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2019 - Mona Hanna-Attisha, MD, MPH, FAAP - National Cancer Prevention Workshop — Transcript

by Less Cancer – National Cancer Prevention Workshop · 2,885 words · 418 segments · language en · Watch on YouTube

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0:00yes so I thank you and thank you to Bill
0:03who has been such an amazing supporter
0:06of Flint and our work especially our
0:08recovery work so thank you for having me
0:10I know I've tried to be here for like
0:11three years in a row it worked out this
0:14year so thank you for you and the board
0:16and everybody who is part of less cancer
0:17for the incredible work that you do and
0:19thank you for all the guests and the
0:21staff members and whoever else might be
0:23here to to participate in in this day to
0:25learn more about what like less cancer
0:27does and really kind of what the role
0:28that everybody can do to make the world
0:30free of you know preventable disease and
0:34exposures shout out to the student where
0:36was that student you're awesome good job
0:40so my main hat is of an educator and
0:44it's all about you guys and your talk
0:47inspires me and should inspire all of us
0:49that and look all these young people
0:51over here in high school students right
0:52I heard about their college students
0:53medical all really important to older
0:56students awesome so you guys are all
0:59incredible so thank you for your work
1:01thank you for your curiosity thank you
1:03for your courage to tackle these you
1:05know hard questions and most importantly
1:08for sharing your science scientists and
1:11doctors we in academics we do a terrible
1:13job sharing our science and often our
1:17science ends up in like journals and
1:19publications that nobody reads and we
1:22really like stumble and we don't know
1:23how to talk and and we're not good
1:24advocates for our science so thank you
1:26for being that great communicator and
1:28sharing your science and really the
1:30critical work that you are doing that
1:31that hopefully more folks can do so I
1:34just want to kind of share a little bit
1:35of kind of the Flint story but really
1:37share but kind of where we are right now
1:40and I brought my water bottle because
1:42I'm thirsty but also to share that Flint
1:45still on bottled water so a lot of you
1:48like thought that Flint was probably
1:50taken care of that was a old story you
1:53know that was something from a few years
1:54ago but to this day Flint is still on
1:57filtered and bottled water we have made
2:00tremendous progress in our water quality
2:02our water is much better than it used to
2:05be but Flynn is is doing this massive
2:08infrastructure project we're replacing
2:09our lead pipes and when you do that
2:11infrastructure work you just
2:13rocked all the gunk that is in those
2:15pipes and especially that lead scale and
2:17that it can increase the risk of lead
2:19release so that should be done hopefully
2:21by this year and hopefully look at the
2:22the all clear and and our water will
2:25hopefully be safe again to drink and I
2:28put safe in quotes because over the last
2:30few years what I have learned about
2:33drinking water and especially the
2:35regulations that are on the books is
2:37that they're weak and that there lacks
2:39and they have not caught up with the
2:41incredible science to date of different
2:45toxicities and chemicals and what we
2:47need to to fully protect the health of
2:49our populations especially our most
2:51vulnerable populations like children so
2:53I don't you know I don't say water is
2:55safe in Flint or in DC or really
2:57anywhere anymore because there's so much
2:59that work that needs to be done in the
3:01policy arena to strengthen the
3:04regulations to really use the concept of
3:07something in public health we call as
3:09the precautionary principle where we
3:11protect folks before we see proof of
3:15harm so there's a lot of work that needs
3:18to happen there a quick recap kind of in
3:20terms of what happened in Flint and why
3:22this became such a national story so who
3:26hasn't heard of the Flint water crisis
3:27okay do you remember seeing those
3:29pictures of literally brown water coming
3:32out of people's sinks like I didn't I
3:35didn't even believe it at first like
3:36brown water was coming out of people's
3:38things
3:39so Michigan has this crazy law which is
3:44still in the books called emergency
3:45management and that law said that if a
3:48city was in financial trouble we would
3:50take over the city and we would run the
3:52city and cut costs so Flint has been in
3:55crisis really for decades and lots of
3:57financial trouble so in 2011 we became
4:00under the control of an emergency
4:01manager and that guy had one job then
4:04though there was a series of them and it
4:05was really austerity it was to save
4:07money and they had decided that the
4:09water that we were getting from the
4:11Great Lakes was too expensive for this
4:13predominantly poor minority population
4:16and instead we will start drawing water
4:18from the Flint River until a new
4:20pipeline it was to be built so I know
4:22there's a few Michiganders in the
4:23audience anybody from Michigan yeah
4:25let's preview so
4:27so she points me where you're from like
4:28we do the mitten thing so you did this
4:31earlier awesome so we are at the mint
4:34state because what are we surrounded by
4:36what's Michigan surround by good really
4:39so we're surrounded by the largest
4:40source of fresh water in the world
4:42twenty percent of the fresh water in the
4:44world is around Michigan yet to this day
4:47we have a population of people who are
4:49predominantly poor and minority who do
4:52not have access to that fresh water so
4:54in this this austerity driven move and
4:56this corrosion of democracy Flint
4:58switched their water source to the Flint
5:01River as a temporary move it was it was
