How ACDP Advances Health Equity
The Acute and Communicable Disease Prevention (ACDP) section works to identify how we promote equal opportunity to achieve the highest attainable level of health for all populations. In 2016, we convened an ACDP health equity working group (HEWG) which meets monthly. This group advances health for people in Oregon by identifying and implementing projects and priorities related to health equity in infectious disease and preparedness. This page describes that work.
Our approach includes the following principles:
- We acknowledge the past and present role of government in creating inequities and doing harm to communities of color and tribal and indigenous communities in Oregon, leading to historical and ongoing trauma.
- We envision an Oregon where all community members thrive and racial inequities are eliminated.
- We believe government has a primary role in disrupting and dismantling these systems, and it is crucial to address systemic inequalities faced by our communities.
To achieve these principles, we lead with race. This aligns with the approach of
targeted universalism as we reduce disparities for priority populations, we will improve overall well-being for our community. Opening with racial equity as a goal will promote equity for all people in Oregon.
In 2019 we completed a 
Health Equity Assessment (pdf). The report is being used to identify priority areas for the ACDP 5-year strategic plan.
Learn more: ACDP Health Equity Work Group
REAL D Data Collection Toolkit
The
Race, Ethnicity, Language and Disability (REAL D) policy applies to all Oregon Health Authority and Department of Human Services programs that collect, record, and report demographic data. These data collection standards provide a consistent method to gather information across all state data systems and will help us notice and address health disparities.
View the Real D Training Modules and Toolkit
Mini-grants
In April 2019, ACDP's Health Equity Work Group awarded six mini-grants to address communicable disease (CD) health disparities in local communities. The funds were awarded to local public health authorities to support implementation of CD projects that address community health disparities among groups that have experienced major obstacles associated with socio-economic disadvantages and historical and contemporary injustices. Grant funds went toward implementation of a direct service in the community. The total amount granted was $40,067.81.
Learn more: Mini-grants
Foundational Knowledge
We operate under the definition of health equity adopted by the Oregon Health Policy Board on October 1, 2019:
Oregon will have established a health system that creates health equity when all people can reach their full health potential and well-being and are not disadvantaged by their race, ethnicity, language, disability, gender, gender identity, sexual orientation, social class, intersections among these communities or identities, or other socially determined circumstances.
Achieving health equity requires the ongoing collaboration of all regions and sectors of the state, including tribal governments to address:
- The equitable distribution or redistribution of resources and power; and
- Recognizing, reconciling and rectifying historical and contemporary injustices.
The following sections on guiding concepts and practices inform our health equity work in ACDP.
What is it?
Racism is a difference in power that allows one group to systematically devalue other groups. This is done through political and cultural power to shape biased institution policies and practices.
There are different forms of racism:
- Interpersonal: This refers to prejudices and discriminatory behaviors where one group makes assumptions about the abilities, motives, and intents of other groups based on race. This set of prejudices leads to cruel intentional or unintentional actions towards other groups.
- Internalized: This is when people start to internalize, or accept as truth, the racist beliefs that they are exposed to. Believing these things holds people back from their full potential. It also reinforces oppression.
- Institutional: When assumptions about race are structured into the social and economic institutions in our society, institutions can limit access to resources and activities for certain groups of people. This type of racism reflects the cultural assumptions of the dominant group.
- Structural: This refers to the accumulation of effects over centuries of a racialized society. This includes the creation of a white middle class and how that group excludes others from the process of wealth creation, home ownership, college education, to name a few.
What does it mean to us?
ACDP is a part of state government and provides services to everyone in the State of Oregon. Understanding racism is imperative for us to be able to provide appropriate and quality services to the diverse groups that make up the population of the state.
Learn more:
- Race Forward a research nonprofit that advances racial equity and justice by working with local government and other institutions to address structural racism.
- The House that Racism Built (pdf) a presentation by David R Williams, Harvard University, on the vastly unequal health outcomes of different racial groups.
Guiding Concepts
What is it?
This is how well a person can find and understand health information and services to make health decisions. Having low health literacy may lead to poor health outcomes.
An organization that is health literate makes it easy for people to find, process, and understand health information. Using plain language is a key strategy in addressing low health literacy.
What does this mean to us?
