Examining Challenges, Successes and Next Steps as Oregon Seeks Health Equity

Public health professionals gathered in Portland April 2-6 to discuss closing the health equity gap in state’s underserved and unrepresented communities

Best practices, next steps, challenges and successes were discussed during Oregon Public Health Week from April 2-6 in Portland. Friday afternoon story sessions wrapped up five days of panel discussions, presentations, films and more that focused on closing the health equity gap in underserved and underrepresented communities in Oregon.

“The event provided a nice opportunity for people to talk about the work they’re doing along health equity,” said Christy Hudson, policy analyst, Public Health Division, Oregon Health Authority. “The week was a good summary both of where we’re doing well and areas where more work is needed. There’s a lot to celebrate.”

One success celebrated was the 2017 passage of House Concurrent Resolution 33, which encourages state employees to become informed about the effects of trauma on children, adults and communities. During a presentation about trauma-informed care, two dozen health advocates and state officials took turns reading the resolution’s text.

Participants included State Sen. Kathleen Taylor, a sponsor of the resolution and co-writers of the resolution, Mandy Davis, Trauma Informed Oregon and Claire Ranit, Resilience Network of the Gorge.

“HCR 33 is packed with education and adversity information,” said Davis. “There’s a lot of work to be done.”

“I believe so many people are suffering in some way,” said Taylor. She added the school system, the prison system and law enforcement would be better equipped if they were better informed about the behavior of traumatized people and “to figure out why people are behaving in these ways.”

“Trauma is an epidemic we don’t recognize in our country. We don’t talk about it,” said Royce Bolen, Oregon Health Authority health policy and analytics division. “We need to make sure we understand the impact of trauma. Being informed about trauma needs to start at the top. We need to change the way we provide services, given almost all of us have had some form of trauma.”

Moving forward, Bolen said the hope is to increase awareness about trauma, develop a plan to implement trauma-informed care, to leverage resources, build relationships between agencies and continue developing training and tools for early intervention of trauma.

Hiring more workers with disabilities

During a discussion about disability in the workforce, panelists spoke about employing more people with disabilities. A first step is for leaders to promote the sense of inclusion as a philosophy.

“The best supervisors look at what people can do, not at what they can’t do,” said David Baldridge, an associate professor at Oregon State University who has cochlear implants and has had a hearing disability since third grade.

“Keep an open mind about hiring people with disabilities,” said Ian Jacquiss, disability trainer and community outreach specialist at Oregon Health Sciences University. “It’s a mostly untapped resource.”

Some assistive technology can assist workers with disabilities to perform their jobs. However, some technology creates barriers for people with disabilities. Baldridge said when offices offer only a computer phone system for those who are calling, some people are excluded. More are included when offices offer multiple ways to communicate, including an optional live chat feature or the ability to talk with a human. He urged offices to consider offering multiple communication methods.

A panel on adolescent health discussed sexual violence prevention and presented an alarming finding: More than half of Oregon’s female population have experienced sexual or domestic violence. A key tool in addressing sexual violence is state-required comprehensive sex education programs in schools. Promoting sexual health prevents sexual violence, said Shelaugh Johnson of Oregon Health Authority.

Each school district can determine what its sex education program looks like. A resource to inform local communities is the Sexual Violence Prevention Resource Map.

The panel rolled out the series of online data maps offering multi-layered data about Oregon adolescents. The maps are a platform to engage local communities, to monitor trends and to help communities determine local strengths to plan gaps in sex education and adolescent health programs.

Offering healthcare to youth with DACA status

During a discussion about increasing healthcare access to Oregon’s immigrant communities, panelists discussed the challenges of implementing SB 558, a new law that provides for the Oregon Health Plan to cover an estimated 15,000 additional children and teens younger than 19, regardless of immigration status. This includes youth with Deferred Action for Childhood Arrivals, or DACA.

A coalition provides workers who help people navigate healthcare coverage. But as outreach workers began going into communities to talk with parents about their children’s healthcare, they found people were fearful of talking and perhaps being deported.

“Fear of immigration enforcement is our number one barrier,” said Josie Silverman-Mendez, the bill’s implementation lead for DHS Community Partner Outreach Program.

The challenge is reaching those families and convincing the parents to sign their children up for available health insurance, said Aldo Solano, advocacy director, Oregon Latino Health Coalition. He emphasized that despite the challenges, “it’s crucial to go into communities that are afraid of talking.”

Learn More:

Explore data by county on the Sexual Violence Prevention Resource Map, found at www.healthoregon.org/svpmap

Read the text of House Concurrent Resolution 33 regarding trauma-informed care at www.oregonlegislature.gov/bills_laws/lawsstatutes/2017hcr0033.pdf

Hear stories about health equity and inclusion on Oregon Health Authority’s website at www.oregon.gov/oha

Susan Parrish is a freelance journalist based in Eastern Oregon. Reach her at [email protected].