St. Clair County, Michigan, has turned everyday public-health topics into heated political fights as county leaders weigh a series of changes promoted by county medical director Dr. Remington Nevin. The debate has touched water fluoridation, childhood vaccination opt-outs, and school-based health services, with supporters portraying Nevin as a critic of the “status quo” and opponents saying the county is moving away from science-backed prevention. Nevin, critics and allies alike say, has become the central figure in how the county defines “public health” and whose values should guide it.
At the center of the conflict is Nevin’s role as the county medical director, a position he has used to advance recommendations on fluoride and immunizations. Detractors and admirers have compared him to Robert F. Kennedy Jr., and the controversy has drawn residents with sharply different views on how local government should handle medical decisions. In an email to Bridge Michigan, Nevin said: “Medical directors are to appropriately advise and direct on all matters of public health policy, ideally in a manner that reflects the values and priorities of the communities that they serve.”
Kevin Watkins, president of the Port Huron branch of the NAACP, said Nevin’s agenda moves the county away from public-health norms. Watkins, a former member of the county’s public health advisory board and a trained nurse, said, “They’re anti-vaccine,” and added, “They’re anti-public health.” In comments describing the conflict, Watkins and other critics said the direction threatens community wellbeing and could weaken efforts meant to prevent children from getting preventable diseases.
Nevin’s recommendations have also pushed fluoride into the forefront. Nevin first suggested the prohibition in June 2025, and this month renewed calls for municipal water systems in St. Clair County to voluntarily discontinue adding fluoride. The AP story said the controversy has been ongoing for more than eight months and has included action by the county’s health advisory board, which in October endorsed Nevin’s stance to adopt local regulations on fluoride. Supporters of the changes cite safety concerns and point to research that concluded excessive fluoride amounts could possibly lead to neurodevelopment problems; the story also noted that the practice of adding fluoride began in 1945, when Grand Rapids became the first city to add it to its water.
While Nevin and local supporters argue for change, opponents say fluoridation remains a proven tool to reduce childhood tooth decay. A letter from the president of the American Academy of Pediatrics reminded county health department leaders in August about childhood tooth decay and the effectiveness and safety of community water fluoridation. The AP report also said several dentists from metro Detroit traveled to object to the proposed shift and pointed to controls intended to keep fluoridation within an acceptable range.
The county’s immunization debate has escalated alongside the fluoride fight. In February, Nevin moved to streamline parents’ ability to opt out of children’s routine vaccines, and the AP story said that drew residents to county board meetings in the days after the decision. It described how residents such as Andrew Eberly said their trust in health departments “eroded” after a child was removed from a neighboring school district because the family refused to take a state-mandated education session required for a vaccine waiver. Eberly later thanked Nevin for providing a letter exempting his child from immunizations, and he called the session “invasive” in his testimony to county commissioners in January.
Critics said the opt-out changes could worsen sliding vaccination rates and make it harder to get vaccinated through the county health department. The AP report said that in 2013, 75% of St. Clair County’s 19-35 month olds had received their recommended shots, and that by 2025 the rate had fallen to 63.7%. It said residents and former officials described additional barriers, including difficulty getting a COVID-19 immunization; Fred Fuller, a former mayor of Yale and county drain commissioner, said officials at the county health department recently requested a doctor’s prescription for the shot, calling it discouraging vaccinations.
The leadership shakeup under discussion is adding another layer of concern for the county’s public health workforce. For years, the AP report said, some public health staff worked “behind the scenes,” but nurse Rebecca Campau told commissioners last week that “Nobody knew that we even existed.” Campau and others said they were now watching a proposal to consolidate the health department’s leadership, a step that the story said could give Nevin more power.
The controversy has also reached into school-based youth clinics. After a commissioner raised concerns that her 12-year-old daughter was exposed to concepts of transgender identity, homosexuality and emergency contraception at Port Huron High School’s teen health center, the board moved to sever ties with the clinic, acting on Nevin’s recommendation. Commissioner Kerry Ange told Bridge of her daughter’s visit and said the brochures available at the teen center were “pornographic,” and she said maintaining the clinic “seems like a waste of money” since the newly renovated county health department is a couple miles from campus.
The AP report said the winding down of the Teen Health Clinic at Port Huron High School, which had more than 1,200 visits in the last school year, is happening as it marks four decades as one of the state’s longest serving school-based clinics. It also said the county is transitioning away from similar clinics in Capac, Algonac and Yale, and that impacted staff were reassigned elsewhere while one nurse was laid off. State-led educational sessions on diversity, equity and inclusion efforts were listed among Nevin’s reasons for rejecting funding for the health centers, and a slide deck described in the AP story as “developing tools for discussing firearms” included questions the story said critics characterized as a “back door” gun registration effort.
Opponents of the closures said the clinics provide practical health access where families struggle to reach traditional care. Brenda L. Tenniswood, superintendent of the St. Clair County regional educational service agency, wrote that school-based clinics provide immediate, comprehensive healthcare where transportation barriers and economic constraints can prevent families from accessing care. The AP story quoted Tenniswood as writing ahead of September closures that the clinics “provide immediate, comprehensive healthcare where our children spend most of their day,” and it added that the proposal to dismantle the clinics, she said, would move the approach “backward” toward centralization that serves bureaucracy rather than communities.
In the public comments, some residents said access is especially important in rural areas, and others described personal experiences of unmet needs. Kate Grantom of Avoca said school-based health centers were a “valuable resource” for her small rural community, and Emrick LaTulip, speaking before the county board, said they wished school-based health care support had been more available when they were a student. The AP story included that LaTulip told Bridge they were sexually abused by a family member and said their experience left them wanting more intensive education earlier, adding, “These people are vulnerable,” as they advocated for children losing access to needed services.
Nevin, the AP story said, framed his actions as aligned with how St. Clair County wants public health decisions vetted through democratic processes. The AP report said he argued that local public health authority should reflect democratic accountability, saying: “Just as individuals should be able to choose their own trusted doctors, the principle of subsidiarity on which Michigan’s decentralized local public health system is based ideally requires candidates for these positions who are directly accountable to those they serve.”