In 2020, Portland reported the most incidents of police brutality across the nation since the start of demonstrations in May, with nearly three times as many reports compared with second-place New York City, according to 2020PoliceBrutality, an open-source project that tracks officer violence in the U.S. Even as loud activists demanded institutional change, wildfires burned across Oregon and the COVID-19 pandemic raged, with both factors disproportionately impacting minority communities.
In September 2020, wildfire smoke created the most hazardous air quality conditions the Portland area had ever experienced, resulting in an 88% surge in visits to hospitals and emergency departments by patients with asthma-like symptoms during this time.
The trifecta of emergencies has magnified the need for culturally sensitive providers conscious of the social determinants of health in the city. In the wake of Black Lives Matter protests, healthcare providers are rethinking how they connect with the community.
“As much of a dumpster fire and awful as 2020 was, it also taught me a lot about the power of mutual aid,” Krieger said. “I’ve never been so excited to be in street medicine and street mental health. It feels like there’s possibility here.”
The EWOKs represent the only street medic teams in the city integrating physical and mental health services, according to Krieger, who works as a crisis therapist and supervisor at a local not-for-profit. But the city is aiming to implement a similar service.
In June 2020, the Portland City Council voted to direct $4.8 million from the police budget to a program called Portland Street Response, which will send trained mental health providers to certain 911 calls instead of law enforcement officers.
By tending to the full spectrum of a person’s health, officials hope to bridge racial health inequities in the city, said Sam Diaz, a senior policy adviser in Portland Mayor Ted Wheeler’s office.
In 2014, a report by Portland State University and the not-for-profit Coalition of Communities of Color found that Black families lag behind whites in the area in health outcomes and law enforcement engagement, like many areas across the country. In these instances, hospitals and healthcare systems often pay for much of the cost of treatment. A 2020 study by the American College of Surgeons found that gunshot wounds cost the U.S. healthcare system $170 billion a year, with hospitals spending $16 billion on operations alone to care for patients.
In Portland, between 2003 and 2007, Blacks were more than six times as likely to die by homicide and twice as likely to die from diabetes as whites, according to the report. Black residents in Multnomah County, where Portland is located, were more than three times as likely to be represented in the criminal justice system than the population as a whole, according to the analysis. In 2019, the county’s Black residents had an average annual income of $46,500, while whites’ income averaged upwards of $80,000, according to U.S. Census data.
“This isn’t new,” Diaz said. “We have report after report after report showing us the data, and it continues to be unacceptable.”