Dr. Debra Bogen at podium. Photo courtesy of the Allegheny County Health Department.

By Dr. Debra Bogen, Director, ACHD, and Lee Harrison, MD and board chair

Allegheny County, like Minneapolis, has substantial racial disparities that impact all of us. Our communities are starkly divided along racial and ethnic lines. With these lines come distinct differences in access to housing, education, transportation and employment.

These differences translate directly to worse health outcomes among our communities of color. In Allegheny County, black people have dramatically higher rates of both maternal and infant mortality, higher rates of nearly every chronic illness, and shorter life expectancies. Despite the great need for health care because of these outcomes, they are less likely to have access to health care services and health insurance.

The murder of George Floyd at the bended knee of a Minneapolis police officer was the spark that ignited the protests, but the woodpile that is burning was built over centuries of racism and inequities at all levels of our society. Protestors are demanding not only justice for George Floyd, his family and community. They are demanding change in institutions that perpetuate racism in their policies, their practices and their ignorance. They are demanding words become actions.

These disparities have been exposed and their tragic consequences laid bare during the COVID-19 pandemic. Across the U.S. and in Allegheny County, COVID-19 has disproportionately impacted communities of color — including startling higher rates of hospitalizations and deaths among black men and women. In Allegheny County, 13% of the population is black. However, 28% of the cases of COVID-19, 32% of the hospitalizations and 17% of the deaths are among black people.

The leadership at the Allegheny County Health Department (ACHD) has been committed to addressing health equity and includes this issue among its core values. We have specific goals to address health equity in our Strategic Plan and the Plan for a Healthier Allegheny.

Despite a long-standing commitment to health equity, the horrific events of the past 10 days have driven us as a group to come together to consider what we as a team of committed public health officials are doing, and what we could do better to help repair the injustices that impact the health and well-being of our communities of color.

What is ACHD doing?

We have and will continue to examine our hiring practices to ensure we reach the broadest, most diverse and committed workforce.

We are working with and promoting our federally qualified health centers (FQHCs) to ensure access to high-quality health care and, more recently, to COVID testing.

We are committed to gathering and sharing information on race in our COVID-19 data collection so that we can understand and address the impact of the virus in different communities, and we’re committed to doing this for all disease.

We are working with the county’s Department of Human Services, the FQHCs, homeless service providers and foundations to develop strategies to increase health care services for the homeless populations in our communities.

We are working with community partners to prevent opioid overdose deaths and increase access to treatment programs. We are working to prevent violence through our partnership with the Cure Violence program.

We are working to improve housing regulations, decrease lead in homes, improve air quality, improve access to breastfeeding support and nutrition programs, and many other important public health programs.

The harder question is what can we do better or more effectively? We can and must be aspirational in our goals. We must be open and available for collaborations. We must put aside personal challenges and forge effective partnerships throughout government, organizations, foundations, businesses and all sectors of society. We — as a team — remain committed to addressing health inequity no matter how hard the challenge.

To our community, we hear your protests loud and clear and your demands for change. We are committed to working with all those who wish to address the health disparities in our county.

This letter was written by Debra Bogen, MD, Director, ACHD, and Lee Harrison, MD, chair, on behalf of the Board of Health:

William Youngblood, vice chair
Donald S. Burke, MD
Anthony Ferraro
Caroline Mitchell
Kotayya Kondaveeti, MD
Joylette L. Portlock, PhD
Edith Shapira, MD
Ellen C. Stewart, MD

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