Attisha and Trejo: Lead in the water

0:00:00.7 Celeste Watkins-Hayes: I am Celeste Watkins-Hayes, Interim Dean of the Gerald R. Ford School of Public Policy here at the University of Michigan and founding director of the Center for Racial Justice. I am really delighted to welcome all of you this evening to our policy talks at the Ford School event hosted in partnership with the Education Policy Initiative and the U of M School of Public Health. And I see some folks from public health in the audience today. It's great to see you. I know we also had support from our partners at the University of Michigan Flint campus, including Beth Kubistkey Dean of the School of Education in Flint, who drove down to join with us today. Great to have Beth here. Tonight's event is supported through the Gilbert S. Oman and Martha A. Darling Health Policy Fund. Established in 2001 by the generosity of Gil Omenn and Martha Darling, the policy fund provides funding for health policy faculty and health policy outreach activities. This fund allows the Ford School to address a spectrum of health policy issues, and I would like to take a moment to thank Gil and Martha for their support. Tonight's event focuses on a public health crisis that continues to have ripple effects on a nearby Michigan community nearly a decade later.

0:01:21.6 CW: In early 2016, the Flint water crisis captured the nation's attention. Major news outlets reported that the city's tap water had been contaminated with lead since April of 2014. Given the well-documented detrimental effects of lead exposure in early childhood on cognitive development, many worried that the academic progress of Flint's youngest residents may have been impacted. Over the past few years, important data have become available, allowing researchers to rigorously study and measure effects of the lead water crisis on children in Flint. Earlier this year, the university's education policy initiative, housed here at the Ford School, produced a working report that linked household water pipe data to educational outcomes. Tonight, you'll hear key findings on the academic impacts of the Flint water crisis 7-8 years later from one of the report's co-authors, Dr. Sam Trejo. Afterwards, Ford School Professor Brian Jacob will convene Dr. Trejo and our expert guests to discuss the big picture implications for young people in the community. Tonight we have with us Dr. Mona Hanna-Attisha, recognized as one of USA Today's Women of the Century for her role in uncovering the Flint water crisis and leading the recovery effort. She's author of the new book on the subject, What the Eyes Don't See.

0:02:50.1 CW: We will also hear from the recently appointed Flint Community Schools Superintendent, Kevelin Jones. There will be time for questions at the end, so please write your questions down on the provided question cards throughout tonight's event and pass them to the center aisle. Those tuning in virtually can tweet your questions to hashtag policy talks. We have two students here who will help us with the Q&A, representatives from two student organizations, U of M's Beta Alpha Rho fraternity and the Flint Justice Partnership. These student organizations have graciously teamed up to provide pizza for everyone after tonight's talk just outside in our great, in our Rebecca Blank Great Hall, so I invite you to join us afterwards for refreshments. Now, before I introduce Dr. Trejo to get us started, I want to acknowledge the very generous support again that we all so appreciate for this lecture. This Health Policy Fund lecture is funded by the generosity of Gil Omenn and Martha Darling who are here with us today. Thank you so much. And we so appreciate your generosity and we are really excited to have this very, very important and critical conversation. So without further ado, Dr. Trejo, would you like to join us? 

0:04:25.7 Sam Trejo: All right. Thank you so much. I'm going to keep this short so that we can kind of move on to the conversation, but the, you know, short talk I'm going to give is the psychosocial impact of the Flint water crisis on school-aged children and I am Dr. Sam Trejo. I'm a professor of sociology at Princeton University. And so because we're not going to go into like super detailed depth about, you know, how we came to the conclusions we came to today, I would point you to two sources that are sort of available online. One is the policy brief and then the other is the actual working paper. And I just wanted to flag that both of this, or all of this research is joint with Gloria Yeomans Maldonado, who's now an assistant professor at the University of Texas Med School in Houston, and then Brian Jacob, of course. So you know, quick timeline of some of the key events of the Flint water crisis, just, you know, for understanding our research design. So in 2014, the Flint water supply was switched from Lake Huron to the Flint River. The river water was corrosive and improperly treated and that led to, you know, there was lead pipes beneath the ground that began to leach into the tap water.

0:05:30.2 ST: And almost immediately residents noticed changes to the color, odor, taste of their tap water. You know, a key piece of, you know, what made the Flint water crisis such a kind of maybe striking event was that for a long time, public officials continued to insist that the tap water was totally safe to drink. And then, you know, in 2016, you know, this is probably where most of us enter the story. Most of us sort of learn about it who are outside of Flint. The crisis is acknowledged, a state of emergency is declared, the EPA sees eminent and substantial endangerment the National Guard comes in, distributes bottled water, and City of Flint starts replacing its lead service lines. And you know, this wouldn't have happened without some of the sort of research and advocacy of, you know, people in this room. So you know.

0:06:13.5 ST: But the punchline was that like when the crisis finally broke, Flint citizens had been exposed to lead contaminated water for about a year and a half, at least that was the period where people were telling them it was safe to drink. And so, you know, for us, for the outsiders, the majority black city quickly became a symbol of government negligence and racial injustice, government mismanagement.

0:06:32.2 ST: And I think, you know, this is an important question. You know, there are many ways in which the Flint water crisis is unique, but this kind of thing happens all around the nation. So you know, near my, you know, university in New Jersey, here's a New York Times article from 2018, an echo of Flint, Michigan water crisis now hits Newark. And you know, there have been other kind of prominent cases of water crises like these in DC, Pittsburgh, Providence, Philadelphia, Milwaukee, and more just to name a few. So the question that sort of I came in with Brian and Gloria trying to answer was can we use modern statistical techniques to quantify the extent and how the Flint water crisis impacted the educational trajectories of, you know, the children living in Flint. And you know, children are, you know, for sort of different various scientific reasons thought to be most at risk for, you know, the damages of lead exposure. And you know, a key thing here is that the education records that, you know, the education policy initiative maintains, you know, in collaboration with the state contain virtually all Flint children before and after the crisis.

0:07:30.8 ST: So it's, you know, of a certain age, right, of school-age children. And we'll come back to that. So we're going to look at four key outcomes. There's math achievement, reading achievement, the fraction of students with a, you know, qualified special educational need, and attendance. So we do two different research strategies. We do one that's a between district analysis and one that's a within district analysis. The between district analysis, we use synthetic control methods and we ask can we compare all Flint children to similar children living elsewhere in Michigan. So we're carrying people in Flint, children in Flint to people elsewhere. And this is going to capture everything that sort of goes into the crisis. It's going to capture things like lead, but it's also going to capture any sort of, like, you know, like more social systemic effects like stigma, marginalization, civil unrest. And then we're going to do a within Flint analysis. Here we're using difference in difference methods and it's going to compare Flint children who were living in homes with lead pipes to kids who were living in homes with copper pipes, which is comparatively safer. And so this is really going to only estimate the narrow effects of lead.

