And as health leaders gather to honor Public Health Week at a Thursday meeting of the Multnomah County Board of Commissioners, the county’s Chief Diversity and Equity Officer Ben Duncan will present a strategic plan on workforce equity that includes recommendations on recruitment and hiring, retention and promotion, and accountability. It’s the culmination of more than six months work by frontline county staff, union representatives, and nonprofit organizations including the Urban League, Verde, APANO, Unite Oregon, and Voz.
Inequality can’t be disentangled from health, Duncan told a gathering of employees at the Oregon Health Authority Monday, as he laid out the county’s process for developing the plan using the county’s Equity and Empowerment Lens.
“Public Health Week is all about people's ability to thrive, to reach their full potential,” he said. “If we don’t look at education, if we don’t look at income, if we don’t look at employment, health insurance, criminal justice, we’re having the wrong conversation…if we don’t understand the relationship between these things as public health practitioners, then we’re not talking about public health approaches.”
The development of the county’s plan bore out lessons for Duncan — lessons that leaders should adopt to address disparities and improve the health of their workforce: Listen to the those most affected. Welcome criticism. Fail gracefully. And move the ball.
An average American will spend 90,000 hours at work over their lifetime. So it’s no wonder that the way people experience work affects their health. At Multnomah County, employees have recounted stories of being discounted, overlooked for promotions and harassed because of their race, gender identity, native language or ability.
“We know, as our [County] Chair likes to say, that we’re not immune to the impacts of racism and sexism and discrimination and homophobia,” Duncan said. “You don’t walk through the doors of institutions and this stuff goes away. We know these things are still happening.”
Multnomah County’s plan was driven by staff most affected by workplace inequities— employees of color, older employees, queer employees, employees with disabilities and immigrant and refugee employees. They spoke about barriers and isolation.
“It shouldn’t be hard to understand that your gender identity, or sexual orientation, your race, gender, accent, disability can make you feel you don’t have the same opportunity,” he said. And those feelings, over a lifetime, impact future generations in a way science is only beginning to grasp.
“The experience of racism shows up in our genetics, it is literally killing human beings and altering our genetics,” Duncan said. “People have talked about intergenerational trauma for a long time. Science is just now telling us that that’s true.”
Yet research shows that social engagement and advocacy creates a sense of agency that promotes health.
“Imagine If you got a prescription to go to a demonstration, a prescription to volunteer, a prescription to testify and tell your story in Salem,” he said. “I’m really proud of the work our frontline employees did, showing the scars on their back to inspire change. We’re going to rely on those stories, we’re going to rely on those experiences, to move our work.”
Duncan will present the draft strategic plan to commissioners during Thursday's board meeting. But he said that was never the goal.
“The end goal is not to write some stuff on paper. End goal is change that makes people’s lives better.”