Lead poisoning in Flint, Michigan, resulting from the city’s decision to switch its water supply from Lake Huron to the corrosive Flint River will cost far more than the approximately $60 million the state has already spent on medical care and bottled water. According to a new analysis in the journal Health Affairs, the total related social costs could reach nearly $400 million.
“The city’s decision to switch its water supply was penny wise and pound foolish,” said Dr. Peter Muennig, associate professor of health policy and management at the Mailman School of Public Health. “In an effort that would have saved approximately $5 million, the city of Flint will suffer losses 80-fold greater.”
[Photo: Dr. Peter Muennig]
Low-level lead exposures, of which there were approximately 8,000 in Flint, are known to depress IQ, which makes children less likely to gradate from high school. That single, critical factor can lead to lower economic productivity, higher welfare use, and additional criminal justice system costs. These costs are not offset by reduced healthcare usage (people without a high school degree since they are less likely to have health insurance, which makes them less likely to go to the doctor).
Dr. Muennig’s research was done in response to an article by Dr. David Rosner, professor of sociomedical sciences, titled “A Lead Poisoning Crisis Enters Its Second Century,” also published in Health Affairs, in May. Reflecting on the history and politics of lead poisoning in the United States, Dr. Rosner wrote, “many policymakers consider the costs of action primarily in economic and financial terms and ignore the costs of inaction on human health and communities’ livelihoods.”
In a response to Dr. Muennig’s letter, also in Health Affairs, Dr. Rosner argues that the issue of protecting American children can never be primarily an economic one. “If this becomes an argument about costs instead of about public health,“ he writes, “I fear Americans will witness a battle among competing economists that will paralyze us, and more generations of children will find their futures dimmed.”
According to Dr. Muennig, “we should never ignore the human costs of lead poisoning.” While many reports have focused on the ways the Flint water crisis has devastated individual lives, he says, “the sheer magnitude of the cumulative costs to the whole community — in terms of life, sickness, suffering, and actual money—ought to guide policymakers as they consider ways to protect our health. Updating the country’s infrastructure will be expensive, but not only is it the right thing to do, these investments will pay huge dividends for all Americans.”
In a 2009 article in JAMA Pediatrics related to research commissioned by the now-defunct Office of the Child Advocate in New Jersey, Muennig estimated the economic benefits of reducing blood lead levels to less than 1 μg/dL in the United States. He found that the societal benefits would amount to $50,000 per child annually and an overall savings of $1.2 trillion by reduced crime and increased rates of on-time high school graduation.
Since the 1960s, as science has advanced on the dangers of lead exposure, the federal limit for what constitutes a safe level of exposure has been lowered six times, from 60 μg/dL to the current standard of 5 μg/dL. In the 1970s, the mean blood lead level was 15 μg/dL. But according to the Centers for Disease Control and Prevention, “No safe blood lead level in children has been identified.”
“Even relatively low levels of exposure may rob children of IQ points and predispose them to violent behavior later in life,” notes Muennig. “If we act now to reduce lead within the pipes feeding the highest risk homes, it will not only save money, but also lives.”
The city of Flint has already spent $2 million in state funds to replace about 500 water lines. The cost of replacing all the city’s hazardous lines is estimated at $55 million. But so far, elected officials from Michigan have been unsuccessful at raising the necessary funds at the federal level.
According to Dr. Muennig, policymakers from China to Chile are using health benefits to help guide policy decisions, whether it increased physical activity related to high-speed rail between Beijing and Shanghai, or lessened air pollution from burying a highway in Santiago. He argues for a similar approach in Flint and the dozens of other cities with aging water systems. “When you consider all the costs, the price tag for replacing these pipes is a bargain.”