Abstract
BACKGROUND: A population-level trauma, the Flint water crisis (FWC) exposed approximately 140 000 people to lead in water. In response, the Flint Registry (FR) was established by a local university in partnership with the community. Lead exposure has been linked to multiple adult-onset chronic diseases, and addressing the health needs of those exposed requires estimating the prevalence of these conditions. Our objective was to calculate the prevalence of chronic conditions among FR-enrolled adults and compare prevalence to state-wide surveillance estimates. METHODS: Data collection for the FR started 4.5 years after the onset of the FWC; this cross-sectional study included participants who completed their enrolment survey December 2018-July 2022. Participants reported if they had ever been diagnosed with 11 chronic conditions. We used crude and age-adjusted prevalence of the 11 chronic conditions and compared them to 2019-2021 Michigan Behavioral Risk Factor Surveillance System (MiBRFSS) estimates. RESULTS: We included 14 274 adult (≥18) participants in this study. Crude and age-adjusted prevalence was higher in FR participants than MiBRFSS estimates for 9 of the 11 chronic conditions, such as kidney disease. Age-adjusted results suggested that 8.1% of participants would have kidney disease if they had the same age distribution as the adult population of Michigan, whereas only 3.4% of the adult population in Michigan has a kidney disease diagnosis. Patterns for males, females, black and white participants were similar to the overall results, though differences between the black FR participants and MiBRFSS estimates were less extreme. CONCLUSION: The FR is a resource for the Flint community and an example for other communities experiencing mass environmental disruptions. We cannot assert the FWC caused any cases of the health conditions evaluated, however, establishing the prevalence of lead-associated conditions among people exposed to the FWC is needed to prioritise secondary prevention efforts and demonstrate the utility of a university-run registry in response to events like the FWC.