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The Flint water crisis: An ongoing public health issue | Jul 06, 2017

Public health officials have a responsibility to understand, communicate and attempt to eliminate potential concerns facing the citizens and communities they serve. These professionals research certain social determinants and their overall impact on people’s quality of life when attempting to find solutions for health problems plaguing individuals.

In the past few years, the most basic resource of life – water – has been in crisis in the United States. Supply is generally dictated by physical environment, whereby unsafe drinking water can negatively affect a person’s overall health, life expectancy, cognitive ability and more.

Currently, the U.S. is dealing with ongoing water crisis issues in Flint, Michigan. This controversy plagues an area with a low-income community, making the problem that much more time-sensitive as these individuals lack access to clean drinking water. Let’s take a closer look:

The search for a cheaper water supply

Since the 1960s, the city of Flint, Michigan, received its water from the Detroit Water and Sewerage Department. In June 2012, officials began looking for a cheaper alternative. They eventually decided to construct their own pipeline to connect to the Karegnondi Water Authority – a move that would save the area around $200 million over 25 years, according to NPR.

Building the pipeline and ensuring the channel is functional would take some time, so the city made the Flint River its source of water in the interim, starting April 2014. By May, residents were making negative statements regarding the quality of the water, which not only emitted an unpleasant odor but was a different color than citizens were used to. In August, locals were instructed to boil their water, as E. coli and total coliform bacteria were found in the Flint water supply. The matter becomes worse in January 2015 when Flint violates the Safe Drinking Water Act due to the amount of disinfection byproducts, known as total trihalomethanes, found in the water, which can act as carcinogens for humans, according to the Centers for Disease Control and Prevention.

Lead detection in the water

February 2015 marked the first findings of high levels of lead in water stemming from the Flint River. Lee Anne Walters’ home was found to have lead content totaling 104 parts per billion, which was 89 parts over the Environmental Protection Agency’s limit for the substance in drinking water. Shortly after, the EPA discovered that the city did not have corrosion control treatment in place at its water treatment plant to ensure pipes weren’t affected by the new supply source.

In September of that year, a study completed by Virginia Tech University found serious lead levels in Flint, which were corroborated by another analysis from Hurley Medical Center. The latter report specifically found elevated lead levels in children under the age of five. Flint issued a lead advisory at the end of that month, and started providing free water filters and testing to the community in October.

Although the city reverted to a Detroit water supply by October 2016, the damage caused was enough to trigger Karen Weaver, the mayor of Flint, to declare a state of emergency on Dec. 16, 2015. That course of action was quickly followed by Michigan Governor Rick Snyder, as well as President Barack Obama. As a result of the commander in chief’s declaration, the Federal Emergency Management Agency can provide the necessary relief and resources to citizens of Flint.

The EPA also distributed an emergency order in an effort for additional action in Flint.

A federal investigation

In February 2016 – a year after the lead was first found in Flint’s water supply – several city officials began to testify regarding the Flint water crisis in front of the House Committee on Oversight and Government Reform. Governor Snyder and Michigan EPA Administrator Gina McCarthy gave their testimony mid-month, before an independent task force found the primary blame falls on state officials, including Flint emergency managers, the governor and the Department of Health and Human Services.

Starting in April, criminal charges were filed against various officials and two corporations by Michigan Attorney General Bill Schuette:

  • Stephen Busch and Michael Prysby: MDEQ state officials.
  • Michael Glasgow: City employee and Flint water quality supervisor.
  • Liane Shekter-Smith: Former director of drinking water and municipal assistance office at MDEQ.
  • Adam Rosenthal and Patrick Cook: Along with Shekter-Smith, they knew about the lack of compliance of Flint’s water treatment plant with lead and copper regulations and misled city and state officials.
  • Nancy Peele: Director of the child health unit.
  • Robert Scott: Peele’s subordinate.
  • Corinne Miller: State epidemiologist, who along with Peele and Scott decided not to release a report showing unsafe levels of lead in the bloodstream of the children of Flint.
  • Veolia: Water-quality consulting company.
  • Lockwood, Andrews & Newman: Firm that aided in operation of Flint water treatment plant.

More charges came in December from Schuette’s office. Those under fire include emergency managers Darnell Earley and Gerald Ambrose, as well as Howard Croft, public works superintendent, and Daugherty Johnson, the utilities administrator, according to the Detroit Free Press.

A period of denial

To make matters worse in the Flint case, various Michigan-based health and environmental organizations have attempted to discredit the nature of the crisis.

