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Did Flint’s Water Crisis Damage Kids’ Brains?

Third-grade reading proficiency has plunged in the lead-poisoned city, setting off a debate about the possible causes.
This story was originally published by New Republic.

Detroit Free Press columnist Rochelle Riley recently noticed a startling fact about kids in the lead-poisoned city of Flint, Michigan: They have become increasingly bad at reading since the water crisis began in 2014. A state government report showed that, from the year 2014 to the year 2017, third-grade reading proficiency in the city dropped from 41.8 percent to 10.7 percent. “That’s nearly a three-quarters drop in third-grade reading proficiency among children whose lives were affected by lead poisoned water during the Flint water crisis,” she wrote.

Other factors were involved in this decline. The test changed to become more difficult in 2015, which led the third-grading reading proficiency statewide to fall from 70 to 44 percent. But Flint’s decline was much worse than the state’s average. Michigan Superintendent of Education Brian Whiston told Riley that this was “unacceptable,” and that some of the decline could be attributed to “stress.” Riley wasn’t having it. “What also isn’t acceptable is the state not putting into place three years ago a program to monitor and continually assess the development of the poisoned children,” she wrote.

Her outrage was shared by others. The Center for American Progress declared that Flint’s water crisis “has lead to a reading proficiency crisis,” while HuffPost reporter Alanna Vagianos tweeted that lead exposure in Flint was “having a significant developmental effect on children.” Their worry is grounded in the fact that, according to the CDC, lead exposure to children “can cause learning disabilities, behavioral problems, and, at very high levels, seizures, coma, and even death.”

Not everyone, however, was convinced that Flint’s water crisis had much to do with lower reading levels. Mother Jones columnist Kevin Drum, wrote that “a modest increase in lead ingestion simply shouldn’t have that big an effect.” Lead, he wrote, “primarily affects 1-5 year-olds. These are 8-year-olds. A smallish increase in lead levels simply wouldn’t have that big or that immediate an effect on 8-year-olds.” He added that if lead did cause the decline in reading proficiency, “then reading proficiency should have increased after 2016, when the lead was removed. It didn’t. It kept dropping, and so did scores throughout Michigan.”

But Drum’s analysis is based on a misunderstanding of how lead poisoning works, and the status of Flint’s water. Lead has not been “removed” from the city’s water system: State test results released Tuesday found that five out of nine schools in Flint had at least one test that exceeded the federal threshold for lead this year. In one elementary school, 14 of 93 tests registered lead levels of 15 parts per billion or more, and two sites registered more than 100 parts per billion. An Associated Press report last month showed that, in the waning months of 2017, four schools and care facilities in Flint had elevated levels of lead in their water.

Even if lead was removed in 2016, the effects of lead on a child’s brain wouldn’t have vanished, said Dr. Philip Landrigan, a pediatrician and the dean for global health at the Icahn School of Medicine at Mount Sinai. Landrigan is a global expert on lead, one of the first scientists to show how lead causes brain damage in children. “Even the very lowest levels of exposure, we know that lead erodes a child’s IQ, shortens attention span, and disrupts their behavior,” he said. “We know when we do follow-up studies that children exposed when they were kids are more likely to be dyslexic, have behavioral problems, and get in trouble with the law. There’s no question about that.”

Drum’s claim that lead wouldn’t have a big impact on eight-year-olds’ reading levels also doesn’t withstand scrutiny: Children who are eight years old today were four or five in 2014, when the water crisis began, and thereby were within the age window that Drum cites. And he was right about that much: Landrigan said lead exposure is the most damaging for children ages 1-5, because their brains and bodies are developing rapidly. But “it doesn’t just come to a stop at age six,” he said. “Really there’s potential for damages into the early 20s.” In addition, lead exposure tends to be chronic, because exposure to tainted paint or water tends to be long-term. Landrigan said it’s likely that an eight-year-old child with lead in her blood has carried it for years.

None of this is to say, definitively, that Flint’s water crisis caused the drop in reading deficiency. “We know there’s million things that can interfere with reading scores in school—everything from the quality of schools to the quality of homes kids come from,” Landrigan said. “Even though I’m a firm believer that lead is terrible for kids, I don’t feel comfortable saying lead caused it.” In order to figure out if lead were the culprit, scientists would have to conduct a multi-year study comparing Flint with a non-lead-contaminated area with similar schools, demographics, and reading tests.

Parents in Flint deserve to know that their worries are legitimate, and so do parents of children across the country who are exposed to lead. The CDC reports that “at least 4 million households have children living in them that are being exposed to high levels of lead. There are approximately half a million U.S. children ages 1-5 with blood lead levels above 5 micrograms per deciliter, the reference level at which CDC recommends public health actions be initiated.” Technically, there is no safe blood level of lead in children. In December 2016, a Reuters investigation found “almost 3,000 areas” in America “with poisoning rates far higher than in the tainted Michigan city.”

Drum writes that “warning people about the dangers of lead is great, but producing panic isn’t. Children know what’s going on around them. If they hear that kids are being made stupider by the water in Flint, they’ll do worse on tests.” He doesn’t cite evidence of this, insisting it’s “common knowledge.” But as Landrigan said, “I can tell you with absolute assurance that lead damages children’s brains”—and thousands of children in Flint were exposed to lead. Acknowledging this reality is meant to spread awareness and spur action. Maybe more parents will get their children tested, and if lead is found in the blood, they can take steps to prevent chronic exposure.

Lead exposure is a solvable problem; the challenge is getting the government to do more to solve it. A month after the 2016 presidential election, Landrigan participated in the National Lead Summit in Washington, D.C., where he and other pediatric health experts laid out a five-year-plan to eliminate lead poisoning in the United States. They proposed task forces that would figure out ways to remove lead in drinking water and paint in vulnerable cities and states, and a jobs program that would train young men and women in lead abatement. “It was a beautifully constructed plan, and it was given to all the relevant agencies—CDC, EPA, all of them,” he said. “I’ve seen no action on it since that time.”

The government’s inaction isn’t due to a lack of sound science but of political will. If Americans insist on waiting for multi-year studies to prove what’s already known about the long-term damage caused by lead poisoning, they’ll be waiting that long for a solution, too.

Emily Atkin

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