Ep 157 - From the Flint Water Crisis to the COVID Pandemic: An interview with Dr. Mona Hanna-Attisha — Transcript

Full transcript

1. 0:00[MUSIC PLAYING]
2. 0:06JOSHUA SHARFSTEIN: Welcome to Season 2
3. 0:08of Public Health On Call, a podcast from the Johns Hopkins
4. 0:11Bloomberg School of Public Health.
5. 0:13I'm Joshua Sharfstein, Vice Dean for Public Health Practice
6. 0:17and Community Engagement and a former Secretary of Maryland's
7. 0:20Health Department.
8. 0:22Our goal is to bring scientific evidence and experience
9. 0:25to the public health news of the day
10. 0:27through informative interviews with scientists community
11. 0:30leaders policy experts, public health officials, clinicians,
12. 0:34and more.
13. 0:35If you have ideas or questions for us to cover
14. 0:38please email us at [email protected].
15. 0:43That's [email protected]
16. 0:46for future podcast episodes.
17. 0:49Today I speak to Dr. Mona Hanna-Atisha
18. 0:52a pediatrician at Michigan State University
19. 0:55who brought to light the water crisis of Flint, Michigan.
20. 0:59We speak about recent progress in Flint
21. 1:01and how steps taken to reduce the impact of lead poisoning
22. 1:04in children have actually prepared the city for COVID-19.
23. 1:09Dr. Hanna-Atisha also shares some lessons of Flint
24. 1:12for all the other places in the country
25. 1:14now coping with unfair and preventable health crises.
26. 1:18Let's listen.
27. 1:20Dr. Hanna-Atisha, I can't tell you
28. 1:23how excited I am to have you on the podcast.
29. 1:25Thank you so much for joining me.
30. 1:27MONA HANNA-ATISHA: Josh, it's always
31. 1:28great to hang out with you.
32. 1:29JOSHUA SHARFSTEIN: So I want to start
33. 1:32with where your great book, What the Eyes Don't See, where that
34. 1:38ended, the Flint water crisis, the fact that there
35. 1:42were so many children exposed to excess levels of lead.
36. 1:46You played such a central role in bringing that story
37. 1:50to the national consciousness.
38. 1:51What's going on with those kids in Flint Now
39. 1:54MONA HANNA-ATISHA: Yeah.
40. 1:55Thanks for asking me, Josh.
41. 1:56And I think that was the hardest part
42. 1:57about writing a book because there was no clear The End.
43. 2:01The crisis was not over then and it's not over now.
44. 2:06So some great things are happening in Flint.
45. 2:08I know Flint's kind of been away from national headlines,
46. 2:11understandably so.
47. 2:12Because we have a lot of other things
48. 2:13that we need to deal with.
49. 2:14We're almost done replacing our lead pipes, which is amazing.
50. 2:17They're supposed to be done by 2020.
51. 2:19We took a short pause during the pandemic.
52. 2:22But all our lead pipes will be replaced soon.
53. 2:24And that will make us just the third city
54. 2:26in the country that has replaced their lead pipes
55. 2:28behind Lansing, Michigan and Madison, Wisconsin.
56. 2:31So that's fantastic news.
57. 2:33And then how I get to spend my every day in Flint
58. 2:36is making sure that the kids who have been exposed
59. 2:38to this preventable public health
60. 2:40crisis with widespread lead exposure
61. 2:42and an outbreak of legionnaires disease and skin issues
62. 2:45and just kind of overwhelming community trauma, my job
63. 2:49is to make sure that those kids have the brightest
64. 2:51future possible.
65. 2:52So from the moment I'm really kind
66. 2:53of recognizing what was happening in Flint,
67. 2:56our focus has been on secondary prevention.
68. 2:58So we failed at primary prevention,
69. 3:00that really important concept in public health
70. 3:02where we should never expose a population to something
71. 3:05like a neurotoxin like lead.
72. 3:07So our focus has been really leaning
73. 3:09on the science of child development and early adversity
74. 3:12and resilience to put into place the interventions
75. 3:16to promote and protect the health
76. 3:18and development of children.
