I believe that no matter where you live, work, learn, or play you deserve the opportunity to live life to your fullest potential. This core belief has driven my passion for public health over the past 15 years and has been instrumental in the St. Clair County Health Department’s aim in achieving health equity through our policies, programs and collaborations. “Equity” is not to be confused with “equality.”

When thinking about health equity, I like referring to a graphic produced by the Robert Wood Johnson Foundation. In it are several bicyclists looking to take a ride. However, they each come to the ride with different characteristics. One uses a wheelchair while the second is very tall. The third rider is average sized and the final rider is a child. If each individual was treated equally and given the same standard issued bicycle, only the average sized person would be able to comfortably ride. Yet, if each individual is given a bike that accommodates their specific needs, the result is an equitable experience where ALL have an opportunity to ride and barriers to participate are removed.

The role public health plays in addressing health equity issues is critical. Public health collects population level data that helps identify gaps in health outcomes and constantly has a “lens” towards how to move the needle towards better health for everyone, especially those with the greatest challenges. It turns out that health is impacted much more from the conditions in the places where people live, learn, work and play, called the social determinants of health (SDOH), than good genetics and quality medical care. Certainly, individual choices are important, however factors in the social environment are what determine access to health services and influence lifestyle choices in the first place. It has been widely reported that SDOH has a profound impact on a broad range of health, functioning and quality of life outcomes. In fact, research shows that SDOH factors can drive as much as 80% of health outcomes. It’s incredible to think of the power our communities hold in shaping our health!

Nonetheless, the work of public health, and in turn health equity, is not our work alone. It is shared amongst everyone in our community. I’m particularly proud of the strong collaborations we have developed with a broad range of community partners, and particularly with leaders in the Southside of Port Huron and the Diversity Initiative of St. Clair County. Our ability to address racial and identity based inequities is greatly enhanced by working together on common goals. Although progress has been made, there is still much work to do. An important step will be reviewing our 2021 St. Clair County Community Health Needs Assessment which will be released in the next few weeks. This data will show where there are significant gaps and inform us on the steps we need to take as a community to ensure equitable health outcomes for ALL residents.

Yours in health,
—Dr. Annette Mercatante, MD, MPH,
Medical Health Officer,
St. Clair County Health Department