Flint: The Canary in America's Coal Mine, a Call for State Surgeons General

The death of a canary in a coal mine was the indicator of poisonous fumes for coal miners. Similarly, Flint's water crisis, which is being touted as one of the biggest public health debacles of the 21st century, should be calling attention to a number of health concerns well beyond lead.

I served as Michigan's first -- and last -- state surgeon general from 2003-2010. Among other duties, I was charged to lead the "Childhood Lead Poisoning Prevention: Call to Action" and later appointed by then-Governor Granholm to lead the Lead Commission. I witnessed the devastating cost of lead poisoning in terms of poor health, human suffering and opportunity loss. Still, focusing on lead alone ignores a larger problem of inequities and health disparities widespread in underserved populations.

As tragic and preventable as the Flint water poisoning was and is, it overshadows a frightening truth: six percent of young lives forever changed by lead exposure in Flint stand next to the 10 percent of children in parts of Detroit -- my hometown -- suffering lead poison from contaminated soil and lead paint. And they are joined by 52 percent of young people suffering from lead poisoning in Houston County, Alabama.

These communities have several things in common: they are more likely to live in poverty, they are more likely to be African American, and they are more likely to suffer from other health issues.

Across the country, when compared to white children, African American children are twice as likely to die before they celebrate their first birthday, twice as likely to battle asthma and three times as likely to die from it. And those that reach adulthood are 60 percent more likely to suffer from diabetes.

Lead may be the issue today, but it is just one of a host of ills that shorten length and quality of life. And the investments we must make include, but go well beyond, changing out a few miles of pipe. We need physician leadership to address profound and persistent health inequities and social factors (including but not limited to lack of housing, education, jobs) that impact health. Health should be considered in all policies.

As our state's surgeon general, a cabinet-level post, I led efforts to safeguard the public's health with stakeholders throughout Michigan. I had a finger on the pulse of the community as well as a direct line to the Governor. With recognition to our many local stakeholders, on my watch the number of children tested for lead in Michigan increased by 68 percent. My last year of service, 2010, was the peak year for testing in the state; numbers have actually dropped in the five years since.

We need leadership with adequate information to anticipate problems. Investments in healthy housing would protect our children from not just lead, but from the mold and vermin that also trigger asthma. We need to address the root causes of environmental racism and generational poverty. These interventions won't just address lead, but the plethora of diseases that are overburdening communities like Flint, Detroit and Houston County, Alabama.

We need surgeons general in every state who won't just sound the alarm once damage has been done, but will work upstream with state, federal and local governments to assess, assure and develop policy to promote health and prevent disease and exposures that plague our children. State leadership should explore the research that outlines this innovative leadership model.

Sick people need doctors, and sick communities need doctors, too. Appointing a state surgeon general will help to ensure communities and their children are no longer canaries in America's coal mine. With a surgeon general in place, the state's doctor will be "in."
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Dr. Kimberlydawn Wisdom is Senior Vice President of Community Health & Equity and Chief Wellness and Diversity Officer, Henry Ford Health System, and a board member at the Public Health Institute. She served as Michigan Surgeon General from 2003-2010.