0:08:30.9 ST: And so by doing these two analyses, it provides us some leverage to separate the lead mechanism, sort of the way that lead or lead pipes in particular, lead service lines impacted children from kind of everything else, the crisis itself. But there's two big limitations I want to point out here. First, we can only study school-age children. These are the only people who are in these education data. So we don't have people who are infants and toddlers at the time of the crisis. And these are the people that from sort of a prior, we would expect to be most affected by the lead mechanisms. And then we also can't say what the non-lead mechanisms are, right? Just quantify to the extent that they exist. So here's a plot. I'm going to use math achievement as my running example for this talk. And on the y-axis, we have standard deviation units. So it's not that important, but you can see that on the x-axis, over time, before the water crisis, Flint's academic achievement is trending upwards. And then we see in 2014, we have the crisis. And in the post-period, it kind of drops pretty precipitously.

0:09:29.9 ST: And so in order to make a causal inference here, so these plots are striking, but they're only observational. We need to sort of know what would have happened. The down could be an underestimate. It could be an overestimate of the true effect. And so this is where we use the synthetic control methods to actually find a comparable set of districts, a weighted average of other districts in Michigan that sort of seem to be similar to Flint in their educational outcomes. And we look at those over time. And so this red line is the synthetic Flint. It's actually made of other districts in Michigan who didn't experience a crisis. And so we see that there actually is a real difference between synthetic Flint and actual Flint. So this is kind of evidence of a causal effect. Here's that same plot on the left. On the right, we're just plotting the difference between those two lines, which is basically the treatment effect. And so you can see that here, the line decreases after 2015. We see that there's sort of about a negative 0.14 standard deviation decrease in academic achievement in Flint. This is math achievement. When we look at special needs, we see the opposite thing.

0:10:26.1 ST: We see an increase in the, which is what you might expect. We see an increase in special needs, moving from before the crisis to after the crisis. So there was meaningful negative effects of the Flint water crisis on the academic outcomes of children in Flint. The 0.14 standard deviation decrease in math achievement, about a 9% increase in special needs. So when we transition over to this other piece of the analysis, which is, can we better understand the role that, so that was the between district results, and now we're going to move to the within district results. And can we better understand the role that lead played in what we're seeing here? And so there, we're going to bring this pretty unique data to bear, which is GIS data on the location of lead service lines in the city of Flint. And this was data that was collected in the aftermath of the Flint water crisis, right? So part of the upheaval and the attention that Flint got brought in a lot of money to replace all the lead pipes. And so we actually now know where they were located. These are only lead service lines, but that's the most common kind of pipe that was historically made out of lead.

0:11:26.6 ST: So it's going to be the pipes that connect individual houses to the sort of broader water main. I want to flag that service lines are typically the primary, but not sole source of lead in water systems. So there's lead fixtures like your sink. There's lead solder that's used sometimes. And so we don't think this is all of the sources of lead. This is just sort of a key source of lead. So we're going to match this lead service line data to sort of individual level student education records. And we're going to compare students who had lead pipes to students who had copper pipes. And we would think that to the extent that the lead pipe stuff was affecting these ages, those would matter differentially. And so this allows us to look at the same academic achievement plot. So this is the same data as before. But instead of adding a new line with external districts, with districts from outside of Flint, we're going to actually just break this blue line into two groups. We're going to break it into a copper group and a lead group. And basically what we see is we see the same pattern for both of these children.

0:12:21.2 ST: Some of our evidence showed that within a very narrow geographic region, like a city block, whether a house had lead or copper pipes was largely unknown. And it was largely sort of quasi-randomly assigned. And so we're able to do difference in difference models. So this is just observational, but we can kind of formally test this. And it seems like the students who lived in houses with lead pipes versus copper pipes in this age range didn't seem to fare differently. And this is just the math results. But basically we have the same story for the other outcomes. So we're seeing these between district effects, and we're not seeing these within district effects. And so I'll just conclude things and tie it all up. But so our results highlight that the Flint water crisis negatively impacted school-age children. But these effects were not largely mediated through their home service line. And so we classify these as likely being indirect psychosocial effects of the crisis that were substantial. And so we think that there's actually ways in which stigma, marginalization, unrest in our data can be shown to have impacted the trajectories of children in Flint. And so it's insufficient to treat the Flint water crisis as merely a public health crisis.

0:13:27.0 ST: One thing I wanted to flag is that maybe the stuff we're observing is actually better than it would have been if efforts by those in Flint to respond to the crisis and create things like the Flint Pediatric Initiative didn't happen. And also this doesn't mean that lead didn't affect children at all. Again, we're looking at a specific source of lead. And it doesn't say anything about these younger kids who we think were probably most at risk. But one thing it does say is that if there are these indirect psychosocial effects on these educational trajectories, that we're currently underestimating the social cost, the societal cost of the Flint water crisis. So existing estimates that use only the increase in blood levels, not the overall impact of what it was like to live in Flint through this period. And so the existing estimates range from something like 50 million to 400 million. But I think we're actually seeing maybe the lead effects are just a piece of the puzzle and so that the true estimates would be much bigger. And that is all I have for you today. And I'm really excited for the conversation that we'll have.

[applause]

0:14:35.7 Brian Jacob: Thank you Dr. Trejo. Good to see you again.

0:14:39.1 ST: Good to see you.

0:14:40.2 BJ: I'm going to now invite you and our other panelists up and we are going to have a little roundtable conversation before we start taking questions from the audience.

0:14:58.6 S?: The hot seat.

0:15:02.7 BJ: Okay, well first of all I'd like to thank all three of the panelists for coming here today. We are incredibly lucky that we were able to get kind of one of the national experts on the Flint water crisis, Dr. Mona Hanna-Attisha and then the current superintendent, Mr. Jones. So I am going to start off by just asking for some quick quick reactions from Dr. Mona and Superintendent Jones. Quick lightning round reactions to the results that you just heard.

0:15:50.1 Mona Hanna-Attisha: Wow, is this is on. So that curve is terrible. And so much of what we do in the Flint is we're not figuring out the why this happened but really what to do next. So you know anecdotally at a population level our surveillance work we're seeing very similar findings. People are struggling. Kids are struggling. But you know what do we need to do next. So I think this validates a lot of the research and the surveillance that we're doing as well. A lot of the stories that you hear from pediatricians that you hear from teachers and how I think the take home is that we need so many more resources and so much work needs to be done to address not only this toxicity but really decades of toxicity that's been hurting our kids.

0:16:38.9 Kevelin Jones: I'd agree. But I would before I answer that I would say it's check mike check one two. We good. Okay. Can you hear me. All right. So first thing I would say is I am a Flint kid born and raised 1977 born and raised lived in what we call the hood and I used to drink water out of the water fountain at my school with no problem. I used to hook up the holes at home playing outside as a young boy and being able to just enjoy my life. I would say to this data that this is so unfortunate it's real and we're living it as the superintendent, it's very difficult to know that I walked the halls of these same schools as a young man and graduated from Flint community schools and is now watching children have to be careful with drinking water. And so when I look at your data I think about our scholars and I think about the opportunities that I had as a young man that some of our scholars growing up have to watch for watch what they do and watch what where what they touch. And so I'm just I just relived it and relive the crisis as I looked at your numbers. So that would be my quick answer.

0:18:39.4 BJ: Thank you. Let me take a minute now I guess following up on this. You know Superintendent Jones you were a teacher in the district at the time...

0:18:52.0 KJ: Principal.

0:18:52.4 BJ: Principal in the district at the time of the crisis. Can you talk a little bit about what it was like in the schools and the district overall then.

