Healthier Together Oregon: 2020-2024 State Health Improvement Plan

Institutional bias is defined as the tendency for resources, policies and practices of institutions to operate in ways which advantage white, heterosexual, cis-gendered, able-bodied individuals and communities. This discrimination results in adverse health consequences for minority groups, such as people of color, people with low income, people with disabilities and people who identify as LGBTQ+.

Adversity, trauma and toxic stress include abuse and neglect, living in poverty, incarceration, family separation, and exposure to racism and discrimination. These events have a lifelong effect on health and are correlated with things like substance use, suicide and even some cancers.

Economic drivers of health include housing, living wage, food insecurity and transportation. Poverty is a strong predictor of poor health. Although Oregon's economy is growing, many are struggling to get out of poverty despite having a job due to the high cost of living or raising a family. People living in poverty experience higher rates of premature death and increased rates of homelessness, mental distress and food insecurity.

Despite an increasing number of people with health insurance, many are challenged to get to a health care provider or see a dentist due to provider shortages, transportation barriers, health care costs, or because they don't feel comfortable with their provider due to language or other cultural difference.

Behavioral health includes mental health and substance use. Oregon has one of the highest rates of mental illness in the country. Tobacco and substance use are the first and third leading causes of death, respectively, in Oregon. Mental distress can lead to lower quality of life, unemployment and increased rates of suicide. Use of alcohol, opioids, methamphetamine and other substances have a significant impact on many families.