Welcome
As one of the largest public health registries in the country, the Flint Registry continues to follow and support people affected by the Flint water crisis.
After joining the Registry and getting referrals to services, adults reported better overall health. Families were also less worried about running out of food compared to the year before. Because of our participants, we can also help communities across the country by sharing what we have learned with places facing environmental and public health disasters.
2025 Activities
The Flint Registry stayed active in the community by taking part in many local events. Through pop-up days at the Flint Farmers’ Market, tie-dye stations at Mott Fest and the Teddy Bear Health Fair, and joining community meetings, to name a few, the Registry focused on listening, staying informed about concerns, sharing information through multiple mediums, and continuing to make connections to services.
Flint Registry 2025 Follow-up Survey
One of the Flint Registry’s main jobs is to keep track of changes in the health and well-being of people exposed to the Flint water crisis. To help with this, we conducted our most recent follow-up survey between January and June of 2025. The survey was open to anyone who had been part of the Flint Registry for at least a year, and nearly 7,500 surveys from adults and children were completed.
Flint Registry Website
The Flint Registry website is one way we share information back with our community. We recently updated key information about community health, needs, and recovery on the Flint Registry website, and we highlight some of those findings here. In this report, you will find information about water use, the health and behaviors of adults and children, and community involvement.
Flint Registry Members Rely Upon Bottled and Filtered Water
Flint Registry enrollees reported that they continue to use bottled water for drinking.
Approximately 80% of participants reported they use bottled water and 30% use filtered water for drinking at least sometimes. Over half of people (53%) rely solely on bottled or filtered water for drinking. The majority (56%) reported spending between $10 and $50 on bottled water monthly.
| Monthly Spending on Bottled Water |
% |
| Less than $10 per month | 9 |
| $10 to $25 per month | 27 |
| $25 to $50 per month | 29 |
| $50 to $75 per month | 14 |
| $75 to $100 per month | 7 |
| $100 or more per month | 6 |
| I do not buy bottled water | 9 |
Table 1. Monthly household spending on bottled water, Flint Registry 2025 survey.
Child Health Survey
The 2025 follow-up survey included about 1,800 surveys completed by caregivers of children enrolled in the Flint Registry.
Children were eligible to join the Flint Registry if they were born before August 1, 2016. Because of this, the number of children who can take the child survey gets smaller each year as children turn 18 and become eligible to complete the adult survey on their own.
Child Health and Prevention
Overall Child Mental and Physical Health (Figure 1)
We asked caregivers to rate their child’s overall mental and physical health. The majority of caregivers reported their children’s mental and physical health to be good, very good, or excellent. However, fewer caregivers reported their child’s general mental health to be good or better (81.4%) compared to their physical health (91.2%).
Compared to Enrollment (Table 2)
We compared changes in child health and preventive service use from enrollment to 2025.
- More children received special education services in 2025.
- More children had at least one check-up with their primary care provider in the last 12 months in 2025.
- More children were reported to have at least one dental check-up in the last 12 months in 2025.
- Among children with health conditions, more caregivers reported their children never had days when their health prevented them from doing things other children were able to do.
Figure 1. Child mental and physical health, Flint Registry 2025 survey.
| Health and Prevention | Enrollment Survey: Those who also completed 2025 Follow-up % |
2025 Follow-up Survey % |
| Check-up with Primary Care Provider in Last 12 Months | ||
| Yes | 87.2 | 92.1 ▲ |
| Preventive Dental Care Visit in the Last 12 Months | ||
| Yes | 86.2 | 90.4 ▲ |
| Child has had a Special Education or Early Intervention Plan | ||
| Yes | 21.0 | 23.7 ▲ |
| Frequency Health Conditions or Problems Affect Child’s Ability to Do Things Other Children Do | ||
| Always | 4.5 | 3.8 ▼ |
| Usually | 6.9 | 4.7 ▼ |
| Sometimes | 38.1 | 34.7 ▼ |
| Never | 50.5 | 56.8 ▲ |
Table 2. Health and prevention measures for children enrolled in the Flint Registry for the 2025 follow-up survey.