0:19:05.7 KJ: You know I would say imagine going home and your water is now it looks like mud. You can't use it. You can't bathe. You can't take your small baby right or mothers that are pregnant. You can't use this water. You're depending on water bottles. You're depending on celebrities and those that actually do care to send water. First of all thank you to all of you who have ever sent water to Flint and supported us in any way. But to go on it was more than emergency. It was the feeling was, is this genocide. Are we really being wiped out. That is the feeling of parents that are not so connected like this great doctor to be able to understand the data right. A parent that has to go to work every day has to feed their children.

0:20:16.8 KJ: This is a disaster for them right. And so living that education wasn't the number one thing at the time. Not dying, not having boils, not knowing what this is. We're not the experts so we don't know not knowing what this is was on our mind. Being a principal my job is to educate scholars and motivate them to learn. But now I have to father and I have to say don't drink that. Stay away from that water fountain here. Let me get you some water. Everything we had to go get water. We had to go and change the way we lived in the school and children had to face that. Think early childhood. Think what comes with that. Changing diapers. All of those things. Kindergarten. Babies need water. Can I go get some water. No. One second. Stop teaching. So all of the stoppage of educating children that we had to do just to open up a water bottle that's hours away from our work and doing what we're supposed to do as educators.

0:21:34.7 BJ: And Dr. Hanna-Attisha you were on the ground there as well. Can you just give us a sense of what it was like in the broader community.

0:21:46.7 MH: Sure yeah. So pediatrician friends spent all of yesterday in clinic taking care of RSV and flu kids. So be careful out there. It's crazy. So for a year and a half parents were coming to clinic with concerns and they knew something was wrong. Like you said it was yellowish and greenish and they would bathe their children and they would get a rash to the water line and moms were coming in asking if they should mix their baby's formula with water 'cause how do you make formula? You mix powder with tap water. That was the recommendation. And they were asking if that was okay to mix tap water with formula. And my response for a long time just like everybody's response was like, "Yeah. How could water not be okay?" For a year and a half I was very much reassuring families because everybody in charge all the state and federal agencies, the government was saying everything was okay. Think about this. Okay. I'm going to put up my hand. What are we surrounded by guys? 

0:22:51.9 S?: Water.

0:22:52.3 MH: Water. Right? The Great Lakes. Here's Flint. Just an hour-ish north of everybody here. So literally surrounded by the largest source of fresh water in the world.

0:23:03.1 MH: In my head I'm like, "Wait a minute. There's rules and there's laws and there's agencies and there's people that our tax dollars pay to make sure that when we turn on a tap and we fill our water, be it in Flint or Ann Arbor, that it's safe. And so that was all going through my head. In addition to all the experts saying everything was okay. So there was a lot of concerns from patients 'cause our... The people knew something was wrong. In their gut they knew something was wrong. Obviously, that reassurance stopped when I heard about the possibility of lead in the water. But, you know, even if a family knew something was wrong, this is a city that didn't have the capacity, didn't have the resources to go out and buy bottled water or nursery water. This is a city with a 60, at that time probably 70% child poverty rate. This is a city that has been ignored for a long time. So many folks when this happened and it was exposed literally said what superintendent said, like this was a purposeful genocide. People talk about trust and the trauma that happened. And this is the acute kind of consequence of the crisis is this lost and severed trust.

0:24:09.7 MH: But that trust was on shaky ground. People had been kind of neglected for quite some time in the city.

0:24:18.9 BJ: Sam, can you talk a little bit about what you kind of first thought when you were kind of doing the analysis and, you know, coming across the findings, was this surprising or unusual and how did it relate to what you expected and what you had read about? 

0:24:42.7 ST: Yeah, that's a good question. I mean, I think I was surprised because I think maybe externally.

0:24:51.1 ST: It's not as easy to see. Until I sort of started to look into there's research that's like really good surveys of Flint residents in the aftermath of the crisis, sort of documenting kind of the mental health stuff, documenting all of the stuff we're getting kind of firsthand accounts of. I think, you know, my outside, you know, my outside sort of prior, my first guess was just that, like, okay, this was clearly a terrible thing that happened. And the main way this is going to be impacting people is by just like or the main ways can be impacting the kids in my study, which again was this very particular sample, was going to be by sort of like the lead effects. So it's a neurotoxin, you know, there's like this big, big literature on lead. But I didn't think at first or I didn't like think to consider at first the way in which just like the crisis itself could really, really matter. And it just that it really it felt like that it disrupted day-to-day life in the city.

0:25:47.6 ST: It felt stigmatizing, marginalized, whatever it was that like that the Flint water crisis was much, much more than just lead in water.

0:25:54.9 MH: Yeah, I would just add and you mentioned this. There's a lot that we still have to learn that we don't know. And a lot of it is like doing detective work. We have a study right now that's collecting kids baby teeth to retrospectively look at lead exposure in utero in the first kind of few months of life because it's really hard to reconstruct what happened and how much that exposure was. And we have some of these baby teeth allies and the graph is kind of similar, like, you know, there's no lead in the teeth and then the water switch happens and lead appears in teeth, but you don't see any of that in blood levels or maybe even in water levels. So there's a lot that we still have to figure out. I think my one of my worst days after the crisis was when we found out lead levels at Freeman Elementary had some of the highest lead levels in a school and schools don't have lead service lines. And that was all kind of lead corrosion from fixtures and faucets and drinking fountains. So even though you may not have a lead service line, like you mentioned, there's lead in the premise plumbing and that which is the plumbing in your house.

0:26:57.7 MH: And that wasn't restricted until 2014. So that that, you know, that was also, you know, leaching lead and in addition to service lines. So so there's a lot that we don't know that, you know, there's a lot of factors that went into this and that, you know, that caused these consequences.

0:27:15.0 BJ: Yeah. So I think one thing that many people probably don't know is how much has been happening and has been done by community members, you know, foundations, nonprofits, and to some extent kind of state and federal resources after the crisis kind of broke. Dr. Hanna-Attisha, can you tell us just a little bit about kind of what you and others in the community have done to try to deal with the situation? 

0:27:49.7 MH: Flint is an amazing place. We said that before. It is an amazing place. You spend a day there, you feel the pride and the loyalty and the history and the grit of this amazing community. And there has been so much that that has been done. And the schools have kind of led that way as well. The day after we released our research about blood levels, the Flint schools was the first to declare a health emergency. I forgot the former superintendent's name.

0:28:17.0 S?: Dr. Lopez.

0:28:17.9 MH: Dr. Lopez? 

0:28:18.0 S?: You've been talking about when in '19 or '18? 

0:28:22.1 MH: No, 2014. Oh, 15. Yeah, yeah. So we've been through many superintendents, but we're really hoping that Mr. Jones stays. It's a tough job 'cause we've underfunded education for way, way too long. Okay. So the day after I released our research and the state went after me and said I'm wrong, the Flint school said, "No, we're protecting kids," and shut off the drinking fountains. And since then, there has been so much that has been put into place to mitigate the impact of this crisis. So I mentioned to students earlier today with something like lead and trauma and any adversity, you're supposed to practice this concept in public health called primary prevention. Like you're not supposed to expose people to lead and bad things, especially in early childhood. So we kind of failed at primary prevention and the focus since has been this concept of secondary prevention. Like what can we do as a community with so many partners to mitigate the impact of the crisis? And I'm just going to list a bunch of things like brand new early childcare centers, EduCare, Cummings. We're celebrating the five-year anniversary of one of our brand new early childcare centers next week.