5:03- you know the long-term plant was a
5:05land that we were going to move to a new
5:07pipeline and the Flint River water the
5:10problem was it wasn't treated properly
5:12so they forgot or never wanted to or
5:15didn't for some reason add an important
5:18ingredient called corrosion control and
5:20to me as a doctor I think of it like a
5:22medicine that you put in the water
5:24treatment to prevent whatever is in the
5:26pipes from coming out of the pipes and
5:28into the drinking water and and before
5:30all this like I as a doctor never even
5:33thought that you could have a lead in
5:35your water and I had been practicing in
5:37Flint for years and before that in
5:39Detroit and when I was a trainee in
5:41Detroit there was never a day that
5:42didn't go by that I didn't take care of
5:44a patient who was admitted to the
5:45hospital with lead poisoning and we
5:47would take these really thorough
5:48histories and we'd ask like how old is
5:50your house and you have to eat the chip
5:52paint and you get you know what are your
5:54parents hobbies does anybody work in
5:55stained glass and you know I'd asked we
5:58do these differentials like what could
6:00be causing this kids let exposure and I
6:02never even thought as a doctor that you
6:05could get led from from water so why am
6:09i amazing students over here so what is
6:11the elemental symbol for lead PB which
6:15comes from the Latin plumbum which means
6:17plumbing so lead actually means plumbing
6:21look and I had no idea that the word
6:23lead actually means plumbing the Romans
6:27when they built their aqueducts they
6:28used lead plumbing and there's actually
6:30strong theory is that hypothesize the
6:32demise of the Romans is because they
6:34used so much light in their plumbing
6:35they also put lead in food which is a
6:38bad idea so
6:40ever since the advent of the use of
6:42Latin plumbing people have had issues
6:44it's probably the most well studied
6:46environmental toxin like there's
6:48articles about about leads toxicity from
6:51centuries ago
6:53what lead does and increasingly over the
6:56last few decades science has taught us
6:59so much more science has taught us that
7:01levels that we thought were okay decades
7:03ago when we had let him paint when we
7:06had lead in gasoline
7:07are no longer okay and we now know that
7:11there is no safe level of lead in the
7:14human body because of what it does to
7:17especially children and really their
7:19entire life course trajectories so it is
7:21a potent irreversible neurotoxin that
7:24attacks the core of who you are it
7:27impacts cognition so actually drops IQ
7:30levels it impacts behavior leads to
7:32things like developmental disorders and
7:35attention deficit disorders and and
7:37behavioral problems and it's even been
7:39linked to criminality so and we
7:42increasingly get with new research kind
7:45of learn more and more about what lead
7:47does it's epigenetics how it can impact
7:50future generations we also know that
7:52lead impacts adults and leads to things
7:54like high blood pressure hypertension
7:56kidney disease early dementia so has one
8:01of the strongest research bases behind
8:03it yet as a nation we were stubbornly
8:06slow to listen to science and it wasn't
8:09until 1986 did we restrict the use of
8:11lead in plumbing in lead service lines
8:14which are the water lines that go from
8:16the water main to the front of your
8:18house and get this not until 2014
8:22did we restrict the use of lead and
8:23fixtures like brass fixtures and faucets
8:26so I share that you know Flint schools
8:29had some of the highest water lead
8:31levels in the thousands and thousands of
8:33parts per billion they didn't have any
8:34lead lines but it was their fixtures
8:37that were corroding lead and their
8:40faucets and drinking fountains that were
8:42getting into our drinking water and
8:43getting into the bodies of our children
8:45so for 18 months lead was really flowing
8:48freely into into through the drinking
8:51water system in Flint throughout this
8:52entire time
8:54state said hey everything is ok
8:55everything is in minimal compliance
8:56relax patients were coming to see me as
9:00a pediatrician asking me should I be
9:02mixing my baby's formula which is a
9:05powder with tap water and I was saying
9:07of course why would you waste your money
9:09buying bottled water of course but tap
9:11water is safe because it's America it's
9:14the richest country in the history of
9:15the world it's the 21st century so in my
9:18book I take a lot of dives into history
9:20I talk about the cholera epidemics of
9:22old London we've come a long way
9:23like civilizations are built on the
9:26delivery of safe drinking water it's the
9:28Great Lakes we're surrounded by fresh
9:30water but despite all that there's rules
9:33and there's regulations and there's
9:34people who wake up every day to make
9:36sure that when we turn on our tap no
9:39matter how poor our city is no matter
9:41the demographics of our population then
9:43it is safe to drink so that changed all
9:46entirely for me when I heard about the
9:49possibility of lead being in the water
9:50any pediatrician any person with a
9:53public health background when you hear
9:54the word lead if you freaked out because
9:57of what it does to you know children's
9:59cognition behavior but also because we
10:02know it's a form of environmental
10:03injustice it's a form of environmental
10:05racism our kids in Flint already had
10:08higher blood levels because of legacy
10:11LED exposure and poor nutrition and
10:13deteriorating infrastructure but just
10:15like kids in Detroit and Chicago in DC
10:18and Baltimore in Philadelphia so it
10:20already impacts our most vulnerable
10:22children who are already struggling with
10:24every obstacle to their development so
10:28when I heard about the possibility of
10:29lead in the water it was there was
10:31really no going back and we did the
