Dominique Strong of Flint, Mich., holds a sign during a Feb. 3 city council meeting, which introduced the topic of whether Flint residents should have to pay for their water bills. Strong is from one of the areas most affected by the city's crisis relating to lead in water. "Not one person thought about the children or us as humans," Strong said. (Brittany Greeson for The Washington Post)

The situation in Flint is bad. Very, very bad. It is hard-to-believe-this-is-happening-in-America bad, even for people who might not have huge faith in their country's government.

If you doubt that or remain fuzzy on the essential, non-political toll of Flint's water crisis , you really should take a moment and listen to this NPR story about a Flint woman -- wife and mother of two -- who must contemplate the number of bottles of water necessary to cook her family different meals and has noticed what she suspects are developmental differences between her older son and younger one. She filled her younger son's bottles with Flint's lead-laden tap water during the time that public officials insisted that it was safe.

If you have a young child in your life whom you love, consider what it would mean to know that you may have poisoned them every time you gave that child a bottle, a bath or a meal. That is how very real the situation is in Flint right now. Do not let the raging game of politicians and bureaucrats pointing the finger fully distract you. Then consider what is also known about the long-term social consequences of lead poisoning and the public spending needs it creates. What follows is based on science -- not politics, not ideology. Science. But there are certainly political questions for each of us to consider here, too.

To help us, The Fix caught up with Richard Rothstein, a research associate at the left-leaning Economic Policy Institute. Rothstein and his colleague, Leila Morsy, a lecturer at the University of New South Wales, released a report in June that really should sit on some kind of recommended national reading list. The report compressed down decades of research on the short- and long-term effects of lead exposure. And there is really only way to summarize it: The truth is both alarming and extremely revealing.

This is not joyful reading, folks. But it is important.

Lead causes permanent brain damage. It can change the lives of those exposed, particularly during early childhood.

You see, all brains need calcium to develop. Unfortunately, the body mistakes lead for calcium when it is present in the body at any level. And that, in turn, damages the brain. The net effect is terrible: diminished cognitive function, reduced impulse control and impaired decision-making, as well as problems with memory and learning capacity.


Flint resident Gladyes Williamson, center, holds a bottle full of contaminated water, and a clump of her hair, alongside resident Jessica Owens, right, who holds a baby bottle containing contaminated water, during a Feb. 3  news conference on Capitol Hill in D.C. (Mark Wilson/Getty Images)

There are no safe lead levels. 

Lead exposure is measured by deciliters -- or more specifically, the concentration of lead found per deciliter of blood in a person's body. You really should read the link below if you would like to know more about measuring lead concentrations in water. But also know this: For some time, the Centers for Disease Control considered any child with lead levels that register at 5 deciliters or more in serious trouble. However, more recent studies have lead the agency to change its standards to indicate that no level of lead exposure is safe. Children with lead levels far below 5 deciliters have been found to suffer from reduced cognitive function and learning problems.

Flint has our attention, but the United States' lead problem is much larger than Flint.

Most lead exposure today comes from elevated amounts of the diesel gas fumes in cities, paint and other household items. And all of the above are most common in older homes and substandard housing. As a result, poor and particularly low-income African Americans are the most likely to suffer from the effects of lead exposure.

But here is the thing: While Flint is a crisis, all of the stuff mentioned above is ongoing at all times in most states. The Washington Post's Yanan Wang explained it exceedingly well this month. So we are going to share what she wrote about the rest of the United States this month:

Data collected by the Center for Disease Control and Prevention shows that over 40 percent of the states that reported lead test results in 2014 have higher rates of lead poisoning among children than Flint.

In Flint, 4 percent of kids age 5 and younger tested with blood-lead levels of at least 5 micrograms per deciliter, the threshold of lead intake that necessitates public health action, as defined by the federal government.

Elsewhere in the country, 12 states reported that a greater percentage of kids under 6 years old met or surpassed that threshold. The most egregious example is Pennsylvania, where 8.5 percent of the children tested were found to have dangerously high levels of lead in their blood.

Only 27 states (including D.C.) reported childhood blood lead surveillance results to the CDC’s national database for 2014, the most recent statistical set available.


In May 8, 2015, gas station attendant Carlos Macar pumps gas in Andover, Mass. States across the country banned the use of lead in gasoline at different times in the 1970s and 1980s. (Elise Amendola/AP)

Now, take a deep breath. Here's a little critical history and why it matters right now. 

