Search Results (13)

Background/Objectives: There is a paucity of research evaluating factors associated with healthy eating behaviors in reproductive-age, non-pregnant women. This study aims to examine the association between sociodemographic, perceived health, and environmental factors with fruit and vegetable (F&V) consumption and adherence to dietary recommendations among women of reproductive age who lived, worked, or attended school in Flint, Michigan, during the Flint water crisis (April 2014–October 2015). Methods: This cross-sectional study used data collected from enrollment surveys completed by participants in the Flint Registry (December 2019–2021). Inclusion criteria were females aged 18–55 having complete data on sociodemographic indicator, general health perception, and dietary assessment data (n = 1239). Pearson chi-square measures of association were used to compare frequencies within groups between sociodemographic characteristics, perceived health and wellbeing (PHW), F&V quality/selection, adherence to recommendations, and total F&V intake. Results: Few participants met recommendations for fruits (22.8%) and vegetables (20.3%). Approximately 50.5% reported having access to a wide variety of F&Vs in their neighborhood and perceived F&V quality to be high. Factors significantly associated with meeting F&V recommendations included education, income, homeownership status, and PHW (p < 0.05). Conclusions: Associations between environmental and socioeconomic factors and daily F&V intake among women of reproductive age offer important considerations for designing interventions to improve this demographic’s nutritional status. Results indicate low adherence to recommended F&V intake but perceived access and quality as high in this population. Targeted interventions addressing key components of socioeconomic barriers, perceived access and quality, and perceived wellbeing are needed to improve F&V intake. Full article

This study’s goal was to evaluate associations of human exposure to unfiltered tap water during the Flint water crisis (FWC) with perceived harm to pets from exposure to contaminated water. We also explored the associations of perceived pet harm with participants’ self-reported general, physical, and mental health, as well as quality of life. Adult (n = 3264) pet owners from a public health registry reported unfiltered tap water exposure, perceived pet health, and general health/quality of life at baseline, as well as health/quality of life 1 year later (n = 1172). Using frequencies, percentages, and odds ratios, we evaluated associations of unfiltered tap water consumption with perceived pet health (cross-sectional) and perceived pet health with general health and quality of life (cross-sectional and longitudinal). Daily unfiltered tap water drinkers were 3.12 (95% CI: 2.33–4.23) times more likely to report the FWC had made their pet ill compared to participants who never drank unfiltered water. Participants who reported Flint water made their pet ill had approximately a two-fold increase in odds of reporting poor/fair across all four health/quality-of-life measures compared to those who did not. Both animals and humans were exposed and impacted by the FWC. This study supports the interconnectedness between human and animal health, especially regarding environmental disaster exposure and outcomes. Full article

Background: The underrepresentation of BIPOC youth in the fields of public health, medicine, and research may be a factor contributing to the disproportionate rates of health disparities in BIPOC communities. In 2004, the Sullivan Commission on Diversity in the Healthcare Workforce, commissioned by the White House and led by the United States Health and Human Services, recommended efforts to increase the number of minority professionals in the aforementioned fields as necessary for addressing racial and ethnic health disparities. More recently, over 240 municipalities in the United States have declared “racism a public health crisis”. This national declaration links racism directly to public health disparities, thus calling for a public health response. The Flint Public Health Youth Academy (FPHYA) provides an effective model of youth engagement steeped in Equity, Diversity, and Inclusion (EDI). FPHYA was created based on a dissertation study designed to explore the motivators for engagement of African American and other minority students into careers in public health and its six recommendations. Methods: The FPHYA Model described in this article uses a case study of the Flint Water Crisis to assess and explore effective youth engagement models for public health. This model is rooted in the Continuum of Community Engagement and Youth Empowerment Theory and explores FPHYA’s contribution of youth voice in operationalizing racism as a public health crisis. Full article

Public works environmental disasters such as the Flint water crisis typically occur in disenfranchised communities with municipal disinvestment and co-occurring risks for poor mental health (poverty, social disconnection). We evaluated the long-term interplay of the crisis and these factors with substance use difficulties five years after the crisis onset. A household probability sample of 1970 adults living in Flint during the crisis was surveyed about their crisis experiences, use of substances since the crisis, and risk/resilience factors, including prior potentially traumatic event exposure and current social support. Analyses were weighted to produce population-representative estimates. Of the survey respondents, 17.0% reported that substance use since the crisis contributed to problems with their home, work, or social lives, including 11.2% who used despite a doctor’s warnings that it would harm their health, 12.3% who used while working or going to school, and 10.7% who experienced blackouts after heavy use. A total of 61.6% of respondents reported using alcohol since the crisis, 32.4% using cannabis, and 5.2% using heroin, methamphetamine, or non-prescribed prescription opioids. Respondents who believed that exposure to contaminated water harmed their physical health were more likely to use substances to the detriment of their daily lives (RR = 1.32, 95%CI: 1.03–1.70), as were respondents with prior potentially traumatic exposure (RR = 2.99, 95%CI: 1.90–4.71), low social support (RR = 1.94, 95%CI: 1.41–2.66), and PTSD and depression (RR’s of 1.78 and 1.49, respectively, p-values < 0.01). Public works disasters occurring in disenfranchised communities may have complex, long-term associations with substance use difficulties. Full article