0:29:31.2 MH: We have Medicaid expansion, which increased the age and income eligibility. Massive expansion literacy programs, imagination library, home delivery of children's books, 300,000 books have been delivered to Flint kids. Nutrition prescriptions, home visiting programs, trauma-informed care, 24-hour crisis lines, mental health services. Like the list goes on and on of awesome that has been put into place. A lot of it is weaved through the Flint registry, which is this CDC-funded effort to see how people are doing and then connect them to resources as well. But it's not rocket science. All these things I talked about, this is basic ingredients for kids to be healthy. And these are things that kids in Flint didn't have. You know, in places like Flint, there's like one book for every 300 kids. Like think about that. And research shows that kids have learned, have heard like 30 million less words by the age of three. And by 18 months, you can see evidence of achievement. There's all this literature and research that in communities like Flint. And we're responding, but it's not enough to once again bridge this longstanding disinvestment, these longstanding inequities that have made it hard for kids in Flint, like in so many places to be healthy and successful.

0:30:50.6 MH: You know, kids in Flint, and like so many places in this country, like depending on where you live, the census track predicts your life expectancy. There's a 20-year difference between a kid in Flint than a kid in another part of our county. Like that is not okay. That is not okay anywhere. So there's a lot of once again structural societal issues that we're trying to address that should have been addressed a long time ago. One thing that we were both involved is mindfulness work in Flint. And I'll let you talk about it 'cause you were a champion when you were principal.

0:31:22.9 KJ: Sure. So there's a couple of things to go with Dr. Mona's response. Mindfulness was very important for our scholars' meditation, right? Teaching our scholars to settle themselves. That's not easy. When you think about those babies that were in the womb, right? And as a principal, now they're pre-K, now they're kindergarten, they come into school and they're jumping all over tables. Now, yes, they're adolescent, yes, they're babies, but this was different.

0:32:03.6 MH: We have a lot of 70% ADHD rate in [0:32:06.2] ____.

0:32:08.1 KJ: Flint Community Schools is now 36%. I might be off by, it might be 37 now. Special education in our district. And so mindfulness is an everyday job in our district to settle scholars. The CRIM Fitness Foundation, we worked very, very heavily with them on mindfulness and being able to do restorative practices and being a trauma sensitive school. All of that work is vital. And at Door Writer, we opened up, that's where I was principal, a mindfulness room. Instead of sending these babies home because they flare up and they get an attitude and maybe throw a pencil or throw an eraser or something lets... We had to figure out a way to keep scholars in school so that they can learn. And mindfulness helps so much. We've had parents come in and learn mindfulness. And so that was one thing that was so vital and it's still vital today. The other is hydration stations. We worked with Kettering University, Dr. Laura Sullivan, who worked very hard to ensure that our hydration stations in our school, we cut ribbon on those last year, 2021. But think about it, 2014-2021, we bottled up, right? 

0:33:39.9 KJ: But that is a positive. Moving in the right direction to have those hydration stations throughout the district so that our scholars can now use water bottles or cups and get the water out of our hydration stations. So I know this is a very, like I said, we thought for a moment this was genocide, but the fact that we are working as a community to ensure the success of all of our scholars and families have been so, it's just been so amazing. And the tremendous work Dr. Mona would like to affirm you for the work that you've done to support Flint schools and Flint kids and Flint families. It's not over. You know, you don't hear a lot about it in the news, but we're still living it. There's still brown water in homes. There's still families affected by what happened years ago. And so you may hear folks say, "You know, we got this changed or we got this changed or we got that changed," but what about the social emotional effects of what has happened with this water crisis? So yes, we've done some things. We've come a long way, but we still have a long way to go.

0:35:07.0 MH: And if I can just add the work that Superintendent Jones has done.

0:35:11.5 S?: Would it be right to drink water? 

0:35:12.9 KJ: No, I'm not doing it. That's like a... Do you guys remember when President Obama came to Flint and he drank the water, it was like a bad move. Okay. That's a different story. So he mentioned the hydration stations and that really kind of started in Flint, this recognition of filtering first. You know, after Flint, there was three national reports about lead in modern schools saying this is a national problem. There is nothing in the Lead and Copper Rule, which is part of the Safe Drinking Water Act regarding lead and water in schools. So Michigan passed in the state Senate recently a filter first policy for schools that all schools in Michigan have to have these hydration stations. And that's because of Flint once again, translating our practice into policy to help kids all over.

0:36:00.3 BJ: Yeah, I want to kind of go off of what you said that there's still a long way to go. I mean, tell, yeah, talk a little bit more about that. What do you think are the biggest challenges, kind of the things that you and your teachers now are focusing on in Flint? 

0:36:21.3 KJ: Yeah, sure. Now, it's about the social, emotional learning of scholars, right? We have multi tiered systems of support given we're working with CRIM Fitness Foundation for scholars to be able to even learn and eat well, eat well. Yes, we have a federal program, but families need to learn about how to take care of themselves. And so we're not just focused on educating our scholars, we're focused on the whole child, right? And so we're looking at how can we help you at home? I know everyone takes turkeys on Thanksgiving, right? We give out turkeys. No, no, no. We give out food on a regular basis to families, cooking classes for parents. And we had to show them how to use the bottle waters and, you know, how to ensure that you save right. And so we're sort of trying to help our community get back into some type of normal, some type of normal. And so the social-emotional supports that we're giving scholars is huge right now in our district.

0:37:38.0 KJ: You know, Maslow's hierarchy of learning, it speaks about that loving care. They need it now more than ever. And so not only are we focused on our interventions and giving more of intervention blocks in our day, in our week, but we are definitely trying to figure out ways to help parents raise their children. To be honest, and to be a Flint person that speaks straightforward, we have kids raising kids.

0:38:14.0 KJ: And it's hard and difficult for parents now to work, to take care of their children. It's not like it was when my parents was taking care of me. It's different. You have a lot more to face. And so as a district, we are trying to continue parenting classes. We have parent facilitators in all of our buildings, which have a meeting with parents monthly basis. We provide gloves. We provide coats. We provide young lady needs and things of that nature. Young men deodorant. We wash clothes, we dry clothes. We provide gas cards. We do so much for our community now because they can't do it on their own. It's easy to say just go get up and work, right? It's easy to say that.

0:39:08.7 KJ: But we're dealing with the effects of a water crisis where parents are pulling out their hair and saying, I don't know what's wrong with this boy. I don't know what to do with him. Mr. Jones, would you do something? Can you please come over? Can you give me a meeting? This is what we're dealing with. And this is our normal. And so helping parents cope with their new normal is where we are as a district. And we believe that until you build the proper relationships and have the relational capacity that's necessary for children to be able to sit and do mindfulness and learn, they'll never be able to change the data that we've seen today. And so our job now is, you know, there's a quote that says, people don't care what you know until they know that you care. And caring is where we are as a district right now. Yes, we're educators, but you have to get to the heart of it. And you have to get scholars to be able to listen to you long enough to want to listen to 2x2, right, or read the diary of a wimpy kid, right? You have to figure out what is it going to take for today's child after they've dealt with this water crisis.