Child Health Conditions
We asked caregivers about health diagnoses in their children (Tables 3 and 4). One in five children were diagnosed at sometime with asthma (21.1%), 1.8% were ever diagnosed with diabetes, 7.7% with frequent or severe headaches, and 6.4% with vision problems. The most common concern was skin conditions like eczema (23.3%).
| Ever Diagnosed With: | 2025 Follow-up Survey % |
| Asthma | |
| Yes | 21.1 |
| No | 78.9 |
| Diabetes | |
| Yes | 1.8 |
| No | 98.2 |
| Frequent or Severe Headaches | |
| Yes | 7.7 |
| No | 92.3 |
| Vision Problems | |
| Yes | 6.4 |
| No | 93.6 |
Table 3. Caregiver-reported diagnoses measured in the 2025 follow-up survey for children enrolled in the Flint Registry.
| Ever Diagnosed With: | 2025 Follow-up Survey % |
| Asthma | |
| Yes | 21.1 |
| No | 78.9 |
| Diabetes | |
| Yes | 1.8 |
| No | 98.2 |
| Frequent or Severe Headaches | |
| Yes | 7.7 |
| No | 92.3 |
| Vision Problems | |
| Yes | 6.4 |
| No | 93.6 |
Table 4. Caregiver-reported diagnoses measured in the 2025 follow-up survey for children enrolled in the Flint Registry.
Adult Health Survey
The Flint Registry tracks the physical and mental health of adults who were exposed to the Flint water crisis, and these data are available to support community decision making about health priorities.
Adult Health and Prevention
Overall Adult Mental and Physical Health (Figure 2)
At the 2025 follow-up survey, we asked adults to rate their overall health. The majority reported their general physical health as good, very good, or excellent (63.4%), and 70.1% of adults reported their general mental health as good, very good, or excellent (Table 5).
Compared to Enrollment (Table 5)
- More adults reported having a check-up in the last 12 months at the 2025 follow-up survey.
- A similar number of adults had at least one preventive dental visit in the last 12 months in 2025.
- Fewer adults reported using tobacco daily in 2025.
Figure 2. Adult mental and physical health, Flint Registry 2025 survey.
| Health and Prevention | Enrollment Survey: Those who also completed 2025 Follow-up % |
2025 Follow-up Survey % |
| Check-up with Primary Care Provider in Last 12 Months | ||
| Yes | 76.8 | 83.1 ▲ |
| Preventive Dental Care Visit in the Last 12 Months | ||
| Yes | 58.2 | 59.6 ▲ |
| Current Use of Tobacco | ||
| Daily | 23.0 | 20.8 ▼ |
Table 5. Health and prevention measures for adult enrollees in the Flint Registry for the enrollment survey and the 2025 follow-up survey.
In the 2025 follow-up survey, we added new questions about the quality of sleep. One in five (20.2%) adults reported their recent sleep quality to be fairly bad or very bad (Table 6).
| Sleep Quality | 2025 Follow-up Survey % |
| Very Good | 11.0 |
| Fairly Good | 40.6 |
| Neither Good or Bad | 28.1 |
| Fairly Bad | 16.4 |
| Very Bad | 3.8 |
Table 6. Sleep quality among adult enrollees in the Flint Registry at the 2025 follow-up survey.
Adult Health Conditions
Flint Registry adults are more likely to have certain health conditions than other adults in Michigan, including kidney disease, high blood pressure, stroke, and arthritis.
| Diagnoses Made by a Health Care Provider: |
2025 Follow-up Survey % |
| Arthritis | |
| Yes | 38.9 |
| No | 61.2 |
| Depression | |
| Yes | 30.6 |
| No | 69.4 |
| High Blood Pressure | |
| Yes | 44.5 |
| No | 55.5 |
| Heart Attack | |
| Yes | 3.8 |
| No | 96.2 |
| Stroke | |
| Yes | 3.8 |
| No | 96.2 |
| Kidney Disease | |
| Yes | 7.6 |
| No | 92.4 |
Table 7. Self-reported diagnoses of health conditions for Flint Registry adult enrollees at the 2025 follow-up survey.
