Read the “A Case Study of Environmental Injustice: The Failure in Flint” topic
material.. Assume the role of a public health leader associated with the Flint case study,
and write a 750-1,000 word paper to address the Flint case study. Address each of the
What is the problem to be resolved or decision to be made?
Who are the key decision makers and leaders? What is motivating each of them?
To resolve the problem or come to a decision, what questions must be addressed? What
issues must be resolved?
What are the ethical dilemmas associated with the case?
What are the primary negotiation and mediation skills you would use to address each
question and resolve each issue? Justify your selection of each.
Explain and justify how you would resolve the issue and articulate the decisions you
would make in this situation.
Flint Case Study
The case study was based on the events that transpired in the City of Flint, Michigan,
on the various governmental levels’ inability to safeguard and protect the public using public
health measures. The case study focuses on the city’s failure to provide safe drinking water to
the residents of Flint after a change in the city’s source of water, leading to exposure to high
lead levels (Campbell, Greenberg, Mankikar, & Ross, 2016) . The environmental injustice
occurred as the majority of those exposed were from low income and minority groups. High
blood lead levels and lead poisoning was recorded among the children leading to detrimental
effects such as behavior change, decreased intelligence, attention, and several other
neurologic signs (Hauptman, Bruccoleri, & Woolf, 2017) . Furthermore, the exposure was
long-term and occurred over 20 months. The relevant governmental, both local and federal,
and the environmental regulatory bodies were not compliant with the lead and copper rule as
stipulated by the Environmental Protection Agency (EPA) to treat corrosive water that may
potentially cause lead poisoning due to the corrosion of lead supply pipes and filler
(Campbell, Greenberg, Mankikar, & Ross, 2016) . As such, the population of Flint was
exposed to lead for a protracted duration resulting in elevated blood lead levels in children
and lead poisoning.
FLINT CASE STUDY 2
Problem Involved and Decisions Made.
The problem in Flint, Michigan was precipitated by the switch in water supply from
Lake Huron to the Flint River and the failure of the local government to comply with the
EPA regulations that anti-corrosives should be used in the treatment of corrosive water to
prevent lead poisoning as it would avoid the corrosion of lead piping and fillers which would
elevate the levels of lead in drinking water and consequent poisoning in the residents.
Furthermore, the exposure was long term and was noted after children blood levels were
elevated. As such, there was a laxity by the local government to protect the population of
Flint due to non-compliance with public health stipulations in the treatment of corrosive
water (Jennings & Duncan, 2017) . The other problem posed in Flint’s water supply was a lack
of adherence to proper testing and acknowledgment by the local government on lead
contamination of the water.
Through the board constituted by the governor, there was a persistent cover-up of the
city’s water as the source of the lead Poisoning and elevated levels of lead in children in Flint.
The decisions that led to the change in the source of water was the bid to reduce the City’s
water supply cost (Campbell, Greenberg, Mankikar, & Ross, 2016) . Ultimately, it led to the
elevated levels of lead in the blood of children in Flint and hence compromised public health.
Thus, there was an apparent failure of a robust response from public health and governmental
systems in ensuring the safety and quality of water supply to the city of Flint (Jennings &
Duncan, 2017) . The decision made after the crisis was highlighted the formation of a task
force to investigate the water mismanagement and faulted all the governmental levels for the
Key Decision Makers and Leaders and Their Roles
Several prominent people were involved in the Flint water Crisis included Dr. Mona
Hanna-Attisha, who was carrying out a study on the blood lead levels in children. She noted
that there was a significant increase, almost double the previous levels in the study pool after
the change of water, which was indicative of contamination. Dr. Edward Marks, a civil and
environmental engineer who advocates against environmental injustice was also involved and
gave testimony to congress that regardless of the crisis, the regional head of the regulatory
body, EPA, was not notified of the contamination (Campbell, Greenberg, Mankikar, & Ross,
2016) . The EPA administrator, Gina McCarthy, also noted that the Michigan Department of
Environmental Quality (MDEQ) was evasive on the Flint water crisis and had failed in its
enforcement mandate for lead levels in the water, thus endangering the lives of the population
in the city. Furthermore, it was noted that the Michigan Department of Health and Human
Services had also failed in the protection of public health (Campbell, Greenberg, Mankikar,
& Ross, 2016) . Governor Snyder’s government was also faulted for poor governance by the
task force that he set up to address the Flint water crisis leading to the subsequent lead
poisoning from the contaminated water.