77. 3:19So it was awesome things happening there.
78. 3:21And it's the continuation of those efforts that really
79. 3:25kind of consumes my everyday and to make sure
80. 3:27that we can do this for as long as the kids need these things.
81. 3:31JOSHUA SHARFSTEIN: That's great to hear.
82. 3:32But I imagine the pandemic has interfered
83. 3:36in some respects with the ability
84. 3:37to keep kids on the upswing in Flint.
85. 3:42MONA HANNA-ATISHA: Yeah.
86. 3:43That's an excellent question.
87. 3:45Imagine a city that is starting to recover
88. 3:48from one man-made preventable public health crisis that
89. 3:53is now in the midst of another preventable public health
90. 3:57disaster.
91. 3:58So we were just kind of putting into place the infrastructure
92. 4:02to support children and families.
93. 4:05And then a lot of that was put on pause, because
94. 4:07of the pandemic obviously.
95. 4:08The schools were shut down.
96. 4:09And child care facilities were shut down
97. 4:11and other resources and enrichment
98. 4:13for family including things like, really important
99. 4:15developmental assessments and school intervention services.
100. 4:20And on top of that Flint is a community,
101. 4:22like so many disparate communities, that
102. 4:24were hard hit by this pandemic.
103. 4:27This pandemic, as we first were told,
104. 4:30is not the great equalizer.
105. 4:32Certain communities predominately minority
106. 4:35and predominantly poor communities
107. 4:37have greater risk factors.
108. 4:39Outside of the metro Detroit area,
109. 4:41which was the hardest hit spot in Michigan,
110. 4:44the next hardest hit spot was the Flint area.
111. 4:47So here is a community, once again,
112. 4:49struggling to recover from one crisis where government failed.
113. 4:53And now is in the midst of another crisis,
114. 4:56threatening kind of a health and really everything
115. 4:58that we've been able to put into place for this very
116. 5:01vulnerable population.
117. 5:02JOSHUA SHARFSTEIN: Did the structures
118. 5:04that had been mobilized to protect kids from the long term
119. 5:09effects of lead to help at all as this pandemic started?
120. 5:14MONA HANNA-ATISHA: Absolutely.
121. 5:16So because of our last public health crisis,
122. 5:19we were able to build some public health infrastructure.
123. 5:23One of those things is the Flint Registry.
124. 5:25It's supported by CDC to identify
125. 5:28folks that were exposed to the crisis and, most importantly,
126. 5:30get them connected to the resources
127. 5:32to support their health and development like Medicaid
128. 5:35expansion, like early literacy support, home
129. 5:38delivery of children's blocks, trauma informed care, nutrition
130. 5:41services, and then continue to follow folks over time.
131. 5:44So because of our work in improving public health,
132. 5:47we are actually designated by the CDC
133. 5:49as a public health authority.
134. 5:51So this registry has been up and running for a couple of years
135. 5:53now.
136. 5:54Over 30,000 people have begun the enrollment into that
137. 5:57registry. .
138. 5:59And then the pandemic hit.
139. 6:00And oh, what do people need?
140. 6:01People need nutrition and they need education enrichment.
141. 6:05And they need health care access.
142. 6:06So fortunately, because of that infrastructure
143. 6:09rebuilt because of our last public health crisis,
144. 6:11we were more than ready to support families
145. 6:15during this public health crisis.
146. 6:16So it's really an important lesson
147. 6:18on the need to be proactive and preventative
148. 6:21and invest in the capacity to support communities.
149. 6:25JOSHUA SHARFSTEIN: That's very interesting.
150. 6:27What you're really talking about is
151. 6:28applicable to other places besides Flint.
152. 6:31So essentially, because of what happened with lead,
153. 6:34you knew which families might be at risk for going hungry,
154. 6:38for example.
155. 6:39MONA HANNA-ATISHA: Yeah.
156. 6:40So because of our water crisis, we
157. 6:42knew we were dealing with a community that
158. 6:46had this overwhelming trauma and had
159. 6:48these potential adverse consequences.
160. 6:51And we had been working in a very kind
161. 6:53of community-informed and community-driven way
162. 6:56to rebuild trust in our communities
163. 6:58so that they could participate in public health promoting
164. 7:00interventions.
