State: Water crisis didn’t affect Flint birth outcomes

Karen Bouffard
The Detroit News

A state health department analysis released Tuesday on birth outcomes in Flint found “no significant differences” before and after the city switched its water source — contrary to a study released last month by researchers in Kansas and West Virginia.

The Michigan Department of Health and Human Services analysis found no significant increases in the rates of infant mortality, stillbirth, preterm birth and low birthweight when comparing data from before and after the city started drawing water from the Flint River in 2014.

A nationally publicized study concluded that overall health at birth had decreased when compared to other cities in Michigan. That study by researchers David J.G. Slusky of the University of Kansas and Daniel S. Grossman of West Virgina University was released in September.

Health and Human Services spokeswoman Angela Minicuci said Slusky and Grossman used different methodology, and referred to a review of the earlier study by Dr. Nigel Paneth, a pediatrician and professor of epidemiologist and biostatistics at Michigan State University.

Paneth questioned the data and methodology used by Grossman and Slusky and concluded that “the data in this paper are an insufficient basis to establish that an adverse effect of the water contamination occurred on rates of fetal death, or on any other adverse birth outcome examined, i.e. birthweight, gestational age or abnormal conditions of pregnancy.”

In an interview with The News on Tuesday, Paneth noted that Grossman and Slusky are economists, rather than epidemiologists, and that their research appeared as a “working paper,” meaning it had not yet been vetted in peer review by a medical journal.

“Given the significant disciplinary difference between the methods used in this analysis and our working paper, which incorporated those at the forefront of health economics, we are reviewing these findings of the Michigan Department of Health and Human Services but have no further comment at this time,” Slusky said in an email late Tuesday.

State researchers didn’t examine Flint’s fertility rate, which Grossman and Slusky determined had decreased by 12 percent after the water switch. But Paneth disagreed that the fertility rate declined.

“In Flint, there has been a steady decline in fertility going back for at least 10 years — and this is not surprising because fertility’s been going down in the U.S. in general for at least 10 years, and Flint is not any different than that,” Paneth added.

State health officials say they collaborated with the federal Centers for Disease Control and Prevention on the study.

The state report said Flint has consistently had higher rates of stillbirth, preterm birth and low birthweight, including both before and after the change to Flint River water, when compared to other Michigan cities.

State researchers did find evidence of an increase in preterm birth in Flint three months after the water source change in the third quarter of 2014, but this rate returned to pre-switch levels for the last three quarters of the year.

The analysis also found a slight increase in the incidence ratios for stillbirth, preterm birth and low birthweight overall and among black, non-Hispanic infants during the post water change period, but the increase was not statistically significant.

The risk of stillbirth, preterm birth and low birthweight in Flint was consistently higher both before and after the city switched water systems, when compared to findings in Detroit, Grand Rapids, Lansing and Saginaw.

“I would say the (MDHHS) research is different (than the Grossman-Slusky study),” said Dr. Mona Hanna-Attisha, the Hurley Medical Center pediatrician who uncovered lead poisoning in Flint children following the water switch.

“The MDHHS looked at infant mortality, stillbirth, preterm birth and low birthweight with actual state record data. The Kansas group looked at miscarriages and fertility. They sound similar, but all different variables. It is my understanding that MDHHS also looked at the data several different statistical ways and with CDC consultation/support.”

Hanna-Attisha said she wasn’t directly involved in the study, but the department shared its methodology and preliminary results. She noted that this kind of research involves multiple variables.

“So my team has ... been very focused on moving forward, building the programming and interventions to minimize ongoing and future complications of the crisis,” she said.