REPORTS
Background
Access to safe water is a critical component of public health and has emerged as a prominent environmental inequity issue in the wake of the “Flint Water Crisis.” Lead service lines have long been recognized as a significant source of lead contamination and poisoning in the United States.1 During city water line maintenance, lead service lines may become disturbed, releasing lead into a home’s drinking water. Since lead service lines are both located on private and public property, their replacement is typically partially considered the homeowner’s financial responsibility.
In 2009, Washington DC implemented a lead service line replacement program designed to better coordinate home lead service line replacements during city water line work. However, a 2020 report by the Environmental Defense Fund and American University’s Center for Environmental Policy revealed that the program had unintended negative consequences that disproportionately affected low-income residents and communities of color.2
Partial vs Full Service Line Replacement
Partial lead service line replacement, which involves replacing only the public portion of the line, is associated with temporary increases in lead drinking water contamination. In contrast, full replacement of both the public and private portions of the line minimizes potential contamination during line service and mitigates a potential exposure source.3 Since even low levels of lead exposure can result in long-lasting and significant neurocognitive and behavioral disturbances, it is crucial for governments to opt for full replacements during water utility maintenance.4 Unfortunately, the 2009 Washington DC program relied on partial replacements as its operating principle and did not offer any cost-sharing or subsidies for low-income residents. The program only provided logistical support for coordinating the replacement of the private portion of lead service lines.
Researchers at the Environmental Defense Fund and American University’s Center discovered a significant relationship between poor health outcomes and household income, percentage of Black residents, and the Area Deprivation Index following the program’s launch in 2009.2 Inequities were further exacerbated by lower rates of full versus partial lead service line replacements for low-income and Black residents. Although the program led to increases in full replacements city-wide, its primary beneficiaries were predominantly wealthy and White residents. This program intensified health disparities and serves as an important case study in the unintended consequences of public programs that fail to prioritize equity as a guiding value.
Call for Action
Public service programs should better incorporate minority stakeholders into the design process and offer full lead service line replacement at no cost to residents. By doing so, they can address the existing disparities and help ensure equitable access to safe water for all communities.
References:
[1] Basic Information about Lead in Drinking Water. EPA. https://www.epa.gov/ground-water-and-drinking-water/basic-information-about-lead-drinking-water#:~:text=Lead%20can%20enter%20drinking%20water,pipes%2C%20faucets%2C%20and%20fixtures.
[2] New report reveals environmental justice issues with lead pipe replacement – and a path forward. Environmental Defense Fund. https://www.edf.org/media/new-report-reveals-environmental-justice-issues-lead-pipe-replacement-and-path-forward. Published March 4, 2020.
[3] Recognizing efforts to replace lead service lines. Environmental Defense Fund. https://www.edf.org/health/recognizing-efforts-replace-lead-service-lines.
[4] CDC. Preventing Lead Exposure in Young Children: A Housing-Based Approach to Primary Prevention of Lead Poisoning. Atlanta, GA: Centers for Disease Control and Prevention; 2004.
