What the Water Crisis in Flint shows about Racism in Public Health

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Since 2014, Flint, Michigan, just about 60 miles outside of Detroit, has been without clean water, creating a mountain of problems for thousands of residents, ranging from skin rashes to developmental issues and from stress to fatalities.

Though Flint has moved closer to a solution due to investments in the city’s water infrastructure, residents are still hesitant to trust the municipal water supply. The implications of the crisis will leave a permanent mark of health problems and distrust in Flint. It should have never gone this far.

The crisis began when city officials switched Flint’s water source from treated Detroit water to water from the Flint River. Although the Flint River had been known to cause myriad problems, such as hurting the wildlife population within the river due to low oxygen levels and containing untreated waste and toxic chemicals, city officials made the move anyway, justifying it as a cost-saving move and one that would be better for the future of Flint. 

Soon after the switch, residents began reporting problems with the smell, taste, and look of the water. It was soon revealed that the initial switch and subsequent treatment of the water were mishandled, resulting in lead contamination. Though the Flint city council voted to switch back to the Detroit water supply shortly after the discovery of lead contamination, the city’s emergency manager Jerry Ambrose blocked the vote, leaving Flint with continued water supply issues. The city has been on a boil water advisory until just recently. 

So, why was Flint ignored? Why did the city not get the resources it needed immediately to fix this problem? Why instead, were its residents forced to deal with this practically on their own, with implications that will affect generations to come?

The answer is systemic racism, as seen through the origin of the crisis and the mishandling of the situation. Flint is a predominantly Black community with high levels of poverty and crime, and the city lacks community resources, services, and funding. Though the people of Flint did not want their water source to be changed, officials persisted in an attempt to cut costs. City officials in Flint were left with a choice: fix the water but forgo the cost savings, or continue to save money and ignore the problems of the water switch. A lack of state support enacted the latter by default and irreparably harmed hundreds of thousands of Flint residents.

Further investigations proved these findings. A 129-page Michigan Civil Rights Commission report found that “historical, structural, and systemic racism” played a significant role in the continuation of the crisis. A resident of Flint quoted in the report stated, “If this was in a white area, in a rich area, there would have been something done. I mean, let’s get real here. We know the truth.”

Systemic racism within public health is not unique to Flint. The people of Jackson, Mississippi faced their own water crisis for months this year due to the failure of a water treatment plant. The city of Jackson, which is 80% Black and has 25% of its residents living in poverty, have had their concerns ignored by elected officials, the vast majority being White. And in Washington, D.C., like many other places across the country, the coronavirus was improperly handled by leaders, disproportionately affecting thousands of residents in minority communities, leading to large racial disparities between White and Black residents of Washington who contracted COVID-19.

Just as systemic racism within public health institutions is perpetuated by the decision-making of elected officials, it also stems from medical professionals within these institutions as well due to stereotypes regarding people of color. For example, racial bias exists in the context of the assessment and treatment of pain. A study published in the Proceedings of the National Academy of Sciences found that “white laypeople and medical students and residents hold false beliefs about biological differences between blacks and whites and … these beliefs predict racial bias in pain perception and treatment recommendation accuracy.” The study also found that physicians often believe Black people have a “higher pain tolerance,” therefore improperly diagnosing pain medication and allowing pain to continue. It was also reported that in some cases, physicians harbor suspicions about whether or not Black patients can pay for medical care, thereby avoiding diagnoses in the first place.

These stereotypes and instances of mismanagement within public health have had a drastic impact on communities of color. Beginning in the 1980s, there has been a large gap between the life expectancies of Black and White Americans, which has further increased after the COVID-19 pandemic. Similarly, members of the Latinx community have a greater risk of developing diabetes and poorer access to healthcare and treatment compared to White Americans.

Considering basic necessities such as water should be a given, forcing officials to choose between providing essentials and fixing urgent problems not only negatively impacts the community itself but also the relationship between the residents and their representatives. Even though Flint has made progress, the mistrust of residents toward their officials still lingers, as most Flint residents still do not use their tap water. And in medical institutions, Black Americans are less likely to have faith in their healthcare providers and systems and are less likely to accept treatment, while being disproportionately affected by chronic diseases and other health issues. 

Flint’s water crisis could have been handled much more effectively, but it was not due to bias and misunderstanding toward communities of color, stereotypes which lead to the mishandling of the health and treatment of minority communities, lack of funding for communities facing poverty, and racism. Early reports of water problems by Flint residents should have been listened to, and control methods used should have been more closely evaluated instead of rushed to “save money.”

The crisis in Flint was preventable, the crisis in Jackson was preventable, and the long-standing trend of racism within public health is preventable. From elected city officials working with the residents of their community to achieve positive change to educational and medical institutions working to reverse racial bias in medicine, steps can be taken by those in positions of power to stop these detrimental instances from taking place. The people within these communities deserve better from their doctors, elected officials, and country. It has been far too long, far too recognized; the pattern must shift.

Image by Imani is licensed under the Unsplash License.