All public policy issues cycle in and out of relevance. They’re important for a while, recede for a while, and return. Unfortunately, that’s true even for something that makes life possible — health.
When I entered state government as an environmental policy advisor in 1983, the furor over toxic waste was peaking. Just three years before, the federal government had evacuated the infamous Love Canal residential neighborhood in New York after the discovery of chemical poisons percolating up from a former dump. The recognition of thousands of such sites across the country prompted Congress to pass the so-called Superfund legislation to pay for cleanup.
Michigan had its share of sites – well over a thousand old dumps, factory spills, leaking tanks and more. Each of the major sites generated local controversy and some rose to statewide significance. Neighbors of the sites feared for their health, worrying that cancer might claim them.
One of the most ominous threats was the groundwater flow of chemicals from a defunct chemical solvent company, a landfill, and other sources moving toward the drinking water wells of Battle Creek. The possibility that contaminants might taint a water supply serving tens of thousands of people and the Kellogg’s Company was petrifying to those of us in state government.
It was doubly so because memories were still fresh of a prior chemical contamination crisis. In 1973, the accidental mixing of a fire retardant known as PBB with cattle feed introduced the toxic chemical into Michigan’s food chain. Eventually, virtually every citizen of the state absorbed PBB into his or her body.
The resulting controversy attracted national media attention, in part because of fears of a massive cancer outbreak. Governor William Milliken, whose environmental record was impeccable, took political punches from critics who said he hadn’t responded aggressively enough by quarantining the contamination and limiting the exposure of Michigan citizens.
We didn’t want any of that. A failure to respond aggressively could result in another PBB disaster, with unknown health effects in ensuing years.
We tasked the state Department of Natural Resources with taking the lead for the state in stopping the flow of contamination, teaming with the U.S. EPA. DNR reported weekly, in writing, to the Governor, while his staff monitored the situation even more frequently. EPA drilled wells to intercept and pump the contaminants out of the ground while the state supplied bottled water, which it did at many other sites.
With luck and an abundance of caution on the part of state officials, citizens living near Michigan contamination sites largely escaped serious health impacts. But that very success – and others like it – bred complacency.
One of those successes was lead poisoning prevention. By the 1960s evidence was irrefutable that the toxic metal damaged the brain and neurological system, especially of kids. Government policies attacked the primary uses of lead, banning its use in paint, gasoline and drinking water supply pipe. The results were dramatic. Levels of lead in air and soils plummeted. So did the percentage of Americans with elevated blood lead levels.
Problem solved – said some politicians. That overlooked the fact that science continued to lower the “safe” level of lead exposure until health agencies declared that any level posed a risk. But few were listening.
Memories of PBB and Love Canal had dissipated. Michigan was ripe for an environmental health crisis.
While the exact causes of the drinking water catastrophe affecting the people of Flint will not be fully diagnosed for some time, the evidence released to date suggests that public health was not a paramount concern of state government for a time. Rather than erring on the side of safety, some state officials first challenged the bearers of the bad news that lead in the blood of some Flint children was rising to levels of concern. At least one official mocked the experts sounding the alarm as professional agitators.
The response could have been different. The nerve endings of state government should have responded to the early warnings, helping mobilize an effective response. Those nerve endings should have sent messages all the way up to the governor’s office. That would have happened if the memory of PBB was preserved – or if the political process took imminent threats to public health with full seriousness. By the time the reality of the threat became clear, it was too late for these children and other Flint residents.
It’s time to consider reforms to correct the institutional failures that allowed Flint to happen. There is no perfect reform – but the status quo is a perfect mess.
One reform should take not a law, but institution of good management practices. The Governor, whoever the governor is, should designate a health advocate on her or his staff who will monitor potential or imminent threats to public health and keep the governor apprised. . Another reform is that the legislature should spell out in clear language, in state law, that public health must come first; that the job of the state’s public health agency is to prevent as well as to respond to threats to the health of the people; and that it is best always to err on the side of public health in the case of uncertainty and an imminent hazard to human health.
A simple reform would be to hang a photograph of a lead-poisoned child on the wall of the executive office of the state health department, lest its directors and staff forget Flint, just as PBB was forgotten.
Now, for a while, things will be different. Every time Flint is mentioned, a public health disaster will come to mind. Elected officials and agency staff will scramble to prevent any possibility of a comparable health threat. And then – unless there is reform — memories will fade. And Michigan will be ripe for another public health disaster.
The state constitution of 1963 declares public health to be a matter “of primary public concern” and adds, “The legislature shall pass suitable laws for the protection and promotion of the public health.” Implementing that mandate will preserve the memory of health crises past, and give citizens a fighting chance to avoid being exposed to another one.
Dave Dempsey