Sanilac County, Michigan

Sanilac County is a fairly large, rural county in Michigan’s “thumb” region covering 962 square miles. Our research tracks their journey to promote health, well-being, and equity.

Over the past five years, there have been few major changes in Sanilac County with respect to health, well-being, and equity. However, there has been a slight shift towards a greater recognition of health promotion and prevention activities, likely driven in part by the pandemic and efforts to entice younger people to move to the region. Organizations remain committed to and sustained in their efforts to meet the needs of residents and continue to work together within the county and regionally. Sanilac County health leaders have deferred to the state for many health-related policies and programs, which they relied heavily on during the pandemic. Although there has been some promising momentum in mental and behavioral health services locally, there continues to be a shortage of healthcare professionals, particularly for women’s health. Investments in workforce training and broadband access have been and will continue to be priorities for the region, both of which help to fill important gaps and address inequities.

Overview

Population

41,295

Race/Ethnicity

Median Household Income

Population Living in Poverty by Race

Sources:

U.S. Census Bureau; photography courtesy Flickr user Dustin Gaffke, CC BY 2.0.

Notes:

* AINA denotes American Indian Native Alaskan

Community Context

Sanilac County has nearly 1,000 square miles of farmland, beaches, and waterways, and it attracts seasonal tourism. Primary industries include manufacturing, healthcare, and retail. The county is a Republican stronghold, and new county commissioners came into office in November of 2020 in three of the five districts. The county also has a new sheriff as of late 2020, signaling a change in law enforcement leadership for the first time in 12 years.

Sanilac County is largely rural, and as a result, a lack of transportation and broadband access are common barriers to accessing healthcare and community assets. The county is also a federally designated Health Professional Shortage Area. Although 16 percent of households fall below the poverty line, an additional 38 percent have incomes above the federal poverty level but below the basic cost of living. Sanilac County is fairly homogeneous in terms of race and ethnicity, with the majority being White and non-Hispanic, and the population is forecasted to decrease slightly over the coming years.

Sanilac County’s Journey to Promote Health, Well-Being, and Equity

Five years into the Sentinel Communities Surveillance Project, Sanilac County’s community capacity to promote health and well-being has remained fairly constant, grounded by anchor institutions and local collaborations centered around healthcare and economic development.

Regional organizations that include Sanilac and neighboring counties also provide important capacity to promote health and well-being. In addition to ongoing work to address substance use in the region, other initiatives have sought to revitalize Sanilac County through scholarships for residents to obtain higher education or complete trade school, campaigns encouraging residents to donate to local nonprofits, and initiatives to encourage former Sanilac residents, particularly those with a healthcare background, to move back to the region. There has been little movement in terms of health priorities and narrative over the past five years, although there is slightly more emphasis on the importance of prevention. Given the racially homogeneous population in Sanilac County, racial equity has traditionally not been a part of the conversation, although this has changed somewhat with state-level initiatives. Within Sanilac County, health equity is largely centered around broadband access as a boon to telehealth.

Lessons Learned: Where is Sanilac County Five Years Later?

Sanilac County has remained largely the same in terms of health priorities and efforts to promote health and well-being, although there has been an increasing recognition around the importance of health prevention and promotion, particularly with respect to mental health. Collaborations have been important in meeting a diversity of needs, particularly for children and young families, although there remain important gaps in healthcare and other services. Other communities can learn from Sanilac County’s investments in its younger children and families and creative strategies to meet mental health needs, particularly for men who may be more reluctant to seek services.

Because Sanilac County is a smaller region where local stakeholders know and have a long history working together, decision-making related to health and well-being is often expedited. Yet, barriers remain, particularly due to a shortage of health providers, a lack of broadband access, and a lack of public transportation.

Facilitators:

State policies and cross-county collaboratives to promote efficiency and minimize duplication
Local businesses share health information
Small-town connections and support

Barriers:

Lack of broadband access
Health-provider shortage area and a medically underserved population
Lack of a reliable public transportation system
Stakeholders are spread thin

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Each of these Sentinel Community Reports provides insight into the various ways communities across America are working to develop a Culture of Health.