Dr. Lisa Merritt on Epigenetics, Access and Equity in Health Care
This article is part of the series Listening to Diverse Voices, proudly presented by Gulf Coast Community Foundation.
Physiatrist Dr. Lisa Merritt is the founder and executive director of Sarasota’s nonprofit Multicultural Health Institute (MHI). She launched MHI in 1995 with the goal of leveling the healthcare playing field by engaging with and empowering underserved and vulnerable communities. Today, MHI offers access to healthcare in all areas, from infant care to cardiovascular disease to Covid.
A graduate of Georgetown and Howard universities, Merritt trained in family and community medicine at University of California, San Francisco, and completed her residency in physical medicine and rehabilitation at Baylor College of Medicine in Houston. She's written extensively about multicultural health issues, physical medicine, rehabilitation, and integrative medicine topics, and has also given talks nationally and internationally.
Merritt, who is an adjunct professor at New College of Florida, moved to Sarasota in 2006 to care for her parents and immediately dove into community outreach work. She's received awards from organizations including the American Medical Association, the National Council of Jewish Women and the NAACP. She was the American Academy of Physical Medicine and Rehabilitation's first Black female board member, and she succeeded her mother, the late Eleanor Merritt—who was the first Black woman on The Ringling's board of trustees—as a member of that board.
Who made the biggest impact on your world view?
"My brilliant parents, Dr. Lorenzo Merritt and Eleanor Merritt, as well as the community in which I was raised.
"My parents were forerunners in their respective fields. They led by example and showed me the power of transformation through persistence, working together and being excellent. Recently, I discovered that my father’s doctorate, back in the '70s, included a discussion of U.S. caste systems and the importance of culturally competent mental health services.
"My parents also instilled a sense of confidence. [My siblings and I] were children of a dream; we were the hope for the future. They had fought and suffered so much to create opportunities for us. So our job was to go to school, become the best we could be at whatever we were doing, never forget where we came from, and keep moving forward."
Where did you grow up?
"I grew up Queens, New York, during the fight for civil rights in the 1960s, and attended public school. I had amazing teachers who challenged and cultivated me, they gave me incredible life skills that I'm grateful for. They encouraged us to read and to think for ourselves. This is something that worries me when I look at education now—it’s become test- and checkbox-oriented. It’s suppression of free thought and critical individual analysis. Those are important things.
"In fact, they're what this pandemic required us to do: take new information, apply it in a different way based on prior experience, and come up with innovative solutions. I was astounded by how hard that was for a lot of people."
How have race relations impacted your life?
"My mom and her cousin struck out to a growing neighborhood in Westbury, New York, where a Jewish developer sold them plots on streets that were going into construction. Now, we are from a multicultural family—Jamaican, Jewish, Scottish—which made for exotic-looking people with an uncertain identification. I don’t believe my mother and her cousin actively played it, but they didn’t think about it. Afterward, they showed up with brown husbands—but it was too late [for anyone to protest]; they owned the property.
"I grew up in a multicultural environment, an oasis with Italians, Polish, French and Spanish. It was an absolute melting pot. Because of that, my immediate interpersonal interactions were informed by positive and loving connections with different kinds of people.
"As a girl, I attended a march with my aunt. The police patrols went into the crowds, swinging, banging and beating people—I saw that firsthand. Later, in middle school, the police spoke to my class and said, ‘The police are your friend.’ I asked, ‘If the police are your friend, then why were they beating those people who were just walking on the bridge?’ I got in trouble for being impudent to our guests.
"It was an incredible juxtaposition; I heard fiery speeches and saw people fighting and struggling for their rights. On the other hand, in my world, it was all different kinds of people together."
What was your college experience like?
"At Georgetown, when I did well on the GRE, I learned about it when students congratulated me. That was when scores were posted for all to see. They were surprised that I had one of the top scores. However, Georgetown initially refused to recommend me for medical school, but the Office of Minority Student Affairs stepped in and advocated for me. After ‘further review’ of my case, the university did ultimately recommend me.
"I was one of three Black students to graduate pre-med and go to medical school out of the nearly 30 who started. A lot of people didn’t want to see us succeed, but we didn’t focus on that. We came from strong family backgrounds and systems of excellence—we were smart and worked hard. I’m grateful for the discipline of that."
What inspired your passion for environmental health?
"While at medical school Howard University, I had a fellowship with the public health service in a building called Black Rock where the Centers for Medicare and Medicaid Services and the National Health Service Corps are housed. That's where I came to understand the mechanisms of public health and how arcane some of it was.
"While I was a medical student, I also worked at the Bureau of Engraving and Printing's health clinic, where I had full clearance. I wrote a paper that changed the whole safety system because we were seeing incredible amounts of dermatological and respiratory issues due to the dyes that are used to make money. Most of the workers were Black. I was astounded and appalled that, at that time, the ventilation was simply cracked-open windows and the workers didn’t have any protective gear. My paper summarized the incidents and offered recommendations for air handlers, etc.
"I also experienced the power of documentation to effect change. My parents always said, ‘Live your truth.’ Be purposeful, tell the truth, and elucidate what the issues are—and, at the same time, come ready with solutions and strategies."
Tell us a little about the beginning of your career.
"I was on the Bilingual Interpreting Service at San Francisco General Hospital because I spoke Spanish. This was at the height of the AIDS epidemic. While interpreting, I became aware of the barriers for people who didn’t speak English as a first language in terms of giving consent, understanding what was going on, and treatment. There was— and still is—a huge difference in the way minorities get treated and the way the system interacts with them.
"In the mid-'90s, I started my own practice in California. At that time, we didn’t yet have the Institute for Medical Studies research on health inequities and disparities, which came along in the 2000s—but I was witnessing it. I would wonder why Black and Spanish people were experiencing diabetes, strokes, and amputations much younger than other races, and not getting the care they needed."
"Today we have epigenetics—the study of how, when you shift the health of one generation positively or negatively, it affects two and three generations down the line. Part of the challenge with diabetes and obesity high blood pressure comes from events that happened to our great-great grandparents, from deprivations to lynchings. We’re living a lifestyle now with those genetic predispositions. Now add to environmental toxicity. For example, half of the superfund sites [polluted locations in the United States requiring a long-term response to clean up hazardous material contamination] in this country are in proximity to communities of color."
How are you working to make change on a local and national level?
"As Dr. Martin Luther King Jr. said, ‘Of all the forms of inequality, injustice in health is the most shocking and inhuman.’
"Fifteen years ago, MHI was the first group to initiate a community-wide assessment in North Sarasota, where the highest concentration of people of color exist. That informed how we prioritized our interventions and shared decision-making with the community.
"Every five years we re-survey. Our most recent was called Data Across Sectors of Health (DASH). We worked with community ambassadors who were trained and certified by New College to summarize and create a data story that could be used for advocacy efforts. It received national recognition and is being used by Florida’s Office of Minority Health and Health Equity."
What would you like your white friends or acquaintances to be doing right now?
"We need allies, not accomplices. It is important for people to use their influence to insist on greater diversity on philanthropic boards, the application of funds received and the recipients of the funds. Also, demonstrate diversity on leadership teams and push for creating opportunities to cultivate potential leaders.
"Get to know people from different backgrounds and worlds. Reach to learn and understand. Choose something to take action and follow through. Stop resting on your privilege."
Listening to Black Voices is a series created by Heather Dunhill