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Flint, Michigan was Supposed to be a Wake-up Call. Why America Still Has a Lead Problem…

Published September 2, 2025

Lead exposure isn’t just about children – it drives heart disease, kidney failure and dementia, turning aging infrastructure into a silent public health emergency.

Flint is back in the news and Dr. Stephen Baruch and Dr. Ed Faeder and I have been talking.

Last month, the State of Michigan reported to a federal court that, more than eight years after a court-ordered settlement, nearly 11,000 lead service lines have been replaced and 28,000 properties restored. The $626 million lawsuit settlement, finalized in 2021, was supposed to bring closure.

And yet, the report admits 4,000 homes in Flint still have lead pipes.

In Chicago, the number is worse: about 400,000 homes still rely on lead service lines.

We like to think lead poisoning is a relic of the past—something solved when gasoline went unleaded and paint was reformulated. But the truth is harder to face: lead never left us.

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The Fantasy vs. The Reality

When most of us hear “lead poisoning,” we picture children: paint chips, school readiness tests, developmental delays. That’s not wrong—but it’s not the whole story.

A New England Journal of Medicine article (October 31, 2024) puts it bluntly:

“Chronic, low-level lead poisoning is a major risk factor for cardiovascular disease in adults and cognitive deficits in children, even at levels previously thought to be safe or innocuous ¹.”

In other words: it’s not just kids. Adults who never had obvious childhood exposure are also paying the price—in their blood pressure, their kidneys, their hearts, even their risk of dementia.

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A Metal That Wouldn’t Let Go

Lead has been mined and used for thousands of years, but the 20th century was when we saturated our environment with it. We added it to gasoline, pipes, paints, cans, and pesticides. Industry fought regulation at every step.

By the 1960s, geochemist Clair Patterson showed that human exposure levels were 1,000 times higher than natural background. His research, dismissed at first, eventually became undeniable ².

And the effects? They touch nearly every organ system.

• Children: higher risk of ADHD, learning disabilities, and conduct disorders ^{3 4 5 6 7 8 9}.
• Pregnancy: increased rates of preterm births ¹⁰.
• Adults: chronic kidney disease, hypertension, cardiovascular disease ^{11 12 13 14}.
• Communities of color: disproportionate exposure from older housing, industrial emissions, and segregated neighborhoods ^{15 16 17}.

“Persons who drink tap water from lead service lines or live near airports or other sites that emit lead pollution are at increased risk for low-level lead poisoning.”
— NEJM, 2024

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The Numbers That Should Stop Us Cold

When the U.S. phased out leaded gasoline in the 1970s and ’80s, something remarkable happened: blood lead levels fell, and so did hypertension. Between 1976 and 1992, the share of American adults with high blood pressure dropped from 32% to 20%.

But the problem never disappeared.

• In one study, British adults in the 1970s carried a total body burden of 165 mg of lead ¹⁸ – the weight of a paperclip.
• Today, one in three children worldwide (over 600 million) still have lead poisoning, defined as blood lead levels exceeding 50 μg/L ^{19 20}.
• In 2019, lead exposure contributed to 5.5 million deaths from cardiovascular disease ²¹.

The American Heart Association concluded in 2023 what public health researchers had been saying for decades: lead exposure is a causal risk factor for heart disease ^{22 23}.

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Flint as Warning, Not Footnote

Flint was supposed to be our wake-up call.. The lawsuits, the hearings, the settlements—these were supposed to mean “never again.”

But Flint is not the exception: Chicago, Philadelphia, Baltimore, Detroit and

thousands of towns have aging pipes, peeling paint, and contaminated soil.

Lead is not gone. It is in our bones, our bloodstreams, our neighborhoods.

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Conclusion

If we treat Flint like a chapter that closed, instead of a mirror we’re meant to look into, then we have hardly known Flint at all. Therefore…….

What can you do? If you live in an older home, have your home tested for dust — and lead. Why? Lead has been found to be a harbinger, a sentinel, the canary in the mine….High lead levels are associated with the prevalence of other toxic metals like beryllium, and other toxic chemicals like arsenic. Dust becomes a carrier for these and other toxic materials that have the capacity to bind to it and cause future health problems.

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¹ Kayaaltı Z, Akyuzlu DK, Soylemezoğlu T. Evaluation of the effect of divalent metal transporter 1 gene polymorphism on blood iron, lead and cadmium levels. Environ Res 2015; 137: 8-13.

² Patterson C, Ericson J, Manea-Krichten M, Shirahata H. Natural skeletal levels of lead in Homo sapiens sapiens uncontaminated by technological lead. Sci Total Environ 1991; 107: 205-36.

