Could It Happen Here? Lessons From The Flint Water Crisis… Katrinell m. davis, ph.d. Department of sociology & African American studies

Why Lead matters Attributed to: *Learning disabilities *Shortened attention span *Lower IQ *Asthma *Growth delays *Death Learning and Reading Disabilities; Loss of IQ, Hearing Loss • Attention Deficit Disorder; Hyperactivitity, Speech Delays • 7 times more likely to drop out of school • 6 times more likely to be involved with the juvenile justice system

The Vulnerability of Children Developmental risk: *greater absorption due to developing body Ingestion: *most common route Routine Risk: *put objects in their mouth (pica)

Various policies were passed to restrict the use of lead in paint, gasoline, plumbing and consumer products. The League of Nations banned the use of lead paint in 1922 U.S. did not ban the use of lead paint in homes until 1978. Lead in gasoline 73-95, solder was banned in 1986 In 1974, Congress passed the Safe Drinking Water Act that requires the EPA to an enforceable maximum contaminant level (MCL) to determine the level of contaminants in drinking water that does not cause adverse health effects. Effective January 1, 1996, the Clean Air Act banned the sale of the small amount of leaded fuel that was still available in some parts of the country for use in on-road vehicles. EPA said fuel ... Consumer Product Safety Improvement Act of 2008, Section 101 • Lead content of product components • Lead content of paint

Racial Variations in Lead Poisoning, 1988-2014

Why Neglect Matters: Disproportionate Health Effects of Raced Space

Lead Contaminated Water in Flint, Michigan Was it intentional? Was it avoidable?

Michigan’s Childhood Lead Poisoning Prevention Program Medicaid Policy *All Medicaid covered children considered at high risk *State requires that all Medicaid-covered children, 1-2 years, be tested for blood lead *CMS mandates that by age 6, Medicaid-covered child be tested Michigan law (Public Act 286 of 2006) *Requires children in the Supplemental Food Program for WIC be tested for blood lead

The Population

My Plan with MDHHS Data 1) Follow up Testing in Genesee County How do follow up testing attempts vary according to: Demographic (adding housing instability) Residence (Flint residence) Timing (3 or 6 month recommendation) 2) Incidence and effect of BLL ≥5 µg/dL How does low level lead exposure vary according to: Demographic Political capacity (voter turn out rates, % owner occupied) Neighborhood quality (distance from: Brownfields, Water Main Breaks, and Residential Water Lead Levels)

Shifts in Lead Poisoning Action Levels * CDC established a new blood lead reference level of 5 µg/dL in 2012 * CDC finally states there is “No safe level of lead” Most states still use 10 or 15 micrograms per deciliter as their blood lead action level STATES ARE ALL OVER THE PLACE WITH THIS: For instance, years after the CDC’s recommendations, Alabama, the level of concern is 10 micrograms per deciliter or greater Additionally, OH law defines lead poisoning as BLL ≥15 μ/dL AND Massachusetts’ level of concern legally defined as ≥25 μg/dL And some states like Mississippi that did not have either state or local legislation to prevent childhood lead poisoning, screens children under 6 the level at ≥15 μ/dL

Recommendations 1. Establish a childhood BLL reference value based on 92.5th percentile of the population [now 3 µg/dL] to: a. Identify children with elevated lead b. Identify environments with lead hazards 2. To develop and implement a local/national strategy to ensure that no child spends significant time in homes, buildings, other environments exposed to lead 3. Advocate for laws that require regulatory agencies to include communities in lead prevention monitoring and remediation efforts