Detroit says no proof water shutoffs harm health. Get real, experts say.

water department

Some 9,500 homes whose water was shut off for nonpayment last year in Detroit remained without service as of mid-January. Detroit officials say there is no evidence shutoffs harm public health. (Bridge photo by Joel Kurth)

Bloomberg and Bernie agree on shutoffs

Add former New York Mayor Mike Bloomberg to the Democratic presidential candidates who are criticizing Detroit’s water shutoffs.

Last week, after Vermont Sen. Bernie Sanders called the disconnections a “moral outrage” on Twitter. Bloomberg senior adviser Antha Williams also condemned them during an environmental policy roundtable in Lansing.

“We have watched with shock as you read these stories about, you know, 9,000 families in Detroit who had their water shut off,” Williams told reporters. “That's just not acceptable, and under Mike Bloomberg we're going to look at all of the tools of the federal government to guarantee clean air, safe drinking water as a basic human right.”

Michigan’s presidential primary is March 10.

                                                                                    — Jonathan Oosting

DETROIT — Water is life, the old saying goes. But does denying it to thousands of people pose a threat to public health?

More than 150 years of science may say yes, experts say, but that may not be enough as the Detroit City Council prepares a resolution asking Gov. Gretchen Whitmer to declare the city’s water disconnections campaign an “imminent danger to public health” and impose a moratorium on them for the needy.

It's an uphill fight because Whitmer’s administration has denied a similar request by the ACLU of Michigan, finding there’s no proof of an epidemic or widespread harm as is required by the Michigan’s Public Health Code.

Officials in Detroit, which has shut service to more than 141,000 residential accounts since 2014 as part of a payment collections campaign, said there is no evidence of widespread health impacts. 

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“To date, the Detroit Health Department has found no association between service interruptions and an epidemic of any reportable communicable disease,” Denise Fair, Detroit's chief public health officer, wrote Bridge Magazine in an email. “Furthermore, there is no clear data to suggest whether or not there are other health risks related to water service interruptions.”

 

In denying a request for a public crisis in September, Michigan Health Director Robert Gordon wrote that while “there are significant challenges faced by residents whose water has been shut off, those challenges do not rise to the level of an imminent danger” because data don't indicate a “causal association between water shutoffs and water-borne disease.” 

Mark Totten, Whitmer’s attorney, repeated the argument in a Friday letter to the ACLU, writing that existing data "does not permit a finding that the city of Detroit is experiencing a public health emergency caused by water shutoffs.”

It’s an argument that baffles Dr. Mona Hanna-Attisha, the pediatrician whose research into a rise in lead levels in children helped uncover the Flint water crisis. 

“It’s a bit ridiculous to even have such a conversation,” she told Bridge. “Water is a medical and public health necessity. The fact that we have to wait to see the deleterious outcomes is backwards and antiprevention and anti-common sense and antiscience.”

“If Flint taught us anything, it’s the need to focus on prevention and not wait until we can prove harm,” she said.

mona

Mona Hanna-Attisha, a Flint pediatrician, says debating whether water shutoffs harm health is “a bit ridiculous.” (Courtesy photo)

Through the Freedom of Information Act, Bridge obtained records from Detroit indicating that 9,500 occupied homes disconnected for nonpayment in 2019 still were without service in mid-January, while the average duration of disconnections for homes with restored service was 29 days.

It’s “absurd to argue there would be no impact” on health, said Nancy Love, a University of Michigan engineering professor who led research into water filters in Flint. She and Hanna-Attisha pointed out that a lack of reliable water is linked to a host of problems from dehydration and skin rashes to gastrointestinal issues. 

“There’s a plethora of literature out there that already makes the point about water and sanitation,” Love said. 

“To suggest that we need to wait for peer-reviewed studies to prove this again [in Detroit] — I don’t think that’s a valid argument.”

Marianne Udow-Phillips, a former director of Michigan’s Department of Human Services, said Michigan’s health code gives the governor “broad discretion” to declare emergencies if they believe there is “imminent danger.”

“They don’t need to wait for research,” said Udow-Phillips, who is now director of the Center for Health and Research Transformation at the University of Michigan.

 

But, she added, “the powers for public health emergencies are expected to be used sparingly” and declarations of emergencies are more typically used to marshall forces to combat an emerging problem. 

