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A new study on the Flint water crisis, co-authored by Dr. David Slusky, finds that fertility rates decreased by 12% and fetal death rates increased by 58% compared to other cities in Michigan

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SHARMINI PERIES: It’s the Real News Network. I’m Sharmini Peries coming to you from Baltimore. The poisoning of Flint, Michigan’s water supply exposed the city’s children to lifelong negative effects. Now, a new study finds that lead in Flint’s water has also resulted in less children being born, a 12% decrease. The study also found a 58% increase in fetal deaths. The authors say Flint has seen a horrifyingly large increase in fetal deaths and miscarriages since its water was poisoned back in April of 2014. That’s when Flint changed its drinking water supply from Lake Huron to corrosive Flint River in a bid to cut costs. I’m now joined by one of the authors of the study, Dr. David Slusky. He’s an assistant professor in applied microeconomics at the University of Kansas. Dr. Slusky, thank you so much for joining us today. DAVID SLUSKY: Thank you so much for having me. SHARMINI PERIES: David, let’s begin with how you determine the direct cause and effect here that the lead caused the reduction in fertility rates and increased the fetal death rate. DAVID SLUSKY: A couple things. One of them is this decision to change the water supply was made by an unelected, state-appointed city manager. You worry any kind of situation that the particular population, not in this case but in other cases, may have had some role in that decision. Here they didn’t. The second thing is that no one really knew there was lead in the water until a year or a year and a half later when the first reports started coming out. We’ve even looked at this in Google analytics data and don’t see any increases in Googling for the word “lead” in Flint. The last thing we did was we going to compare changes in these outcomes in Flint before and after with changes in a variety of comparison studies across the state to control for other things that were changing at the same time. SHARMINI PERIES: Is a high level of lead consistent with both lower birth rates and much higher fetal death rates, and how did you exactly come to that conclusion? DAVID SLUSKY: The lower fertility rate can happen from a variety of things. It can happen from less conception, miscarriages early in the pregnancy, or fetal death late in the pregnancy. We weren’t able to look at conceptions and miscarriages directly because they’re not tracked in the vital statistics the way that fetal death is, but there’s medical literature about pharmacists prescribing lead pills in the early 20th century to women who wanted to have abortions. There’s been other work done in other cities finding similar decreases in the fertility rate and increases in the fetal death rate when cities switched to a water source that brings in more lead. SHARMINI PERIES: Let’s talk about the ways in which you first identified the problem. I imagine it’s from other research you’ve done in this area that probably gave you the indication here, as the reports were coming out about Flint that this might be the case here. Give us a sense of how you identified that this would be a problem and how you went about actually doing the study. DAVID SLUSKY: I’ve done two other studies that are related in some way to this. One, there’s medical literature that Vitamin D in the second trimester of pregnancy, the mother’s vitamin D, affects asthma and lung development. I have another study that used sunlight variation to look at how that affected the asthma rates and asthma emergencies for those children once they were born and found a substantial relationship there. I also have some work looking at birth rates in Texas after women’s health clinics closed there and there was less access to abortion and less access to contraception and family planning. I was both familiar with the fetal origins and fetal exposure side of things and also with working with birth certificate data on birth rates. When this story made national news in January of 2016, I and my co-author thought that we might have a way to look at a causal relationship here on birth rates and on birth outcomes. SHARMINI PERIES: Give us a sense of what other results you’ve found that concerns you in the study. DAVID SLUSKY: We looked at birth outcomes as well, about birth weight and other kinds of birth conditions, and we didn’t find large effects there. Part of that is there’re two countervailing forces here. If this shock during pregnancy is causing the least healthy fetuses to not survive, that would actually raise average outcomes of the survivors. If the survivors are then also being scarred, that would then lower their outcomes. The two effects might cancel out and have us not see anything. One more thing we looked at is we looked at the sex ratio of the live births, and I found that that’s shifted toward there being more female births. This has been well-documented in health economic literature in a variety of contexts that when there’s more stress in a fetal environment, the more fragile male fetuses don’t survive and the sex ratio shifts toward girls. SHARMINI PERIES: How is the city responding to this now? DAVID SLUSKY: We have not heard from the city specifically, though our legal process in this country has been working its way through indictments and trials of the various involved public officials. I expect that process to continue now for a long time. There was also an effort at Michigan State I believe to set up a registry of individuals who may have been affected by this so that they can receive additional screening and treatment going forward. SHARMINI PERIES: The people of Flint who are exposed to more than just direct drinking water as you just mentioned, it’s also bathing water, but people also wash their hands in this water, plants are watered using these waters, are there other ways in which the water is getting routed to your body in order to affect birth rates this way? DAVID SLUSKY: There can be, yes. I think that talking to some civil engineers and water scientists, it sounds like the city officials who work on water treatment in Flint really had kind of an impossible problem dealt to them with a variety of different issues coming out of the water from the Flint River and often contradictory solutions for dealing with each of those problems. SHARMINI PERIES: Just a few minutes ago when we were talking, we were rolling in some B rolls with signs against water fountains in schools for example that says, “Contaminated: Do not drink.” Do we have a sense of the post-birth effects on children who might’ve been exposed to this now? Now I know it’s not the direct subject of your study, but do we have a sense of how the children are fairing after being exposed to this contamination? DAVID SLUSKY: I haven’t seen any studies on that yet in Flint, though those children are really not old enough to be in schools and taking standardized tests. There is research coming out of Providence that we’re able to match up lead readings in individual homes and those children’s test scores. There is a very clear negative relationship between lead exposure and test scores in schools. We also have other literature looking at the phase out of leaded gasoline and the impact of that on crime. There’s evidence both in the US and from other countries that one of the main reasons we’ve seen such a large decrease in crime in the last generation was because of the removal from lead in gasoline a generation earlier when those young adults were children. SHARMINI PERIES: David, coming out of your study, you must have certain recommendations for the city of Flint and of course the health departments and hospitals. What are they? DAVID SLUSKY: One of them is that our study added an estimate of another dimension of the cost of this water switch beyond other research and other estimates that have been made in Flint and elsewhere. Our recommendation often as economists is that those costs and those consequences be taken into account in future policy-making decisions. SHARMINI PERIES: All right, David. I thank you so much for joining us today. I have a feeling that this just the first of many interviews on this subject because, not only in Flint, but there are sites throughout the world where people’s lives are contaminated in this way. There’s these kinds of results appearing in other parts of the world. I thank you so much for the study as well as for joining us today. Thank you. DAVID SLUSKY: Great. Thank you for having me. SHARMINI PERIES: Thank you for joining us here on the Real News Network.

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David Slusky is an economist who studies how changes in public policy and environmental exposure affect health outcomes. His research has shown that women's health clinic closures reduce preventive and increase the fertility rate for unmarried women, that Medicaid expansion reduces medical divorce, and that maternal sunlight exposure while in utero reduces asthma rates. He has a bachelors degree in Physics and International Studies from Yale University, and masters and doctoral degrees in Economics from Princeton University.