Schools of Public Health Tackle Health Crises to Improve the Lives of Marginalized Groups

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While schools of public health around the country continuously engage in research regarding the effects of societal issues on marginalized populations, many of them are taking their scholarly work and turning it into action. At some schools, faculty members are now on the front lines of everything from mitigating water contamination to reducing gun violence, attempting to make a difference in the underserved and underrepresented communities they so often study.

Flint Water Crisis
In April 2014, the city of Flint, Mich., began drawing its water from the nearby Flint River, which, unbeknownst to residents, had not been properly tested and treated for lead — resulting in widespread contamination in the area and criminal charges filed against several public officials. The situation would also catapult the Michigan city of about 100,000 people into the media spotlight.

The situation in Flint is a public health crisis Dana Thomas has grappled with since it began. As director of public health practice in the University of Michigan’s (UM) School of Public Health, Thomas is one of the many academics and researchers who have been helping Flint’s citizens understand why their water became saturated with dangerous toxins and how they can continue moving forward post-exposure. “Flint residents are now experts on how this works,” Thomas says.

Although the story of the Flint water crisis has deep roots in the region, it essentially began in 2011, when the state of Michigan took over the city’s troubled finances. With a water supply fund $9 million in the red, Flint switched from using water from Lake Huron to drawing it directly from the river — a move residents vehemently protested because of pollution issues with the waterway over the years.

In an effort to save money, a state official decided not to treat the water with certain anti-corrosives before distributing it to residents; this failure caused lead to leak from municipal service lines and the pipes of older homes. Even after residents began noticing the water’s strange color and foul smell, they were told it was safe to drink. Third-party testing eventually revealed it wasn’t.

Although no level of lead is considered acceptable in drinking water, the EPA sets the maximum at 15 parts per billion (ppb). At one point, testing revealed that Flint’s water contained a massive 13,000 ppb.

Members of the UM community prepare to distribute bottled water to a neighborhood in Flint, Mich.
Members of the UM community prepare to distribute bottled water to a neighborhood in Flint, Mich.

To address the crisis, UM’s School of Public Health has been working with community organizations, state and local officials, and other colleges and universities. The University of Michigan-Flint, UM’s Ann Arbor campus, and Michigan State University partnered to establish the Healthy Flint Coordinating Center to help guard against the city’s becoming one big laboratory. Together they work to prevent duplication of research efforts and build bridges in a place where a deep sense of betrayal has prevailed.

“We found that the biggest issue in Flint, then and now, is trust,” Thomas says.

The city’s population is majority African American, and 40 percent live in poverty, causing some observers to call the situation in Flint an act of environmental racism and leading the school to proceed cautiously. “When the crisis became national, that was an interesting time for us,” Thomas says. “We wanted to be careful in how we approached the work.”

Allaying distrust happens in a variety of ways. One of UM’s approaches involves a training piece called “See for Yourself What’s in Your Water” that seeks to empower residents. The School of Public Health put it together with the help of an Environmental Protection Agency grant. Another module shows people how they can mitigate lead exposure by eating leafy green vegetables and incorporating more calcium into their diets.

UM students, faculty, staff, and alumni are volunteering in the community to provide this and additional education and support to those whose water is contaminated. In addition to offering training modules on how the local water system functions and what to do after being exposed to lead, Thomas and others have listened extensively to community partners’ concerns and reacted with the short, intermediate, and long term in mind. They also regularly partner with area churches to hand out bottled water to those who still don’t trust what is coming out of their faucets.

Furthermore, UM has created a liaison position to make sure residents have accurate information about their water and recently hosted an environmental justice summit.

Gun Violence
It’s a scene that’s become increasingly common: A gunman opens fire on a crowd of innocent people, killing dozens and wounding many more. The twist: The victims on this occasion were at a gay nightclub favored by Latinos in Orlando, Fla., and the perpetrator was a first-generation American who claimed ties to ISIS.

Outraged and saddened by the tragic event at Pulse nightclub in June 2016 — which at the time was considered the worst mass shooting in modern U.S. history.— faculty members at Boston University (BU) School of Public Health, nearly 1,200 miles away, mobilized to launch a social media campaign calling for an end to gun violence in America — particularly against members of the LGBTQ community.

Called “Enough,” the campaign was intended to disrupt acceptance of gun violence as well as call attention to the high number of gun-related deaths in the U.S. each year, says Emily Barbo, a communications specialist in the School of Public Health’s Activist Lab, where the campaign originated.

BU School of Public Health students during a peace walk
BU School of Public Health students during a peace walk

“Enough” kicked off with a guest column published in the Boston Globe, titled “After Orlando: Will We Say ‘Enough’?,” by Sandro Galea, MD, DrPH, the Robert A. Knox professor and dean of BU School of Public Health. In it, she cited the 133 mass shootings that had occurred in the U.S. up to that point in 2016, as well as the 6,000 firearm-related deaths and the more than 12,000 gun-related injuries that occurred around the country last year.

The campaign consisted of four short videos in which faculty members spoke out about “access to guns in the United States and the culture of hate that exists in some segments of society,” according to BU Today. Since that time, the videos have been viewed more than 2,000 times on YouTube and have been shared widely on Facebook, Twitter, and Instagram. They were also distributed through the school’s weekly newsletter, which reaches 15,000 subscribers.

In addition to the first video of Galea, the videos individually feature Michael Siegel, MD, a professor of community health sciences at BU School of Public Health, who talks about the lack of data on the damage of gun violence and the need for more research on its effects; Sophie Godley, DrPH, a clinical assistant professor of community health sciences, who discusses hate speech and discrimination against LGBTQ individuals; and Harold Cox, associate dean for public health practice and an associate professor of community health sciences, who calls for action on the issue.

“I’m tired about hearing about any more events like Sandy Hook and Orlando; I’m especially tired of hearing that our government can’t do anything about guns,” Cox says in the video. “So it’s time for you and I to get angry, and then we have to turn our anger into action — and most importantly, we have to continue to act until there are laws that protect all men, women, and children in our country against senseless gun violence.”

Harold Cox
Harold Cox

Since then, other shootings have supplanted Orlando’s and Sandy Hook’s in the national and international spotlight — more recently the tragedies that took place in Las Vegas and Sutherland Springs, Texas — but BU is far from finished trying to, at the very least, call attention to the issue.

Cox, who is also director of the Activist Lab, says department planning continues, and the campaign could be extended or reignited in the coming year. “We would like to continue,” he says. “There’s certainly an interest in doing so.”

Since the initial campaign launched last year, the school has held a closed-door meeting with representatives from 42 schools of public health to, as Barbo puts it, “stake the claim that gun violence can no longer be ignored as a public health threat.” She said the group released a paper right before President Donald Trump took office in January, issuing a call to action for gun safety, and has hosted a campus-wide event called Gun Violence: Stories Behind the Numbers.

Should BU launch another leg of “Enough,” Barbo says it’s likely to share stories such as this — of people who have been affected by gun violence, including healthcare workers, community members, and victims and their families.

As the incidences of gun-related violence increase in the U.S., BU School of Public Health’s message is no less pertinent today than it was when the campaign was first launched — nor is Cox’s plea for change.

“Today, speak out,” Cox says in the closing of his video, “and most importantly, write to your congressperson and say to them ‘Enough.’”

Lindsay Jones is a contributing writer for INSIGHT Into Diversity.