Detroit’s water shutoff situation, Udow-Phillips added, is rooted in poverty and a host of other issues that could make it difficult to address with a health emergency.

‘Always push back’

In fact, there has been research into the health effects of Detroit water shutoffs, but much of it has been controversial, said Mary Sheffield, president pro-tem of the City Council.

Sheffield is sponsoring the resolution seeking the moratorium that the council could consider Tuesday. She also wants the state to conduct “independent research” into the health effects, which she contends have been downplayed by the administration of Mayor Mike Duggan. 

“There’s always been pushback and pressure not to do [studies] here,” contended Sheffield, who added the council is considering its next steps now that Whitmer has denied the ACLU's request for an emergency.

Related: 

 

One disputed study was released in 2017, when researchers at the Henry Ford Global Health Initiative found an association between shutoffs and water-borne illnesses like gastrointestinal and soft tissue infections. 

Working with anti-shutoff activists We the People of Detroit, researchers compared block-level disconnection data with admissions at Henry Ford Hospital in Detroit. They found that patients who lived in a block with shutoffs were 1.55 times more likely to have a water-associated illness, even when other socioeconomic situations were taken into consideration.

In a 2017 statement, one of the authors, Alexander Plum, said the study showed that “depriving people of access to water has health consequences.” Another Henry Ford study participant, statistician Kyle Moxey, presented the findings at a March 2017 meeting of the International Joint Commission, saying "when people don't have access to clean drinking water, people get sick."

Soon thereafter, a study co-author, Dr. Marcus Zervos, accused water activists of politicizing “preliminary findings” for “political purposes" and saying more study on the issue is needed.

The study is no longer online, and water activists accused Duggan’s staff of stifling it.  

The city’s former deputy health director, George Gaines, issued a smaller report in 2018 that concluded a “positive causal relationship” between shutoffs and diseases was “plausible.”

It noted that, since the shutoffs began, the city had experienced outbreaks of three waterborne diseases: shigellosis, acute dysentry; giardiasis, a diarrheal disease, as well as Campylobacter infections, which affects the intestines.

Whitmer’s attorney, Totten, criticized both studies in his Friday letter, saying they have “serious limitations.” The state's review of Detroit data found that cases of shigellosis and Campylobacter rose in multiple locations from 2014 to 2017, while giardiasis increased in Detroit in 2017 but dropped again in 2018, said Lynn Sutfin, a state health spokeswoman.

Gary Brown

Gary Brown is director of Detroit’s Water and Sewerage Department. He said the city is expanding help to avoid disconnections, but can’t stop them because doing so would harm the city’s finances. (Courtesy photo)

This review "did not identify any unexplainable increases in these diseases in the City of Detroit ... [or] support any causal association between Detroit’s water shut offs and these diseases," she wrote in an email to Bridge.

In a response to the state, ACLU staff attorney Mark Fancher wrote that the Whitmer is missing the point of the request.

“We don’t need data or studies to know that if thousands of people in a city don’t have water, their health will be seriously impaired or they will die,” Fancher wrote. “Nevertheless, the state has stubbornly refused to even address this aspect of our petition.”

Burden of proof

Two other studies that are still amid the peer review process attempt to “quantify the obvious”: That water shutoffs hurt mental and physical health, said Nadia Gaber, a researcher at the University of California-San Francisco.

She also worked with the We the People group for the 2017 studies that looked at the impacts of shutoffs citywide, as well as a closer look at the impoverished Brightmoor neighborhood on Detroit’s west side.

The studies found increases in anxiety, severe headaches and depression among those with shutoffs, and concluded that more than 40 percent of residents studied in Brightmoor collected water from an undesirable source.

“The reason we had to do this work is because there’s no official reason and no good research on the health effects … because we haven’t seen anything like this in a major U.S. city,” Gaber told Bridge.

“But there’s a massive body of literature worldwide and the health effects are very clear.”

The studies found that “water shutoffs exacerbate already existing social and economic vulnerabilities, disproportionately impacting poor families, the very young and very old, people of color and the medically vulnerable.”

All told, those vulnerabilities apply to more than 80 percent of the city, the study found. That would mean any moratorium on shutoffs for the needy or elderly likely would have the effect of a total ban.

