Front Lines, Front Pages

Front Lines, Front Pages

When word broke last fall that the water supply in Flint, Michigan, had been contaminated with lead as a result of a switch in the city’s water supply in 2014, the state’s seventh-largest city became a global news story. U-M SPH alumni, aculty, students, and staff are at the forefront of efforts to address the crisis.

In April, SPH Dean Martin Philbert established a Flint Task Force to partner with the Flint community; with local, state, and federal agencies; and with other U-M faculty to investigate best-practice, sustainable solutions to protect the health of Flint residents. For updates visit Addressing the Public Health Crisis in Flint. Here, members of the U-M SPH community weigh in on the emergency. We wanted to know, what lessons have you learned? What’s next?

Governmental public health is not set up to make quick assessments and quick decisions, especially a public health department like the one in Genesee County, which has been so eviscerated financially. But the question of ethical responsibility is something we have to deal with. At what point do people have an ethical obligation to abrogate a technical role and take on the role of public advocates? These are questions people need to ask. In my view, it’s better to err on the side of overly communicating than waiting until you know for sure that every element you’re saying about prevention or secondary prevention is actually on point.

Another lesson to be learned is that sometimes you don’t need to know who to punish—you just have to figure out what happened and get it fixed. So it never happens again. The Flint community needs to rebuild and heal, physically, mentally, psychologically, economically, and socially. Our obligation is to use our body of knowledge and our energy to carry this out. Solutions can only be found and implemented as a team. No one person or organization has all the answers.

Peter Levine, MPH ’80, Executive Director, Genesee County Medical Society

Health doesn’t just happen in a doctor’s office, it happens in all sectors of the community. I don’t believe we would be at the current action level responding to the crisis in Flint if our community’s health care leaders—doctors, hospitals—as well as university and business leaders hadn’t come together to identify the health risks and speak out with urgency to address this. We’re so fortunate in Flint that we have strong partnerships and the kind of collaborative infrastructure that the public health world increasingly suggests is necessary to address population health issues. We talk about the importance of infrastructure, of funding public health on a national scale and on a state and local scale. And yet it’s always the first thing that is cut, or one of the first things. We can’t do that anymore.

Kirk Smith, MHSA ’08, President and CEO, Greater Flint Health Coalition

We need to invest and prioritize in the evidence-based interventions that will mitigate this exposure, that will promote childhood development, and that will build childhood resilience. We are trying to flip the story. We’re trying to build that model public health program. Because these kids did absolutely nothing wrong. Their only fault was that they lived in a poor city that was almost bankrupt and that didn’t treat their water. So we have to be their advocates. Our goal is that our kids have a much better tomorrow than even their yesterday was.

Mona Hanna-Attisha, MD, MPH ’08, Program Director, Pediatric Residency, Hurley Children’s Hospital, Hurley Medical Center, MSU College of Human Medicine, Department of Pediatrics and Human Development

If we’re thinking about a solution, I’d like to think about something that’s scalable. Flint is not the only place in the U.S. that has had a problem. Back in November of 2000, the city of Washington, D.C., made a technical decision to switch their water purification process from using chlorine to a chemical called chloramine. Basically that change in the chemistry, without an appropriate adjustment in buffering, resulted in significant elevations in blood lead for all the same reasons that occurred in Flint. But that decision wasn’t imposed by an emergency manager, it was self-inflicted. It also wasn’t publicly disclosed for three years. So here we have an unfortuante example where, for different reasons, the same problem emerged. In fact, there are lots of cities where this has happened in the past 10 or 15 years. This is not rare, unfortunately. There are examples of solutions, such as the city of Lansing, Michigan, which has been replacing its lead-service lines over the last decade. This is a case that merits further study and could serve as an example for the rest of Michigan and the entire country.

Al Franzblau, MD, Professor of Environmental Health Sciences, U-M SPH

For me, the takeaway from Flint is that we need our government agencies to be empowered to advocate for the public’s health. In Flint, we had the example of an Environmental Protection Agency staff member, Miguel Del Toral, who advocated protective measures, but then administrative decisions blocked appropriate follow-up action. So the right thing happened, and the wrong thing happened. Regardless, it’s important that people recognize that the EPA is necessary and must be an advocate for public health protection. And if we don’t like what the EPA is doing, we need to be talking to our legislators and other government officials. y colleagues and

I in the Michigan Center on Lifestage Environmental Exposures and Disease are especially concerned about the Flint water contamination because the very young, including the unborn, are much more sensitive to the toxic actions of lead. Even at low levels, children’s brains, especially, are vulnerable to lead exposure.

Rita Loch-Caruso, Professor of Environmental Health Sciences, U-M SPH; Director, Michigan Center on Lifestage Environmental Exposures and Disease