Did a nocebo effect contribute to the rise in special education enrollment following the Flint, Michigan water crisis?
Author(s) / Creator(s)
Roy, Siddhartha
Petrie, Keith J.
Gamble, Greg D.
Edwards, Marc A.
Abstract / Description
Background: Exposure to waterborne lead during the Flint Water Crisis during April 2014-October 2015 is believed to have caused increased special education enrollment in Flint children.
Method: This retrospective population-based cohort study utilized de-identified data for children under six years of age who had their blood lead tested during 2011 to 2019, and special education outcomes data for children enrolled in public schools for corresponding academic years (2011-12 to 2019-20) in Flint, Detroit (control city) and the State of Michigan. Trends in the following crisis-related covariates were also evaluated: waterborne contaminants, poverty, nutrition, city governance, school district policies, negative community expectations, media coverage and social media interactions.
Results: Between 2011 and 2019, including the 2014-15 crisis period, the incidence of elevated blood lead in Flint children (≥ 5µg/dL) was always at least 47% lower than in the control city of Detroit (P<0.0001) and was also never significantly higher than that for all children tested in Michigan (P=0.33). Nonetheless, special education enrollment in Flint spiked relative to Detroit and Michigan (P<0.0001). There is actually an inverse relationship between childhood blood lead and special education enrollment in Flint.
Conclusion: This study failed to confirm any positive association between actual childhood blood lead levels and special education enrollment in Flint. Negative psychological effects associated with media predictions of brain damage could have created a self-fulfilling prophecy via a nocebo effect. The findings demonstrate a need for improved media coverage of complex events like the Flint Water Crisis.
Keyword(s)
blood lead lead exposure Flint water crisis nocebo effect special educationPersistent Identifier
Date of first publication
2023-03-06
Journal title
Clinical Psychology in Europe
Publisher
PsychArchives
Publication status
acceptedVersion
Review status
reviewed
Is version of
Citation
Roy, S., Petrie, K. J., Gamble, G. D., & Edwards, M. A. (in press). Did a nocebo effect contribute to the rise in special education enrollment following the Flint, Michigan water crisis? [Accepted manuscript]. Clinical Psychology in Europe. http://doi.org/10.23668/psycharchives.12568
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Roy_Petrie_Gamble_et_al_2023_Nocebo_effect_Flint_water_crisis_CPE_AAM.pdfAdobe PDF - 2.26MBMD5: 70cb25c6449e42a7309a1ec906819c15Description: Accepted Manuscript
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There are no other versions of this object.
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Author(s) / Creator(s)Roy, Siddhartha
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Author(s) / Creator(s)Petrie, Keith J.
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Author(s) / Creator(s)Gamble, Greg D.
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Author(s) / Creator(s)Edwards, Marc A.
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PsychArchives acquisition timestamp2023-03-06T15:25:47Z
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Made available on2023-03-06T15:25:47Z
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Date of first publication2023-03-06
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Abstract / DescriptionBackground: Exposure to waterborne lead during the Flint Water Crisis during April 2014-October 2015 is believed to have caused increased special education enrollment in Flint children. Method: This retrospective population-based cohort study utilized de-identified data for children under six years of age who had their blood lead tested during 2011 to 2019, and special education outcomes data for children enrolled in public schools for corresponding academic years (2011-12 to 2019-20) in Flint, Detroit (control city) and the State of Michigan. Trends in the following crisis-related covariates were also evaluated: waterborne contaminants, poverty, nutrition, city governance, school district policies, negative community expectations, media coverage and social media interactions. Results: Between 2011 and 2019, including the 2014-15 crisis period, the incidence of elevated blood lead in Flint children (≥ 5µg/dL) was always at least 47% lower than in the control city of Detroit (P<0.0001) and was also never significantly higher than that for all children tested in Michigan (P=0.33). Nonetheless, special education enrollment in Flint spiked relative to Detroit and Michigan (P<0.0001). There is actually an inverse relationship between childhood blood lead and special education enrollment in Flint. Conclusion: This study failed to confirm any positive association between actual childhood blood lead levels and special education enrollment in Flint. Negative psychological effects associated with media predictions of brain damage could have created a self-fulfilling prophecy via a nocebo effect. The findings demonstrate a need for improved media coverage of complex events like the Flint Water Crisis.en_US
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Publication statusacceptedVersionen_US
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Review statusrevieweden_US
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SponsorshipUS Environmental Protection Agency (#8399375); Spring Point Partners, LLCen_US
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CitationRoy, S., Petrie, K. J., Gamble, G. D., & Edwards, M. A. (in press). Did a nocebo effect contribute to the rise in special education enrollment following the Flint, Michigan water crisis? [Accepted manuscript]. Clinical Psychology in Europe. http://doi.org/10.23668/psycharchives.12568en_US
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ISSN2625-3410
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Persistent Identifierhttps://hdl.handle.net/20.500.12034/8102
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Persistent Identifierhttps://doi.org/10.23668/psycharchives.12568
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Language of contentengen_US
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PublisherPsychArchivesen_US
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Is version ofhttps://doi.org/10.32872/cpe.9577
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Is version ofhttps://doi.org/10.23668/psycharchives.12807
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Is related tohttps://doi.org/10.23668/psycharchives.12807
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Keyword(s)blood leaden_US
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Keyword(s)lead exposureen_US
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Keyword(s)Flint water crisisen_US
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Keyword(s)nocebo effecten_US
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Keyword(s)special educationen_US
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Dewey Decimal Classification number(s)150
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TitleDid a nocebo effect contribute to the rise in special education enrollment following the Flint, Michigan water crisis?en_US
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DRO typearticleen_US
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Journal titleClinical Psychology in Europeen_US
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Visible tag(s)PsychOpen GOLDen_US
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Visible tag(s)Accepted Manuscripten_US