Thank you, Miss Michigan, for lifting up the public health threat of lead exposure!

By Sukhdip Purewal Boparai

From left to right: Monica Lewis Patrick, We The People of Detroit [Source: riverwisedetroit.org]; Emily Sioma, Miss Michigan [Source: dlisted.com]; Flint residents marching for clean water [Source: bet.com].

“From the state with 84 percent of the US fresh water but none for its residents to drink, I am Miss Michigan” — Emily Sioma, Miss America contestant


This week, Emily Sioma, Miss Michigan, was widely applauded for highlighting the issue of lack of access to safe and clean drinking water for Michiganders. Looking closely at the Flint Water Crisis and other contaminated drinking crises in the Midwest and around the country, we find deep issues of inequity — communities of color and low-income communities disproportionately lack access to safe and clean water.¹ ² ³

What exposure to lead—a neurotoxin—can lead to

Exposure to lead has been linked to the following outcomes⁴:

  • Childhood developmental delays and learning difficulties
  • Abdominal pain in kids and adults
  • Elevated blood pressure and headaches in adults
  • Joint and muscle pain in adults

Black, Brown, and poor people experience exposure to lead at greater prevalence than White, economically-stable kids and families.⁵ ⁶

The link back to our work at HIP…

Earlier this year, we at Human Impact Partners, with support from the Joyce Foundation, kicked off a project to understand the implications of lead policies for low-income communities and communities of color. Our goal was to produce a more nuanced and equitable set of recommendations on lead prevention and reduction policy, specifically through applying an equity analysis to a handful of policies outlined in this comprehensive report on childhood lead exposure risks and solutions released last year by the Pew Charitable Trusts.

As part of this project, we facilitated a two-day convening last month for participants to co-create a set of equity-focused recommendations to reduce exposure to lead. We brought a diverse group of stakeholders together from the lead poisoning prevention world: residents from directly impacted communities, local and national policy advocates, researchers, health professionals, water utility managers, and health agency officials at the federal, state, and local levels.

Going into this project, I didn’t know much about lead exposure or lead policy. As a researcher with a deep focus on childhood adversity and trauma, I was surprised to learn that lead exposure is itself a traumatic issue, and is related to adverse stressors like housing displacement and incarceration.⁷ ⁸

In preparation for the meeting, I researched lead policies, and the effects of their implementation around the country. Despite the decades of research and policy aimed at eliminating lead, the U.S. has failed, and it has especially failed communities who have been marginalized for decades. I found examples of how governmental policy and practice went awry in places like Flint and East Chicago (Indiana). I also learned of community advocates who have dedicated their lives to fighting for justice — some of whom would participate in the meeting. I was nervous, intimidated, and excited about meeting the influential stakeholders who are playing a critical role in everything I had been reading about.

Participants at Equity Analysis of Lead Policies Consensus Conference Meeting in Chicago, on August 16, 2018.

Meeting everyone in person, and especially listening to detailed stories of how individuals whose health and the health of their loved ones had been compromised as a result of lead exposure, was moving to say the least. The meeting participants were not intimidating — they were all engaging, hard-working, and committed people.

I was energized by the passion and energy that participants brought to the meeting. Everyone agreed to a set of values to guide the two days together and brought their best selves — their skills, experiences, ideas. It was undebatable that every person in that room wanted to eliminate lead from drinking water and from homes.

Seeing the intelligence and passion in the room, I realized that the inadequacy of lead policies in protecting people of color and low-income people is the result of how systems are designed: they’re built on policies that protect some, but not all, and are generally not holistic or cognizant of lived experiences.

Over the course of the meeting I learned a few more important lessons:

To be successful, solutions must be rooted in community wisdom

People and communities hold expertise through their lived experience. And yet, decision-makers often leave community members out of the decision-making process, at every level of policymaking (local, state, federal). Residents who attended the meeting from Flint and Detroit expressed immense frustration — as one advocate put it, “righteous anger” — that policy-related meetings take place outside of their cities or behind closed doors. There is no way for them to know what is going on. Even when opportunities to provide input exist, decision-makers seldom incorporate recommendations from communities members, who end up feeling tokenized. This understandably leads to lack of trust, and policy solutions that don’t work and/or make things worse.

