Assessment of Behavioral Health Concerns in the Community Affected by the Flint Water Crisis - Michigan (USA) 2016

Prehosp Disaster Med. 2018 Jun;33(3):256-265. doi: 10.1017/S1049023X18000250. Epub 2018 Apr 19.


Objectives: The Flint Community Resilience Group (Flint, Michigan USA) and the Centers for Disease Control and Prevention (CDC; Atlanta, Georgia USA) assessed behavioral health concerns among community members to determine the impact of lead contamination of the Flint, Michigan water supply.

Methods: A Community Assessment for Public Health Emergency Response (CASPER) was conducted from May 17 through May 19, 2016 using a multi-stage cluster sampling design to select households and individuals to interview.

Results: One-half of households felt overlooked by decision makers. The majority of households self-reported that at least one member experienced more behavioral health concerns than usual. The prevalence of negative quality of life indicators and financial concerns in Flint was higher than previously reported in the Michigan 2012 and 2014 Behavioral Risk Factor Surveillance System (BRFSS) survey.

Conclusions: The following can be considered to guide recovery efforts in Flint: identifying additional resources for behavioral health interventions and conducting follow-up behavioral health assessments to evaluate changes in behavioral health concerns over time; considering the impact of household economic factors when implementing behavioral health interventions; and ensuring community involvement and engagement in recovery efforts to ease community stress and anxiety. FortenberryGZ, ReynoldsP, BurrerSL, Johnson-LawrenceV, WangA, SchnallA, PullinsP, KieszakS, BayleyegnT, WolkinA. Assessment of behavioral health concerns in the community affected by the Flint water crisis - Michigan (USA) 2016. Prehosp Disaster Med. 2018;33(3):256-265.

Keywords: BRFSS Behavioral Risk Factor Surveillance System; CASPER Community Assessment for Public Health Emergency Response; CDC Centers for Disease Control and Prevention; GAD-2 Generalized Anxiety Disorder-2; MDHHS Michigan Department of Health and Human Services; PHQ-2 Patient Health Questionnaire-2; CASPER; Flint water crisis; behavioral health; disaster.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Behavioral Risk Factor Surveillance System
  • Centers for Disease Control and Prevention, U.S.
  • Child
  • Child, Preschool
  • Demography / statistics & numerical data
  • Female
  • Health Behavior*
  • Humans
  • Lead Poisoning* / psychology
  • Male
  • Michigan
  • Middle Aged
  • Problem Behavior*
  • Self Report
  • United States
  • Water / adverse effects*
  • Young Adult


  • Water