0:40:30.5 KJ: And so we're focused on culture and climate in our schools. And that's kind of where we're focused on right now.

0:40:40.8 BJ: Okay. I think one last question before we open up to the audience. We are in a school of public policy now, and many of the folks in the audience are students and people that may go into careers in health or education or other social service and policy areas. And so I want to know, what are some of the big lessons you think the kind of future policymakers should take from the crisis, the response to the crisis, the current situation, kind of the whole package of things? 

0:41:23.9 ST: Don't just go and try to make policy without coming to these communities and seeing how we have lived and what we've had to suffer. Don't come in just to get a vote, but come in to find out what it is that we really need. The grassroots communities, talk to them as well. Yes, you're going to hear some complaining. Yes, you're going to hear some griping. But listen to the heart of the matter before you determine to go and take a vote on what we need and you haven't had to live it.

0:42:03.2 ST: That's very important for many of our parents speak about how are people making decisions for me and they are not living the life that I have to live. And so I would say, come and speak, come to the schools and we'll set up opportunities for you to speak to parents and understand what they've gone through. And so that's the advice I would give.

0:42:30.6 MH: I would just add, and I've said this before, what happened in Flint was a policy decision. It was an acute policy, but really decades of policy that neglected and starved the city. But most acutely, it was the emergency management policy. So it was put into place against the will of the people. It was something that was voted down on a ballot measure. It was pushed through our formerly gerrymandered legislature. And the purpose was not to listen to the people. It usurped democracy. It took away the voice of elected and accountable officials. And the emergency managers reported to the governor it was their decision to change our water source and to not listen to people. I mentioned to the class earlier today, the former emergency manager was subpoenaed before Congress before the oversight committee. And Congressman Cummings asked him why didn't you listen to the people? They knew something was wrong. They were coming to you with jugs of brown water. Why didn't you listen to them? And he said I didn't have to. I wasn't accountable to them. So let this be a lesson of the consequence of unrepresentative policy of folks who do not care about a community, do not are not responsive to a community, are not representative of a community.

0:43:51.1 KJ: I would sit in meetings after the water crisis was exposed with the former administration. And I would just walk into a meeting, my jaw would drop. It was just all white men in dark suits. And I'm like, "Do you think this is maybe part of the policy that we have nobody from a community, that we have no women, that we have no diversity?" That you think this is one of the many reasons? So run for office, listen, all of our recovery work, like superintendent said, is hand in hand in partnership with community. I have a parent advisory group. I have a director of community engagement. I have kids that advise me 'cause our kids are amazing. Our Flint kids are national leaders and have made kind of impact on national policy and have put the lexicon in the words environmental justice and the kind of the mouthpieces of so many policymakers now. And that's really been done by a lot of our kids. So lots of policy lessons related to transparency, representation, responsiveness. Huge lesson from Flint in the pandemic is the need to invest in public health infrastructure, the need to invest in prevention, the need to invest in education infrastructure, which public health and education have been chronically underfunded and under resourced.

0:45:07.3 BJ: Okay. Well, I think it's a good time to open it up to questions from our audience. We're going to have the representatives from the student groups will be collating and then asking the questions, right? Okay. Great.

0:45:28.8 CW: All right. Thank you guys again for coming. This has been a great panel so far. Very informative. To start us off, we were just wondering if you could tell us a little bit about how you dealt with the Flint water crisis simultaneously to the COVID crisis. Have you seen any differences or similarities between the two? Kind of a loaded question.

0:45:54.2 KJ: It's tough. Okay. So, but there's some silver lining. Okay. But, imagine the national education impacts of the pandemic and imagine that on top of this, right? So both the pandemic and the water crisis have implications for education, implications for health, widening gaps and all these things. But in some ways, the water crisis was almost like a dress rehearsal for the pandemic. Our water delivery stations became testing stations, became vaccine stations. We were used to working together. Agencies were used to working together. Community partners were working together. So in a sense, we were able to more kind of readily respond to the pandemic. Our Flint registry, which I mentioned earlier, connects people to things like enrichments for children and healthcare and mental health support and nutrition and emergency food and medical home doctors.

0:46:45.1 KJ: And those are the exact same things people needed during the pandemic. So because we had built that public health infrastructure, we were able to more readily respond. Another kind of big similarity between the two is this kind of, is the recognition of science denial. Like Flint is this tragic example of what happens when you dismiss science, basic common sense science. This is how you're supposed to treat water. This is what scientists are saying, not attack them. We also once again saw that during the pandemic, another example, especially early on of the consequences of science denial, people will get hurt and die.

0:47:17.5 KJ: We were still passing out water when this pandemic took place, it's a principle. And families were, "Mr. Jones, what are we doing?" We were putting together packets of work. I mean, other school districts did the same thing, but we had already dealt with so much trauma. We were just continuing to deal with more trauma. And so when COVID hit, I lost my father to COVID and we shut down schools the same month and we were trying to figure out, okay, what is going to be the best plan for scholars not to lose more education. And so it was, there was a silver lining. However, it was more work. It was hard. It was very difficult, but we went right into work mode. We met as principals. We met as a district. We were telling families, "Hey, we're going to be in touch. Let's do what the governor told us. Let's go home." We had to get computers out. We had to ensure that every scholar had a computer at home. Keep in mind, not everyone had internet. So we had to get approvals to be able to buy hotspots for all of our scholars. Principals had to come back up when it was time to ensure that families got those hotspots.

0:49:00.4 KJ: We were still having food stations, allowing families to drive up to the schools to get lunch, to get breakfast and to get an afterschool snack. We just went into survival mode. And it was difficult. It was hard, but that shows the resilience of Flint and all of those that were supporting us at the time.

0:49:25.7 CW: Thank you so much for sharing. Thank you so much once again. Sorry, I don't know if you can hear me, but the next question we have is from the audience and it's from a Flint resident actually. And so they said that I'm from the Flint area and my family has been very involved in Flint community schools. So how do you reckon with the shrinking school sizes and how do you get students the resources that you need? And you've definitely touched on that in the last question.

0:49:55.1 KJ: I missed the last part of the question.

0:49:57.7 CW: Okay. The first part is how do you reckon with the shrinking school size? 

0:50:03.6 S?: Good question. And if you're from Flint, hey, wherever you are. Hey, all right. Well, there's definitely some leveling that we need to do as a district and working with community partners to even build a new for Flint. We haven't had a new building since the early '70s. And so there's been so much that has taken place over the last 20 years. We've gone from 48,000 scholars in our district in the '80s and early '90s to we're right about 2,900 scholars. So many different things that have happened. Water crisis was a part of it. I'm not going to say water crisis was all of it, but water crisis was a part of it. You got school of choice, you had charters, PSAs.

0:51:05.8 S?: I think in the year before the water crisis, it was like almost 45% of kids who had an address that was in the Flint city limits were attending a charter school.

0:51:14.1 S?: Absolutely.

0:51:14.9 MH: These are policy problems that when a kid leaves, the money leaves with them.

0:51:20.2 KJ: But understand this, hear this, hear me close. You have PSAs, charter schools that keep a kid long enough to get paid. And I told you earlier, with 36% special education, they come back to us after payday.