Gaber and Hanna-Attisha said research is so conclusive that living without running water is bad for public health that the onus should be on Detroit to prove shutoffs are safe, rather than on researchers proving they aren’t.

“The assumption should be that this would be a public health danger,” Gaber said. “The burden of proof should be on the government.”

Love, the U-M professor, added that as “the threat of coronavirus is approaching pandemic status, although airborne, people need to maintain appropriate sanitation practices when quarantined. With this in mind, the notion that water shutoffs have no public health impact is further hard to understand.”

The assumption should be that this would be a public health danger. The burden of proof should be on the government.'

— Nadia Gaber, researcher at UC-San Francisco

When Bridge asked city officials if Detroit has any studies showing shutoffs are safe, they responded with the statement from Fair, the city health department chief, noting there is no uptick in waterborne illnesses but the city is working to expand financial-assistance programs.

The shutoffs have helped increase water bill collections in a city where more than a quarter residential accounts were delinquent in 2013, when Detroit fell into bankruptcy. 

Now, the collections rate is more than 90 percent since the shutoffs began, adding more than $50 million to the bottom life of the city that emerged from bankruptcy in 2014.

Editor's note: This story was updated March 2 to add context to statements from Dr. Marcus Zervos' stance on the Henry Ford health study. 

Michigan Health Watch is made possible by generous financial support from the Michigan Health Endowment Fund, the Michigan Association of Health Plans, and the Michigan Health and Hospital Association. The monthly mental health special report is made possible by generous financial support of the Ethel & James Flinn Foundation. Please visit the Michigan Health Watch 'About' page for more information.

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Comments

Kevin Grand
Wed, 02/26/2020 - 8:30pm

It should be fairly obvious why Gov. Whitmer won't do anything...ever.

When DWSD wouldn't (not couldn't) collect monthly bills from delinquent accounts, they simply shifted to costs to the suburbs to make up for this shortfall.

After that started to become widely obvious, people realized that it was much easier to not be responsible, and their cost got shifted elsewhere.

Former Gov. Snyder realized this, which is why he included the WRAP program as part of the GLWA in order to make it somewhat self-sufficient and easier to sell politically.

The problem with returning to this "business practice" is that the suburbs are now aware that they had been taken advantage of all this time, and won't stand for a return to the old ways.

First and foremost Gov. Whitmer is a politician. She has read the political tea leaves and realized that capitulating to the "free stuff" crowd won't help her re-election in 2022.

And if the political phonies like Mike Bloomberg & Bernie Sanders feel so strongly about this issue, what is stopping them from acting on their own?

Mike Bloomberg spends $25-million/week on TV ads alone since November.

Paying off all of those past due bills would be pocket change for him.

Bernie Sanders has a net worth of $2-million (on top of his yearly paycheck of $174,000/year as a US Senator).

Selling off just two out of the three homes he owns alone would wipe out a significant number those bills.

When those two hypocrites put their own money where their mouths are, please let readers know.

https://nypost.com/2020/01/10/mike-bloomberg-will-continue-funding-campa...

https://www.aldvingomes.com/bernie-sanders-net-worth/

J Hendricks
Thu, 02/27/2020 - 8:53am

A thousand Bingos, Kevin! You nailed it. I guess we are supposed to add “free water” to all the other “frees” in the new world of Bernie, Pocohantas, etc.

Matt
Thu, 02/27/2020 - 8:27am

Water alone isn't enough to address these health concerns. They also need soap and other various cleaners, and sponges, mops, paper towels etc etc, Water alone won't do it, the good Doctor here knows this ..., I hope. This logic dictates those should be provided also. But what if the family in question can't do this cleaning? Wouldn't that require getting them some professional cleaning people? This is also healthcare after all, and it's a right! Detroit has plenty of money and it's a jobs program.

