinking water in the United States. The Flint water crisis was the result of a confluence of factors operating at multiple scales in time and space. My aim is to draw out more explicitly the role of policy, and specifically rationalized policy, in incentivizing and allowing the mistakes and decisions that most proximately led to the Flint water crisis. I build on and extend existing analyses of the Flint water crisis, drawing on thirteen semi-structured interviews and publicly available reports, testimony, newspaper articles, and secondary data. My analysis brings to the fore the particular vulnerability to the marginalizing effects of rationalized policy and its implementation of poor and minority communities in the United States, and it reveals the stickiness and entrenchment of these rationalized policies. The response to the Flint water crisis, both in Michigan and nationally, has centered on renewed commitment to risk-based standards and rulemaking for safe drinking water protections, and maintains interventionist approaches to municipal financial distress. I discuss important alternatives that are emerging and indicate areas for future research on the politics of safe drinking water.

P115 Breastfeeding Peer Counselors: Support Mothers Can Trust

<h3>Objective</h3> The Flint water crisis left many mothers of all income levels with limited trust in outside resources. With the support of the Greater Flint Community Foundation, a peer counselor was hired to support breastfeeding mothers. A peer counselor is a local mother representative of the community who has already developed trust within the community. This study looks at the effectiveness of community-funded breastfeeding peer counselors representative of their communities. <h3>Use of Theory or Research</h3> One of the most highly effective preventative measures a mother can take to protect the health of her infant is to breastfeed. In the US, 81% of babies initiate breastfeeding; 22% are exclusively breastfed 6 months later. According to the CDC, peer support programs are effective in increasing initiation, duration, and exclusivity of breastfeeding. Peer counseling is rooted in the theory of reasoned action which recognizes the influence of peers on individual behavior. Breastfeeding peer counselors help to normalize breastfeeding within their own community. <h3>Target Audience</h3> Pregnant and breastfeeding women who reside in Flint, Michigan. <h3>Program Description</h3> The peer counselor provided evidence-based education and support to increase initiation, duration, and exclusivity. The peer counselor educated, supported, and encouraged women to continue breastfeeding exclusively for 6 months and continue until at least 1 year of age. The peer counselor conducted home visits and was available during evenings and weekends. The number of visits varied depending on the needs of the mother. If possible, at least 1 visit was completed prenatally and minimally 1 visit within the first week after delivery. Additional contacts were provided through home visits, phone calls and FaceTime during the immediate postpartum period when one‐on‐one support for initiation of breastfeeding is critical. <h3>Evaluation Methods</h3> Women were recruited through referrals from a variety of community agencies that work with families in the city of Flint. Demographic (age, race, ethnicity, income), initiation, duration, and exclusivity information was collected from all participants who enrolled in program. <h3>Results</h3> Fifty presentations on benefits of breastfeeding reached 547 families between September 2018 – September 2019. Of the 103 mothers enrolled in the program, 98% initiated breastfeeding and 76% were still breastfeeding at 6 months. <h3>Conclusions</h3> Home visiting peer counselors were effective in promoting breastfeeding success in mothers in Flint. Many participants mentioned the importance of the peer counselor being a trusted mother representative of their community. This strategy should continue to be utilized and expanded to improve breastfeeding rates.

In‐Home Tap Water Consumption Trends Changed Among U.S. Children, but Not Adults, Between 2007 and 2016

AbstractDespite evidence that tap water is often safer and cheaper than alternative sources, tap water is avoided when perceived to be unsafe. Therefore, we conducted the first nationally representative U.S. trends analysis of in‐home tap water avoidance between 2007 and 2016. We tested whether changes occurred during/after the Flint water crisis, and whether not drinking tap from one's main water source differed by age, race/ethnicity, and socioeconomic status across time. Finally, we tested whether tap water avoidance was associated with higher prevalence of bottled water consumption among children. We used data on 12,915 children and 23,139 adults from the National Health and Nutrition Examination Survey. Significant covariate‐adjusted quadratic time trends were found in the prevalence of avoiding tap water with an inflection at 2013–2014 for children, but not adults. Piecewise log‐binomial regressions estimated that between 2007 and 2014 each survey cycle was associated with 14% lower prevalence of not drinking tap water (prevalence ratio [PR] 0.86, 95% CI: 0.80–0.93), but in 2014–2016 a 53% (95% CI: 1.12–2.09) higher prevalence was found for children corresponding to the water crisis. Younger children, Hispanic, non‐Hispanic black, and those from low socioeconomic status backgrounds had consistently higher probability of avoiding tap water over time. Children who avoided tap water had 92% higher prevalence of drinking bottled water. In 2015–2016, 78% of non‐Hispanic black children who avoided tap water drank bottled water on a given day. Avoiding tap water may indicate underlying water insecurity in the United States. Efforts to address tap water distrust have critical health and economic implications.

