America’s Path to Drinking Water Infrastructure Inequality and Environmental Injustice: The Case of Flint, Michigan

  • Adrienne L. Katner
  • Komal Brown
  • Kelsey Pieper
  • Marc Edwards
  • Yanna Lambrinidou
  • Wilma Subra


Much of America’s aging drinking water infrastructure is in a state of disrepair that threatens our water quality and public health. If the goal of equitable access to safe water is to be realized, we must rise to the challenge of replacing or upgrading this infrastructure starting in communities that can least afford to do so. This chapter examines the disparate financial burdens, potential health impacts, and environmental justice implications that water infrastructure inequality poses through the problem of lead in drinking water and opportunistic premise plumbing pathogens. The lead-in-water crisis and Legionella outbreak in Flint, Michigan, provides a clarion call to address funding needs, strengthen regulations, incentivize regulatory compliance, promote meaningful public participation, ensure government accountability, and improve public health outcomes.


Lead Legionella Drinking water Infrastructure inequality Environmental justice Flint Michigan 


  1. ABC12 News Team. 2015. Flint Is Now the Second Most Poverty-Stricken City in the Nation., September 18. city-in-the-nation-328164611.html. Accessed 7 Jan 2017.
  2. Advisory Committee on Childhood Lead Poisoning Prevention (ACCLPP). 2012. Low Level Lead Exposure Harms Children: A Renewed Call for Primary Prevention. Atlanta: US Department of Health and Human Services, CDC, ACCLPP. Accessed 2 Jan 2017.
  3. Agency for Toxic Substances and Disease Research (ATSDR). 2012. Lead Toxicity: What Are the Physiological Effects of Lead Exposure? August 20. Accessed 28 Jan 2017.
  4. American Academy of Pediatrics (AAP). 2011. Letter from American Academy of Pediatrics to Aaron Yeow of EPA. EPA, March 22.$File/aapcomments.PDF. Accessed 7 Jan 2017.
  5. American Water Works Association (AWWA). 2013. Buried No Longer: Confronting America’s Water Infrastructure Challenge. Accessed 31 Jan 2017.
  6. Anderson, E. 2016. Legionnaires-Associated Deaths Grow to 12 in Flint Area. Detroit Free Press, April 11. Accessed 7 Jan 2017.
  7. Balazs, C., and I. Ray. 2014. Drinking Water Disparities Framework: On the Origins and Persistence of Inequities in Exposure. American Journal of Public Health 104 (4): 603–611.CrossRefGoogle Scholar
  8. Beer, K.D., J.W. Gargano, V.A. Roberts, V.R. Hill, L.E. Garrison, P.K. Kutty, E.D. Hilborn, T.J. Wade, K.E. Fullerton, and J.S. Yoder. 2015. “Surveillance for Waterborne Disease Outbreaks Associated with Drinking Water” − United States, 2011−2012. CDC Morbidity and Mortality Weekly Report 64: 842–848.CrossRefGoogle Scholar
  9. Bouffard, K. 2016. Hospital Ties Legionnaires’ to Flint water. The Detroit News, January 22. Accessed 28 Jan 2017.
  10. Brown, M.J. 2009. Letter from Mary Jean Brown to Avis Russell, Interim General Manager, DC WASA. cc’d to District Department of Environment and Environmental Protection Agency’s Office of Water. September 4.Google Scholar
  11. Brown, M.J., J. Raymond, D. Homa, C. Kennedy, and T. Sinks. 2011. Association Between Children’s Blood Lead Levels, Lead Service Lines, and Water Disinfection, Washington, DC, 1998−2006. Environmental Research 111 (1): 67–74.CrossRefGoogle Scholar
  12. Calow, R., and N. Mason. 2014. The Real Water Crisis: Inequality in a Fast Changing World. Overseas Development Institute. Accessed 7 Jan 2017.
