The Flint River water starts flowing to Flint, Mich. on April 25, 2014. Without corrosion control, lead leeched from the pipes.

The Flint River water starts flowing to Flint, Mich. on April 25, 2014. Without corrosion control, lead leeched from the pipes. / Getty Images

Almost a decade ago, pediatrician Mona Hanna-Attisha took to a podium in Flint, Mich. and demanded that the world pay attention to an unfolding water crisis.

The city of Flint was near bankruptcy and controlled by emergency financial managers. To save money, officials decided to switch the municipal water source from Lake Huron to the Flint River on April 25th, 2014. Flint is a majority-Black city, and at the time, an estimated 40% of residents lived in poverty. Many immediately noticed a difference in their water quality.

"We had greenish and brownish water. It smelled weird. It was giving peoples rashes and they were losing hair. Patients were asking, 'Was it okay to use this tap water to mix their babies' formula?" recalls Dr. Hanna-Attisha, associate dean for Public Health at Michigan State University.

State and city officials reassured Flint residents that the water was safe. That wasn't true.

Elin Betanzo, a former employee of the Environmental Protection Agency had also seen a lead crisis unfold in Washington D.C. in 2004. Betanzo implored Hanna-Attisha, a friend from high school, to look into the issue.

"She literally stared me down like, 'Mona, the water doesn't have corrosion control.' That is the moment that I heard about the possibility of lead being in the water. And that's the moment my life changed," Hanna-Attisha remembers.

Corrosion control changes the chemistry of the water to make it less likely for any material in the pipes to leach into the water. Without that corrosion control, the lead in Flint's pipes got into the water supply of tens of thousands of residents.

Centers for Disease Control and Prevention says no amount of lead in children is safe. Lead poisoning in young children can damage their brains and nervous systems, cause learning and behavioral problems, and harm hearing and speech. In adults, lead exposure is associated with kidney damage, high blood pressure and cardiovascular problems.

After the water source change, Dr. Hanna-Attisha saw a crisis in the making and began looking for data to prove it. On September 24, 2015, a year-and-a-half after that water switch, she went public with her results. They showed that the percentage of children in Flint with elevated levels of lead in their blood had gone up.

At first, the state dismissed her findings. But Hanna-Attisha was right.

Water quality in Flint — and beyond

Today, Hanna-Attisha is the author of the book What the Eyes Don't See and founding director of the Pediatric Public Health Initiative, which connects Flint families to programs aimed to alleviate poverty, support education and improve health outcomes. Rx Kids is a cash-transfer program gives new moms in Flint a no-strings-attached check of $7500.

"In a city that so many folks know as a city that failed kids, Flint is a city that's learning, that's leading with science. That's leading with prevention to promote the healthy development of kids by boldly eradicating infant poverty," she says.

In the last decade, the city's water quality has improved. Thousands of lead pipes in Flint have been replaced, but not all. That means that not every resident in Flint has clean, fresh water.

It's a problem goes well beyond Flint.

Cities and towns all over the United States are facing their own issues with water quality, aging infrastructure and inadequate lead safety protections.

A 2023 report from the EPA revealed that in 2021, lead made up 9% of the nation's service line infrastructure, representing an estimated 9.2 million pipes. Half of those pipes are concentrated in six states: Florida, Illinois, Ohio, Pennsylvania, Texas and New York.

In Chicago alone, 400,000 homes still get their tap water through lead service lines. A recent study published in JAMA Pediatrics found that nearly 70% of young children in the city are exposed to lead through their home tap water. The study also found that Black and Hispanic neighborhoods are more likely to have lead exposure, but less likely to be tested for lead.

Proposed federal rule changes may limit lead exposure

The Lead and Copper Rule — first issued by the EPA in 1991 — requires local water systems with over 15 parts per billion of lead in the water to initiate corrosion control. But about 90% of cases where local water systems exceeded these limits never got reported to the federal government, according to EPA audits.

"This was probably the worst reported and enforced regulation in the history of the drinking water program," says Elizabeth Southerland, former director of the Office of Science and Technology in the Office of Water at EPA and a current member of the Environmental Protection Network.

In November 2023, the EPA proposed Lead and Copper Rule Improvements, among them:

  • Requiring every water system in country produce a map of where their lead pipes are located
  • Improving water sampling and lowering the lead action level from 15 parts per billion to 10 parts per billion
  • Requiring the vast majority of water systems to replace all their lead pipes within the next ten year

Chicago, however, would get an exemption to the 10-year timeline, as it would take an estimated 40 years to replace the 400,000 pipes.

"That's decades. That's generations of children and adults consuming lead contaminated water. It's incomprehensible to tell a resident that they need to wait that long for safe drinking water," said Chakena Perry with the Natural Resources Defense Council.

Perry and others are pushing for the EPA to close up those exemptions when the rule changes are finalized this fall.

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This episode was produced by Rachel Carlson. It was edited by our showrunner Rebecca Ramirez. Pien Huang and Emily Kwong checked the facts. The audio engineer was Patrick Murray.