Public Health Seattle & King County (PHSKC or Public Health”) is a large metropolitan health department in Washington State, serving over 2.2 million residents with over 1,400 employees. PHSKC reaches across 39 cities that span urban, suburban, and rural areas, and serves residents who speak over 100 different languages [1]. The Seattle and King County region has rapidly increased in population including racially and ethnic communities in recent years. The population in King County is 19% Asian, 10% Hispanic/Latinx, 7% Black, 5% Multi-racial, 1% Native Hawaiian/Pacific Islander, and 1% American Indian/Alaska Native. Over half of new residents since 2010 are foreign-born, with the top five countries of origin being India, China, Mexico, Vietnam, and the Philippines [2].
The rapid growth of Seattle and King County has led to gentrification in the area, pushing lower-income residents further from services and community, into the surrounding suburbs. These areas, often to the South, face barriers to transportation, furthering marginalization and lack of access to basic services and social support for these communities. Health inequities have widened in recent years, especially with the impacts of the COVID-19 pandemic, with disproportionately high rates of communicable and chronic disease health indicators in these communities.
During the first half of 2020, PHSKC and other King County departments established a community-facing branch and an equity team within the COVID-19 Incident Command Structure, led by a new Office of Equity and Community Partnerships (OECP, previously the Community Mitigation and Recovery Branch). The OECP within PHSKC promotes work both within the department, growing its equity and community-facing capacity, and externally, working to be anti-racist and co-create with community to shift power, develop pro-equity policies and systems, and ultimately address health inequities. The OECP works to sustain and routinize community- and equity-centered work within the department. The department is working to transition the COVID-19 one-time emergency funded investments made early in the pandemic to do anti-racist and community-centered work as core throughout the department. These changes are aligned to King County's 2010 equity and social justice ordinance (Ordinance 16948), the 201622 Equity and Social Justice Strategic Plan, which call for the use of a racial equity lens and community partnerships in public health and all county work, and the 2020 declaration by King County of Racism as a Public Health Crisis.
The OECP's approach is community-centered and multi-pronged and involved the creation and sustained efforts of new teams developed during the pandemic: the Pandemic and Racism Community Advisory Group, the Community Navigator Team, the Priority Populations Teams, the Language Access Team, the Equity Response Team, and a team of OECP leaders and community consultants working towards organizational development and building department capacity:
- The Pandemic and Racism Community Advisory Group (PARCAG) works to identify, inspire, and mobilize bold solutions in response to the urgent, interconnected crises of COVID-19 and systemic racism. The public-private committee provides community insight and input on PHSKC's policy-making process, implementation of programs/services, and information needs for COVID-19 to King County residents.
- Community Navigators work with over 45 communities, representing those most impacted by health inequities. These are compensated community leaders who educate, equip, and serve as connectors to their communities by providing culturally responsive information and resources, addressing social determinants of health, and provide guidance to Public Health.
- The Priority Population Teams consist of Public Health staff and community partners addressing health inequities in the following communities: Black, African Immigrant, Native/Indigenous, Latinx, Pacific Islander, Asian, South Asian, LGBTQ+, and people living with disabilities.
- The Language Access Team provides translation and interpretation services to advance language access, working with 130 contracted community members and serving 44 languages. The team delivers meaningful language access assistance resulting in accurate, timely, and effective communications for King County's multilingual and linguistically diverse communities. Language access services are provided through staff trainings and certifications with provision of rapid, high-quality translations in response to community needs. The team's work includes to strengthening existing relationships and building new relationships with translators, other Public Health Language Access Liaisons, and integrating health literacy and plain language into Public Health work.
- The Equity Response Team addresses cross-cutting issues raised by the team and partner agencies through advocacy and guidance. As an internal think tank” for anti-racism and crisis response, this team examines and improves internal and community-facing programs, strategies and policies. They promote equity between community workgroups focused on Black, Indigenous and People of Color (BIPOC) populations and Public Health teams through advocacy and guidance by developing review processes such as equity checklists to address internal and external processes, programs and policies.
- The OECP leadership team consists of three key OECP staff who work alongside community consultants and department leadership to create substantial and sustained changes to PHSKC human resources, contracting, budgeting and strategic planning, plus supporting work by divisions. The leadership team includes the Director of the OECP, the Deputy Equity Officer, and the Equity, Inclusion, and Belonging Manager.
Together, the OECP teams work to prioritize communities affected by structural racism, to support county leaders and staff to create better public health policies and decisions, and to address the root causes of health inequities including systemic racism.
King County Website: https://kingcounty.gov/depts/health.aspx
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References
[1] Public Health-Seattle & King County. About Us. https://kingcounty.gov/depts/health/about-us.aspx
[2] Gene Balk, New milestone in King County: Immigrant population tops 500,000,” The Seattle Times, January 14, 2019, https://www.seattletimes.com/seattle-news/data/new-milestone-in-king-county-immigrant-populationtops-
500000/