Association of Public Works Disasters with Substance Use Difficulties: Evidence from Flint, Michigan, Five Years after the Water Crisis Onset

Abstract

Public works environmental disasters such as the Flint water crisis typically occur in disenfranchised communities with municipal disinvestment and co-occurring risks for poor mental health (poverty, social disconnection). We evaluated the long-term interplay of the crisis and these factors with substance use difficulties five years after the crisis onset. A household probability sample of 1970 adults living in Flint during the crisis was surveyed about their crisis experiences, use of substances since the crisis, and risk/resilience factors, including prior potentially traumatic event exposure and current social support. Analyses were weighted to produce population-representative estimates. Of the survey respondents, 17.0% reported that substance use since the crisis contributed to problems with their home, work, or social lives, including 11.2% who used despite a doctor’s warnings that it would harm their health, 12.3% who used while working or going to school, and 10.7% who experienced blackouts after heavy use. A total of 61.6% of respondents reported using alcohol since the crisis, 32.4% using cannabis, and 5.2% using heroin, methamphetamine, or non-prescribed prescription opioids. Respondents who believed that exposure to contaminated water harmed their physical health were more likely to use substances to the detriment of their daily lives (RR = 1.32, 95%CI: 1.03–1.70), as were respondents with prior potentially traumatic exposure (RR = 2.99, 95%CI: 1.90–4.71), low social support (RR = 1.94, 95%CI: 1.41–2.66), and PTSD and depression (RR’s of 1.78 and 1.49, respectively, p-values < 0.01). Public works disasters occurring in disenfranchised communities may have complex, long-term associations with substance use difficulties.

A Possible Nocebo Effect in Children Following the Flint Water Crisis: Evidence From Schoolteacher Perceptions and Neuropsychological Evaluations

“…11 Similar messaging has been repeated within the community for over six years (Roy et al, 2023 14 : Table S2), amidst reports of higher rates of depression, post-traumatic stress disorder, substance use, and other mental health problems in the general Flint population. [16][17][18][19][20][21][22][23][24] Beliefs about the effect of the FWC lead exposure on children's cognitive abilities cannot be reconciled with data on blood lead levels in Flint children. Research demonstrated that children's blood lead levels in Flint were not significantly different from the State average and were dramatically lower than children in neighboring Detroit.…”