Questions That Require to be Addressed
Several issues would require to be addressed to provide a relevant solution to the high
blood lead levels in children from Flint due to the consumption of contaminated water. The
first question would be on the immediate action by the relevant authorities to ensure that the
water was safe for drinking? Secondly, there is a need to address the queries that are
FLINT CASE STUDY 3
associated with lead poisoning intervention measures among the population of the city. As
such, there is a need also to put forth the question of the financial implication of treatments
and intervention measures as the effects of lead poisoning are long term, with the majority
being asymptomatic. Besides, inquiries on the accountability of the governance and
management of regulatory authorities would be included as their mismanagement led to the
protracted period of poisoning.
The ethical dilemma noted from the Flint water crisis is poor management, a lack of
accountability, and corrupt morals, as indicated by the falsified water analysis, which led to
the exposure of the city’s population to lead poisoning. The local government, in a bid to cut
costs, also jeopardized the health and safety of its citizens and caused irreversible damage
with lifelong consequences (Chavez, Perez, Tunnery, & Nunez, 2017) . As such, there is a
need to address the poor management issues from the high-ranking state officials as they
explicitly put the cost of an essential commodity over the lives of the population. Hence there
is a need to ensure that the environmental injustice is addressed by conferring charges related
to professional negligence against the individuals involved. Inaction from state officials also
exacerbated the crisis as it led to a continual consumption of the contaminated water by the
Primary Negotiation and Mediation
Due to the permanent nature of the adverse effects associated with Lead poisoning,
there is a need to ensure that there is mediation between the population of Flint and Michigan
state. The main aim is to ensure that there is a settlement between the parties involved.
Evidence has been tabled, incriminating the state and officials that act on behalf of the state,
and hence Michigan state should take responsibility (Ruckart et al., 2019). Furthermore,
negotiations should involve the healthcare expenditure of the population exposed to lead
poisoning as a result of negligent sate and federal officials. Additionally, there should be
measures in place to address the poor governance accountability and transparency shown by
the state government. The skill is to balance the wrath of the population and remorse of the
state and accept the measures instituted to ensure that public health concerns are addressed
and safeguarded. The mediation environment should be calm and guided to provide a lasting
solution and hence settlement ultimately.
Resolution of the Crisis
The efforts to resolve the Flint water crisis are to offer a reprieve for the irreparable
life-long health issues associated with lead poisoning that resulted from the exposure of the
individuals to the contaminated water. The recommendation of prosecution of the state
officials responsible for the crisis due to professional negligence would also appease the
affected parties (Chavez, Perez, Tunnery, & Nunez, 2017) . Moreover, setting up a medical
fund to aid in the treatment of the concerned individuals is also essential as the associated
medical bills are high. Also, the provision of educational meetings with the population would
lead to an increase in sensitization regarding lead toxicity and its detrimental effects. The
provision of free testing would also ensure that the affected population is appeased. It would
also lead to an increase in testing for the blood lead levels as most of the patients are
asymptomatic (Jennings & Duncan, 2017) . Additionally, town hall meetings would also
FLINT CASE STUDY 4
ensure that the state and the federal government is aware of the grievances that the population
have regarding governance, transparency, and competency. As such, it would improve the
strained relationship between the city’s population and the relevant governmental and
FLINT CASE STUDY 5
Campbell, C., Greenberg, R., Mankikar, D., & Ross, R. D. (2016). A case study of
environmental injustice: The failure in Flint. International Journal of Environmental
Research and Public Health, 13(10), 951.
Chavez, M., Perez, M., Tunnery, C., & Nunez, S. (2017). Accountability and transparency
diluted in the Flint water crisis: A case of institutional implosion. Norteamérica,
Hauptman, M., Bruccoleri, R., & Woolf, A. D. (2017). An update on childhood lead
poisoning. Clinical Pediatric Emergency Medicine, 18(3), 181-192.
Jennings, B., & Duncan, L. L. (2017). Water safety and lead regulation: Physicians’
community health responsibilities. AMA Journal of Ethics, 19(10), 1027-1035.
Ruckart, P. Z., Ettinger, A. S., Hanna-Attisha, M., Jones, N., Davis, S. I., & Breysse, P. N.
(2019). The Flint water crisis: A coordinated public health emergency response and
recovery initiative. Journal of Public Health Management and Practice: JPHMP,
25(Suppl 1, Lead Poisoning Prevention), S84-S90.