Advancing Equity through Health, Human Services and More

Multnomah County touches the lives of more than 800,000 people as the state’s most extensive social safety net, the Local Public Health Authority, a leader in sustainability and one of the region’s largest employers. We are committed to inclusively leading with race in all of this work, as many of the systems and institutions we work through have historically underserved and harmed communities of color. The County has both the opportunity and the responsibility to advance equity and justice through the many ways we affect the daily lives of community members. 

Workforce Equity

*Updated September 2020; to be updated monthly

Status Key:
In Research: Assessing feasibility and best practices

In Discussion: Engaging stakeholders

In Progress: Implementation is underway

Complete: Commitment fulfilled
Commitment Status Status Note

Workforce Equity Strategic Plan

As an organization, Multnomah County is accountable to serving a diverse and changing population. We have committed to creating an organization that is not only reflective of the diversity of the communities we serve, but also ensures that our employees who represent and are members of these communities have the supports needed to thrive in the workplace. The Workforce Equity Strategic Plan creates a foundation for our internal equity efforts upon which we can build transformational workforce equity practices and advance culture change.

In Progress

Since the formal adoption of the Workforce Equity Strategic Plan in 2019, the County has invested in a fully staffed Civil Rights Policy Unity, Protected Class Investigations Unit and equity practitioners in each department, and gas met initial 2019 goals for the plan. Countywide committees paused some of their work in winter 2020 due to the onset of the COVID-19 pandemic. In fall 2020, the Workforce Equity Strategic Plan Advisory Committee will reconvene and review goals and progress for 2020 and 2021.

COVID-19 Response

Commitment Status Status Note

Supporting communities of color in our COVID-19 response

An effective, equitable response to the pandemic that first touched our community only months ago requires us to acknowledge and actively address the disease that has been endemic to this country for 400 years — racism. As the local public health authority, Multnomah County is committed to putting that acknowledgement into action by inclusively leading with race and investing in culturally specific strategies. Since the beginning of our pandemic response, we have worked to listen to voices of color, institute practices and bolster resources to ensure that Black, Indigenous and other communities of color are served equitably. This commitment to specific measures that prioritize the needs of communities disproportionately impacted by COVID-19 is reflected in our basic needs supports, response activities and in our reopening strategies. Dozens of employees, community members and culturally specific organizations helped create the initial response and reopening work plan that was launched in spring 2020. 

In Progress

Implementation of the plan is ongoing and evolving as more is learned about COVID-19, and state and federal guidelines shift. Several areas of this plan have been implemented. 

The County is reviewing and updating core aspects of the plan with community partners this fall.

Racism as a Public Health Crisis

Multnomah County has long recognized racism as a public health issue that negatively impacts the social determinants of health, which include social, environmental and economic factors like access to housing, education, transportation, employment opportunities and food. Over the past several years, Multnomah County has reinvigorated our efforts to eliminate health disparities perpetuated by systemic racism by addressing these underlying factors. This work extends far beyond declaring racism as a public health crisis; we are focused on creating clear and actionable pathways to address systemic oppression using every tool we have.

Commitment Status Status Note

Multnomah County Community Health Improvement Plan

In January 2019, the Board voted to formally recognize and adopt the Multnomah County Health Improvement Plan (CHIP), which was led by the Oregon Health Equity Alliance and informed by more than 20 listening sessions and ongoing community engagement through a model called Community Powered Change. The CHIP lays out a plan for addressing racism as a public health crisis. 

In Progress

In the coming months, the Board will work with the Multnomah County Health Department to review the progress of the CHIP in partnership with community based organizations and communities of color. As part of that process, Multnomah County will reaffirm the County’s commitment to addressing systemic racism as a public health crisis. 

Board of Health policy framework

The recommendations captured in this framework were developed with the goal of addressing the leading causes of preventable death by focusing on nine areas, including nicotine, nutrition and safer streets. Taking measures to support access to healthy and safe communities can result in enormous benefits to communities of color, which experience disproportionately higher rates of chronic illness, violence and injury. The estimated annual cost of health inequalities in Multnomah County is $442 million, including $332 million from premature mortality and $92 million in direct healthcare costs. 

The process to develop this framework has been underway for nearly two years. In November 2018, after years of community engagement to identify strategies, the Multnomah County Health Department launched a series of briefings for the Board of County Commissioners on the leading causes of preventable death in Multnomah County. Meanwhile, the Multnomah County Public Health Advisory Board (MCPHAB) developed and presented a set of nearly 40 recommendations to address the leading causes of preventable death in Multnomah County to the Board of Commissioners.

Working off of the recommendations developed by MCPHAB, the Public Health Division narrowed the list to nine actionable policy recommendations, which were presented to the Board in November 2019. 

In Progress

At the onset of the COVID-19 global pandemic some of these strategies were temporarily put on hold while the Public Health Division shifted its focus to addressing the spread of the virus in our communities. However, the pandemic only further brought to light the measurable impacts of generations of discriminatory policies and practices in housing, access to healthcare, nutrition and healthy environments (the social determinants of health). The result was higher infection and hospitalization among Black, Indigenous, and people of color. 

With the added urgency and gravity that the impacts of this pandemic present within Black, Indigenous, and other communities of color, the Public Health Division will review and modify the framework and bring it back to the Board of County Commissioners for consideration in 2021.

The Climate Crisis

Our planet’s climate crisis is resulting in more frequent and more prolonged bouts of extreme heat, smoke from wildfires, air pollution and other environmental hazards that are made worse by rising temperatures. In our country, these consequences fall first and worst on Black, Indigenous and other communities of color because of institutional racism that has led to persistent and growing disparities in access to quality affordable housing, household wealth, healthcare, and a host of other social determinants of health and stability. Climate justice goes beyond utilizing an equity lens-based approach to shared benefits and burdens, to one that centers power and priorities on the needs and solutions of frontline communities. 

Commitment Status Status Note

Climate Justice Initiative

Multnomah County’s Climate Justice Initiative will use a human-centered approach that convenes governments and the communities they serve with the intent to co-design and co-create climate justice strategies. The approach recognizes that frontline communities — communities that experience systemic racism — can be the source of the most innovative and multi-benefit solutions, and reflects a shared commitment to equitable processes and outcomes.

A critical piece of the approach recognizes the distinct yet critical roles of the government and the community. More often than not, the government has tokenized communities in its efforts to achieve goals by focusing on the downstream impacts of problems, rather than exploring and addressing the upstream needs that result in inequities. The Climate Justice Initiative is a new model that reflects and leverages the respective strengths of government and community through the creation of a “third space.”

This third space will be co-designed, co-created, and co-convened by Multnomah County and frontline communities. The Climate Justice Initiative will develop shared solutions to reduce carbon emissions and protect our community from climate impacts through a focus on racial and social justice. The priority at this time is to build trust with frontline communities by using our agenda-setting power to commit to a new approach.

In Progress

The project is underway with pre-work largely completed. The initial engagement phase is scheduled to begin fall 2020.