Jim Olson
Thu, 02/27/2020 - 8:41am

Look, Governor Whitmer's administration and the request for emergency, although needed immediately, entirely misses the reality of a person's right to water when it comes from Lake Huron or the Great Lakes. These are public waters, subject to the public trust doctrine, with a right of each citizen as legal beneficiary to access water for drinking, bathing, and sanitation. The burden of proof under public trust law is on those who seek to impair or interfere with the right of access and drinking water, or sustenance. The whole approach to Detroit and Flint is flawed. If we see and treat the situation as a matter of public trust, the government has a duty, and if water access and the inconvenience, turmoil, and, frankly, discrimination that occurs is not rectified, the trust duty is violated. What we need to do as a state, and civilized society, is to recognize this public water, public trust, and start acting that way. How? Move off the strictly ratepayer pays system, there are many ways to do this, and it will improve the so-called "bottom line" and remove this continuing injustice. Pass something similar to FLOW's Public Water Public Justice Model Law per its report, 2019. www.flowforwater.org. This will shift to creating flexibility to water boards to set prices in tiers, authorize affordability plans as part of the definition of "costs," and assure a certain amount of water and spread that as part of the cost, charge higher users more, which will encourage conservation, and then spread the cost across the state to all taxpayers, then start requiring bottled water companies to obtain a license, pay a royalty or fee to sell (not just use) our public water, place it into a fund ($250 million or more a year), and right this inequity. We're in this together--We are all citizens of Detroit and Flint.

Matt
Thu, 02/27/2020 - 12:26pm

Awesome! The whole state should pay Detroit's and now Flint's water bills! And your idea of somehow attaching this water cost to what, your state income tax bill? is a fantastic touch! How about low-income folks out it the rural areas too? We should somehow cover their water costs too. Wells, water softeners, reverse osmosis systems are very expensive and obviously should be covered too since water is a human right! What about sept fields since Detroit's water bill includes sewer costs? Again, it's healthcare! What about gas? Isn't warmth a human right? We're jsut getting started and with the help of groups like FLOW and the Bernie Bros, Michigan will be a paradise in no time. To hell with all those rich greedy bastards moving out of the state, we don't need them.

Val
Thu, 02/27/2020 - 1:03pm

If the state should be required to provide water to its people free of charge, then they need to not only provide free municipal water but also pay for people's wells and the electricity to run those - water for all, not everyone can hook up to city water. Not fair to make taxpayers pay for services for city people but leave rural people hanging.

Bones
Thu, 02/27/2020 - 2:31pm

It's so telling how myopic and misanthropic you all are that a world where basic services like water and electricity aren't denied to the poor is unthinkable

Matt
Fri, 02/28/2020 - 11:44am

Absolutely!! What about garbage service too? Just attracts disease carrying vermin, another health issue!! Food needs to get more consideration also, maybe government operated cafeterias in each neighborhood serving only healthy meals? Maybe ... we just cut the corner here and have government provided dormitories? Would be so much easier to force everyone into healthy decisions!! Does this work for you Bones?

Dave
Thu, 02/27/2020 - 5:45pm

Yes, water is a right, but delivery is a service. No one is stopping anyone from dipping a bucket into the river in Hart Plaza, but asking others to pay to keep some one in a house that they can't afford, instead of looking for a more permanent solution is throwing good money after bad.

Jim Olson
Thu, 02/27/2020 - 8:42am

Look, Governor Whitmer's administration and the request for emergency, although needed immediately, entirely misses the reality of a person's right to water when it comes from Lake Huron or the Great Lakes. These are public waters, subject to the public trust doctrine, with a right of each citizen as legal beneficiary to access water for drinking, bathing, and sanitation. The burden of proof under public trust law is on those who seek to impair or interfere with the right of access and drinking water, or sustenance. The whole approach to Detroit and Flint is flawed. If we see and treat the situation as a matter of public trust, the government has a duty, and if water access and the inconvenience, turmoil, and, frankly, discrimination that occurs is not rectified, the trust duty is violated. What we need to do as a state, and civilized society, is to recognize this public water, public trust, and start acting that way. How? Move off the strictly ratepayer pays system, there are many ways to do this, and it will improve the so-called "bottom line" and remove this continuing injustice. Pass something similar to FLOW's Public Water Public Justice Model Law per its report, 2019. www.flowforwater.org. This will shift to creating flexibility to water boards to set prices in tiers, authorize affordability plans as part of the definition of "costs," and assure a certain amount of water and spread that as part of the cost, charge higher users more, which will encourage conservation, and then spread the cost across the state to all taxpayers, then start requiring bottled water companies to obtain a license, pay a royalty or fee to sell (not just use) our public water, place it into a fund ($250 million or more a year), and right this inequity. We're in this together--We are all citizens of Detroit and Flint.

