Reversing the History of Illness

Sobering picture for residents of color

Michael Leighton | 2/4/2015, 3:56 p.m.
People of color in Multnomah County face “extremely sobering’’ disparities that lead to more illness, fewer opportunities and shorter lives.
Representatives from the Multnomah County offices of Health, Diversity and Equity, Human Services and the Board of Commissioners give voice to the health disparities faced by the county’s residents of color.

People of color in Multnomah County face “extremely sobering’’ disparities that lead to more illness, fewer opportunities and shorter lives.

Entering 2015, public health officials have a new mandate to address racial and ethnic health disparities in the Portland area where African Americans experience grave differences in almost all 33 measures of health, but where disparities also persist for Latinos, Native Americans, Alaska Natives, Asian Americans and Pacific Islanders.

“The number and breadth of the disparities across this range of indicators highlights the need of a multi-layered, cross sectional strategy to address them. This is not just a Health Department issue,’’ said Dr. Julie Maher, the health official who led a recent analysis. “This is an extremely sobering picture for our communities of color.’’

The fifth Health Department disparities report in a decade and the most comprehensive yet was released in December. It reviewed the underlying causes of poor health such as economic status, education, literacy, air quality, access to healthy food and health care.

“This report is not about healthcare, it’s about health,’’ said Health Department Director Joanne Fuller. “We’re really talking about... the totality of people’s lives. That totality includes racism and discrimination that research shows has a deep and lasting impact on people’s health.”

Gerald Deloney, co-chair of the group Communities of Color, said that as disturbing as the findings are, people of color were not surprised.

“We live this on an everyday basis, and we know how bad that it really is,” Deloney said.

Among the findings were figures showing that infant mortality and deaths from diabetes for local African Americans was 2 ½ times higher than non-Latino whites and six times the rates of homicide.

African Americans were also four times as likely to have children living in poverty, and were twice as likely to be unemployed, have children not meeting third-grade reading standards and live in a single-parent household.

Native American and Alaska Natives were three times as likely to have children in poverty and have twice the rates of unemployment, teen births and smoking.

Latinos had 3 ½ times the teen birth rate and twice the rate of children in poverty, children not meeting third-grade reading standards and homicide.

Asian/Pacific Islanders had twice the rate of needing health insurance than whites and were more likely to live in areas of poor air quality and neighborhoods that lacked healthy food retailers.

During an emotional briefing on the findings, Suzanne Hansche, the Elders in Action representative to the Oregon Health Equity Alliance, asked the board of commissioners to support the group’s legislative agenda as part of their approach to reducing disparities. Among their key items: a “Ban the box,’’ bill that would stop someone with a criminal conviction from being automatically disqualified for work and a policy that supports paid sick leave. She also asked the board to invest in community efforts and programs outside the Health Department.

The Health Department listed several ways it will address the inequities, including making more investment in early childhood and adolescence programs; creating a public health advisory board and formal Community Health Improvement Plan to authentically engage the community and build on community-based strengths; and increasing culturally-specific and community specific approaches to healthcare.

“The disparities my colleagues have spoken of are unacceptable,’’ said Rujuta Gaonkar, manager of the Health Equity Initiative at the Multnomah County Health Department. “Moreover they are avoidable.”

Gaonkar said that as the single parent of color of a four-year old, her son sees the future as limitless. “I don’t want that to change and the reality is that I also have a job that affords me paid sick leave, I have access to healthy food, and affordable, high-quality education. I want to be able to say that for every child growing up in Multnomah County and right now, I cannot.’’