What lessons and insights can the broader Church learn from Christian faith leaders in Flint, Michigan, who have been in a sustained struggle for justice amidst the still unfolding impacts of environmental racism? How did the baptismal identities of faith leaders function as a resource in this struggle, and on a broader level how might Christian baptismal practices and theory be a resource for solidarity in the struggle for racial and environmental justice in and beyond Flint? In other words, might the waters of Christian baptism also “bring together” Christians to tangibly resist racism? This essay emerges from a qualitative research project examining baptismal practices amidst the water crisis in Flint, Michigan. Using liberationist methodology and employing conversation as a means of co-constructing theological knowledge, this article seeks to define a baptismal ethic born from the water crisis based upon the lived experiences of Christian leaders and their communities. Full article

The increasing prevalence of traumatic events requires our public health workforce to be knowledgeable about ways trauma influences population and individual health. There is a gap in student training about the various ways that traumatic events affect their capacity to perform public health work and the communities they serve. While other human services disciplines explicitly use trauma-informed terminology and concepts in student training, references to trauma-informed approaches are more implicit in public health curricula. This study examined trauma-informed principles and related terminology for use in public health coursework in the context of a community-wide water contamination public health crisis in Flint, Michigan, USA. We addressed the principles of trauma-informed approaches across key competency areas common to USA public health accredited programs, including discussion to support student understanding of the principle in action. Using trauma-informed language (1) enhances our capacity to name and respond empathetically in traumatized communities, (2) provides guiding principles for less community-engaged efforts, and (3) fosters stronger relationships for more community-engaged initiatives by providing areas of accountability for unintended consequences throughout the program’s development and implementation processes. Rising public health professionals equipped with knowledge of trauma-informed approaches can more intentionally minimize unintended negative consequences of public health initiatives. Full article

In 2014, city and state officials channeled toxic water into Flint, Michigan and its unevenly distributed and corroding lead service lines (LSLs). The resulting Flint water crisis is a tragic example of environmental racism against a majority Black city and enduring racial and spatial disparities in environmental lead exposures in the United States. Important questions remain about how race intersected with other established environmental health vulnerabilities of gender and single-parent family structure to create unequal toxic exposures within Flint. We address this question with (1) an “intercategorical ecology” framework that extends the “racial ecology” lens into the complex spatial and demographic dimensions of environmental health vulnerabilities and (2) a multivariate analysis using block-level data from the 2010 U.S. decennial census and a key dataset estimating the LSL connections for 56,038 land parcels in Flint. We found that blocks exposed to LSLs had, on average, higher concentrations of single-parent white, Black, and Latinx families. However, logistic regression results indicate that the likelihood of block exposure to LSLs was most consistently and positively associated with the percentage of single-father Black and single-mother Latina families, net of other racialized and gendered single-parent family structures, socioeconomic status, and the spatial concentration of LSL exposure. Full article

Flint, MI experienced two outbreaks of Legionnaires’ Disease (LD) during the summers of 2014 and 2015, coinciding with use of Flint River as a drinking water source without corrosion control. Using simulated distribution systems (SDSs) followed by stagnant simulated premise (i.e., building) plumbing reactors (SPPRs) containing cross-linked polyethylene (PEX) or copper pipe, we reproduced trends in water chemistry and Legionella proliferation observed in the field when Flint River versus Detroit water were used before, during, and after the outbreak. Specifically, due to high chlorine demand in the SDSs, SPPRs with treated Flint River water were chlorine deficient and had elevated L. pneumophila numbers in the PEX condition. SPPRs with Detroit water, which had lower chlorine demand and higher residual chlorine, lost all culturable L. pneumophila within two months. L. pneumophila also diminished more rapidly with time in Flint River SPPRs with copper pipe, presumably due to the bacteriostatic properties of elevated copper concentrations caused by lack of corrosion control and stagnation. This study confirms hypothesized mechanisms by which the switch in water chemistry, pipe materials, and different flow patterns in Flint premise plumbing may have contributed to observed LD outbreak patterns. Full article

Though fruit and vegetable consumption is essential for disease prevention and health maintenance, intake among children fails to meet dietary recommendations. Limited access to and the affordability of fresh produce, particularly among low-income youth, are barriers to adequate intake. To address these challenges, researchers and pediatricians in Flint, Michigan, expanded a successful fruit and vegetable prescription program that provides one $15 prescription for fresh fruits and vegetables to every child at every office visit. Vendors include the downtown farmers’ market and a local mobile market. This study describes baseline characteristics, dietary patterns, food access, and food security among 261 caregiver–child dyads enrolled August 2018–March 2019. The child-reported mean daily intake of vegetables (0.72 cups ± 0.77), dairy products (1.33 cups ± 1.22), and whole grains (0.51 ounces ± 0.49) were well below recommendations. Furthermore, 53% of children and 49% of caregivers who completed the food security module indicated low or very low food security. However, there were no statistically significant differences in the child consumption of fruits and vegetables between households that reported high versus low food security (p > 0.05). Results validate and raise deep concerns about poor dietary patterns and food insecurity issues facing Flint children, many of whom continue to battle with an ongoing drinking water crisis. Additional poverty-mitigating efforts, such as fruit and vegetable prescription programs, are necessary to address these gaps. Full article