Barry Visel
Thu, 02/27/2020 - 10:42am

“...and then spread the cost across the state to all taxpayers,...”. Except, where there is a public water system, customers almost always are forced to hook up and can no longer use a well. They don’t have a choice. Where’s the public trust argument there? This taxpayer gets water from my own well. How would a statewide tax system help me, except make me pay twice for my water?
Getting back to the source of the problem (which, unfortunately won’t help Detroit’s current situation), we have to stop building infrastructure while failing to account for the long term cost by charging low, unsustainable rates. Same with roads...we’re going to borrow to repair some of our roads but we still don’t have a revenue source to sustain those improvements long term. Ditto for unfunded medical and retirement benefits. Ditto for my school district that wants $40million to build two new buildings when they say they can renovate the existing 50 year old buildings for $32 million...and they don’t have a long term capital improvement fund either. Somewhere this all has to stop. The pie is only so big.

A. Watters
Thu, 02/27/2020 - 10:04am

They used to condem the property if there was no water. Thats why most rentails included the water.

jwier3@gmail.com
Thu, 02/27/2020 - 10:37am

As individuals we all learned of the essential need for water and sanitation in grade school. As a society we figured it out a couple of centuries ago. Talk of studies is nonsense. This must be fixed yesterday. Oh, by the way, i only see talk in all these articles about drinking water, never the sanitation side....

Val
Thu, 02/27/2020 - 12:59pm

what is the alternative? How would you get people to pay for public services like water if there were no consequences for not paying for the water? Are you advocating making water, sewer, electrical, etc free, paid for by what? If there are no consequences for not paying your water bill do you think anyone will pay a water bill?

Doug L
Thu, 02/27/2020 - 1:02pm

I think we all can agree that having clean running water is desirable. How to pay for it is the real question here. Up to this time, water has been paid for by the consumer. Is it reasonable to have water supplied for free to all those connected to a municipal water system, while the costs are paid by increased taxes? Detroit already has high taxes. Those of us in rural areas, who have paid for our own well and septic systems, certainly are not interested in paying for someone else's water system also. This will be a very hard sell to the taxpayers.

Pat
Thu, 02/27/2020 - 1:12pm

Your columns are helpful to point out issues that deserve attention and correction. When read entirely they always add nuanced understanding of the issue. Most people, including me, don’t read the whole article even when interested.
You do try to present both sides of stories but to do so with every issue sometimes is superfluous and adds to the over-wordiness which can discourage a complete reading of the message. Also, I must say the lead-in headline re: Bernie’s and Bloomberg’s views on the shut-offs can be immediately read as that they declared support for the shut-offs, which on further reading shows the opposite.
Thank you

Ronald VanAtta
Thu, 02/27/2020 - 1:49pm

Nothing is free in life.

Jeffrey Kless
Thu, 02/27/2020 - 5:11pm

Except 60 of this nation's paid zero taxes in 2018 on $79 billion in profits

Subee
Thu, 02/27/2020 - 7:01pm

What's next? Public open air toilets like in India?

Kenneth Tokarz
Thu, 02/27/2020 - 5:17pm

Detroit residents could pay their water bills if they did not have drainage fee’s , name one other community in Michigan with drainage fee’s. Detroit Public Schools spend $8Million dollars a year on drainage fee’s.

Matt
Fri, 02/28/2020 - 11:56am

You're saying they should be allowed to get away with this polluting scot free? Who should pay for this? Raise water bills? City taxes? What should they do?

Dave
Thu, 02/27/2020 - 5:38pm

When people can't pay their water bill, they often can't pay their gas or electric bill, they most likely can't fix a leaky roof, or upgrade windows or insulation. All basic parts of home ownership that can affect health. Instead of having society fund a loosing battle, might we not be better off steering these people toward subsidized housing and encouraging them to sell their homes to some one who can afford to maintain them?

Subee
Fri, 02/28/2020 - 10:38am

Who's going to pay forall that subsidized housing? Would 't it be better to help them fix houses they own rather than putting them into housing somebody else owns? Sometimes people need so little to get a running start, like running water or a car that works.