Flint Kids: Tragic, Resilient, and Exemplary

Lead is not an issue just for kids in Flint, Michigan. Our country’s most vulnerable children, in Detroit, Michigan; Chicago, Illinois; Los Angeles, California; Baltimore, Maryland; and other cities, are burdened with lead exposure as well as every other type of toxic stress that threatens their futures. Lead is an entirely preventable environmental, social, and economic injustice; and in Flint, that injustice only widened.

TRAGIC

By now, you must be familiar with the Flint tragedy. The story begins with an almost bankrupt city taken over by a state-appointed emergency management team where austerity reigned, no matter the cost. The emergency manager severed a half-century relationship with the Detroit Water and Sewerage Department, which had provided Flint with fresh, Great Lakes, pretreated water from Detroit. Flint started drawing water from the local Flint River. However, the Flint River water was not treated properly: it was missing a chemical compound that inhibited corrosion.

The untreated, corrosive water wrought havoc: discolored and distasteful water, bacterial contamination and water-boiling advisories, rashes and skin irritation, water main breaks and leaks, one of the largest outbreaks of Legionnaire’s disease, an uptick in pneumonia deaths, and—as proven to a dismissive government—lead exposure. Exacerbated by an oversized water distribution system and the highest water rates in the country, Flint’s corrosive water created a perfect storm for lead to leach out of plumbing and into the bodies of children. Potent and causing irreversible harm, lead is probably the best studied neurotoxin. It affects cognition and behavior; and thanks to emerging science, we now know that even the smallest amounts of lead, and especially the first increments of exposure, can do tremendous damage. There is no safe level.

The immediate tragedy of the water crisis cannot be divorced from Flint’s history. Flint, the birthplace of General Motors and the United Auto Workers¹ and notably the grand bargain that heralded the postwar middle class, was a booming industrial city, a promised land in the Great Migration north and for immigrants all over the world. However, like many postmanufacturing cities, Flint has suffered from decades of disinvestment, unemployment, racism, poverty, violence, declining unions, population loss, crumbling schools, food deserts, and almost every measurable disparity. Flint is where our inequality problems, our injustice problems, are most striking; life expectancy in Flint is 15 years less than in a neighboring zip code.

The Flint water crisis, and especially the population-wide lead exposure, is an added toxic stress to a population already riddled with toxic stresses. Toxic stress, especially early adversity—be it from poverty or lead exposure—affects a child’s entire life course trajectory, and even longevity, in a graded and predictable manner.

RESILIENT

From the moment we proved the water switch added more lead to the bodies of our Flint children,² our focus shifted to tomorrow. There is no magic pill for lead, and we needed to figure out how to best preserve the tomorrows of our children. It was a race against time. This was a race not only to alert everyone to stop drinking the toxic water and to reverse the water switch but also to mitigate its impact. For 18 months, the people of Flint were drinking contaminated water while being told to relax. Eighteen months is an eternity in the rapidly developing nervous system of a young child.

Reinvesting in Flint and in our kids, long-standing partners Michigan State University, a land grant university, and Hurley Medical Center, a public hospital, both with footprints in Flint for more than a century, launched a model public health program: the Pediatric Public Health Initiative. Through community and clinical programs, childhood health policy and advocacy, and robust evaluation, the Pediatric Public Health Initiative works with many partners, including our heroic parents and kids, as a center of excellence, with the primary goal of mitigating the impact of the Flint water crisis and serving as a national resource for best practices.

In Flint, we are wrapping our kids in a nutrient-rich environment of development-promoting interventions. A blend of governmental and philanthropic sources now supports expanded maternal–infant support programs, universal home-based early intervention, a new high-quality early education center with another opening in a year, family and parenting support programs, massive investment in early literacy and two-generation literacy initiatives, universal preschool, school health services, mindfulness programming, breastfeeding support, nutrition prescriptions, WIC (Special Supplemental Nutrition Program for Women, Infants and Children) colocation with primary care, mobile grocery stores, trauma-informed care, health care expansion via Medicaid waiver, and more. We are investing in our youngest and our most vulnerable kids, prioritizing the developmentally sensitive prenatal to preschool window.

Fittingly, we are leaning on abolitionist Frederick Douglass, who more than 150 years ago said, “It’s easier to build strong children than repair broken men.” In a city once known for building strong cars, we are now building really strong kids.

EXEMPLARY

In a few years, we hope to share our lessons. What we hope to share is not what lead does but how a community came together, proactively invested in our children’s future, and flipped the story. Our Pediatric Public Health Initiative is leading the evaluation effort by building a robust registry to identify, track, and support victims of the water crisis.

However, fixing Flint, and Flints everywhere, will take more than long-term investments in health, education, and health. With a 60% childhood poverty rate in Flint, the most potent medication we can prescribe is to lift our families out of poverty, as we strive for equity and justice and opportunity. In Michigan we know that not all the manufacturing jobs are coming back. But our new economy, grounded in health care, education, and recovery, must also be an economy with a renewed focus on living wage jobs to help us create economic prosperity.

There are towns like Flint everywhere, from the rust belt to coal country and beyond, where children are waking up to an existence stacked against them, insurmountable toxic stresses, whether it is poverty or racism or contaminated water. Every hurdle for these kids, sometimes hurdles as simple as obtaining a meal or clean water, can be the tipping point between success and survival.

Flint has awoken the nation to the ongoing issues of early adversity, lead contamination, water quality, inadequate public health regulations, deteriorating infrastructure, public health disinvestment, and environmental injustice. Flint was entirely preventable, and we have learned many lessons on how to prevent future Flints. However, if our current Administration in Washington successfully moves toward regulatory cutbacks in public health and environmental protection, there likely will be more Flints to come.

Flint may now be synonymous with usurped democracy, environmental injustice, and criminal governmental neglect, and we have a long way to go until we are able to drink water out of our taps, both in restored water quality and restored trust. There also remains an ongoing need for accountability and restorative justice and long-term sustainability to heal our people and our pipes.

Despite this tragedy, I want to remind you that our Flint kids are more than resilient: they are exemplary, and they are leading the way forward.

THE WATER BOTTLE CHANDELIER

Flint toddlers and their teachers recently made beauty out of tragedy. The water bottle chandelier—a symbolic masterpiece (Figure 1)—hangs in the clinic and serves as a daily reminder that our work in Flint is just beginning. Like our exemplary kids, we are turning a tragedy into something beautiful.

FIGURE 1—

The Water Bottle Chandelier

Source. Doug Pike, Hurley Medical Center.

Note. A few months ago, teachers from one of our toddler classrooms in Flint, Michigan, came to the clinic to give me a chandelier made of recycled water bottles. In a city now on its fourth year of contaminated water, there are a lot of empty water bottles. It is hard to imagine a water bottle chandelier, especially something made by two-year-olds; but it is a gorgeous multicolored masterpiece that sways in the wind and beautifully captures the light. In this high-quality early education center, the toddlers were following directions, sharing and taking turns, learning colors, working on their fine and gross motor skills, and taking breaks for nutritious snacks, lunch, and a midday nap. Most importantly, they were having fun—playing, laughing, and hopefully making a mess. This is exactly what all kids are supposed to be doing, but especially our Flint kids.