Association of Public Works Disasters with Substance Use Difficulties: Evidence from Flint, Michigan, Five Years after the Water Crisis Onset

Tuviere Onookome-Okome, Angel Hsu, Dean G. Kilpatrick, Angela Moreland and Aaron Reuben ()
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Tuviere Onookome-Okome: Institute for the Environment, University of North Carolina Chapel Hill, Chapel Hill, NC 27517, USA
Angel Hsu: Institute for the Environment, University of North Carolina Chapel Hill, Chapel Hill, NC 27517, USA
Dean G. Kilpatrick: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
Angela Moreland: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
Aaron Reuben: Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA

IJERPH, 2023, vol. 20, issue 23, 1-12

Abstract: Public works environmental disasters such as the Flint water crisis typically occur in disenfranchised communities with municipal disinvestment and co-occurring risks for poor mental health (poverty, social disconnection). We evaluated the long-term interplay of the crisis and these factors with substance use difficulties five years after the crisis onset. A household probability sample of 1970 adults living in Flint during the crisis was surveyed about their crisis experiences, use of substances since the crisis, and risk/resilience factors, including prior potentially traumatic event exposure and current social support. Analyses were weighted to produce population-representative estimates. Of the survey respondents, 17.0% reported that substance use since the crisis contributed to problems with their home, work, or social lives, including 11.2% who used despite a doctor’s warnings that it would harm their health, 12.3% who used while working or going to school, and 10.7% who experienced blackouts after heavy use. A total of 61.6% of respondents reported using alcohol since the crisis, 32.4% using cannabis, and 5.2% using heroin, methamphetamine, or non-prescribed prescription opioids. Respondents who believed that exposure to contaminated water harmed their physical health were more likely to use substances to the detriment of their daily lives (RR = 1.32, 95%CI: 1.03–1.70), as were respondents with prior potentially traumatic exposure (RR = 2.99, 95%CI: 1.90–4.71), low social support (RR = 1.94, 95%CI: 1.41–2.66), and PTSD and depression (RR’s of 1.78 and 1.49, respectively, p -values < 0.01). Public works disasters occurring in disenfranchised communities may have complex, long-term associations with substance use difficulties.

Keywords: Flint water crisis; mental health; disinvestment; substance use (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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