Developing an Ion-Selective Electrode Membrane Sensor to Detect Lead Levels in Drinking Water

Lead contamination in drinking water is often a close-to-home contamination caused by corroded lead service pipes connecting households to main lines or lead-based pluming within the households. This is particularly evident in houses built prior to 1986 when the United States Environmental Protection Agency (EPA) amended the Safe Drinking Water Act (SDWA) to prohibit the use of any lead-based pipe. Despite the legally established action limit of lead level of 15 parts-per-billion (ppb) in drinking water, incidents with disastrous consequences have occurred repeatedly (e.g. water crisis in Flint, Michigan). The objective of this research is to develop a polymeric ion-selective electrode (ISE) for the detection of lead levels at the EPA action level, or 10-9 molar concentration (M). Primarily, various ratios of sodium tetraphenylborate, resin powder, and lead-selective ionophore were considered and investigated to accomplish this goal. Two commercially available ionophores (Dibenzo-18-Crown-6 and Tert-Butylcalix(4)Arene-Tetrakis) were investigated as well as a synthesized poly (AN-co-HSA) copolyaniline ionophore. The commercially available ionophores were able to consistently achieve a limit of detection (LOD) of 10-6 M when used for the ISE electrode while the synthesized ionophore showed a less consistent LOD between 10-6 M and 10-9 M.

The Role of the Legal System in the Flint Water Crisis.

Policy Points A major factor explaining government actors' failure to mitigate or avert the Flint, Michigan, water crisis is the sheer complexity of the laws regulating how governmental agencies maintain and monitor safe drinking water. Coordination across agencies is essential in dealing with multiple legal arrangements. Public health legal authority and intervention mechanisms are not self-executing. Legal preparedness is essential to efficiently navigating complex legal frameworks to address public health threats. The Flint water crisis demonstrates the importance of democracy for protecting the public's health. Laws responding to municipal fiscal distress must be consistent with expected norms of democracy and require consideration of public health in decision making. Context The Flint, Michigan, water crisis resulted from a state-appointed emergency financial manager's cost-driven decision to switch Flint's water source to the Flint River. Ostensibly designed to address Flint's long-standing financial crisis, the switch instead created a public health emergency. A major factor explaining why the crisis unfolded as it did is the complex array of laws regulating how governmental agencies maintain and monitor safe drinking water. Methods We analyzed these legal arrangements to identify what legal authority state, local, and federal public health and environmental agencies could have used to avert or mitigate the crisis and recommend changes to relevant laws and their implementation. First, we mapped the legal authority and roles of federal, state, and local agencies responsible for safe drinking water and the public's health-that is, the existing legal environment. Then we examined how Michigan's emergency manager law altered the existing legal arrangements, leading to decisions that ignored the community's long-term health. Juxtaposed on those factors, we considered how federalism and the relationship between state and local governments influenced public officials during the crisis. Findings The complex legal arrangements governing public health and safe drinking water, combined with a lack of legal preparedness (the capacity to use law effectively) among governmental officials, impeded timely and effective actions to mitigate or avert the crisis. The emergency manager's virtually unfettered legal authority in Flint exacerbated the existing complexity and deprived residents of a democratically accountable local government. Conclusions Our analysis reveals flaws in both the legal structure and how the laws were implemented that simultaneously failed to stop and substantially exacerbated the crisis. Policymakers need to examine the legal framework in their jurisdictions and take appropriate steps to avoid similar disasters. Addressing the implementation failures, including legal preparedness, should likewise be a priority for preventing future similar crises.

The Flint water crisis: local reporting, community attachment, and environmental justice

ABSTRACT This study examines local news reporting about the Flint water crisis. The analysis is based on in-depth interviews with local reporters to explore journalistic practices and perceptions of the crisis. The study utilised a framework grounded in concepts from community journalism and crisis reporting, as well as environmental justice and racism scholarship. The qualitative thematic analysis centres around four themes: coverage practices and professionalism, resources and challenges, connections to place, and environmental justice and racism. The results reveal that the crisis served as a catalyst for some news organisations to make substantial investments in their newsrooms; but this was not the case for small organisations that depend mostly on grant-funding. Local reporters generally claimed that despite their attachment to the Flint community, they maintained their normal journalistic standards. However, some reporters struggled to separate their personal experiences from their professional practices, evidence consistent with prior studies on crisis reporting. Reporters demonstrated empathy towards victims impacted by the water crisis, and this heightened their distrust towards official sources and motivated their outreach efforts. Finally, for those reporters, their ideologies were largely consistent with both historical and emerging claims on environmental justice and environmental racism, that persons of colour, minority populations, and poor neighbourhoods in cities are more likely to suffer from environmental hazards compared to white and more affluent communities. Suggestions for crisis reporting in environmental justice contexts are discussed.