We do our best to provide materials that are easy to read, understand, and act on.
Learn more:
What is it?
This term describes how our social situation affects our health. The five main social areas are:
- income
- education
- social and community groups
- health and health care
- neighborhood
Unequal access in these areas leads to poor health outcomes. It is important to address these factors when promoting health equity.
What does this mean to us?
We need to know the diseases that affect certain social groups more than others. This helps us respond to and reduce these health differences.
Learn more:
- Social Determinants of Health Video. This 10-minute video developed by the Oregon Public Health Division Health Equity Work group introduces a framework for understanding the Social Determinants of Health as they relate to health inequities. Watch the video.
- Cultural Competency. There are a variety of tools and information available at Think Cultural Health.
What is it?
We think of othering as when people (or groups) are treated as different or less important. Othering blocks people from having good health and meeting their potential. Examples of othering are:
- Stigma: This is when something about a person is viewed poorly by society. For example, using drugs has a social stigma.
- Intersectionality: This is when the experience of othering is made worse by multiple identities combined. For example, being both a person of color and a woman.
- Marginalization: This is when certain people are held back on purpose by people with power. Groups of people who are marginalized include, but aren't limited to:
- people of color
- people who are lesbian, gay, bisexual, or transgender
- people who are older
- people with disabilities
- people who are undocumented
- vulnerable children
- Discrimination: Discrimination protects powerful and privileged groups and hurts marginalized groups. This can be structural or individual. For example, structural discrimination limits where certain people are able to live or go to school. Individual discrimination refers to negative interactions between individuals.
What does it mean to us?
In ACDP, it is our responsibility to:
- learn about and address our unconscious biases. This will help us positively engage communities in ways that support their health.
- recognize and respond to communicable diseases in ways that are respectful, trauma-informed and supportive.
- work to change practices, policies, rules, or laws that harm community health through bias, discrimination, stigma or inaction.
- help communities in Oregon reduce their risk of developing communicable diseases by reducing the effects of oppression and marginalization.
Learn more:
What is it?
Unconscious bias describes the attitudes and stereotypes that we have about each other without realizing it. This affects how we understand people, how we treat people, and how we make decisions.
Unconscious biases can be positive or negative and we all have them. Here are a few points about unconscious biases:
- They are not permanent.
- They can change over time.
- They have real world effects on things like education, employment, and health care, to name a few.
What does it mean to us?
We are working to learn about our unconscious biases. Being aware of our biases helps us to question our ideas and work to treat people equitably. We are working to apply this to our interactions with community, hiring, grantmaking and other processes to remove barriers to correct historic injustices and be culturally responsive.
Learn more:
(Definition adapted from: State of the Science, Implicit Bias Review, 2014).
Guiding Practices
What is it?
CLAS standards help us serve diverse communities. Goals are to:
- Improve health care quality
- Promote health equity
What does it mean to us?
During outbreak and disease investigations, we talk with people all around the state. We do our best to match our services with the culture and language needs of each person. This helps get the best information and builds trust. CLAS standards guide our work.
Learn more:
What is it?
These are the strategies and policies that work to reduce the harm of substance abuse. In public health, harm reduction can prevent deaths, overdoses, or diseases.
Harm reduction can be used at the individual, community, or societal level. There is no one way to practice harm reduction. It's important to focus on the needs of the specific individual or community. (definition adapted from Harm Reduction Coalition)
What does it mean to us?
We work to respond to substance use-related disease outbreaks using a harm reduction-based response.
Here are some ways we do that:
- Listen to understand people's lives with respect and care. This helps us to understand what is contributing to their disease risk.
- Involve affected people when we make plans for how to prevent infections, respond to outbreaks and advise policy.
Learn more:
What is it?
Experiencing trauma is emotionally painful and often affects mental and physical health. Trauma can be caused by things like:
- violence
- abuse
- neglect
- loss
- disaster
- war
- other emotionally harmful experiences
We aim to implement trauma-informed practices by keeping these things in mind when working with people.
What does it mean to us?
We recognize trauma as a risk factor for poor health. Here are some areas in which we apply trauma-informed practices:
- how we treat one another, our partners, and the public
- when we hire new people
- outbreak investigations
- how we run our meetings
Learn more: