Hostname: page-component-848d4c4894-75dct Total loading time: 0 Render date: 2024-05-13T06:12:04.175Z Has data issue: false hasContentIssue false

Assessment of Behavioral Health Concerns in the Community Affected by the Flint Water Crisis — Michigan (USA) 2016

Published online by Cambridge University Press:  19 April 2018

Gamola Z. Fortenberry
Affiliation:
Epidemic Intelligence Service, Office of Public Health Scientific Services, Centers for Disease Control and Prevention, Atlanta, GeorgiaUSA Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GeorgiaUSA
Patricia Reynolds
Affiliation:
Genesee Health System, Flint, MichiganUSA
Sherry L. Burrer
Affiliation:
Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GeorgiaUSA
Vicki Johnson-Lawrence
Affiliation:
Department of Public Health and Health Sciences, University of Michigan–Flint, Flint, MichiganUSA
Alice Wang
Affiliation:
Epidemic Intelligence Service, Office of Public Health Scientific Services, Centers for Disease Control and Prevention, Atlanta, GeorgiaUSA Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GeorgiaUSA
Amy Schnall
Affiliation:
Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GeorgiaUSA
Price Pullins
Affiliation:
Office of Medical & Psychiatric Services, Michigan Department of Community Health, Lansing, MichiganUSA
Stephanie Kieszak
Affiliation:
Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GeorgiaUSA
Tesfaye Bayleyegn*
Affiliation:
Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GeorgiaUSA
Amy Wolkin
Affiliation:
Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GeorgiaUSA
*
Correspondence: Tesfaye Bayleyegn, MD Senior Service Fellow, Health Studies Branch Division of Environmental Hazards and Health Effects National Center for Environmental Health Centers for Disease Control and Prevention Mailstop F-60, 4770 Buford Highway NE Chamblee, Georgia USA 30341 E-mail: bvy7@cdc.gov

Abstract

Objectives

The Flint Community Resilience Group (Flint, Michigan USA) and the Centers for Disease Control and Prevention (CDC; Atlanta, Georgia USA) assessed behavioral health concerns among community members to determine the impact of lead contamination of the Flint, Michigan water supply.

Methods

A Community Assessment for Public Health Emergency Response (CASPER) was conducted from May 17 through May 19, 2016 using a multi-stage cluster sampling design to select households and individuals to interview.

Results

One-half of households felt overlooked by decision makers. The majority of households self-reported that at least one member experienced more behavioral health concerns than usual. The prevalence of negative quality of life indicators and financial concerns in Flint was higher than previously reported in the Michigan 2012 and 2014 Behavioral Risk Factor Surveillance System (BRFSS) survey.

Conclusions

The following can be considered to guide recovery efforts in Flint: identifying additional resources for behavioral health interventions and conducting follow-up behavioral health assessments to evaluate changes in behavioral health concerns over time; considering the impact of household economic factors when implementing behavioral health interventions; and ensuring community involvement and engagement in recovery efforts to ease community stress and anxiety.

FortenberryGZ, ReynoldsP, BurrerSL, Johnson-LawrenceV, WangA, SchnallA, PullinsP, KieszakS, BayleyegnT, WolkinA. Assessment of Behavioral Health Concerns in the Community Affected by the Flint Water Crisis — Michigan (USA) 2016. Prehosp Disaster Med. 2018;33(3):256–265.

Type
Original Research
Copyright
© World Association for Disaster and Emergency Medicine 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Conflicts of interest: none