While the story of the Flint water crisis has frequently been told, even sympathetic analyses have largely worked to make invisible the significant actions of Flint residents to protect and advocate for their community. Leaving the voices of these stakeholders out of narratives about the crisis has served to deepen distrust in the community. Our project responds to these silences through a community-driven research study aimed explicitly at elevating the frame of Flint residents in and around the Flint water crisis. This paper describes the coming together of the research team, the overall project design for each of the three research efforts, and lessons learned. The three sub-projects include: (1) a qualitative analysis of community sentiment provided during 17 recorded legislative, media, and community events, (2) an analysis of trust in the Flint community through nine focus groups across demographic groups (African American, Hispanic, seniors, and youth) of residents in Flint, and (3) an analysis of the role of the faith-based community in response to public health crises through two focus groups with faith based leaders from Flint involved with response efforts to the water crisis. Our study offers insight for understanding trust in crisis, which could be valuable to other communities and researchers seeking to address similar situations. The project offers community science as a model for considering community engagement in research as part of the process of resilience. Full article

The failure by the city of Flint, Michigan to properly treat its municipal water system after a change in the source of water, has resulted in elevated lead levels in the city’s water and an increase in city children’s blood lead levels. Lead exposure in young children can lead to decrements in intelligence, development, behavior, attention and other neurological functions. This lack of ability to provide safe drinking water represents a failure to protect the public’s health at various governmental levels. This article describes how the tragedy happened, how low-income and minority populations are at particularly high risk for lead exposure and environmental injustice, and ways that we can move forward to prevent childhood lead exposure and lead poisoning, as well as prevent future Flint-like exposure events from occurring. Control of the manufacture and use of toxic chemicals to prevent adverse exposure to these substances is also discussed. Environmental injustice occurred throughout the Flint water contamination incident and there are lessons we can all learn from this debacle to move forward in promoting environmental justice. Full article

The need for high quality and timely disaster research has been a topic of great discussion over the past several years. Recent high profile incidents have exposed gaps in knowledge about the health impacts of disasters or the benefits of specific interventions—such was the case with the 2010 Gulf Oil Spill and recent events associated with lead-contaminated drinking water in Flint, Michigan, and the evolving health crisis related to Zika virus disease. Our inability to perform timely research to inform the community about health and safety risks or address specific concerns further heightens anxiety and distrust. Since nearly all disasters, whether natural or man-made, have an environmental health component, it is critical that specialized research tools and trained researchers be readily available to evaluate complex exposures and health effects, especially for vulnerable sub-populations such as the elderly, children, pregnant women, and those with socioeconomic and environmental disparities. In response, the National Institute of Environmental Health Science has initiated a Disaster Research Response Program to create new tools, protocols, networks of researchers, training exercises, and outreach involving diverse groups of stakeholders to help overcome the challenges of disaster research and to improve our ability to collect vital information to reduce the adverse health impacts and improve future preparedness. Full article

In Flint; MI; USA; a public health crisis resulted from the switching of the water supply from Lake Huron to a more corrosive source from the Flint River in April 2014; which caused lead to leach from water lines. Between 2010 and 2015; Flint area children’s average blood lead patterns display consistent peaks in the third quarter of the year. The third quarter blood lead peaks displayed a declining trend between 2010 and 2013; then rose abruptly between the third quarters of 2013 from 3.6% blood lead levels ≥5 µg/dL to a peak of about 7% in the third quarter of 2014; an increase of approximately 50%. The percentage of blood lead level ≥5 µg/dL in the first quarter of 2015 then dropped to 2.3%; which was the same percentage as the first quarter of 2014 (prior to the Flint River water source change). The Flint quarterly blood lead level peak then rose to about 6% blood lead levels ≥ 5 µg/dL in the third quarter of 2015; and then declined to about 2.5% in the fourth quarter of 2015. Soil lead data collected by Edible Flint food collaborative reveal generally higher soil lead values in the metropolitan center for Flint; with lower values in the outskirts of the city. The questions that are not being asked is why did children’s blood lead levels display a seasonal blood lead pattern before the introduction of the new water supply in Flint; and what are the implications of these seasonal blood lead patterns? Based upon previous findings in Detroit and other North American cities we infer that resuspension to the air of lead in the form of dust from lead contaminated soils in Flint appears to be a persistent contribution to lead exposure of Flint children even before the change in the water supply from Lake Huron to the Flint River. Full article