165. 7:02Because of that groundwork that was built with community,
166. 7:05we were ready to step up when this pandemic hit.
167. 7:08Obviously not enough and there's still
168. 7:10a lot of work that needs to be done
169. 7:11and there's still a massive underinvestment
170. 7:13in these resources.
171. 7:15But because we were trusted partners
172. 7:18already in the community and, once again,
173. 7:20working hand-in-hand with community,
174. 7:22we were able to be more effective.
175. 7:24JOSHUA SHARFSTEIN: When this all started, people--
176. 7:28meaning the pandemic started, the story of Flint
177. 7:31was really the story of Flint.
178. 7:33You know people really understood what happened.
179. 7:37You told it so well in the book.
180. 7:39And there were sort of echoes in other parts of the country,
181. 7:42maybe.
182. 7:43How has the pandemic shifted, if at all, that perspective?
183. 7:47MONA HANNA-ATISHA: I'm so glad you asked me that.
184. 7:49And you know it's one of the reasons I wrote
185. 7:51the book, to share the story of Flint,
186. 7:53but really to share with folks that this is a national story.
187. 7:58It's about that one city over there
188. 8:00that had brown water coming out of their tap,
189. 8:03but it's more than that.
190. 8:05It's about so many of the deeper crises
191. 8:07that we're in right now as a nation.
192. 8:09And the pandemic couldn't be more relevant.
193. 8:12The lessons that we learned in Flint
194. 8:14are the lessons that the nation is learning right now.
195. 8:17And for me I see that as a silver lining.
196. 8:20I am this eternal optimist.
197. 8:21I'm like, the whole nation is acutely
198. 8:23learning what we learned in flint
199. 8:26and maybe we can hopefully learn these lessons.
200. 8:29So in Flint we learned that we need good governance.
201. 8:33We need leaders in charge who value public health
202. 8:36rather than dollars and the economy.
203. 8:39So that was one of the reasons that we got into our mess.
204. 8:42That's very relevant with this pandemic.
205. 8:44We have really a failure of leadership
206. 8:46at the federal level to respect public health.
207. 8:49In Flint, we learned that we need
208. 8:50to respect science and facts and scientists and medicine.
209. 8:55The lack of proper water treatments, the dismissal
210. 8:58of scientists throughout our Flint story
211. 9:00also resonates to what's happening
212. 9:02today with science and facts and especially those
213. 9:05in public health and medicine.
214. 9:06In Flint, we also learned that we can't just
215. 9:09react to public health disasters.
216. 9:11We have to proactively invest in public health infrastructure.
217. 9:15Our public health infrastructure from our water treatment
218. 9:19to surveillance systems failed because
219. 9:22of chronic disinvestment and lack of resources.
220. 9:26We are also seeing that, with this pandemic,
221. 9:28nationally we're not ready.
222. 9:30Our public health systems have really
223. 9:32suffered from decades of austerity
224. 9:34and can't muster what we need to muster
225. 9:39right now during this pandemic.
226. 9:41In Flint, we also very [INAUDIBLE]
227. 9:43learned the story of disparities.
228. 9:46The crisis in Flint never would have
229. 9:48happened in a richer or whiter community.
230. 9:50It's kind of this emblematic environmental and health
231. 9:53injustice.
232. 9:53And that's been kind of cited in the several reports,
233. 9:56including from the Michigan Civil Rights Commission
234. 9:58and the list goes on.
235. 10:00And that's what we're learning once again in this pandemic,
236. 10:03that the issues of inequities--
237. 10:07income inequities, health inequities, injustices, racism,
238. 10:11all these long standing issues--
239. 10:14provide some communities with clean water and some
240. 10:17communities without that and some communities have greater
241. 10:20risk factors to things like pandemics and some don't.
242. 10:24So some of the very, very same lessons
243. 10:26are being learned at a national scale.
