Population Health Blog

Population Health Blog

Why It Matters

Access to water service in Detroit continues to be a population health issue


By Esperanza Cantu

Access to water service by vulnerable populations remains an issue for the Population Health Council. Recently, Professor john powell, director of the Haas Institute for a Fair and Inclusive Society, co-chair of the Population Health Council, advised its Community Engagement and Advocacy Advisory Committee, to work within the purview of the Council’s expertise and focus on the public health effects of lack of access to processed water. The committee issued a statement approved in June that advocated for public health-based exceptions to the water shutoffs. Building upon a memorandum from Raquel Castañeda-López, City Council Member of District 6, the statement advocates for a moratorium on water shutoffs for the following:

• Infants and children under the age of 18
• Seniors age 62 and above
• Persons with mental illness
• Persons with disabilities
• Expectant and/or breastfeeding mothers
• Persons dealing with chronic diseases or otherwise in need of critical and/or medical care

The Population Health Council continues to support the adoption of a water affordability plan, as opposed to the current assistance plan administered by the Great Lakes Water Authority. Philadelphia City Council passed water affordability legislation unanimously in November 2015, and Mayor Michael Nutter signed the ordinance on December 1, 2015. “The law marked the beginning of a fundamental shift in how the City of Philadelphia would assist low-income families in maintaining life-essential water service,” according to Community Legal Services of Philadelphia.According to the legislation, Philadelphia’s water affordability plan must be implemented by September 2017. Importantly, current available research suggests that water affordability plans result in higher utility revenues because customers are better equipped to pay bills that are based on household income.

Back in Detroit, however, community members opposed to the current water assistance plan released a report entitled “Mapping the Water Crisis, The Dismantling of African-American Neighborhoods in Detroit, Volume I.” The group, called “We the People of Detroit Community Research Collective,” presented research that shows a correlation between water shutoffs and home foreclosures. In 2006, the Detroit Water and Sewage Department decided that unpaid water bills could be included in property taxes. The majority of foreclosed homes with unpaid taxes in Wayne County have been in Detroit. It is estimated that between 12 and 27 percent of tax-foreclosed homes had water debt included in unpaid property taxes. Despite the poor data available to the community research collective, the picture that emerges reveals structural racism that unfortunately continues to disparage Detroit’s Black community.

Recently, mixed reports have emerged suggesting funding for Detroit’s water bill assistance program may not last through the month. The Detroit Water and Sewage Department and Great Lakes Water Authority released a statement that indicated the program is adequately funded and is not running out of money, despite recent reports indicating that it was in fact out of funds.

As officials continue to grapple with how to receive payments from water customers, the Population Health Council continues to advocate for a water affordability plan as a long-term solution, and a moratorium to the populations listed above as exceptions based on public health.

Esperanza Cantu is manager of Health Equity and Collaboration for Authority Health

Less is not more when austerity impacts public health

By Esperanza Cantu

At a keynote address called “The Body Economic and Population Health,” of the Inaugural Forum on Population Health Equity forum at the Harvard T.H. Chan School of Public Health in late 2015, Dr. David Stuckler, Professor of Political Economy and Sociology of Oxford University, made a radical proposition: Fiscal austerity is bad for your health. He chronicled the decline in health of populations by historical events, including the U.S. foreclosure crisis, the Great Depression, Sweden’s banking crisis, Greece’s financial crisis, among others. Through gathered evidence, he purported that to strengthen a community’s health, its social protection systems needed to support fairer, more equal societies.

At that same time, the largely African American community of Flint was experiencing a tragedy that affected its nearly 100,000 residents. The Flint water crisis began in April of 2014 when Flint changed its water source from the Detroit Water and Sewage Department to the Flint River. Due to a failure to apply corrosion inhibitors, the public water infrastructure was contaminated with lead, causing a widespread water contamination and public health emergency. Flint’s residents, including thousands of children, have been exposed to lead during this tragedy, which will likely have devastating long-term health and developmental effects. The Flint Water Crisis may affect much more than just the water supply; this tragedy’s effects will be felt well into the future as property values and tax revenues could decrease, and the people’s trust in structures meant to protect them have failed them. Several lawsuits against government officials, including nine criminal charges filed by Michigan Attorney General Bill Schuette, have occurred in the assignment of accountability.

Professor Peter J. Hammer of Wayne State University’s Damon J. Keith’s Center for Civil Rights, takes it a step further. Delivered as a written testimony to the Michigan Civil Rights Commission as part of the hearings related to the Flint Water Crisis, Professor Hammer released a 65-page report titled “The Flint Water Crisis, KWA and Strategic-Structural Racism.” In this report, Professor Hammer details how emergency management, fiscal austerity, and strategic racism resulted in the decisions that led to the Flint Water Crisis. He concluded by likening the Flint Water Crisis to the Tuskegee Syphilis Experience and reminding us all that nothing about the Flint Water Crisis was accidental.

From a population health perspective, the Flint Water Crisis is another example of how fiscal austerity has affected the lives of thousands, perpetuating racial injustice and health disparities. Read this story by the American Civil Liberties Union of Michigan by Curt Guyette, who provided a brief summary of the report, and Professor Hammer’s testimony here.

Professor Hammer delivered a presentation on structural racism and public health as the collaborative foundation for the next Civil Rights movement, at the 2016 Population Health Forum.  See that presentation here. He is also a member of the Population Health Council

Esperanza Cantu is manager of Health Equity and Community Engagement for Authority Health.