1.1. Aging Infrastructure, Extreme Precipitation & Health in Detroit, MI
Greater Flint is a postindustrial region of nearly 500,000 people struggling from years of disinvestment by the automobile industry and associated manufacturing activities: the region has lost 77% of its manufacturing employment and 41% of employment overall since 1980 … Greater Flint’s struggles have been amplified by a history of racial discrimination, whereby exclusionary housing practices were common. Such attitudes toward integration later precipitated White flight and emboldened home-rule governance, causing a massive decline in tax revenue for the city. The declining industrial and residential tax bases strained the city’s ability to provide basic services and reversed the public health fortunes of the city and suburbs.
1.2. Study Purpose
2. Materials and Methods
2.1. Data Collection
2.2. Data Analysis
3.1. Study Participants
3.2. Experiences with & Impacts of Flooding
Additionally, immediately following flood events, some participants expressed concerns about individuals, primarily children, not understanding potential exposures, as they were “stomping around in the puddles outside that were raw sewage,” explained a participant in District 3. Several participants described a need for rapid clean up support in households where people, often seniors living alone on fixed incomes, may start cleaning up themselves without proper protection to reduce exposure to infectious disease.I just think I’m more concerned about the elderly and disability … I do have a few family members that are disabled. It’s hard for my mom to get around. So I’m just concerned about, like I said, how can emergency crews, fire departments, and police officers respond to when we’re already lacking in that, that area. How can they get there quickly?
One participant in District 3 explained, “Y’all haven’t even cleaned the first mess up, and we’re just sitting ducks.” He argued that the city needed to support his senior neighbors in properly cleaning up after the 2014 flood because a few years later they were now experiencing mold in their homes and additional flooding was likely.And I still do have some black mold left. And then I had to find someone to clean up the black mold, and that’s another problem. Who cleans up black mold? So I had to find somebody through all these different programs and the lady said that they’re volunteers. I got in touch with them in 2014. I still haven’t had any help from them.
Several participants relied on loved ones for tangible support, specifically a place to stay immediately following a flood event. Some relied on loved ones to help with clean up or provide a place to store items or do mass amounts of post-flooding laundry, but some also mentioned not wanting their friends or family exposed to sewage, as described by a senior woman in District 7, “Everyone wanted to help. We said you’re not coming to help ... you’re not coming to help! My son’s girlfriend has asthma, breathing issues so we said you’re definitely not coming to help.” Again, participants expressed concern for those that are socially isolated, as described by a senior man in District 6, “I am fortunate enough to not be subject to it as bad as other people, but I have people that can’t go anywhere...can’t leave their house .... I am the fortunate one because I have somewhere else to go to.” Nearly all participants discussed some sort of tangible social support they sought or needed.I got this feeling of ‘Okay, it happened. We’re sorry. This is why it happened. Okay, fill out this paperwork and go about your day.’ Until a person lives there and knows what it is like to smell raw sewage or knows what it’s like to slip and fall and break a bone and be lying in raw sewage, you can kind of disconnect from those stories and be like okay, just do this and get your money back. But it’s much more than just money that’s needed to mitigate the situation. It’s just, what are you doing to prevent it? Because you can’t pay me for the stress I feel every time I see a heavy rain happen. There’s no paying for that.
3.3. Strategies for Protecting Residents before, during and after Flood Events
I guess, the first thing that comes to mind is making sure that people don’t come in contact with the water and understand to never touch anything with your bare hands. Don’t wear the same shoes you wear in your basement upstairs. That’s a practice I have, like a basement pair of slippers. So, when I go downstairs, I switch out of my upstairs shoes and put on the basement shoes and leave them downstairs, you know? In the event you may not have sanitized to a level that is safe and that restores the level of cleanliness in your basement, you can at least have some of those practices, at least.
Similarly, another young woman in District 3 described the need for a ready-made kit with gloves, a facemask, and goggles, whereas many people just start cleaning without protection to get rid of the sewage and related odors as quickly as possible regardless of potential exposures. She also explained, “document, take pictures, write down everything that was in your basement ... I mean, you’re going into emergency mode naturally, but in order to get back the things you’ve lost, you do need to document what’s happened.” These insights may be vital for other residents likely to experience future household flooding.And, other things that I think health practitioners might be able to offer is what to do when you’re exposed: What kind of behaviors might you have? Maybe have all that stuff, ‘What to do when your house floods kits,’ and make sure those are dispersed in flood zones. Including that [information] on our monthly water bill, I think some tips and stuff would be helpful.