  13. Carmody, S. 2016. Gov. Snyder’s Sweeping Plan for Flint Water Crisis Gets a Reality Check., March 26. Accessed 7 Jan 2017.
  14. Cecil, K. 2008. Decreased Brain Volume in Adults with Childhood Lead Exposure. PLOS Medicine. Accessed 7 Jan 2017.CrossRefGoogle Scholar
  15. Centers for Disease Control and Prevention (CDC). 2005. Preventing Lead Poisoning in Young Children. Atlanta: U.S. Department of Health and Human Services. Accessed 5 June 2016.
  16. Cornwell, D.A., R.A. Brown, and S.H. Via. 2016. National Survey of Lead Service Line Occurrence. Journal of the American Water Works Association 108 (4): E182–E191.CrossRefGoogle Scholar
  17. Dawsey C.P. 2017. Soaring Pneumonia Deaths in Genesee County Likely Linked to Undiagnosed Legionnaires’, Experts Say. The Center for Michigan. Bridge. Accessed 28 Jan 2017.
  18. Del Toral, M., A. Porter, and M. Schock. 2013. Detection and Evaluation of Elevated Lead Release from Service Lines: A Field Study. Environmental Science & Technology 47 (16): 9300–9307.CrossRefGoogle Scholar
  19. Deshommes, E., and M. Prevost. 2012. Pb Particles from Tap Water: Bioaccessibility and Contribution to Child Exposure. Environmental Science and Technology 46 (11): 6269–6277.CrossRefGoogle Scholar
  20. Dooling, K.L., K. Toews, L.A. Hicks, L.E. Garrison, B. Bachaus, S. Zansky, R. Carpenter, B. Schaffner, E. Parker, S. Petit, et al. 2015. “Active Bacterial Core Surveillance for Legionellosis” − United States, 2011−2013. CDC Morbidity and Mortality Weekly Report 64 (42): 1190–1193.CrossRefGoogle Scholar
  21. Edwards, M. 2004a. Testimony to the 108th Congress of the United States. Lead in DC Drinking Water. House Committee on Government Reform, 5 March 2009. 29 pages.Google Scholar
  22. ———. 2004b. Designing Sampling for Targeting Lead and Copper: Implication for Exposure. Webinar to the US EPA National Drinking Water Advisory Council for Lead and Copper. Accessed 29 Jan 2017.
  23. ———. 2014. Fetal Death and Reduced Birth Rates Associated with Exposure to Lead Contaminated Drinking Water. Environmental Science and Technology 48 (1): 739–746.Google Scholar
  24. ———. 2015. Corrosion Control in Water Distribution Systems: One of the Grand Engineering Challenges for the 21st Century. Edited by Simon Parsons, Richard Stuetz, Bruce Jefferson and Marc Edwards. Water Science and Technology 49 (2): 1–8.Google Scholar
  25. ———. 2016a. Understanding Flint’s Water Infrastructure Crisis: Water Infrastructure Inequality in America., December 9. Accessed 7 Jan 2017.
  26. ———. 2016b. Contaminated Drinking Water in Flint [February 2016]. Congressional Hearings on Flint Water Crisis. Accessed 29 Jan 2017.
  27. Edwards, M., and A. Dudi. 2004. Role of Chlorine and Chloramine in Corrosion of Lead-Bearing Plumbing Materials. Journal of American Water Works Association 96 (10): 69–81.CrossRefGoogle Scholar
  28. Edwards, M., and Y. Lambrinidou. 2009. Institutional Scientific Misconduct at U.S. Public Health Agencies: How Malevolent Government Betrayed Flint, MI. Oversight and Government Reform. Accessed 7 Jan 2017.
  29. Edwards, M., W.J. Rhoads, A. Pruden, A. Pearce, and J.O. Falkinham III. 2014. Green Water Systems and Opportunistic Premise Plumbing Pathogens: The Grand Challenge of Meeting Water and Energy Sustainability Goals Without Endangering Public Health. Plumbing Engineer (November): 63–65.Google Scholar