244. 10:27JOSHUA SHARFSTEIN: So given that in Flint you've actually
245. 10:32been able to make progress, you got people's attention,
246. 10:36people really recognize this as a matter of right and wrong,
247. 10:39and they're actually investing in the kinds of infrastructure
248. 10:43and programs to make a difference, what
249. 10:46are the implications of Flint's experience
250. 10:48there for the national experience for the pandemic?
251. 10:52MONA HANNA-ATISHA: Yeah, I definitely
252. 10:53see this crisis as an opportunity
253. 10:57to learn and to build and really to rebuild.
254. 11:02The New York Times did a series of a couple months ago called
255. 11:05"The America We Need" and they asked me to write a piece.
256. 11:07And my piece was I'm sick of asking children
257. 11:10to be resilient.
258. 11:11And it's all about how do we learn from this pandemic.
259. 11:18How do we grow?
260. 11:19How do we build a new America where public health is valued,
261. 11:24where we are driven by science, and where we strive for equity?
262. 11:28So I absolutely believe that we can move forward
263. 11:33in this direction.
264. 11:33We're trying to do that in Flint by being governed
265. 11:37by the science of not just what works for families and children
266. 11:40but really what works for communities,
267. 11:42what enables self-determination and participatory democracy,
268. 11:46what builds equity, what provides economic development.
269. 11:49All of these things are critical ingredients
270. 11:51for the success of communities and ultimately
271. 11:55their health and, most importantly,
272. 11:57the success of our children's trajectories.
273. 11:59JOSHUA SHARFSTEIN: I think it matters
274. 12:01that you not only were involved in identifying the problem
275. 12:06but you've committed so much to addressing
276. 12:10the challenges in Flint.
277. 12:11I think that is a lesson for a lot of people,
278. 12:14that it's one thing to recognize the challenges of the pandemic.
279. 12:18But really to roll up your sleeves and get in there
280. 12:22and try to turn the tables on these problems,
281. 12:28and it's not something that's an easy fix.
282. 12:31MONA HANNA-ATISHA: No.
283. 12:32Thank you for mentioning that.
284. 12:33I definitely don't want to be known for blowing
285. 12:37the whistle on Flint.
286. 12:38I want to be known for what we did next, what we did together,
287. 12:41kind of in partnership with so many folks
288. 12:43to mitigate the impact of our crisis
289. 12:45and to share our best practices with communities everywhere.
290. 12:48Like I said earlier, the Flint story is not isolated.
291. 12:51It's a story all over this country,
292. 12:53especially for our children that wake up
293. 12:55to some of those same nightmares as Flint kids where
294. 12:58via their zip code or their school
295. 13:00district or their drinking water source
296. 13:02or their color of skin or state of birth,
297. 13:05country of origin, where all of those predictors
298. 13:08play a greater role in their outcomes than their potential.
299. 13:13So my story, the Flint story, is this kind
300. 13:17of nationally relevant story, how
301. 13:19we have to really all kind of open our eyes to injustices
302. 13:23that are happening, be it kind of in our communities
303. 13:26or as a nation, and not just kind of recognizing
304. 13:29or kind of blowing that whistle or sounding alarm
305. 13:32but doing that hard work of making sure
306. 13:34that this doesn't continue.
307. 13:37We bucked the status quo.
308. 13:39We did the impossible. .
309. 13:40If anything, my story is a story that we
310. 13:43don't have to accept what's going on right now.
311. 13:46And we can work to build a place that is more fair and more just
312. 13:50and more resilient for our community.
313. 13:52JOSHUA SHARFSTEIN: So well said.
314. 13:53Thank you so much for joining me on the podcast today.
315. 13:56MONA HANNA-ATISHA: Josh, it's always great to talk with you.
316. 13:58JOSHUA SHARFSTEIN: Public Health On Call
317. 14:00is produced by Joshua Sharfstein, Lindsey Smith
318. 14:03Rogers, Stephanie Desmond, and Namari Morales.
319. 14:06Audio production by Spencer Greer, Niall Owen McCusker,
320. 14:10[INAUDIBLE] Oates, and Matthew Martin with support
321. 14:13from Chip Hickey.
322. 14:15Distribution by Nick Moran.
323. 14:17Thank you for listening.
324. 14:19[MUSIC PLAYING]