What is public health? According to Alison Buttenheim, Associate Professor of Nursing and Health Policy, public health is focused on providing, promoting, and protecting the conditions that guarantee health for all; health for populations, and health for communities.” Public health goes beyond the provision of basic healthcare. It is also about recognizing and treating racism and sexual violence as public health crises, prevention of and response to communicable disease outbreaks and pandemics like COVID-19, affordability and accessibility of food, housing, and transportation, employment and wages, chronic illness prevention, and the environment as a system of public health.
I am an advocate for a public health equity framework for decision making. This means I center prevention, interconnection, and interlocking harms in order to address all of our communities’ issues.
Firstly, as the local health authority, there are tremendous opportunities for the Lane County Commissioners to be on the forefront of creating and maintaining policies and programs that foster healthy communities. But it is also our collective responsibility to do what we can to protect the health and well-being of individuals, families, and all of Lane County. In the time of COVID, this includes following the guidelines of our local health authorities by wearing a mask in public spaces, washing our hands, maintaining physical distance from others when possible, and having empathy for those that have stricter boundaries than ourselves.
Secondly, racism is a public health crisis that underpins so many of the issues I’ve been working on for decades—food access, safe transportation, housing and homelessness, preserving our environment, consumer financial protections, fair wages, paid leave, and more. White supremacy will continue to devastate our communities until we name it, confront, and dismantle it. Local governments, in particular, are obligated to act to protect our most marginalized communities. This work begins with recognizing our role in the systems and structures which uphold racism, reorganizing our priorities, and reallocating and redirecting resources appropriately.
Thirdly, response to sexual violence and support for survivors is an integral part of promoting community health and safety. It is important to call out sexual violence as the pervasive and pernicious harm that it is and the primary targets of this abuse of power: women and LGBTQIA people. Using phrases like “misconduct” or “inappropriate behavior" when we mean sexual or gender-based violence is unacceptable. I am committed to dedicating more resources toward community education on sexual violence (such as defining forms of violence and practicing consent), policy advocacy (such as closing loopholes that allow perpetrators of domestic violence to obtain guns), and trauma and healing support services (that are based in harm-reduction and survivor-centered approaches) and more public health nurses trained in sexual violence response (Sexual Assault Nurse Examiners, or “SANE”) in Lane County clinics. Most importantly, we need a community that fights sexual violence together—not as one survivor, one household, one school, or one place of work.
Fourthly, I continue to fully support and advocate for universal health care. Everyone should have access to consistent, high-quality care; regardless of where, or whether, they are employed. The county plays a huge role as the primary care provider to many of those that have no health care or struggle to afford care. While we have one of the lowest uninsured rates anywhere (at around four percent), we should strive to make that zero.The County is one of the largest providers of healthcare in Lane County, serving as the primary medical home to roughly 30,000 people. I am increasingly concerned about the quality, equity in availability, accessibility, and affordability of that care. We know what works, we just aren’t always doing it. For example, we have maternal-child health programs that include 8,000 WIC clients in the county seeking support for food and other necessities. According to Lane County’s Health Equity Report in 2017, 15% of pregnant people do not receive any prenatal care and much of this is due to a lack of transportation to distant offices. Families need available and accessible nutritious foods. We have effective public health programs, but we could do so much more with a real commitment of resources to prevention and proven programs—particularly in mental health services.
Lastly, I have always been committed to efforts that support families and their rights and abilities to care for their loved ones. The passage of Oregon’s Paid Family Medical Leave Act was a great step towards giving working families access to leave to care for themselves and loved ones and should have been implemented much earlier—as the COVID-19 pandemic has revealed. I would look to find ways to strengthen and expand this program here in Lane County.
For more on the benefits of paid sick time, living wages, and affordable housing and childcare—see WORKING FAMILIES.
For more on the relationship between Public Health and our environment, see CLIMATE CHANGE AND OUR ENVIRONMENT.