In Milwaukee, tens of thousands of households still receive drinking water through lead service lines. The pipes were installed many decades before medical research made clear that even a small amount of lead is toxic, particularly for small children. After the U.S. Environmental Protection Agency and the Wisconsin Department of Natural Resources advised that municipalities should include neighborhoods facing health and economic challenges in their criteria for prioritizing replacement work, the Milwaukee Water Works turned to a tool created at the University of Wisconsin–Madison to implement a new strategy for lead pipe replacement. The Area Deprivation Index (ADI) maps neighborhood-level disadvantage using factors such as income, education, employment and housing quality. Researchers in the UW School of Medicine and Public Health developed the tool to help communities better understand how place shapes health and to guide decisions about where resources are needed most. The Milwaukee water utility relied on ADI data when working with the city’s elected officials to change an ordinance that had previously required property owners to share the cost of replacing lead service lines—an unrealistic prospect in neighborhoods riddled with the old pipes. The city then adopted a new prioritization system built largely around the ADI and expanded its replacement program from around 1,100 replacements in 2023 to a goal of 5,000 in 2026 and beyond.
