A water crisis, unfiltered: UWM sociologist looks at barriers to lead filter adoption

Before the COVID-19 pandemic, Milwaukee was grappling with another public health crisis: Lead pipes were – and still are – an important source of possible lead exposure in homes across the city.

Like thousands of municipalities across America, many of Milwaukee’s water pipes are lead laterals, built before building codes and EPA standards prevented their use. In fact, 46 percent of the city’s nearly 170,000 service lines use lead laterals, according to a 2018 report by Milwaukee Water Works.

In addition, internal plumbing in homes can also be a source of potential lead contamination. "So, even if the city could magically replace all the laterals, some residents would still be exposed through the plumbing inside their homes," Chesley said.

The problem truly came to light after the 2014-19 water crisis in Flint, Michigan, brought attention to lead contamination through drinking water. Here in Milwaukee, mayor Tom Barrett encouraged any city residents living in older homes to use over-the-counter filtering systems.

Thanks to decades of racial segregation in Milwaukee, many racial and ethnic minorities, as well as lower-income residents, live in older housing with lead plumbing and fixtures.

“That kicked off a lot of discussions here in Wisconsin about the state of water,” Noelle Chesley said, “and we need to get at some of the social inequalities around this problem.”

Noelle Chesley

Chesley’s is one of those older Milwaukee houses that has a lead lateral. She was an early adopter of lead water filters, so she knows firsthand that using them day-in and day-out can be a challenge.

“You have to know enough to buy … a filter with the ‘NSF 53’ certification. A Brita filter won’t work,” she said. “(Using a filter) is not as easy as it sounds, and that’s for somebody who has a lot of resources, a lot of time, money, education. I started to get skeptical about whether solving this problem will be as easy as simply telling people, go out and get a filter. That spurred me into wanting to research this.”

Chesley is an associate professor of sociology at UWM. Last autumn, she and several UWM coauthors, including Helen Meier (Zilber School of Public Health), Jake Luo (College of Health Sciences), Immaculate Apchemengich (Zilber School of Public Health), and Hobart Davies (Psychology), published a paper examining how people have – or haven’t – adopted lead filters to keep their drinking water safe.

The group used survey data to gauge a national sample of people’s understanding of water quality and their use of lead water filters. Chesley was especially interested in how a respondent’s race and socioeconomic status impacted their reasons for adopting filters, and how they use them once they have them.

She found several interesting results that could help inform officials about how to best mitigate the dangers of a city’s contaminated water.

• Knowledge is power

The first hurdle in getting people to adopt a lead water filter is helping them figure out if they have a possible means of lead exposure to begin with.

“That’s important because we found a strong connection between people who said that they had lead plumbing and were using a filter capable of removing lead, which makes perfect sense,” Chesley said. “But a lot of people in our survey didn’t know one way or the other.”

Chesley and her team also asked respondents about their knowledge and attitudes surrounding lead contamination. Were they aware of how lead pipes and plumbing can taint water? Do they know the health effects of lead poisoning? Those who reported a higher level of knowledge about lead issues were those who were more likely to adopt lead filters.

Finally, the authors also examined how people used their filters. Most people knew to change out their filters every two to three months, but Chelsey still found large gaps in users’ knowledge that could put their health at risk.

“People in general reported that they were using the filtered water for drinking. The rates were lower for cooking, and the lowest for hygiene, for things like brushing your teeth, water that you might be consuming in the bathroom where there might not be a filter on the faucet,” she said.

• Concern matters, but so does income

The more that survey respondents were concerned about lead levels in their water, the more likely they were to purchase a lead water filter. But there’s a caveat.

“Level of concern is impacted by income,” Chesley said. “We found that it takes higher levels of concern before a lower-income person will actually go out and purchase a filter.”

In other words, two people might report the same level of concern about lead in their water, but the person with greater economic means is more likely to use a lead water filter than the person with lower income.

“That makes sense; when resources are scarce, it’s going to have to feel like a much more urgent problem before you will go out and put the money and the intention to solving that problem,” Chesley said.

• Race is an integral factor

The health effects of lead poisoning don’t discriminate, but society does. Time and again, racial and ethnic minorities are most affected by lead-contaminated water. As such, Chesley noticed a definite racial component in her results.

“What we find is that levels of concern about lead in the water are much higher among racial and ethnic minorities than among whites,” she said. “We know that disparities in housing are linked to race and ethnicity, and we know that older housing is where lead plumbing is.”

That’s given rise to a mismatched set of priorities, Chesley has observed. For Milwaukee’s black and other minority residents, lead is a much more urgent issue than it is for many white residents.

“There are people who live in communities that are seeing a lot of kids who seem to be exhibiting the symptoms of lead poisoning, or some of the complications that we would often associate with lead poisoning, and it feels like the sky is falling down – and it is!” Chesley said. “But it doesn’t feel that urgent to other parts of the community, and certainly the pandemic is taking a lot of the oxygen out of the room around that.”

• These results have implications for public policy

Chesley’s results show that higher-income earners are more likely to adopt lead water filters on their own at an “average” level of concern. Therefore, “You want to have a filter program that is very, very targeted, and it would be ideal to support the purchase and the ongoing maintenance of those filters over time for that (lowerincome) community,” she said.

Milwaukee’s efforts to replace lead laterals have run into pandemic headwinds, and there wasn’t much state or federal funding for lead pipe remediation even before that.

“I think we’re in the same situation that a lot of cities around the country are in, which is that the buck is stopping at the local community on so many issues without a lot of support for state and federal level funding initiatives,” Chesley said.

And that’s her unfiltered opinion.

By Sarah Vickery, College of Letters & Science