Flint Rx Kids program targets economic hardships of pregnancy and early infant caregiving

Flint residents Tatiana Lopez-Marshall, 39, and her husband welcomed their third son earlier this year. Lopez-Marshall said she has had difficulty saving money since she went on maternity leave because she’s not receiving a regular paycheck.

She said things became even more challenging when her car needed new tires and brakes, followed by the transmission going out on her husband’s car. Fortunately, she says, she began receiving payments from Flint Rx Kids, a citywide program that provides what it calls “prescriptions” of cash for mothers and infants. The payments have helped with the sudden expenses.

Flint Rx Kids provides all pregnant women in the city of Flint, regardless of income, with no-strings-attached cash “prescriptions” of $1,500 during pregnancy; it also provides the baby’s primary caregiver $500 each month throughout its first year. 

“I tried to save up a little bit here, a little bit there, but it’s just, it’s not enough,” Lopez-Marshall said. “So finding out about the Rx Kids program and being eligible to get that money — I feel very joyful; I feel blessed. I feel like things just came up at the right time, because I really didn’t know what I was going to do.”

The Flint Rx Kids initiative is led by Dr. Mona Hanna-Attisha, who’s best known as the pediatrician who exposed elevated lead levels in the city’s water, later referred to as the Flint water crisis.

Medical research has shown that being born into poverty has severe consequences for a child’s overall health and continues to affect aspects of their educational and professional future through adulthood.

The goal of Flint Rx Kids is to ensure that families see a way out of poverty to prevent such disparities, specifically at a time when they’re most economically vulnerable.

As of April 15, the Flint Rx Kids program has allocated over $1 million in cash prescriptions to more than 500 families since the program began in January. The cash prescriptions give families the freedom to use the money on whatever they need, unlike programs for low-income families that impose limitations, such as the Special Supplemental Nutrition Program for Women, Infants, and Children and Section 8 vouchers.

“This is not just early childhood,” said Hanna-Attisha, who is the program’s co-director. “This is also birth equity, it’s economic justice, it’s community development. This is about revitalizing local economies, because this money is going to get spent back into the local economy. This is about health, and this is about education. This is about racial justice. This is about so many things.”

Hanna-Attisha has been a champion for families and children in Flint since she began her career as a medical student at the Michigan State University College of Human Medicine roughly 20 years ago.

She told the Michigan Independent she admired the pride and loyalty that Flint’s residents had for their city, but the obstacles those residents were facing moved her to become not just a doctor, but also a public health advocate. She noted the high rates of poverty, violence and poor nutrition that were making it difficult for children to be successful in Flint, the poorest city in the state and one of the poorest in the nation, where almost 70% of kids grow up in poverty.

Hanna-Attisha said she returned to Flint, after her residency and after she obtained a degree in public health policy, when MSU was beginning to build public health infrastructure there. “That is what drew me back to Flint in 2011,” she said, “this potential to work hand in hand with the community to address these big inequities that impact the health of our patients.”

The situation in Flint reached the point of crisis soon after the city switched its water source from Detroit to the Flint River in April 2014. Residents’ concerns about the water’s foul smell, color and taste were ignored by city and state officials. In 2015, Hanna-Attisha began a study that found that levels of lead in the blood of Flint children had doubled since the city switched its water source.

“I was just so upset that this was a preventable thing, that the water was switched and it wasn’t treated properly, and it potentially exposed an entire population of children who are already struggling with so much, with another adversity,” Hanna-Attisha said.

Approximately 99,000 people were exposed to lead in the drinking water. An outbreak of Legionnaires’ disease that killed 12 people and sickened at least 87 was attributed to water from the Flint River.

While Flint in 2016 implemented a program scheduled to replace lead and galvanized-steel water service lines within three years, the Natural Resources Defense Council notes that, as of April 2024, the work has not been completed.

Now the associate dean for public health at the Michigan State University College of Human Medicine, Hanna-Attisha said she’s always wanted to “prescribe an antidote to poverty.” For her, this means preventing the causes of ill health rather than treating sickness after the fact.

“One of the root causes of ill health and poor outcomes is growing up in poverty. So as a pediatrician, it’s maddening to hold a little baby in my arms, and to do everything that I should be doing and can be doing to make sure that they’re healthy today and to make sure that they’re healthy tomorrow, but not being able to do something about poverty,” Hanna-Attisha said. “It’s so frustrating. It’s felt like my hands have been tied.”

“Families talk about a weight that’s been lifted off their shoulders,” Hanna-Attisha said of the Flint Rx Kids program. “They talk about their ability to buy things like a car seat and diapers and baby monitors, to buy toys and baby books, to save money to pay for rent and utilities and have transportation to get to the doctor’s office.”

With funding from state and private donors, Hanna-Attisha said, they’re looking to expand the program to Detroit, Saginaw, Benton Harbor, Kalamazoo, and areas of the eastern Upper Peninsula by January 2025.

 She said programs like Flint Rx Kids are helping to rebuild public trust in government and academia in the wake of the water crisis in Flint. Her clinic has also brought in a social worker, prescribed books, and begun home visiting programs that are outside the scope of traditional medicine.

“That’s one of the reasons we have Rx Kids,” Hanna-Attisha said. “It is, once again, this refusal to be OK with the status quo, and to do better, especially on behalf of our children.”