We need mutual understanding — stakeholders have to find ways to collaborate and communicate meaningfully

People working on lead issues are operating from different lenses and may speak past one another. To one person, addressing lead is professional work, to another, it is a means of survival for their family and community. One of the most memorable parts of the meeting was when a utility manager reframed his purpose — saying that now he understands that when we wakes up in the morning, he needs to do everything in his power to provide safe drinking water to his city.

By designing comprehensive lead prevention policies we could be so much more effective

Policymakers have set up unnecessarily fragmented lead prevention policies. Policies tend to focus on the source of the lead exposure (e.g. water versus paint), or the location (e.g. schools versus residences), and so on. Funding agencies have also made it challenging to address lead problems comprehensively through siloed, restrictive and insufficient, or nonexistent funding pools. What ends up happening is that institutions compete with one another to make the case for which source or setting of lead is most important to combat — this takes away opportunities to work together in addressing lead once and for all. At the meeting, an advocate expressed regret for spending much of her career arguing that lead from paint vs. water was the primary source of lead exposure in communication with funders.

Through her brief and unexpected statement, Emily Sioma reminded us that lack of access to drinking water is still a problem.

It’s unfortunate, but true: without moments when public voices speak up like this one, the general public may lose consciousness and understanding of the scale of the lead problem. Meanwhile, communities in Flint, Detroit, Chicago and elsewhere endure daily obstacles to accessing one of the most fundamental and basic needs of life.

What happens next?

We at Human Impact Partners are working on a report that compiles and summarizes the recommendations from our 2-day convening. We hope that policymakers will start thinking about how the policies they develop really impact communities and shift toward creating positive, effective, and long-lasting change.

We will be ready to share our findings and materials sometime in early 2019 (sign up for our email updates to get our announcement about it! Sign-up is on the bottom of this page). In the meantime, you can learn more about lead exposure and preventing it, by learning about and supporting some of the nonprofit organizations who participated in the convening last month:


Sukhdip Purewal Boparai is a Senior Research Associate at Human Impact Partners. Sukh conducts and elevates rigorous research to advance health equity, with a commitment to true community collaboration. Sukh is especially passionate about addressing racial and economic injustices impacting youth and families — she believes that research is a powerful mechanism to advance change.

Sukh is native to the Bay Area. For fun, she enjoys progressing on her bucket list, photography, and traveling with her husband.


References

[1] Safe Water Alliance, Environmental Justice Coalition for Water, and the International Human Rights Law Clinic, University of California, Berkeley, School of Law. April — May 2015. Barriers to Access to Safe and Affordable Water for Disadvantaged Communities in California. Accessed from: https://www.law.berkeley.edu/wp-content/uploads/2015/04/Shadow-Report-on-Right-to-Water-JS25-150511.pdf

[2] Mock B. January 2016. If you want clean water, don’t be Black in America. Accessed from: https://www.citylab.com/equity/2016/01/if-you-want-clean-water-dont-be-black-in-america/426927/

[3] Jones PA, Moulton, A, Unitarian Universalist Service Committee. May 2016. The invisible crisis: Water unaffordability in the United States. Accessed from: https://www.uusc.org/sites/default/files/water_report_july_2016_update.pdf

[4] Mayo Clinic. Lead poisoning: Symptoms. Accessed from: https://www.mayoclinic.org/diseases-conditions/lead-poisoning/symptoms-causes/syc-20354717

[5] Sampson RJ, Winter AS. 2016. The racial ecology of lead poisoning. Du Bois Review. Accessed from: https://scholar.harvard.edu/files/alixwinter/files/sampson_winter_2016.pdf

[6] Sacks V, Blading S. February 2018. The United States can and should eliminated childhood lead exposure. Accessed from: https://www.childtrends.org/publications/united-states-can-eliminate-childhood-lead-exposure

[7] Gastner J, Gaitan V. August 2017. Lead-contaminated soil does more than poison residents. Accessed from: https://howhousingmatters.org/articles/lead-contaminated-soil-poison-residents/

[8] Wright JP, Dietrich KM, Ris MD. May 2008. Association of prenatal and childhood blood lead concentrations with criminal arrests in early adulthood. PLOS Medicine. Accessed from: https://doi.org/10.1371/journal.pmed.0050101