References

1. Dixon, J. How Flint’s water crisis unfolded. Detroit Free Press. http://www.freep.com/pages/interactives/flint-water-crisis-timeline/. Accessed May 25, 2016.Google Scholar
2. Agency for Toxic Substances & Disease Registry (ATSDR). Lead Toxicity: what are the physiologic effects of lead exposure? http://www.atsdr.cdc.gov/csem/csem.asp?csem=7. Updated August 20, 2007. Accessed May 25, 2016.Google Scholar
3. Murata, K, Iwata, T, Dakeishi, M, Karita, K. Lead toxicity: does the critical level of lead resulting in adverse effects differ between adults and children? J Occup Health. 2009;51(1):1-12.Google Scholar
4. Hanna-Attisha, M, LaChance, J, Sadler, RC, Schnepp, AC. Elevated blood lead levels in children associated with the Flint drinking water crisis: a spatial analysis of risk and public health response. Am J Public Health. 2016;106(2):283-290.Google Scholar
5. Genesee County Board of Commissioners. Public Health Emergency Declaration for People Using the Flint City Water Supply with the Flint River as the Source. http://www.gc4me.com/docs/public_health_emergency_announcement_10_1_15.pdf. Accessed May 25, 2016.Google Scholar
6. Buttke, D, Vagi, S, Bayleyegn, T, et al. Mental health needs assessment after the Gulf Coast oil spill—Alabama and Mississippi, 2010. Prehosp Disaster Med. 2012;27(5):401-408.CrossRefGoogle ScholarPubMed
7. Palinkas, LA, Petterson, JS, Russell, J, Downs, MA. Community patterns of psychiatric disorders after the Exxon Valdez oil spill. Am J Psychiatry. 1993;150(10):1517-1523.Google Scholar
8. Arata, CM, Picou, JS, Johnson, GD, McNally, TS. Coping with technological disaster: an application of the conservation of resources model to the Exxon Valdez oil spill. J Trauma Stress. 2000;13(1):23-39.Google Scholar
9. Carrasco, JM, Pe´rez-Go´mez, B, Garcı´a-Mendiza´bal, MJ, et al. Health-related quality of life and mental health in the medium-term aftermath of the Prestige oil spill in Galiza (Spain): a cross-sectional study. BMC Public Health. 2007;7:245.Google Scholar
10. Chung, S, Kim, E. Physical and mental health of disaster victims: a comparative study on typhoon and oil spill disasters. J Prev Med Public Health. 2010;43(5):387-395.CrossRefGoogle ScholarPubMed
11. Sabucedo, JM, Arce, C, Senra, C, et al. Symptomatic profile and health-related quality of life of persons affected by the Prestige catastrophe. Disasters. 2010;34(3):809-820.Google Scholar
12. Malilay, J, Flanders, WD, Brogan, D. A modified cluster-sampling method for post-disaster rapid assessment of needs. Bull World Health Organ. 1996;74(4):399-405.Google Scholar
13. US Department of Health and Human Services. HHS Approves Major Medicaid Expansion for Flint. https://archiveit.org/collections/3926?q=HHS+Approves+Major+Medicaid+Expansion+for+Flint&page=1&show=Sites. Updated March 3, 2016. Accessed June 23, 2016.Google Scholar
14. Centers for Disease Control and Prevention (CDC). Community Assessment for Public Health Emergency Response (CASPER) Toolkit. Second edition. Atlanta, Georgia USA: CDC; 2012.Google Scholar
15. Centers for Disease Control and Prevention. About BRFSS. https://www.cdc.gov/brfss/about/index.htm. Accessed March 7, 2017.Google Scholar
16. Kroenke, K, Spitzer, RL, Williams, JB. The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care. 2003;41(11):1284-1292.CrossRefGoogle ScholarPubMed
17. Kroenke, K, Spitzer, RL, Williams, JB, et al. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med. 2007;146(5):317-325.CrossRefGoogle ScholarPubMed
18. Tryon, WW. Evaluating statistical difference, equivalence, and indeterminacy using inferential confidence intervals: an integrated alternative method of conducting null hypothesis statistical tests. Psychological Methods. 2001;6(4):371-386.Google Scholar
19. Michigan Department of Community Health. Health Risk Behaviors in the State of Michigan, 2012 Behavioral Risk Factor Survey 26th Annual Report. http://www.michigan.gov/documents/mdch/2012_MiBRFS_Annual_Report_FINAL_435019_7.pdf. Accessed June 16, 2016.Google Scholar
20. Michigan Department of Health and Human Services. Estimates for Selected Risk Factors and Health Indicators by Emergency Preparedness Region. Michigan Behavioral Risk Factor Surveillance System. http://www.michigan.gov/documents/mdch/2014_MiBRFS_EP_Region_Tables_FINAL_500162_7.pdf. Accessed June 16, 2016.Google Scholar
21. Michigan Department of Health and Human Services. Health Indicators and Risk Estimates by Community Health Assessment Regions & Local Health Departments. Michigan Behavioral Risk Factor Surveillance System. http://www.michigan.gov/documents/mdhhs/2013-2015_MiBRFSS_Reg__LHD_Tables_9.16.16_535671_7.pdf. Updated September 16, 2016. Accessed January 17, 2017.Google Scholar
22. Osofsky, HJ, Osofsky, JD, Hansel, TC. Deepwater horizon oil spill: mental health effects on residents in heavily affected areas. Disaster Med Public Health Prep. 2011;5(4):280-286.Google Scholar
23. Green, BL, Lindy, JD, Grace, MC, et al. Buffalo Creek survivors in the second decades: stability of stress symptoms. Am J Orthopsychiatry. 1990;60(1):43-54.CrossRefGoogle ScholarPubMed
24. US Department of Health and Human Services. Substance Abuse and Mental Health Services Administration. Getting through tough economic times. http://www.samhsa.gov/economy/. Updated December 2, 2011. Accessed July 3, 2012.Google Scholar
25. United States Environmental Protection Agency (USEPA). Flint Drinking Water Response. https://www.epa.gov/flint. Accessed July 3, 2012.Google Scholar
26. Reynolds, BS, Seeger, MW. Crisis and Emergency Risk Communication. Atlanta, Georgia USA: CDC; 2012.Google Scholar
27. Couch, SR, Coles, CJ. Community stress, psychosocial hazards, and EPA decision-making in communities impacted by chronic technological disasters. Am J Public Health. 2011;101(Suppl 1):S140-S148.Google Scholar
28. Southwick, SM, Vythilingam, M, Charney, DS. The psychobiology of depression and resilience to stress: implications for prevention and treatment. Annu Rev Clin Psychol. 2005;1:255-291.Google Scholar
29. United States Census Bureau. Flint City, Michigan Quick Facts from the US Census Bureau. http://www.census.gov/quickfacts/table/PST045215/2629000,00#flag-js-X. Accessed June 3, 2016.Google Scholar
30. Michigan Department of Technology, Management, and Budget. Is Michigan’s Economic Recovery Real? Re-Thinking the One-State Recession. http://www.michigan.gov/documents/cgi/cgi_census_OSR_Pres_11-0516_354250_7.pdf. Accessed February 27, 2017.Google Scholar
31. Frasquilho, D, Matos, MG, Salonna, F, et al. Mental health outcomes in times of economic recession: a systematic literature review. BMC Public Health. 2015;16:115.Google Scholar