In the 2025 follow-up survey (Table 8), we also started asking about diagnoses of health conditions like post-traumatic stress disorder.
| Diagnoses Made by a Health Care Provider: |
2025 Follow-up Survey % |
| Eczema | |
| Yes | 14.3 |
| No | 85.7 |
| Skin Rashes | |
| Yes | 11.3 |
| No | 88.7 |
| Post-Traumatic Stress Disorder | |
| Yes | 10.7 |
| No | 89.3 |
Table 8. Self-reported diagnoses for conditions new or revised in the 2025 follow-up survey for Flint Registry adult enrollees.
New Data for the 2025 Follow-up Survey
The 2025 follow-up survey included questions that helped us evaluate community engagement and satisfaction with the Flint Registry.
Adult Community Engagement
Many adults reported they agreed or strongly agreed with statements asking about changes in their level of community engagement since the Flint water crisis (Table 9). Approximately 37% of adults agreed that they were more involved with their community, and 35.7% agreed that they are more connected to their neighbors or community groups.
| Adult Community Engagement in Flint |
% |
| Since the water crisis, I am more involved in my community. | |
| Strongly Agree | 11.5 |
| Agree | 25.1 |
| Neither Agree or Disagree | 47.4 |
| Disagree | 10.6 |
| Strongly Disagree | 5.4 |
| Since the water crisis, I am more connected to neighbors or community groups. | |
| Strongly Agree | 11.5 |
| Agree | 24.3 |
| Neither Agree or Disagree | 46.7 |
| Disagree | 11.9 |
| Strongly Disagree | 5.6 |
Table 9. Community engagement measures for adults enrolled in the Flint Registry at the 2025 follow-up survey.
Flint Registry Impact on Children
Most caregivers of children agreed that enrolling in the Flint Registry provided some benefit to their children.
| Impact of the Flint Registry on Children | Agree % | Disagree % |
| Enrolling in the Flint Registry connected me to resources and programs that are improving my child’s health or development. | 75.3 | 24.7 |
| Enrolling in the Flint Registry has allowed me to better understand my child’s health or development. | 76.1 | 23.9 |
Table 10. Caregiver report of the impact of the Flint Registry on their children, 2025 follow-up survey.
Referrals Turn Your Information Into Action
By staying connected and completing surveys, Flint Registry members help the community better understand the impact of the water crisis and support continued advocacy efforts.
Through survey responses, participants can express health concerns and choose to receive more information and referrals. These referrals to services and resources are one way the Flint Registry works to keep our members counted, connected, and supported.
In 2025, the Flint Registry made nearly 14,000 referrals to services in categories ranging from dental and health services to behavioral and mental health services, health insurance, and food assistance. A majority of those referrals were to behavioral and mental health services and general health services.
In health services, the largest amount of referrals were to Hamilton Medical and the Senior Crisis Intervention Program through the Valley Area Agency on Aging (VAAA). For behavioral and mental health services, Access Center and Family Supports Coordination through Genesee Health System (GHS) and Hamilton Behavioral Health at Hamilton Community Health Network were the most referred.
Figure 3. Flint Registry referrals by organization type.
Policy Updates
Since the Flint water crisis, Michigan and the federal government have changed laws related to the regulation of lead in our environment.
Federal Updates
A 2024 update to the federal Lead and Copper Rule, called the Lead and Copper Rule Improvements, requires cities to replace lead service lines by 2034. As of November 1, 2027, the policy also lowers the minimum action level for lead contamination for water systems — from the current 15 micrograms per liter of water to 10 micrograms per liter of water.
State of Michigan Updates
The State of Michigan has adopted policies that support adherence to the Lead and Copper Rule Improvements policy and supports identification of children at risk for lead exposure. Here we highlight a few of Michigan’s recent policy updates.
Cities Must Publish Pipe Inventories
Updates to the State of Michigan’s Safe Drinking Water Act required cities to complete an inventory of service line materials. These inventories, called Complete Distribution
System Materials Inventories, are required to be updated annually and made available to the public. Data provided to the State of Michigan show that as of March 2025, 10% of Michigan service lines are lead or galvanized previously connected to lead, and 12% are lead status unknown.