Many participants recognized a major challenge with risk communication regarding flooding is that, although heavy precipitation may be somewhat predictable, the resulting severity and location of floods may or may not be predictable. Thus, in addition to messaging during and after a flood, risk communication must occur widely and in advance to support development of household emergency plans.They may say there’s possibly, you know, possible warnings, but nobody can say, ‘Okay, there’s going to be flooding at exactly six o’clock (laughs), make sure they have everything together...Only thing I can say is that just have a plan for it. I didn’t have a plan for it, nobody did. And the next time this does happen, I mean I know there were a lot of families that were affected way worse than I was and they just, you know, don’t really talk about it but my only thing is just have a plan for it, be prepared, help your children and pray.
And, one woman in District 4 noted the complexity of the city’s economic and infrastructure challenges coupled with the challenges of having many vacant households in her neighborhood, which required additional municipal management:… but I don’t know how you could get that in Detroit. I mean there’s so much. I mean I’m not knocking my city. I love my city, but there’s so much that we could be doing, so many things that you have to do. It’s impossible to just say now we need this. They just don’t have the resources for it.
Management of stormwater relates to management of vacant land and households, as some participants explained how water infrastructure needs to be recalibrated to accommodate their neighborhood’s changing land use and smaller population. Finally, most participants expressed how the cost of flooding added to compounded extra costs they experienced as Detroiters, which they note are relatively higher than other cities, for example, city taxes, water and stormwater drainage fees, and car and housing insurance.I think that there should also be some evaluation of some impact of vacant homes. I can think of the times I’ve seen water flowing into some vacant homes—and what impact does that have on the system of the street or streets that have high vacancy and it’s like a couple people living near them who don’t have that water flow necessary to keep those systems working properly.
Again, participants suggested a range of recommended strategies needed at different points in time to better anticipate frequent household flooding, offer rapid response, and build in long-term efforts to support households and communities in relief and prevention.That’s information that can be gleaned from people who have experienced the floods. And I think hearing those stories—at least I would hope—that would compel them to act more quickly and see this as a public health concern, an economic concern. People have to take off work. People have to spend money that they either don’t have or weren’t planning to spend. And it just puts you in a whole mess of things to do and things to consider. So, as they’re creating those programs, I think talking to people who have experienced these floods can give them this insight into how to design their programs so that they can be effective ... so that they can be time-sensitive and relevant. It doesn’t help me to find out about something 30 days after the fact. It needs to happen rapid response to it. And, talk to other agencies that may provide support in other areas, whether that’s within the Metro area or the state and looking to other communities that have experienced floods more frequently.
4.1. Lessons Learned
4.2. Implications for Detroit and Beyond
Conflicts of Interest
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|Aging infrastructure||Economic factors or impacts|
|Disinvestment/bankruptcy||Lost living space (e.g., basement)|
|Stormwater management—community or neighborhood||Cultural or linguistic factors|
|Stormwater management—household level||Educational or literacy factors|
|Clean up||Social support|
|Short term||Vulnerable populations|
|Long term||Health exposures/outcomes|
|Other (e.g., small business association, ngos)||Stress/trauma|
|Federal Emergency Management Agency||Safety/injury|
|Documentation of flooding (e.g., photos)||General quality of life|
|Description of household flooding (e.g., location, severity)||Health risk perceptions|
|Description of neighborhoods flooding||Transportation|
|Description of recurrence||Emergency preparedness|
|Appliances, heating & cooling systems||Media warnings/advisories|
|Electrical/power grid issues||Role of municipal leadership|
|Other orgs or agencies (e.g., United Way, Red Cross)||Additional feedback to community leaders|
|Insurance (e.g., housing, flood)||Comparisons to other geographies|
|Frequency (%)||Mean (SD)||Range|
|Age (years)||46.5 (17.2)||21–80|
|Gender (% Female)||9 (50.0)|
|Black/African American||13 (72.2)|
|Arab American||2 (11.1)|
|Living in Detroit (years)||15 (83.3)||46.6 (17.1)||21–80|
|Living in Current Residence (years)||25.2 (18.0)||2–70|
|Owns home (vs. rents)|
|Household flood events since 2014||4.2 (2.2)||3–10|
|Infectious disease||We have had incidents where we had rats in the city because people dump garbage in their neighborhoods and then floods come and it builds up ... that’s how your dogs get fleas and rabies and stuff. (District 1)|
We had a Hepatitis A * incident with two of our residents on the lower east side of the neighborhood, so I think that it’s—that’s a big concern for me. (District 3)
|Mold||Also, black mold from after the flood goes away. And, you know, we live in homes that are over 100 years old, and you know, that’s brick and mortar. That space is destroyed. Like my girlfriend, their basement was finished and they had to get rid of all their drywall and all their everything because it had black mold in it. It affects your health very much. (District 5)|
