Multnomah County Chair Deborah Kafoury this week announced that Jessica Guernsey, deputy director of the Public Health Division, will take over as the division’s director later this month.
Public Health Director Rachael Banks is leaving Oct. 26 to become the State of Oregon’s Public Health director.
The transition highlights the advancement of two career Public Health professionals who both have centered their work in community, equity and access.
“I’m so proud of the work these two Public Health leaders have done and what it says about the County,’’ said Chair Deborah Kafoury. "They have been working side-by-side for two decades to make Multnomah County a healthier place for everyone.’’
Banks, appointed in 2017 to lead the Public Health Division, has worked for the County for nearly two decades.
She started in 2002 as a community health worker focused on preventing sexually transmitted infections, HIV and hepatitis. Three years later she took on a broader role as a health educator to help Public Health staff better reach communities of color and others who are disproportionately impacted by poor health.
Banks later worked as a program specialist on public health policy and community engagement, then as a supervisor for community wellness and prevention. She became director of the Health Birth Initiative, securing millions of dollars in grant money and teaming up with nonprofits and other partners to improve the health of mothers, infants and children.
Banks also oversaw Public Health’s tobacco policy program as the County implemented Oregon’s smokefree workplace law, covering more than 80,000 businesses. And she led many of the County’s obesity prevention efforts, including increasing healthy food access for more than 60,000 people in faith-based settings.
Under Banks’ leadership, the County in 2014 won $3 million as part of its first Racial and Ethnic Approaches to Community Health grant from the Centers for Disease Control and Prevention, focusing the funds on tobacco-use prevention and improving access to nutritious food for African American residents.
Banks was born and raised in Portland, and has worked for Multnomah County almost her entire adult life. When she talks about leaving to work for the Oregon Health Authority, her voice catches.
“The best thing about being here are the people. Jessica and those other longtime loyal public health champions who work job to job to job, always ready to shift to where the need is, thinking about the next thing coming,” she said. “But I’m also a lifelong Oregonian, and this is a great opportunity.”
“At every point, she has made it easier for people in our community to have a healthier environment and healthier lives. I will always consider Rachael an example of the best that Multnomah County brings to our employees and to our community,” Chair Kafoury wrote in a staff announcement of Banks’ departure. “And now she’s taking the skills and abilities she’s honed at Multnomah County as our public health director and Health Department deputy director, and bringing them to a whole new level to benefit people across the state.”
Banks said she’s excited to take the skills she’s learned and the relationships she has built at Multnomah County and expand that reach statewide.
“We've seen how a regulatory framework can be used to protect those who are most vulnerable,” she said. “So what will I take from my time at Multnomah County? The lesson that you can both protect everybody and focus on the most vulnerable populations at the same time.”
Central to that mission is modernizing public health.
“The pandemic illustrates exactly why we need a public health system to respond to issues of today,” she said. “We have built a system on issues of the past. Now we have emerging threats, longstanding chronic disease and entrenched disparities. We need to shift that system.”
Banks has worked towards those goals throughout her public health career, alongside Guernsey.
Guernsey joined Public Health in 2001 to work on heroin overdose prevention. Later, as a health educator, she helped develop a strategic plan on hepatitis C prevention and created a volunteer program to support syringe exchange.
After Sept. 11, 2001, federal and local governments began planning on how to respond to a bioterrorism attack such as smallpox or anthrax. But by 2007, local health systems in the Portland metro area suggested the County use a more likely scenario for its planning. And so Guernsey began working on a strategic plan for how the region should respond to a potential influenza pandemic. That plan called for measures that sound all too familiar now: physical distancing and work to ensure the equitable sharing of vaccinations, among other measures.
“Jessica was absolutely critical to the community outreach, working with school districts on their planning, working with community organizations, keeping the focus of the community,” said Dr. Gary Oxman, the regional health officer at that time.
“She emphasized the community piece, but in terms of how she approached the issue she used science as the basis for the county's response,” Oxman said. “It's an important message about her career, that she has a passion for the community but she also is clearly rooted in science.”
Because of that foresight, the County was prepared when, in the Spring of 2009, It got its first case of the pandemic flu H1N1.
“It was clearly the precursor to COVID,” Banks recalls. “Jessica was the first person I heard talking about social distancing, vaccine distribution, helping us prepare to talk about when something is a commodity, like testing or vaccines. She warned that if we’re not intentional about our approach, those who have more resources will get those commodities first.”
Banks called Guernsey's thinking “futuristic” and said her penchant for planning doesn’t get in her way.
“She can think ahead in a way that’s not paralyzing. She can see what’s coming, raise key issues and do something about it,” Banks said. “A lot of people are good at raising problems. They walk up to your desk and say, ‘Here’s a big fat problem. Let me know what to do about that.’ But she lays out solutions.”
The characterization makes Guernsey chuckle.
“I’m usually thinking down the road, which isn’t always rosy,” she said.
No matter how much you try, Guernsey said she’s learned, you still can’t plan for everything. The best you can do is build relationships across jurisdictions, draft a plan and protocols that can be tailored, and practice scenarios with a broad spectrum of your partners. And most importantly, maintain the core day-to-day work of public health that lays a foundation for response.
“You don’t know what’s going to happen. And having a global robust public health system that works in concert is necessary,” she said. “The best response is early detection and prevention. And that includes correcting long-standing health inequities.”
Guernsey earned a master’s in public health at Portland State University, but it’s her past 20 years at Multnomah County that has taught her how to practice what she learned with heart, she says.
“Everything I learned about real public health I learned from people like Rachael. Public health is about health and healing, not treating symptoms. It’s about community strength and wisdom. And leading with that,” Guernsey said. “To me the most important work will be carrying on Rachael’s and the Public Health Division’s focus on health equity. There isn’t anything more central to public health.”