Schools Must Have a Testing Plan
Michigan has two policies that contribute to the Filter First policy: the Clean Drinking Water Access Act and the amended Child Care Organizations Act. The policies were signed into law in October 2023 and require that schools and daycares in Michigan have:
- A drinking water management plan
- Lead-reducing filters installed on water faucets that provide drinking or cooking water
- Testing of filtered water for lead
Support for Children
The current blood lead reference level for Michigan is a blood lead concentration of 3.5 micrograms per deciliter or higher. When a child has a blood lead concentration at or above that, eliminating the exposure source becomes a priority. The Mid-Michigan Community Health Access Program (CHAP) is available to support families in this situation.
Outreach
Through ongoing outreach efforts, the Flint Registry continues to elevate Flint’s story, share critical lessons learned, and help shape policies, partnerships, and public health initiatives that drive meaningful change.
Community Councils Drive Direction of Public Health in Flint
Membership Advisory Council and Community and Partner Advisory Council
The Flint Registry Membership Advisory Council (MAC) is a volunteer group of Flint Registry participants who help plan and guide what the Flint Registry does. The MAC ensures that the voice of the community continues to shape important decisions, future priorities, and how information is shared. Members meet four times a year to collaborate, provide feedback, and help strengthen Registry projects that serve the Flint community. Participants who previously completed the Flint Registry survey were eligible to apply, and selected members represent the lived experiences and perspectives of the community.
Community Council Key Insights
In meetings with our community councils, we have heard the importance of clear, transparent, and community-focused communication. Community members requested ongoing digital newsletters and text messaging as options. They encouraged continuing these efforts while expanding into additional formats such as short videos and more visual content to increase engagement. Members also emphasized the importance of maintaining printed materials and in-person outreach to ensure residents without reliable internet access remain connected.
Leading and Learning Public Health Globally
CLEAR Forum
The Flint Registry is also a founding member of the CLEAR Forum (Cohort Longitudinal Engagement and Retention). This global collaboration of long-term public health projects meets virtually throughout the year to share best practices, learn from one another, and find the best path forward in their communities and beyond. These project locations include New York, Boston, Hawaii, London, New Zealand, and others.
Communication and Engagement
The Flint Registry’s communications and outreach efforts centered on strengthening connections, sharing data-informed insights, and providing clear updates on program milestones.
The Registry maintains regular contact with residents through monthly website and social media updates and quarterly newsletters. We focus on the Registry’s mission to reduce ongoing lead exposure, support wellness and recovery, and serve as a trusted hub for resources in the Flint community.
The Flint Registry participated in the following community events:
- We hosted Men’s Health Conversations with a nationally recognized physician, a local speaker and leader, and we shared lead poisoning prevention resources through our social channels.
- The Flint Registry was represented and engaged at events such as Trunk-or-Treats, community clean-ups, and neighborhood meetings.
- Commemorated the launch of our survey by creating a pop-up tie-dye station at the outdoor stalls of the Flint Farmers’ Market.
Future Directions
Moving forward, the Flint Registry will continue monitoring health concerns and connecting residents to resources and support services.
In Summer 2026, the Flint Registry plans to launch a mini survey focused on the topics community members identified as most important, including current well-being, mental health, and access to resources. The Registry also plans to increase youth engagement and strengthen partnerships with trusted local organizations to reach more residents.
Collaborations
Highlighting important partnerships.
The Flint Registry works with a number of community partners and organizations. One of the Flint Registry’s closest collaborators is the Mid-Michigan Community Health Access Program (CHAP).
The Mid-Michigan CHAP is a community-based, family-centered medical home improvement program that works to improve the health outcomes of children and adults. Mid-Michigan CHAP is a free program that is available to anyone in need, regardless of age or insurance status.
Conclusion
As the Flint Registry enters the next chapter, our work continues to make a difference in Flint and across the country. It shows how community-led public health programs can help communities grow stronger over time.
The data shared in this report and on the Flint Registry website highlight important health conditions and public health concerns that can help guide community priorities and future action in partnership with Michigan State University and community organizations. With more than 22,000 Flint residents enrolled and 35,647 referrals made to connect people with services, the Flint Registry has helped residents access support and better understand the long-term effects of the water crisis.