Now when I called about the mold problem they told me, “Well, you can have someone come out.” But that’s gonna cost us money too, for them just to look at it and I just didn’t happen to have that kinda cash. So, I just had maybe a friend of a friend come look over it, and they told me it looked like something topical, and I could just go to home depot or something to look at it...but I don’t know ... to me it looked like it’s just, it didn’t looked like something I could just spray and get rid of. I keep spraying it and tried to get rid of it but there is certain parts of my basement that just the end part of the corner of my floor looks like black mold. (District 7)
|Sewage||It’s not like a complete system that washes out constantly. It’s a system that builds up, releases, builds up, releases, and unfortunately during floods there is a lot of backup whether it’s through a drain or even through the houses personal unit. We have drains in the basement that are connected directly to sewage so if there’s that then and the sewage do get flooded they do get water in our house. And when we do get a flood we always mop it and wash it, you know, we use heavy detergent to try to clean which in itself is a health risk. (District 1)|
The smell was absolutely noxious and having to wait about 12 to 48 h to have that cleaned and some of the residents have done that cleaning on their own. (District 3)
|Mental health||So I used to enjoy hearing the sound of rain, it was very calming, relaxing, and helped put me to sleep. Now it’s the source of great anxiety. It rained yesterday and the day before and the first thing I do is look in my basement, or if it’s pooling in the streets, because if it’s pooling in the streets then the system is not acting right and potentially could be a problem. (District 4)|
|Quality of life||I could probably have fully evaluated whether or not the three incidences I had in 2016, if they caused any personal health impacts, but I could imagine probably more extreme health-related issues like cancers or prolonged exposure to mold, headaches, chest aches, just body aches and they don’t know where these things are coming from and likely due to some allergen roaming in their house that is a result of some of type of sewer backup in the house. Those are some of the things that come to mind that people I know who’ve experienced basement floods, some of the physical ailments they’ve experienced. I noticed that, quite frankly. now that I’ve been thinking about it, that I’ve had far more headaches in the past couple years and I’ve never been a headache person. And I’ve never really considered that this could be a reason, I’d just take some Advil and keep it moving. (District 4)|
|Respiratory health||I have asthma and for me it was very challenging, and it was also a very hot day, and we have central airing in our house. So you have to keep the central air off because it will continue to have the sewage floating through the house. So it was hot and humid and sewage. I can’t describe what hot poop smells like but it was a really horrible smell. And for someone with asthma it was pretty bad. (District 3)|
So my brother gets pneumonia very easily. He had pneumonia very badly before...then he got pneumonia again. He was coughing, walking with pneumonia two weeks after [the flooding]. (District 5)
Well, it got really bad. My allergies went crazy, and my eyes was watering, and I was just in bad shape there for a while. It just really affects me. That’s why I’m in such a hurry to clean it up, it’s because I know that if I don’t, that it will really affect me. (District 7)
|Safety/injury||The generators we use cause carbon monoxide and that one time we did have that power outage from the floods for a week you could smell the carbon monoxide in the house so I’m sure that has had an effect on us. (District 1)|
Because where my bedroom is is where the furnace is beneath it so it was seeping carbon monoxide throughout the home. And it was a very scary experience, but the crazy thing is was that after DTE said that carbon monoxide was highest in this room. When they opened up the windows and turned off the furnace, and it was a cold snowy day. I remember it was a snowy night going into the next morning. I woke up the next morning with no headache no longer nauseous, no longer dizzy. I felt perfectly fine. I felt completely normal, and since then we’ve had the furnace replaced and I’ve been completely fine. (District 3)
And at that church there was a story of an elderly woman who didn’t know what was happening in her basement, she thought it was just running water so she said let me go down and turn it off. And at that moment she slipped and fell and actually ended up breaking a bone in her lower leg. And she was in a cast. But to think that she slipped and fell in raw sewage, sitting there in raw sewage in pain in the basement of her home, and that was very sad to hear that story of that woman being injured by it. (District 3)
|Appliances||I can’t afford another flood. I would die. Literally, I’ll come back to life but I’ll die for about two seconds. It’s 3000 dollars, to know I already took one out [furnace] because the flood already damaged, and to put one in before I can fire it up for the winter? (District 3)|
I need the furnace, and I need the water tank, but everything is just, I can’t afford it now … so it still hanging on a thin thread. I did spend quite a bit. I just don’t have it in front of me right now. (District 4)
A lot of loss. I mean, my last appliance died last week. A deep freezer full of food. And I was just like—at this point—I was just beyond the anger point. I mean, I’ve replaced two water heaters. I’ve replaced the washer and dryer. I’ve had numerous furnace issues, and all of those things just outright replace them. There’s no grant. That’s my own income coming to be diverted from other things to replace them because you have to have them. Just the toil of going through things that have been exposed to sewage and having to discard it, move it from a basement … I would probably say at this point in the tens of thousands. There are so many unaccounted for costs. I really don’t know what’s happening in my basement, and I’m concerned that I’m going to have to move considering how many floods I have and so close together, considering that the costs have been insurmountable. (District 4)