  30. Federal Register. 1991. EPA. Maximum Contaminant Level Goals and National Primary Drinking Water Regulations for Lead and Copper; Final Rule. Federal Register, 56 FR 26460, 40 CFR Part 141, Subpart I. June 7
  31. Feigenbaum, J., and C. Muller. 2016. Lead Exposure and Violent Crime in the Early Twentieth Century. Harvard University. Accessed 7 Jan 2017.CrossRefGoogle Scholar
  32. Flint Water Advisory Task Force. 2016. Flint Water Task Force Final Report. Accessed 8 Jan 2017.
  33. Gabler, E. 2011. High Lead Levels Found in Chicago Water. Chicago Tribune, August 5. Accessed 28 Jan 2017.
  34. Ganim, S., L. Tran, and M. Simon. 2016. Exclusive: Michigan Legionnaires’ Deaths Were Preventable, Official Says., February 12. Accessed 7 Jan 2017.
  35. Global Researcher. 2008. Looming Water Crisis., 2(2): pp. 27–56. Accessed 29 Jan 2017.
  36. Goodnough, A., and S. Atkinson. 2016. A Potent Side Effect to the Flint Water Crisis: Mental Health Problems., April 30. Accessed 7 Jan 2017.
  37. Gould, E. 2009. Childhood Lead Poisoning: Conservative Estimates of the Social and Economic Benefits of Lead Hazard Control. Environmental Health Perspective 117 (7): 1162–1167.CrossRefGoogle Scholar
  38. ———. 2016. Delivering Fresh Water: Critical Infrastructure, Environmental Justice, and Flint, Michigan. American Journal of Public Health 106 (8): 1358–1360.CrossRefGoogle Scholar
  39. Guyette, C. 2015. Scary: Leaded Water and One Flint Family’s Toxic Nightmare. Deadline Detroit. Accessed 28 Jan 2017.
  40. Hanna-Attisha, M., J. LaChance, R.C. Sadler, and A.C. Schnepp. 2016. Elevated Blood Lead Levels in Children Associated with the Flint Drinking Water Crisis: A Spatial Analysis of Risk and Public Health Response. American Journal of Public Health 106 (2): 283–290.CrossRefGoogle Scholar
  41. Hodge, A.T. 1981. Vitruvius, Lead Pipes and Lead Poisoning. American Journal of Archaeology 85 (4): 486.CrossRefGoogle Scholar
  42. Hullet, S. 2016. In Flint, Trust in Filters – And Government – Elusive., June 30. Accessed 7 Jan 2017.
  43. Kaplan, S., and C. Hiar. 2012. How an EPA Project Backfired, Endangering Drinking Water with Lead., August 8. Accessed 8 Jan 2017.
  44. Katner, A., K.J. Pieper, L. Lambrinidou, K. Brown, C. Hu, H.W. Mielke, and M.A. Edwards. 2016. Weaknesses in Federal Drinking Water Regulations and Public Health Policies that Impede Lead Poisoning Prevention and Environmental Justice. Environmental Justice 9 (4): 109–117.CrossRefGoogle Scholar
  45. Lambrinidou, Y. 2015. Long-Term Revisions for the Lead and Copper Rule (LCR) [Letter of Dissent to the National Drinking Water Advisory Council (NDWAC)].
  46. Lambrinidou, Y., and R. Scott. 2013. Empirical and Legal Evaluation of Public Health Protection Under the Federal Lead and Copper Rule: Qualitative Research (Preliminary Findings). Invited Presentation at Robert Wood Johnson Foundation, Public Health Law Research Annual Grantee Meeting “Making the Case for Laws that Improve Health,” New Orleans, LA. January 16–18.Google Scholar
  47. Lee, T. 2015. The Rust Belt: Once Mighty Cities in Decline. Accessed 7 Jan 2017.
  48. Legionella: Legionnaires Disease and Pontiac Fever. CDC. 2016. Accessed 28 Jan 2017.
  49. Leonnig, C.D., J. Becker, and D. Nakamura. 2004. Lead Levels in Water Misrepresented Across the U.S.: Utilities Manipulate or Withhold Test Results to Ward off Regulators. Washington Post. Accessed 23 Feb 2018.