0:51:43.1 KJ: This is what happens in our community. And I'm sure it's happening somewhere else. So I'm not going to act as though it's just us. But couple that with the water crisis and couple that with Fortune 500 companies leaving Flint. You had Buick leave, you had GM leave. And so families are migrating, but you still have families in need that can't help themselves. And so it's a tough problem. We are trying to work with community partners to find the funds and get the funds donated for a new high school for our community. While yet determining to close some of the old buildings that we have because we do not... Our footprint is too large as it pertains to buildings that we're operating. And so we're working with our board now to determine what buildings we're going to close. And there's a positive effect to that, but there's also a negative effect.

0:52:50.4 KJ: Right when you hear that your district is closing schools, you don't want to be in a district where it seems like you're failing. And so we're going to have to suffer some more to be able to have a brighter future. So we're currently working at that.

0:53:06.1 S?: So what superintendent brought up is kind of the crux of what the water crisis was about was population loss. So the city had lost a lot of people. At one point, I think we were close to 300,000. And in 2014, the population was like 90,000. And because of the way Michigan funds cities, it's based on property taxes. So a shrinking city was now having to fund the infrastructure of a city that was built twice its size. So it was impossible for them to fund things like policing and public health and water infrastructure. That tax base wasn't there before. And there had been efforts in Flint's history to move to regionalization. Why don't the suburbs? Why isn't it a county effort, like other states? The whole county supports each other. But for racist reasons and other reasons, that never happened. And that's this very similar story. And then we were near bankrupt as a city, taken over by emergency management. Water switch happened. So one of the crux of the problems is lack of regionalization, the fact that we depend on tax bases in shrinking cities to support basic public services like education and water delivery. And so it's highly inequitable.

0:54:26.6 S?: And still having to pay a water bill with the type of water that we had to deal with. It sounds crazy, right? But that's the reality.

0:54:36.8 S?: Something that was striking to me about the regionalization bit or the population decline was that the population of the county hasn't really changed that much. And it's just...

0:54:44.8 S?: Cities moved to the suburbs.

0:54:45.8 S?: Exactly.

0:54:46.2 S?: And there's an effort called One Flint, all these efforts to try to regionalize. But no, highways were built and they cut through black neighborhoods and they allowed people to go in, extract wealth and go out and not contribute to the city. This is a similar story in many other situations, cities. So all of these things had consequences. These are policies.

0:55:10.8 CW: Great. And then the next question, combining two that were submitted, this is aimed more for you, Dr. Trejo. So it's about the lower math achievement, academic achievement overall. Do you have any theories on the specific mechanisms driving this decrease in educational performance? Is it purely from the lead? I know you mentioned earlier in your presentation that's also from the social outcomes of this crisis. If you could touch a little bit more on that.

0:55:41.4 ST: Yeah, it's a good question. I mean, I think we don't totally know, but there are... So these are kids who are tested in grades three through eight. And we're looking at basically the five years right after the crisis. So these kids are by and large above the age of five when the crisis actually occurred. And so there's a lot of evidence that basically lead affects younger children the most. I think lead in water in particular affects infants because of what Mona was saying about baby formula. But then other sorts of lead, like lead paint, I think is really heightened like age 1-3, but especially below 5. So I think there's actually some sort of previous research to suggest that these kids would be less affected by the lead than maybe some of our other kids in Flint, which is part of the reason that we come to conclude that there must have been more than just the lead effects. There must have been these psychosocial pathways. I think part of the question might have been why do we see it in math and not reading? And I think that's to some extent still an open question, but there is sort of a pattern of results like that in education literature.

0:56:49.8 ST: I think it seems like especially short term shocks, like math seems more sensitive than reading. So one example would be like summer learning loss. Another example would be like there's like studies about whether you sort of incentivize high scores on tests with money and do people's performance change. You see changes in math, but not in reading. I think it's kind of a big open question.

0:57:10.3 MH: I think also the COVID results. I think what we're seeing nationally with COVID is a bigger decrease in math achievement than reading.

0:57:18.2 CW: Interesting and I'm sure as more research comes forward, it's going to be really interesting to see what happens with that, especially that there's such a big difference. Sorry, sorry. No, I was just saying that it's interesting that with the COVID outcomes too, that math is decreasing at a higher rate than reading, but with more research, I'm sure we'll be able to learn more about it. So our next question is what can federal policymakers, so Congress, EPA, etcetera, do to help close the educational gaps in Flint? And then the second part is how do you think leaders in government and policymakers can earn trust from communities? 

0:58:09.6 S?: This may be funny, but pay teachers, right? I mean.

[applause]

0:58:19.7 KJ: And I say that because you know, you want a hundred percent from staff because staff, believe it or not, they're dealing with all of the crisis that we're talking about today, right? And so not everyone wants to come and work in the inner city even before the crisis.

0:58:46.6 MH: We're hiring, we're always hiring.

0:58:48.9 KJ: We have 47 vacancies, a large percentage of those vacancies are teachers for special education. They're going to suburbial districts, they're going elsewhere because we do not have the funds to be able to pay. We have scholars with many disabilities. We have to deal with a lot of the inner city issues that come up. Crime, Flint, Michigan has been in the top 10 for some time in crime. And so no one wants to really come and work in the inner city. And so it's going to be important that we pay teachers and pay them. We pay doctors. Don't take, don't do that.

0:59:50.1 S?: Not as much pediatricians. It's okay.

0:59:52.1 KJ: I'm just not a hate on you. But you know, why are the ones that are creating the next generation of professionals not being paid? That is a crime, right? And so teachers need to be paid. That's what lawmakers need to understand. We need more money to go into education as it pertains to human resource. That is the number one thing that they can do to support us. I won't go further because as I think about our staff and how many staff members we have and making them making a livable wage and being able to take care of themselves, that would be the number one thing I would say and I would just leave it right there.

1:00:38.4 KJ: I'm going to reiterate that. And not only do we need to pay teachers, we need to pay early childhood teachers. If we respect the science of brain development and child development, that period of 0-5 is the greatest period of brain development. Your brain triples in size. What happens there, despite the badness you may be exposed to, if you can put in goodness of good high quality early education and supports and parenting programs and all this good stuff at that time, you can mitigate a lot of that badness. This is a lot of science terms that I'm not making science terms. Our early childhood teachers are barely paid minimum wage. They're part of this pink workforce. They're eligible for a lot of the programs that they're providing. Those are the folks that we also significantly need to raise their salaries and their benefits. I think it's ironic we're talking about benefits and salaries and living wages because what's Flint the birthplace of? The middle class in America. So it's the birthplace of the Flint sit down strikes and the UAW and living wages and occupational health and safety and benefits. That was born in Flint.

1:01:45.8 KJ: The very first subdivision in America is in Flint. And Flint spread that throughout the nation. And yet here we are almost 100 years later from that time where we're still talking about these basic things that people need to raise a family. If the federal government and the state government wanted to do something for our families is lift them out of poverty. So much of what we do, what I do, what superintendent Jones does are band aids when we haven't addressed these fundamental upstream issues like childhood poverty. And it's embarrassing in Flint. We have neighborhoods in Flint where it's 80-100 percent child poverty. That's crazy. I mean, it's about 15% for the nation state but in some of our neighborhoods it's 80-100 percent. You cannot expect any child to grow up and be healthy. So we need to renew the child tax credit. We need to fundamentally address things like child poverty to make sure our kids are healthy.