|Damage assessment & clean up||But the cleanup in 2016—because of how noxious it was—we actually called a company to come sanitize and drywall. And that cost well over 1000 dollars, and I live in a home with my mother, who a single mother, and I am a student so that definitely was a big deal for us to pay for. (District 3)|
... because to have somebody come out and look at it cost over a thousand dollars. I think that’s kinda extreme, that’s just somebody looking at it, not you know, (laughs) fixing the problem or even saying you know this is what you can get from just looking at it, this is mold and what type of mold. (District 7)
|Housing||... a friend of mine who lost her Section 8 voucher because she couldn’t get her basement to stop flooding. As a result, she was homeless. (District 3)|
|Personal items||We have a senior population who lived in the neighborhood for a number of years. Some of them have raised their children and their grandchildren are there. So for people who have lived there for decades they have a lot of things in their basement. So for them it would be to have someone there to come and be able to do some that heavy lifting because some of that stuff is quite heavy. (District 3)|
We were in debt for a while too because of it. A lot of things that we had to replace. My mom had to get things from the thrift shop. She had to like rebuild it. (District 5)
|Preventative strategies||Oh yeah, that [sump] pump was very expensive itself. The pump itself, I think it was over 1000 dollars and they had to come and actually dig through the cement in the basement and put the pipe down and also, the thing is, the pipe is not 100 percent either. Any company is like—this should work, but it’s not 100% guaranteed as well. So that’s a big concern: that it’s not a guarantee for us. (District 3)|
|Emergency planning||I wanna say a lack of, like there’s not many police officers and emergency that they can come to homes as quickly as they should … I mean we need a lot more emergency personnel. We need more police officers. We really do. We need that resource in our community. Now the bad part is it takes money ... a few more firemen, emergency officers, I think it would help us. I do. (District 6)|
... more of just checking up. More of organizations, seeing if they need help. I know Americorps does a phenomenal security thing. CERT [Community Emergency Response Team] is amazing. In cases like that [the 2014 flood] where the fire trucks couldn’t get through, the people from CERT could communicate back and forth...what street they’re on. Even just the communication, for someone to be on the phone for them, and at least have available some communication network during this situation. (District 7)
I look at it as more planning. I mean if there is an event, some of the nursing homes or some of the people who do live alone, if they are disabled or elderly, they need some type of planning. ‘Like, okay, I’m by myself. If there’s possibly a flood, possibly a snowstorm coming, is anybody here going to assist me or help me?’ I don’t know if it can be done but I look at it as a plan. What can they do in future planning? (District 7)
|Other municipal services||We pay $300 on our tax bill for trash pick up. It’d be nice if when you have a flood event in your home and things need to be disposed of you can just haul them out to the curb and request a special pick up rather than that stuff having to sit out there until the next cycle, which is every two weeks. So if it floods on an off-week that means that’s going to be sitting on the curb which is a public health issue. It’s stuff that has been exposed to raw sewage …. (District 4)|
|Outreach & communication||Community leaders and healthcare providers need to advertise. We have this general feeling that everyone knows, but everyone doesn’t know. We should make sure everyone’s on the same page and that we do our best, you know, to have a strong standard for resources and information available to everyone in a variety of ways because otherwise people are missing out. And this is how residents and the City of Detroit find themselves in the situations that they’re in—from missing opportunities that they could have known about. (District 1)|
|Partnerships||With as many people as had moved in and out of the neighborhood. I didn’t know a lot of them and they didn’t know about such a thing as a community organization. They need to know that these organizations are in place so they can start asking questions. Community organizations should work directly with the City Council. (District 7)|
|Prevention & relief programs||I do wish that there were prevention programs, grants that would be used to address these issues, whether it’s putting a liner in your foundation for people who have basements making sure that they’re insulated and protected from standing water...I wish there were grants that would say if you have constant flooding or water or a lot of backup sewage there should be grants to help address it, and there’s not. (District 1)|
There should be a relief fund that somebody’s putting up for. Because we know that somebody is going to be tapping into this fund. We should not, as a municipality, be relying on FEMA, any federal anything. Locally, we know what we’re up against. It’s unnatural the way they built the whole city … so let’s stop acting like it’s a federal emergency when each city can contain some responsibility for what they’re doing. (District 3)
|Stormwater infrastructure||And the other thing is that the water department should have some accountability. If you know these drains are bad and old you should replace them. You don’t mind us charging for drainage fees but you won’t correct the problem. (District 5)|
|Utilities||Utilities need to be publicly owned. And, while the Great Lakes Water Authority is a publicly owned utility, it has moved towards privatization and the basis for service shouldn’t be to satisfy bond holders, it should be to satisfy the people. (District 5)|
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