  50. Livengood, C. 2015. Loan Forgiveness Sought for Flint to Replace Lead Pipes., December 6. Accessed 7 Jan 2017.
  51. Livengood, C. 2016. Flint Mayor: Water Fix Could Cost as much as $1.5B., January 7. Accessed 7 Jan 2017.
  52. Lombardo, C., and D.J. Hall. 2017. DNR and Milwaukee Leaders Agree: Wisconsin Must Do More About Lead in Drinking Water. Wisconsin Center for Investigative Journalism, January 13. Accessed 31 Jan 2017.
  53. Mack, E.A., and S. Wrase. 2017. A Burgeoning Crisis? A Nationwide Assessment of the Geography of Water Affordability in the Unites States. PLoS ONE 12 (1): e0169488. Accessed 30 Jan 2017.CrossRefGoogle Scholar
  54. Mantha, A. 2016. Clean Water for St. Joseph, LA: A Victory in the Battle Against Infrastructure Inequality., December 17. Accessed 7 Jan 2017.
  55. Masters, S., and M. Edwards. 2015. Increased Lead in Water Associated with Iron Corrosion. Environmental Engineering Science 32 (5): 361–369.CrossRefGoogle Scholar
  56. Masters, S.M., H. Wang, A. Pruden, and M. Edwards. 2015. Redox Gradients in Distribution Systems Influence Water Quality, Corrosion, and Microbial Ecology. Water Research 68: 140–149. Scholar
  57. Milman, O., and J. Glenza. 2016. At Least 33 Cities Used Water Testing ‘Cheats’ Over Lead Concerns. The Guardian, June 2. Accessed 29 Jan 2017.
  58. Muennig, P. 2016. The Social Costs of Lead Poisoning. Health Affairs 35 (8): 1545. Scholar
  59. National Research Council (NRC). 2003. A Century of Innovation: Twenty Engineering Achievements that Transformed Our Lives. Washington, DC: The National Academies Press. Scholar
  60. Nevin, R. 2007. Understanding International Crime Trends: The Legacy of Preschool Lead Exposure. Environmental Research 104: 315–336.CrossRefGoogle Scholar
  61. Olson, E., and K.P. Fedinick. 2016. What’s in Your Water? Flint and Beyond. National Resource Defense Council (NRDC). Accessed 7 Jan 2017.
  62. Pieper, K., L.H. Krometis, D.L. Gallagher, B.L. Benham, and M. Edwards. 2015. Incidence of Waterborne Lead in Private Drinking Water Systems in Virginia. Journal of Water and Health 13 (3): 897–908.CrossRefGoogle Scholar
  63. Pieper, K.J., M. Tang, and M.A. Edwards. 2017. Flint Water Crisis Caused by Interrupted Corrosion Control: Investigating “Ground Zero” Home. Environmental Science and Technology 51 (4): 2007–2014.CrossRefGoogle Scholar
  64. Pruden, A., M.A Edwards, and J.O. Falkinham. 2013. State of the Science and Research Needs for Opportunistic Pathogens in Premise Plumbing. Denver: Water Research Foundation (WRF). Accessed 28 Jan 2017.
  65. Rabin, R. 2008. The Lead Industry And Lead Water Pipes: ‘A Modest Campaign’. American Journal of Public Health 98 (9): 1584–1592.CrossRefGoogle Scholar
  66. Sandvig, A. M., P. Kwan, G. Kirmeyer, B. Maynard, D. Mast, R.R. Trussell, S. Trussell, A. Cantor, and A. Prescott. 2008. Contribution of Service Line and Plumbing Fixtures to Lead and Copper Rule Compliance Issues. Denver: American Water Works Research Foundation (AWWaRF). Accessed 7 Jan 2017.
  67. Schwake, D.O., E. Garner, O.R. Strom, A. Pruden, and M.A. Edwards. 2016. Legionella DNA Markers in Tap Water Coincident with a Spike in Legionnaire’s Disease in Flint, MI. Environmental Science and Technology 3 (9): 311–315.Google Scholar
  68. Scipioni, J. 2016. Is the Flint Water Crisis Getting Worse?, December 5. Accessed 7 Jan 2017.
  69. Stecker, T. 2016. Federal Law Makes Lead-Pipe Removal Anything but a Cinch. E&E News, July 7. Accessed 7 Jan 2017.
