Experiences of the Flint Water Crisis Among Reproductive-Age Michigan Women in Communities Outside of Flint: Differences by Race and Ethnicity

Did the public attribute the Flint Water Crisis to racism as it was happening? Text analysis of Twitter data to examine causal attributions to racism during a public health crisis

The Flint Water Crisis (FWC) was an avoidable public health disaster that has profoundly affected the city's residents, a majority of whom are Black. Although many scholars and journalists have called attention to the role of racism in the water crisis, little is known about the extent to which the public attributed the FWC to racism as it was unfolding. In this study, we used natural language processing to analyze nearly six million Flint-related tweets posted between April 1, 2014, and June 1, 2016. We found that key developments in the FWC corresponded to increases in the number and percentage of tweets that mentioned terms related to race and racism. Similar patterns were found for other topics hypothesized to be related to the water crisis, including water and politics. Using sentiment analysis, we found that tweets with a negative polarity score were more common in the subset of tweets that mentioned terms related to race and racism when compared to the full set of tweets. Next, we found that word pairs that included terms related to race and racism first appeared after the January 2016 state and federal emergency declarations and a corresponding increase in media coverage of the FWC. We conclude that many Twitter users connected the events of the water crisis to race and racism in real-time. Given growing evidence of negative health effects of second-hand exposure to racism, this may have implications for understanding minority health and health disparities in the US.

Vicarious structural racism and infant health disparities in Michigan: The Flint Water Crisis

Building on nascent literature examining the health-related effects of vicarious structural racism, we examined indirect exposure to the Flint Water Crisis (FWC) as a predictor of birth outcomes in Michigan communities outside of Flint, where residents were not directly exposed to lead-contaminated water. Using linear regression models, we analyzed records for all singleton live births in Michigan from 2013 to 2016, excluding Flint, to determine whether birth weight (BW), gestational age (GA), and size-for-gestational-age (SzGA) decreased among babies born to Black people, but not among babies born to White people, following the highly publicized January 2016 emergency declaration in Flint. In adjusted regression models, BW and SzGA were lower for babies born to both Black and White people in the 37 weeks following the emergency declaration compared to the same 37-week periods in the previous 3 years. There were no racial differences in the association of exposure to the emergency declaration with BW or SzGA. Among infants born to Black people, GA was 0.05 weeks lower in the 37-week period following the emergency declaration versus the same 37-week periods in the previous 3 years (95% CI: -0.09, -0.01; p = 0.0177), while there was no change in GA for infants born to White people following the emergency declaration (95% CI: -0.01, 0.03; p = 0.6962). The FWC, which was widely attributed to structural racism, appears to have had a greater impact, overall, on outcomes for babies born to Black people. However, given the frequency of highly publicized examples of anti-Black racism over the study period, it is difficult to disentangle the effects of the FWC from the effects of other racialized stressors.