10:33research in rapid speed which you can
10:35read about in the book so so Oprah put
10:37this book on her summer reading list and
10:39it's said it had the gripping intrigue
10:41of a Grisham thriller so like who knew
10:43like science and research could be so
10:45exciting and a page-turner
10:47so so enjoy it but but then very
10:50publicly shared this research so when
10:53you do research all the academics in the
10:54audience when you do research how do you
10:56share your research scientific articles
11:00publications presentations how long does
11:03it take forever so you have to go
11:06through this peer review process
11:07which is a really important thing in
11:08science however it takes forever and I
11:11literally walked out of my clinic stood
11:13behind a podium that was taller than
11:15this and you guys learned I'm really
11:16short so you couldn't even see me and
11:19shared this research because our kids
11:20didn't have another day and really since
11:24then have been working in our recovery
11:27which is really building a model public
11:31health program to mitigate the impact of
11:33this exposure we can't take this away
11:35there's no cure there's no antidote we
11:37failed at primary prevention so our
11:40focus now is secondary prevention what
11:42can we do to to really wrap our children
11:46with every evidence-based develop
11:48promote development promoting
11:49intervention so right now in Flint we
11:52have things like two brand new child
11:53care centers and massive investment in
11:55early literacy places like Flint but as
11:58a deficit of children's book there's a
12:00children's books there's about one book
12:01for every 300 kids by the time our kids
12:04reach the age of three they've heard
12:06thirty million less words by the time
12:08they hit kindergarten the achievement
12:10gap is already there that's almost
12:11impossible to bridge so now in a Flint
12:14we have something called the imagination
12:15library program which they have here in
12:17DC every kid in Flint gets a book mail
12:19to them every single month we've mailed
12:2170,000 books we have pretty amazing we
12:26have expanded reach out and read which
12:28is another evidence-based clinic based
12:30program we've given out 40,000 books
12:32there we've a brand new born to read
12:35program where babies born at the
12:36hospital get a bundle of books and
12:38signed up for these programs we just
12:40celebrated our 1,000th baby in this
12:42program so this is one example in terms
12:45of early literacy Medicaid expansion
12:47thanks to the federal government for
12:49Flint mindfulness in our schools our
12:52kids in schools - like yoga meditation
12:54holistic LED elimination programs thanks
12:57to Medicaid chip dollars school health
13:00services we used to have one school
13:01nurse and now we have over ten school
13:03nurses in Flint so a few of kind of the
13:05wraparound things that we've been able
13:06to put in place - to really promote the
13:08development of our children and and the
13:10story of Flint is is really not an
13:12isolated story and and through efforts
13:15like the Flint registry which actually
13:16just launched a couple weeks ago which
13:19is a massive CDC funded registry
13:21modeled after things like the World
13:23Trade Center industry we are identifying
13:25folks that were exposed we're getting
13:26them most importantly connected to these
13:28resources to promote their health and
13:30development and to follow them long-term
13:32but through things like that registry in
13:34our very academic data-driven hats we
13:37hope to share our best practices with
13:39with communities everywhere because
13:41Flint is you know may have been kind of
13:43the most you know media to the city but
13:47there's communities all over in places
13:49all over that are suffering from
13:51significant environmental contamination
13:53that are suffering from really the
13:56obstacle every single obstacle you can
13:58imagine to to the success of the
14:00population especially your children so
14:02we hope to share our best practices so
14:04with these other communities and
14:06continue advocating at the state and the
14:08national level for the policies to
14:11strengthen a lot of the regulations to
14:14really advocate for things like primary
14:15prevention we shouldn't have to do
14:17decades of painstaking research on one
14:19chemical substance to get that substance
14:21banned we should really be all operating
14:24with the mindset of precautionary
14:25principle and to do no harm especially
14:28when it comes to our vulnerable
14:30populations so that's kind of where
14:32we're Flint is right now Watts a really
14:34positive ripple effects from our work
14:35but really you know this present-day
14:38example of what can happen when people
14:41who are charged with protecting children
14:44protecting public health protecting the
14:45environment really fail and look the
14:48other way but what we're hoping to share
14:51and especially kind of the message of my
14:53book the title is what the eye is don't
14:55see it's it's about kind of letting
14:57water we don't see its Invisibles
14:58colorless it's about LED being in a
15:01silent pediatric epidemic we don't see
15:03the consequences right every every day
15:05but it's it's it's so much more than
15:07that it's about people and places and
15:09problems that we choose not to see and
15:10it's really easy not to see
15:11environmental health issues because
15:13sometimes I don't present for years
15:15decades generations later but really our
15:17obligation to kind of open our eyes and
15:19not only open our eyes but but to act on
15:21these and justices so I think I will end
15:24there I once again want to thank les
15:25cancer and especially thank bill for his
15:27tremendous advocacy and support thank
15:29you
15:30[Applause]

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