  70. Stephenson, J.B. 2008. The District of Columbia and Communities Nationwide Face Serious Challenges in Their Efforts to Safeguard Water Supplies, GAO-08-687T. Washington, DC: Government Accountability Office (GAO).Google Scholar
  71. Telvock, D. 2016. Looking for Lead (In All the Wrong Places: How Disparity, ‘Cheating’ and Potential Conflicts Plague Buffalo’s Sampling Program for Lead in Drinking Water. Investigative Post. Accessed 31 Jan 2017.
  72. Tiemann, M. 2016. Drinking Water State Revolving Fund (DWSRF): Program Overview and Issues. Federation of American Scientists. Accessed 7 Jan 2017.
  73. Triantafyllidou, Y., and M. Edwards. 2011. Galvanic Corrosion After Simulated Small-Scale Partial Lead Service Line Replacements. Journal of American Water Works Association 103 (9): 85–99.CrossRefGoogle Scholar
  74. Triantafyllidou, S., and M. Edwards. 2012. Lead (Pb) in Tap Water and in Blood: Implications for Lead Exposure in the United States. Critical Review of Environmental Science and Technology 42 (13): 1297–1352.CrossRefGoogle Scholar
  75. Troesken, W. 2006. The Great Lead Water Pipe Disaster. Cambridge, MA: MIT Press.Google Scholar
  76. Ungar, L., and M. Nichols. 2016. 4 Million Americans Could Be Drinking Toxic Water and Would Never Know., December 13. Accessed 7 Jan 2017.
  77. United Nations (UN). 2015. Progress on Sanitation and Drinking Water: 2015 Update and MDG Assessment. WHO/UNICEF, UN.
  78. US Environmental Protection Agency (US EPA). 2014. U.S. EPA NDWAC Lead and Copper Working Group. EPA, November 11–12. Accessed 7 Jan 2017.
  79. ———. 2017. Learn About Environmental Justice. [online] Available at: Accessed 2 Feb 2018.
  80. VanDerslice, J. 2011. Drinking Water Infrastructure and Environmental Disparities: Evidence and Methodological Considerations. American Journal of Public Health 101 (S1): 109–114.CrossRefGoogle Scholar
  81. Walton, B. 2016. Water System Needs Investment and Affordability. management/infrastructure/water-systems-need-investment-affordability/. Accessed 7 Jan 2017.
  82. Wang, H., S. Masters, Y. Hong, J. Stallings, J.O. Falkingham, M. Edwards, and A. Pruden. 2012. Effect of Disinfectant, Water Age, and Pipe Material on Occurrence and Persistence of Legionella, Mycobacteria, Pseudomonas aeruginosa, and Two Amoebas. Environmental Science & Technology 46 (21): 11566–11574.CrossRefGoogle Scholar
  83. Wang, H., S. Masters, M.A. Edwards, J.O. Falkinham III, and A. Pruden. 2014. Effect of Disinfectant, Water Age, and Pipe Materials on Bacterial and Eukaryotic Community Structure in Drinking Water Biofilm. Environmental Science & Technology 48: 1426–1435. Scholar
  84. Wang, H., S. Masters, J.O. Falkinham, M. Edwards, and A. Pruden. 2015. Distribution System Water Quality Affects Responses of Opportunistic Pathogen Gene Markers in Household Water Heaters. Environmental Science & Technology 9 (14): 8416–8424. Scholar
  85. Wells, K. 2016. Flint’s Water System Is Falling Apart. Fixing It Could Cost $100 Million., August 9. Accessed 8 Jan 2017.

Copyright information

© The Author(s) 2018

Authors and Affiliations

  • Adrienne L. Katner
    • 1
  • Komal Brown
    • 1
  • Kelsey Pieper
    • 2
  • Marc Edwards
    • 2
  • Yanna Lambrinidou
    • 2
  • Wilma Subra
    • 3
  1. 1.Louisiana State University- HealthNew OrleansUSA
  2. 2.Virginia Tech UniversityBlacksburgUSA
  3. 3.Louisiana Environmental Action NetworkNew IberiaUSA

Personalised recommendations