Article Version of Record

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
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 < .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 < .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 education

Persistent Identifier

Date of first publication

2023-03-31

Journal title

Clinical Psychology in Europe

Volume

5

Issue

1

Article number

Article e9577

Publisher

PsychOpen GOLD

Publication status

publishedVersion

Review status

peerReviewed

Is version of

Citation

Roy, S., Petrie, K. J., Gamble, G., & Edwards, M. A. (2023). Did a nocebo effect contribute to the rise in special education enrollment following the Flint, Michigan water crisis?. Clinical Psychology in Europe, 5(1), Article e9577. https://doi.org/10.32872/cpe.9577
  • Author(s) / Creator(s)
    Roy, Siddhartha
  • Author(s) / Creator(s)
    Petrie, Keith J.
  • Author(s) / Creator(s)
    Gamble, Greg
  • Author(s) / Creator(s)
    Edwards, Marc A.
  • PsychArchives acquisition timestamp
    2023-04-28T10:04:21Z
  • Made available on
    2023-04-28T10:04:21Z
  • Date of first publication
    2023-03-31
  • 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 < .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 < .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
  • Publication status
    publishedVersion
  • Review status
    peerReviewed
  • Citation
    Roy, S., Petrie, K. J., Gamble, G., & Edwards, M. A. (2023). Did a nocebo effect contribute to the rise in special education enrollment following the Flint, Michigan water crisis?. Clinical Psychology in Europe, 5(1), Article e9577. https://doi.org/10.32872/cpe.9577
    en_US
  • ISSN
    2625-3410
  • Persistent Identifier
    https://hdl.handle.net/20.500.12034/8330
  • Persistent Identifier
    https://doi.org/10.23668/psycharchives.12807
  • Language of content
    eng
  • Publisher
    PsychOpen GOLD
  • Is version of
    https://doi.org/10.32872/cpe.9577
  • Is version of
    https://doi.org/10.23668/psycharchives.12568
  • Is related to
    https://doi.org/10.23668/psycharchives.12578
  • Is related to
    https://doi.org/10.23668/psycharchives.12568
  • Keyword(s)
    blood lead
    en_US
  • Keyword(s)
    lead exposure
    en_US
  • Keyword(s)
    Flint Water Crisis
    en_US
  • Keyword(s)
    nocebo effect
    en_US
  • Keyword(s)
    special education
    en_US
  • Dewey Decimal Classification number(s)
    150
  • Title
    Did a nocebo effect contribute to the rise in special education enrollment following the Flint, Michigan water crisis?
    en_US
  • DRO type
    article
  • Article number
    Article e9577
  • Issue
    1
  • Journal title
    Clinical Psychology in Europe
  • Volume
    5
  • Visible tag(s)
    Version of Record
    en_US