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
COVID-19 Response
Racism as a Public Health Crisis
The Climate Crisis

Workforce Equity

_{*Last updated December 2022}

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 (WESP) 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 has 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. The Workforce Equity Strategic Plan Advisory Committee reconvened in October and December, where the County’s Organizational Learning and Complaints Investigation Units presented on their work and progress in 2020.

In 2021, the Board of County Commissioners received a series of briefings on the progress of the WESP. Presentations included updates from Central Human Resources, the Complaints Investigation Unit and the Civil Rights Policy Unit, as well as a briefing about WESP’s “Inclusively Leading with Race” focus area. In fall 2021, a team from the Office of Diversity and Equity (ODE) met with each department about their work and progress towards minimum standards.

In October 2022, ODE and other County leaders presented the Workforce Equity Strategic Plan annual report to the Board, focusing on changes in Central Human Resources, improvements to the County’s Americans With Disabilities Act (ADA) accommodations process, and the first set of findings from a new exit interview pilot program. The full annual report can be found here.

COVID-19 Response

_{*Last updated January 2022}

Commitment	Status	Status Note
Supporting communities of color in our COVID-19 response An effective, equitable response to the pandemic 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 continuously reviewing and updating core aspects of the plan and adding new strategies and goals related to testing and vaccine education, outreach and distribution for all eligible age groups. The latest data shows that 70% of the vaccine doses that Multnomah County distributed have gone to people from communities of color.

Commitment

Status

Status Note

Supporting communities of color in our COVID-19 response

An effective, equitable response to the pandemic 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 continuously reviewing and updating core aspects of the plan and adding new strategies and goals related to testing and vaccine education, outreach and distribution for all eligible age groups. The latest data shows that 70% of the vaccine doses that Multnomah County distributed have gone to people from communities of color.

Racism as a Public Health Crisis

_{*Last updated December 2022}

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	On April 8, 2021, the Multnomah County Board of County Commissioners reaffirmed the County’s commitment to addressing systemic racism as a public health crisis and passed a resolution declaring racism as a public health crisis and committed to championing the continued integration of equity-related practices into the County’s policies and procedures, and supporting the implementation of a public health approach in policy development within each department. The County’s work to advance the health equity priorities laid out in the CHIP are ongoing and have played a key role in shaping the County’s response and recovery efforts relating to the COVID-19 pandemic.
Board of Health policy framework The recommendations captured in the Board of Health policy 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 December 2023, the Board of County Commissioners, acting as the Board of Health, adopted a ban on the sale of flavored tobacco and nicotine products, the centerpiece of the leading cause of death framework.	Partially Complete, 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, as well as immigrant and refugee communities, the Public Health Division will review and modify the framework and bring it back to the Board of County Commissioners.

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

On April 8, 2021, the Multnomah County Board of County Commissioners reaffirmed the County’s commitment to addressing systemic racism as a public health crisis and passed a resolution declaring racism as a public health crisis and committed to championing the continued integration of equity-related practices into the County’s policies and procedures, and supporting the implementation of a public health approach in policy development within each department. The County’s work to advance the health equity priorities laid out in the CHIP are ongoing and have played a key role in shaping the County’s response and recovery efforts relating to the COVID-19 pandemic.

Board of Health policy framework

The recommendations captured in the Board of Health policy 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 December 2023, the Board of County Commissioners, acting as the Board of Health, adopted a ban on the sale of flavored tobacco and nicotine products, the centerpiece of the leading cause of death framework.

Partially Complete, 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, as well as immigrant and refugee communities, the Public Health Division will review and modify the framework and bring it back to the Board of County Commissioners.

