Since it began in 2014, the water crisis in Flint, Michigan has remained omnipresent in national media. Cornell has likewise focused recent attention on the issue: a team of social scientists led by Prof. Jerel Ezell, africana studies, has conducted a study observing how increased lead exposure has impacted the children of Flint.
The study, recently published in the Journal of Racial and Ethnic Health Disparities, was officially conducted in 2019 — five years after the water crisis began.
In April 2014, Michigan officials looking to cut back on expenses switched Flint’s water supply from Lake Huron to Flint River. Poor execution of the switch exposed an entire population to an incredibly polluted water supply.
Water that looked, smelled and tasted strange was actually contaminated with lead, trihalomethanes — a known carcinogenic — and the bacteria Legionella, which has been linked to more than 100 deaths in the city.
According to Ezell, adverse exposure to such contaminants — especially lead — has been particularly concerning for children, who are incredibly vulnerable to the physical and cognitive risks it poses.
“We specifically care about lead because it’s associated with a lot of things that are going to prevent children from having full lives or certain opportunities,” Ezell said. “In areas like Flint or other lower income cities it becomes particularly problematic, because these are already cities that are under-resourced and underserved.”
Ezell and his team found that of the 244 children evaluated in Flint, 76.6 percent screened for detectable levels of lead in their bodies after the water supply switch, with approximately a quarter of those children having more extreme cases of clinician-diagnosed elevated blood lead levels.
After testing for a number of health issues, the study also found that 38.9 percent of the children suffered from skin rashes, and 10.7 percent experienced hair loss.
But the extent of elevated blood lead levels goes beyond physical impacts. Lead poisoning in children can increase the likelihood of permanent neurological damage, developmental delays and behavioral issues such as attention deficit hyperactivity disorder.
Of the children screened, 43.9 percent experienced hyperactivity, 39.3 percent had emotional agitation and 29.1 percent had comprehension issues or learning delays.
Black children, specifically, were almost twice as likely to experience emotional agitation compared to other races.
While the observational study did not use a randomized sample, co-author Sanvi Bharwaj ’24 explained that it was a very accurate representation of the socio-economic and racial demographics in the Flint area.
“Health disparities, as much as people like to claim don’t exist, absolutely do,” Bharwaj said. “As far as medical technology has come, there’s still a long way to go for us to actually have equity in this health system because it’s clear, just on racial lines, that we are nowhere near the point that we should be.”
However, according to Ezell, the increased rates of elevated blood levels cannot conclusively be linked to the water crisis.
“[W]hat has made the crisis very convenient for government officials is that they can say, ‘It’s not the water where they’re getting the lead, it’s the soil, it’s the paint,’” he said.
While this may be possible, Ezell noted that the rates of adverse effects observed were extreme, and evidence points to the fact that elevated blood lead levels are far above what would be expected without the water crisis.
In 2014, the Center for Disease Control and Prevention found that 4.2 percent of children in the United States tested for elevated blood lead levels. With 25 percent of the sampled children screening for clinically-diagnosed elevated blood lead levels, Flint has seen almost six times the national average.
The study calls attention to the need for more clinical monitoring of Flint children for elevated blood lead levels, particularly among Black and low-income children.
According to Ezell, children in Flint may have not been screened for a variety of reasons, including a lack of time, access and transportation. But there is perhaps a more apparent reason: community-wide distrust in the government.
“[W]e’re talking trust issues, and we continue to see this with COVID-19, where a lot of people are saying ‘[T]he government has done X, Y and Z, I don’t trust your healthcare providers and I don’t trust your vaccine,’” Ezell said.
90 percent of the children in Flint are still only drinking bottled water — three years after the Environmental Protection Agency declared the water in Flint was safe to drink in 2019.
“Government and healthcare institutions in Flint have not been able to engage with the community in such a way where people are going to feel comfortable drinking that water again,” Ezell said. “[A]nd that hesitation, in light of the history, is entirely understandable.”
Bharwaj emphasized that community stakeholders should be the first consulted on decisions that could drastically impact their cities.
“People involved in the community are going to know what the community needs, as opposed to some lawmaker who has never been to the community, giving solutions that only seem good on paper, but definitely not in practice,” Bharwaj said. “That’s going to be the first step to ensuring nothing like this ever happens again.”