What can we expect next in the long history of lead poisoning in the US?

"The crisis in Flint brought the true costs of a neglected infrastructure to the nation's attention, but in the finger-pointing there are deeper debates over public and private responsibility and the impact of dysfunctional politics on public health," said David Rosner, PhD, co-director of the Center for the History and Ethics of Public Health at Columbia University's Mailman School of Public Health and author of the commentary, "Entry Point: A Lead Poisoning Crisis Enters Its Second Century," which is available online in the May issue of the journal, Health Affairs.

"A much more concrete problem is also visible: the fact that so much--yet not enough--is known about who is affected by tainted water, where the problems lie, and how extensive the problem is," noted Rosner, who is also Ronald H. Lauterstein professor of Sociomedical Sciences and co-author of the 2013 book Lead Wars. "Just as worrisome is the fact that the problem extends beyond lead pipes to lead paint on the walls of nearly all buildings built before the 1950s."

In the United States, over 500,000 children have blood lead levels above the level of concern set by the Centers for Disease Control and Prevention. Still unknown, however, is in which communities, states, and homes children are most exposed, and how to prevent damage elsewhere before it occurs. According to Rosner, until there is a standardized national database that reliably allows officials to identify specific children at risk of lead exposure before they are harmed, and the main means of identifying a dangerous home is by testing the blood of exposed children.

In addition to Flint, residents of many communities are affected--including Newark, New Jersey; Cleveland and Sebring, Ohio; New York City; and in Jackson, Mississippi --where the "situation illustrates another aspect of the broad paralysis facing the nation," stated Rosner. From testing the water in just a minority of homes the Mississippi Department of Health found that samples had high lead content--above the 0.015 per liter level established by the U.S. Environmental Protection Agency. But today, Jackson residents overall still do not know much about the safety of their drinking water.

In closing, Rosner points out that even if large sums awarded by the courts reach the communities in need, those funds will never be enough to alleviate the damage already done.