³ Needleman HL, Gunnoe C, Leviton A, et al. Deficits in psychologic and classroom performance of children with elevated dentine lead levels. N Engl J Med 1979; 300: 689-95.

⁴ Clay K, Hollingsworth A, Severnini ER. The impact of lead exposure on fertility, infant mortality, and infant birth outcomes. Cambridge, MA: National Bureau of Economic Research, June 2023 (http://www.nber.org/papers/w3137 ).

⁵ Froehlich TE, Lanphear BP, Auinger P, et al. Association of tobacco and lead exposures with attention-deficit/hyperactivity disorder. Pediatrics 2009; 124(6): e1054-e1063.

⁶ Nigg JT, Knottnerus GM, Martel MM, et al. Low blood lead levels associated with clinically diagnosed attention-deficit/ hyperactivity disorder and mediated by weak cognitive control. Biol Psychiatry 2008; 63: 325-31.

⁷ Wright JP, Dietrich KN, Ris MD, et al. Association of prenatal and childhood blood lead concentrations with criminal arrests in early adulthood. PLoS Med 2008; 5(5): e101.

⁸ Fergusson DM, Boden JM, Horwood LJ. Dentine lead levels in childhood and criminal behaviour in late adolescence and early adulthood. J Epidemiol Community Health 2008; 62: 1045-50.

⁹ Marcus DK, Fulton JJ, Clarke EJ. Lead and conduct problems: a meta-analysis. J Clin Child Adolesc Psychol 2010; 39: 234-41.

¹⁰ Bui LTM, Shadbegian R, Marquez A, Klemick H, Guignet D. Does short-term, airborne lead exposure during pregnancy affect birth outcomes? Quasi-experimental evidence from NASCAR’s deleading policy. Environ Int 2022; 166: 107354.

¹¹ Batuman V, Landy E, Maesaka JK, Wedeen RP. Contribution of lead to hypertension with renal impairment. N Engl J Med 1983; 309: 17-21.

¹² Pirkle JL, Schwartz J, Landis JR, Harlan WR. The relationship between blood lead levels and blood pressure and its cardiovascular risk implications. Am J Epidemiol 1985; 121: 246-58.

¹³ Navas-Acien A. Lead and cardiovascular mortality: evidence supports lead as an independent cardiovascular risk factor. NCEE working paper 21-03. Washington, DC: National Center for Environmental Economics, May 2021 ( https://www.epa.gov/environmental-economics/lead-and-cardiovascular-mortality-evidence-supports-lead-independent ).

¹⁴ Wu J, Basha MR, Brock B, et al. Alzheimer’s disease (AD)-like pathology in aged monkeys after infantile exposure to environmental metal lead (Pb): evidence for a developmental origin and environmental link for AD. J Neurosci 2008; 28: 3-9.

¹⁵ Mielke HW, Gonzales CR, Powell ET, Egendorf SP. Lead in air, soil, and blood: Pb poisoning in a changing world. Int J Environ Res Public Health 2022; 19: 9500.

¹⁶ Levin R, Brown MJ, Kashtock ME, et al. Lead exposures in U.S. Children, 2008: implications for prevention. Environ Health Perspect 2008; 116: 1285-93.

¹⁷ Council on Environmental Health. Prevention of childhood lead toxicity. Pediatrics 2016; 138(1): e20161493.

¹⁸ Barry PSI. A comparison of concentrations of lead in human tissues. Br J Ind Med 1975; 32: 119-39

¹⁹ Rees N, Fuller R. The toxic truth: children’s exposure to lead pollution undermines a generation of future potential. New York: United Nations Children’s Fund, July 2020 ( https://www.unicef.org/reports/toxic-truth-childrens-exposure-to-lead-pollution-2020 ).

²⁰ µg/L = micrograms per liter, or one-millionth of a gram per liter, equivalent to parts per billion (ppb) in water, and is used by agencies like the EPA to report contaminant levels.

²¹ Larsen B, Sanchez-Triana E. Global health burden and cost of lead exposure in children and adults: a health impact and economic modelling analysis. Lancet Planet Health 2023; 7(10): e831-e840

²² Integrated science assessment for lead. Final report. Washington, DC: Environmental Protection Agency, June 2013 (http://ofmpub.epa.gov/eims/eimscomm.getfile?Pdownloadid=518908 ).

²³ Lamas GA, Bhatnagar A, Jones MR, et al. Contaminant metals as cardiovascular risk factors: a scientific statement from the American Heart Association. J Am Heart Assoc 2023; 12(13): e029852.