1:02:42.1 KJ: Just to add just another piece to keep going forever. Yeah. Because this piece here is huge. You know, the tragedy that happened in Oxford, you know, so many different districts began to figure out what are we going to do about safety? Well, Flint has had metal detectors and wands for years. So this goes back to why we need to pay teachers. They've been dealing with these things for years. Many have just started saying, "Hey, let's get some, you know, some safety wands in the school. Let's do this. What are we going to do?" And it made CNN. It made all this news. So, Flint has been dealing with these type of issues for years. Not the same thing as Oxford per se. I don't want to take away from that. But our teachers are walking through metal detectors every day. All right. We've had to replace metal detectors several times because they've just worn out. So teachers being paid less than, like you stated, the minimum wage and to have to come to work every day to deal, pick up the issues of the scholars and also deal with the water crisis and COVID and you still paid. And here's the thing. Boards are, you know, our boards are brought on to ensure that you are doing what's best for the district.

1:04:10.3 KJ: But at the same time, they have to push us as administration to find money for teachers. That means we're going to have to cut something. When you find money for teachers, you find money for principals, you find money, you have to cut something. So you end up cutting valuable workers that you need in central office to keep the work done and also in the buildings just so you can keep a person in front of children. So that's why I say pay teachers, give us more money to support our staff so that we can continue to do the work that we're supposed to do for children every day.

1:04:50.7 CW: And our next question is directed to Dr. Mona Hanna-Attisha. Could you describe the moment that made you realize, like, and initiate your investigation to what was going on in Flint and was that your clinic at home or was that aha moment for you that made you realize something was wrong? 

1:05:09.6 MH: Awesome. Great question. So it was what was the aha moment that something might be wrong that propelled me to do my research? Well, you all have a copy of my book, so you can read that. I'm not going to give it away. But basically, it was learning about the possibility of lead being in the water. That is the moment that my life changed. I know what lead is. I was a student here 30 years ago in the environmental school. One of my professors was this brilliant man, Flint native Bunyan Bryant, who was one of the fathers of the field of environmental justice and learned even then that lead is a form of environmental racism, that it's a potent neurotoxin. Incredible science since then has told us that there's no safe level and that, you know, has all these detrimental cognitive and behavioral impacts. So when I heard about the possibility of lead in the water, I stopped sleeping, I stopped eating. I knew I needed data to figure out what was going on and that I shouldn't have had to do my research, which was looking at blood lead levels, that, like, you know, you should have just listened to people.

1:06:13.8 MH: You should have listened to the other scientists who were telling you there was lead in the water. You didn't need proof that it was in the blood of children to do anything about it. But nobody was listening to anybody else, the authorities that be. And so ended up seeing what was happening to the children and looking at their blood lead levels. But read the book.

1:06:34.2 CW: Thank you for sharing that. So our next question is actually from a teacher who's returned back to get their masters at U of M. And so the question is, how have teachers and school personnel been supported through the water crisis and COVID? 

1:06:50.6 KJ: Thank you for asking that question. That was a good question. We as a district, we received, well, you know, the ARPA funds that came to us as a district, we received ESSER I, ESSER II, and partial of ESSER III so far. What we did as a district is we gave every employee of the district $22,500. And that was to support them through the work of the COVID-19 pandemic that we dealt with. We were able to do that. It was legal. We went through MDE. We figured, "Hey, we need to support our staff. We need to do something special for them." We also gave them new technology so that they were able to do their work from home. We supplied them with opportunities. There was a time where we had to do remote work. We were in school, but there were teachers that, you know, had to go out for remote work. We were able to pay them at the time. It's still not enough. So don't get me wrong. Still not enough, but we did what we could to support our teachers at the time that they were going through this crisis with us. We lost staff members to COVID-19 and it was just a tragedy.

1:08:30.4 KJ: I lost family members. And so this, it wasn't easy, but we... The first thing we did with the funds is we did technology for scholars. So every one of our scholars is 2-1, meaning you have a computer at school, you have a computer at home. We did the technology as far as everyone had a Zoom account. We did all of that. We worked all of that out. But the second thing we've done is we paid our teachers and they were able to get a stipend for the work that they've been doing.

1:09:03.8 CW: Thank you so much for sharing, Superintendent Jones. Our next question is asking about how you deal with the frustration and burnout because this has been ongoing for so many years.

1:09:17.1 KJ: Prayer. Mindfulness. You know, I was a part of a group called Transformational Education Leadership. And that tail-group taught us mindfulness before we got into this pandemic and we needed it as a district due to the water crisis. And so we began doing work with mindfulness and really trying to just be there for one another, right? I am a relational leader. I believe that building relationships is first and foremost.

1:10:00.3 KJ: And then after that, the work will follow. And so trying to just care for one another, calling, text messages, affirmations. We have a program called Capturing Kids' Hearts. We build social contracts. We do meetings together. We do gatherings together. And this is all to keep us sane, right? Our scholars, same thing. We build social contracts in every classroom. How do you want to be treated by the leader? How do you want to be treated by each other? How are we going to deal with conflict when it arrives? Those are the type of things that we had to put in place in order to just keep us all moving in the right direction. It's not easy. Everyone's still overwhelmed. But positive words go a long way, right? Positive words go a long way. And we're constantly trying to deal with the stress. It's stressful. It's stressful for boards. It's stressful for administration, teachers, principals. I mean, it's a stressful.

1:11:09.9 KJ: Occupation. And so you're doing it because you love it and you love children, right? And I would say definitely for the staff in Flint, you're not doing it for the money. You're doing it for the love.

1:11:24.6 KJ: So just loving on one another, being there for one another, the mindfulness practices, capturing kids' hearts program that we have in place. We purchase books for everyone. There was a book by Patrick Lencioni called The Five Dysfunctions of a Team. We purchased that book and did PD on that. It talks about trust, commitment, attention to results and things of that nature that would just keep us moving in the right direction. And we do a lot of work in that space.

1:11:56.8 KJ: I would echo that.

1:11:57.3 KJ: One more thing. Food.

1:11:58.6 MH: Food is key. So mindfulness come up a lot. So Flint is one of the first four mindful cities. So the whole city has been trained on mindfulness, including the head of our police department, the mayor, the head of the hospitals. And when the George Floyd murdered happened and Flint had like a peaceful march with the head of the police department, and he credited mindfulness training for why he was able to why everything in Flint was peaceful in terms of the response. So there's a lot of amazing work happening around mindfulness. And his school that he mentioned when he was principal of the room, like he didn't talk about the statistics. Like you had higher test scores 'cause of the mindfulness and decreased suspensions, like some really, really cool stuff. But every day we're writing a grant for these things. So you know, dude, I'm on the mindfulness board. Yeah, yeah, we're doing it. So, you know, we're trying to sustain a lot of this this goodness. But the question was about like burnout and how do you keep going? And he said it's about it's about the kids.