To begin, the state Department of Environmental Quality’s initial report regarding lead levels in the Flint water supply excluded two samples that showed the amounts were over the federal action limit. Lacking these two indicators, the water crisis raged on far longer than it needed to, without national government interference.

MDEQ spokesman Brad Wurfel denied the problem on two separate occasions – first, after the results from Lee Anne Walters’ home showed high lead levels, and second, after the results from the Virginia Tech study were published. Michigan’s Department of Health and Human Services also attributed to the higher lead levels to a source other than the water supply: seasonal changes, they claimed, could be to blame.

Wurfel’s continued dismissal of the problem and the eventual revelation of the seriousness of the crisis led him and MDEQ Director Dan Wyant to resign in December 2015.

A strategy for the future

Following his testimony, Governor Snyder released a plan of action to help the citizens of Flint on March 21. The program offered the following public health services to the citizens of the city, among others:

  • Professional support and case management for children under the age of 6 with high blood lead levels.
  • Addition of three extra Child and Adolescent Health Centers in Flint.
  • Replace water faucets and fixtures in public places that are connected to the Flint water supply.
  • Institute and comply with a higher standard than existing federal Lead & Copper Rule in Flint and all other Michigan communities
  • Plan for future connection to Karegnondi Water Authority with assistance from city and county.
  • Provide children of Flint under the age of six with screenings for behavioral health needs.

Lead levels in the water continued to improve, but additional research from Virginia Tech found the water was still unsafe to drink as of April 2016.

Moving forward

On January 24, 2017, Flint’s water was finally found to be below the federal limit for lead – a full two years after city residents first complained about health issues caused by the supply, and after more than 1,000 days without clean drinking water. Despite this positive news, however, residents are still being advised to use filtered water for drinking and cooking, according to The Washington Post.

Following the end of the water bill subsidy program in March, President Trump met with Mayor Weaver to discuss the future funding for Flint.

Continued actions to counterbalance the effects of the water issue were implemented as well. First, Gov. Snyder started the Child Lead Exposure Elimination Commission to prevent lead poisoning in the future. Next, the state received approval for $97 million to remove and replace water lines with lead contamination for around 18,000 homes in the city over a three-year period. Lastly, a $100 million grant from Congress is intended to remove lead piping at 6,000 more Flint homes.

Residents and local, city, state and public health officials are still on alert. Until all lead pipes are replaced, Flint is still dealing with the repercussions of the tainted water supply. Earning back the community’s trust will likely be an even harder uphill battle.

A public health initiative

When President Obama visited the city in May 2016, he cited an unfair regularity of low-income areas being at greater risk for issues like the contaminated water supply in Flint – where more than 40 percent of citizens live in poverty.

“We especially underinvest when the communities that are put at risk are poor, or don’t have a lot of political clout, and so are often not as heard in the corridors of power,” Obama said. “This kind of thinking — this myth that government’s always the enemy — that forgets that our government is us. It’s us. That it’s an extension of us, ourselves.”

This statement – and the water crisis, in general – demonstrate a need for public health officials to pay even closer attention to poor areas where social determinants are waging war on life expectancies and the overall health of citizens. Professionals in this field have a responsibility in maintaining a level of trust with individuals, especially when it pertains to something as important as their health.

Students who earn a Master of Public Health from the University of Arizona can utilize their education and expertise to make a difference in communities like Flint, both nationwide and around the world.

Recommended Readings:
Social Determinants and Their Effects on Quality of Life
Five Countries with the Greatest Water Scarcity Issues
Use your MPH to Become a Health Educator

Sources:

http://www.who.int/hia/evidence/doh/en/

https://www.cdc.gov/safewater/publications_pages/thm.pdf

http://www.npr.org/sections/thetwo-way/2016/04/20/465545378/lead-laced-water-in-flint-a-step-by-step-look-at-the-makings-of-a-crisis

http://www.michigan.gov/snyder/0,4668,7-277-66946-379415–,00.html

http://www.freep.com/story/news/local/michigan/flint-water-crisis/2016/12/20/schuette-flint-water-charges/95644964/

http://www.cnn.com/2016/05/04/politics/obama-flint-michigan-visit/index.html

https://www.washingtonpost.com/news/post-nation/wp/2017/01/24/flint-water-falls-below-federal-lead-limits-but-residents-still-asked-to-use-filtered-water/?utm_term=.8b03feaea258

http://www.cnn.com/2016/03/04/us/flint-water-crisis-fast-facts/index.html