In the 1970s, lead exposure levels were far higher across the entire population, because the gasoline most of us put into our cars contained it. It was the primary source of lead exposure for most, but not all, white Americans. And eliminating this, more than one very solid study has found, is responsible for much of white children's gains in the kind of cognitive performance that can be readily measured. It also partially explains the long-term gap between the cognitive performance of black and white children in the United States.

Here it is, simply put: A larger share of the black population lives in poverty than the share of whites who do the same. The reasons for that are complex. But it's that poverty that puts people at greater risk for multiple sources of lead exposure.

Marinate on that for a moment. The implications are huge.


Brittny Giles of Flint, Mich., teaches her son Joshua, 5, how to practice drawing the alphabet at their home on Feb. 4. Giles recently had her children's blood lead levels tested, which came back low, but she said she is still concerned. (Brittany Greeson for The Washington Post)

There are also long-term consequences to lead exposure. And science has proved it.

People exposed to lead during childhood are statistically far more likely to engage in crime and spend time in jail, to get pregnant as a teenager and to engage in other risky behaviors. There is a lot of very serious multi-disciplinary research to support all of the above. Yes, even the most uncomfortable parts of it.

States across the country banned the use of lead in gasoline at different times in the 1970s and 1980s. So, there's not only evidence that shows how consistently lead levels detected in the blood of people in different states corresponded with state gas policies, researchers can also see when IQ's in those states began to rise, when and how crime began to go down along with teen pregnancy. They can see consistent patterns in how long it took for those trends to begin, to peak and so forth. And the difference this change made is collectively huge.

Children with 10 percent more lead in their blood makes a 1 percent increase in behavior problems, but, by the teen years that grows to a 4 percent increase in aggressive behavior, a 5 percent increase in criminal behavior and an 8 percent increase in teen pregnancy.

In fact, in states where the gas requirements were in place long enough to reduce detectable lead levels (in residents' bodies) in half, researchers found a 24 percent decline in the likelihood of teen pregnancy, the Economic Policy Institute report found.

People have been wondering and, in some cases, pontificating for years about the reasons that both crime and teen pregnancy have dropped so significantly for such a sustained period of time since the 1990s. Well, there's a lot of evidence to suggest the reason is the entire population's reduced exposure to lead. We strongly suggest that you take a look at our expert's research. It includes links to all the source material of which you could ever dream.


The Flint Water Plant tower is seen in Flint, Mich., on Feb. 7. The mayor of Flint, which is struggling to cope with dangerous levels of lead in its drinking water, said on Feb. 9 that the city would replace all residents' pipes and was counting on state and federal help to foot the estimated $55 million bill. (Rebecca Cook/Reuters)

Unfortunately, all of this is very bad news for Flint and the rest of the country. 

Crises like the one in Flint will create both short-term and very, very long-term needs. The city is very likely to face more significant challenges trying to educate it's children, elicit the right behavior in schools for learning and doling out the kind of discipline that won't prevent it. The city may well see teen pregnancy and crime increase, per the data above.

It's all really, really grim, with just a sliver of hope -- more public spending than some voters may like. As Rothstein put it, there's also a lot of social science that supports the idea that certain policy responses are needed. For instance, making long-acting reliable forms of birth control more widely available tends to reduce both the teen pregnancy and overall unintended pregnancy rate. There's similar evidence about college-going and employment. But what are we collectively willing to spend to make teen pregnancies less likely using these proven tools? And what about the long-running objections some Americans have to discussing, much less providing, birth control?

See what we meant about polarizing solutions?


An illustration shows a woman holding a birth control pill. Young people with high lead levels in their blood might have a higher chance of risky behavior resulting in difficult outcomes, such as teen pregnancy. (Eric Gaillard/Reuters)

Okay, so you have the facts. And you have political beliefs. But here's a bit more for you to consider.

Rothstein suggested that people trying to evaluate the two Democratic presidential candidates on the debate stage Thursday night and where they stand on issues related to Flint, government responsibility, environmental hazards (including lead poisoning), should probably look and listen for which candidates are thinking about these issues in the long-term.

Replacing Flint's pipes matters; it matters a great deal right now. But so do these long-term implications. Which candidates seem aware of them or reflect an understanding of what may need to be done to mitigate them?

And know this: Children covered by Medicaid undergo mandatory lead level testing between the ages of 1 and 2 because of the relationship between poverty and lead exposure. The goal is to detect it, treat it medically and provide what educational and social supports possible to mitigate the damage.

And although Michigan has a Republican-controlled state government, it is one of the states that expanded access to Medicaid to more people under the terms of the Affordable Care Act, better known as Obamacare.

We warned you this was not cheery reading. But it is important.