The Climate Crisis

_{*Last updated December 2022}

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 is using a human-centered approach to convene local 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, systemic problems that result in inequities. The Climate Justice Initiative is a new model that reflects and leverages the respective strengths of government and community. Using this model, the County and its frontline partners will develop a first ever Climate Justice Plan in 2023. The Climate Justice Plan (CJP) will serve as Multnomah County’s climate justice agenda over the next decade, and is grounded in a commitment to ongoing and deep collaboration between local government and frontline communities to advance a shared vision of climate justice. The CJP will provide an important tool for frontline communities and other community stakeholders to support organizing, ensure government efforts align with community priorities, and hold local government accountable. The CJP will set the foundation for systems change by: responding to the climate crisis as an intersectional issue rooted in justice; committing and holding government accountable to a new approach of co-creation with community; and adopting a new planning model that is nimble, iterative and focused on collective impact. The Climate Justice Plan is being co-designed, co-created, and co-convened by a number of partners. Multnomah County and the Coalition of Communities of Color initiated the project and secured philanthropic support of community capacity to participate. Additional community-based organizations have since joined the Climate Justice Plan Executive Committee: Unite Oregon, Familias en Accion, and Urban League of Portland. The City of Portland’s Bureau of Planning and Sustainability and an unaffiliated community leader with expertise in environmental justice have also joined.	In Progress	The concept for the Climate Justice Plan emerged as one of several outcomes of a year-long series of convenings under the Climate Justice Initiative, which was centered on trust building across local government and community and exploring new models of deep and lasting collaboration. The Climate Justice Plan was identified as a priority by government and community alike to move from “building” to “doing,” and to create a lasting framework for partnership and accountability. In fall of 2022, the Executive Committee was formed and focused on developing a shared understanding of the opportunity and process, and secured working agreements between the partners. In winter and spring of 2023, the Executive Committee will lead a co-creative process with a wide and diverse set of stakeholders to develop a shared 2030 climate justice vision, and identify the priority actions needed to achieve this vision. This work will happen through a series of convenings and workgroups, including a Climate Justice Summit in early 2023. A draft Climate Justice Plan will be completed by summer 2023. Funding from foundations (Partners for Places, Meyer Memorial Trust), and from the City of Portland and Multnomah County and the City of Portland has been secured to fully resource frontline community capacity to participate. A series of community workshops hosted by the Coalition of Communities of Color were held in spring 2021 to test the concept and attract the participation of additional community-based organizations.

Commitment

Status

Status Note

Climate Justice Initiative

Multnomah County’s Climate Justice Initiative is using a human-centered approach to convene local 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, systemic problems that result in inequities. The Climate Justice Initiative is a new model that reflects and leverages the respective strengths of government and community. Using this model, the County and its frontline partners will develop a first ever Climate Justice Plan in 2023.

The Climate Justice Plan (CJP) will serve as Multnomah County’s climate justice agenda over the next decade, and is grounded in a commitment to ongoing and deep collaboration between local government and frontline communities to advance a shared vision of climate justice.

The CJP will provide an important tool for frontline communities and other community stakeholders to support organizing, ensure government efforts align with community priorities, and hold local government accountable. The CJP will set the foundation for systems change by: responding to the climate crisis as an intersectional issue rooted in justice; committing and holding government accountable to a new approach of co-creation with community; and adopting a new planning model that is nimble, iterative and focused on collective impact.

The Climate Justice Plan is being co-designed, co-created, and co-convened by a number of partners. Multnomah County and the Coalition of Communities of Color initiated the project and secured philanthropic support of community capacity to participate. Additional community-based organizations have since joined the Climate Justice Plan Executive Committee: Unite Oregon, Familias en Accion, and Urban League of Portland. The City of Portland’s Bureau of Planning and Sustainability and an unaffiliated community leader with expertise in environmental justice have also joined.

In Progress

The concept for the Climate Justice Plan emerged as one of several outcomes of a year-long series of convenings under the Climate Justice Initiative, which was centered on trust building across local government and community and exploring new models of deep and lasting collaboration. The Climate Justice Plan was identified as a priority by government and community alike to move from “building” to “doing,” and to create a lasting framework for partnership and accountability.

In fall of 2022, the Executive Committee was formed and focused on developing a shared understanding of the opportunity and process, and secured working agreements between the partners. In winter and spring of 2023, the Executive Committee will lead a co-creative process with a wide and diverse set of stakeholders to develop a shared 2030 climate justice vision, and identify the priority actions needed to achieve this vision. This work will happen through a series of convenings and workgroups, including a Climate Justice Summit in early 2023. A draft Climate Justice Plan will be completed by summer 2023.

Funding from foundations (Partners for Places, Meyer Memorial Trust), and from the City of Portland and Multnomah County and the City of Portland has been secured to fully resource frontline community capacity to participate. A series of community workshops hosted by the Coalition of Communities of Color were held in spring 2021 to test the concept and attract the participation of additional community-based organizations.