1:13:06.8 MH: Like you know, I, like I said, I was in clinic yesterday and I ask every single patient that is verbal, like, what do you want to be when you grow up? And I had a, you know, a little kid is my favorite question. He's like 4. I'm like, well, what do you want to be when you grow up? He's like, I want to be 5. I'm like, "Yes. Like, how cute is that?" Like, so like teachers and pediatricians like we have that we do the same work. Like it's not so much about the kid today in front of us. It's about what they will become. It's about the promise of that child. And and it's our job to make sure that they have every potential available to them. And we fiercely protect that. So I think staying grounded in that and with me, it's every patient encounter grounds me. And there is days where I'm frustrated and I'm angry and I'm mad. And you know, it's a roller coaster of emotions. And I just want to bang my head on the wall. But that doesn't get that doesn't get me anywhere. When I'm able to kind of ground myself and ask myself why like Mona, why are you doing this? 

1:14:02.7 MH: Like, why are you here today? Why did you write a book? Why are you in the clinic? Why? Why? And my why is always kids. And that enables me to kind of push forward. So find your why. It's going to be different for all of you. And I think if you can kind of stay grounded in your why that enables you to kind of persevere, especially when times are hard.

1:14:20.9 KJ: And I'll just add, how many of you ever participated in mindfulness? Okay, that those of you who haven't, you know, a lot of times I'm asked that question, how do we go on? We are more than happy to show you what that is at any time, even after we're done, and take you through a mindful practice because really...

1:14:42.9 MH: I think we should end that way, don't you? Yeah.

1:14:43.8 KJ: Yeah, I think it would be cool. But I'm not running this thing. So you know, I don't want to not be invited back again. So that will definitely be up to you all. But you know, we're very open. And I'm very open to have conversations outside of this. But mindfulness is meditation is very important. Some people will call it a religious thing or this or that. Well, you know, it's whatever you need it to be, right? So having that with children, you'll be amazed. If any of you are thinking about being a teacher, take mindfulness...

1:15:19.6 MH: Or a parent.

1:15:21.8 KJ: Yes. I do it at home with my children, you know, and we'll stop and dad, no, come on, let's do our mindfulness. Sit down, take a moment. We we listen to the room, we feel we do whatever we need to do to just really calm. And once we're done, we go about our day. But it grounds you. And I think it's very important that more people get into that space.

1:15:53.0 CW: Awesome. Hopefully, we can try to do that at the end.

1:15:55.9 KJ: It's not my show. It's not my show.

1:16:00.4 CW: We just have time for one more question and then maybe mindfulness and then pizza afterwards. Here's [1:16:03.0] ____ with the last question.

1:16:06.4 S?: So our last question is going to be how can we as students address the issues that you mentioned within the Flint community? So you touched on the idea of lived experience and it's very important to our understanding. However, many of us may not have that lived experience particularly. So, you know, how can we tackle these issues and spread awareness about everything that's happening within a community that's not necessarily our own? 

1:16:32.8 MH: I think there's many ways. People often ask me, "How can I help Flint? What can I do?" You can always donate to our work, which is great. But I think the take home is, you know, there's injustices like this everywhere. And we just need to kind of open your eyes and see them in your own backyard and, you know, build a team of allies and you'll find them in unexpected places. Most importantly, from the impacted community. And keep fighting for change. You know, the Flint story, despite it being a story of a crime committed against some of the most vulnerable people in the country is also this amazing story of people saying no, of refusing to accept the status quo and to, you know, building a better future, especially on behalf of kids.

1:17:21.8 MH: When we were building our Flint registry, we were meeting with our parent group and we were talking about what the logo of the registry should be. And a Flint resident said, "Well, I think it should be the Sankofa bird. I know you guys have a Sankofa center here or something here. And that bird is this mythical bird from Ghana that's flying forward yet looking back and holding an egg in its mouth. And I think I love it because it's symbolic of everything that we are doing and really what we should do in so many places. It's about pushing ahead, about moving forward. But never forgetting the past, never forgetting the injustices that have happened, the history. We step over history every day. We cannot move forward without learning our past. And then prioritizing the young. That's the egg in the mouth. And I think that's something that we can do in all of our situations that we're in. I think it's something that we can do as a nation. If we want to push forward as a nation, we have to start by looking back and coming to terms with a past that may be kind of dark and difficult.

1:18:23.2 KJ: But also prioritizing our young. We talk about our young. We put them on a pedestal. But our policies don't often follow. Our kids are not an electorate. The needs of our kids are not often forefront in policy. So how do we better elevate that? So you don't have to help Flint. You don't have to give to Flint. But I'm hoping that all of you learn from this story kind of the need to have empathy, understanding, to kind of step in the shoes of others, recognize those others as your own. You know, my book is called What the Eyes Don't See. And that's about, you know, a group of... A city that was unseen. People in a place and, you know, a problem that folks chose not to see. But how, once again, can we all see and most importantly care? So I will leave it at that.

1:19:19.6 KJ: Come read to the kids. Like get a group from U of M. Come on. Like come to Flint. I'll take you around. I think those things are important, right? Just spending an hour with children that have faced a crisis like this. Get a group together, sororities or frats, right? Or just groups of you decide to come together and say, "You know what, we're going to link up with Mr. Jones. We're going to figure out a school to go to. And we're going to spend a couple hours there. And we're just going to be with children, right? We're going to be with kids." That goes a long way. You know, adopt a school. If there's any programs that want to adopt a school and you care for that school and you do things for that school. If you're going to ask that question, right, I'm going to get down to the brass tacks. Is being in front of children. Putting a smile on these babies' face. And if I can get you to do anything, keep your money, but come and be a part of the work of rebuilding Flint.

1:20:37.0 BJ: That seems like a great place to end. I want to just make sure I thank before we close. And I was getting there. Closing thank yous, mindfulness and then pizza. So the closing thank yous are thanks to the wonderful panelists that have joined us here today. It was a fantastic discussion. Thank you to all of the people, many of whom are behind the scenes that really made this happen. The communications and IT staff at the Ford School. The staff at the Education Policy Initiative. The staff in the Dean's Office. The students and the student organizations who are responsible for the questions and the groups and the pizza. So thanks to everyone.

1:21:37.8 ST: Let's see. I mean, I am not an expert in mindfulness. So Mr. Jones, you want to lead us in a mindfulness, a pre-pizza mindfulness? 

1:21:47.5 KJ: Sure. Sure. I want to ask everyone, if you will, to put your feet flat on the floor and just relax yourself in your chair. Just relax, relax. I'm going to ask you to, if you don't mind, to close your eyes. If you don't mind, if you don't feel comfortable with that, you can keep your eyes open. But I'm going to ask you to feel the tips of your fingers. Feel one, two, three, four, five. The tips of your fingers with your thumb against each finger. But I want you to take a moment and just think about what we've learned today, what we've talked about. What resonates with you as you are just feeling, you're feeling, you're sitting there, you're breathing. What resonates with you as you're thinking of that? I want you to take a couple of deep breaths and I'm going to lead you. Take a deep breath in, hold, and exhale. Again, take a deep breath in, hold, and exhale. Don't worry about the sounds you hear, but take in the sounds that you hear as you listen to my voice.

1:23:12.9 KJ: Just really think about the learning today, the conversation. Continue to breathe. Feel your body. Feel your breathing. Acknowledge what resonated with you today. Acknowledge it. Acknowledge it. Just think about it as you're breathing. I want you to take one more deep breath in, inhale. Hold it. Exhale. I want you to just go ahead and open your eyes. Thank you very much.

[applause]