On May 30, black smoke plumed from a warehouse in South Omaha. Emergency signals alerted Omahans that the fire ignited harmful concrete-sealant chemicals which were being emitted into the air. But not everyone heard the warnings.
For days and weeks after the fire, confusion persisted in part due to the county’s failure to provide immediate warnings in Spanish in an area where English is often not people’s first language. As questions about what harm the chemical smoke may have caused persisted, some felt the pressure wasn’t as high to provide answers to this poorer area of Omaha.
“[The City] forgot about it,” said Nancy Valentino. “They thought, ‘It’s over, it’s done. Who cares?’”
For the Douglas County Health Department’s Health Equity Office it’s another example of local government falling short in protecting all its citizens. But it’s also an opportunity to learn.
“I will readily admit that we can do better…,” said Jamin Johnson, advisor of the county’s Health Equity Office.
In 2008, Dr. Frank Peak created the Health Equity Team, an internal group of employees who met once a month to talk about health disparities in the community. Following the 2020 declaration of racism as a public health crisis, the Douglas County Health Department began a Health Equity Office in 2021, where there are now employees working on health equity issues full-time.
While the main responsibility of the Health Equity Office is to address the 22 action steps outlined in the Racism as a Public Health Crisis Declaration, they are also working in conjunction with the Douglas County Emergency Management Agency to solve problems regarding emergency signaling when events like the warehouse fire happen in the future. In order to do this, they are working to pinpoint the most prevalent languages spoken in different parts of Omaha, so that everyone has an equal opportunity to understand the message in case of emergency.
Since the office is relatively new, Johnson’s office tasked with making sure traits like race, poverty or geographic location don’t stop Douglas County residents from leading a healthy life. Instances like Nox-Crete are opening their eyes to all they still have to learn about those they are supposed to protect.
Most of the information the office is using to identify health inequities comes from data such as birth and death certificates, as well as the information collected from the Census Bureau about the Douglas County residents. Johnson said this information is a bit disconnected from lived experiences. Especially with something as personal as health, he’d like to see the process become more qualitative.
“We recognize that we are looking at things from the press box and not necessarily the field and we need to find ways to marry that data we get with the perspective of the people in the communities,” Johnson said.
Many disparities are also multi-faceted and generational. The health of your parents, grandparents and ancestors down the line can inform long-term trends and point employees of the Health Equity Office toward common, underlying issues. For example, if someone can’t access safe housing or quality education, they’re less likely to escape poverty, which The Reader has covered in its (DIS) Invested series.
In looking at birth and death certificates, Andy Wessel, a community health planner for the Health Equity Office, said there’s a 12-year gap between the wealthy and poor in Omaha. He, and many others, believe you can trace that back to historical patterns of discrimination like redlining, a discriminatory practice that put certain services out of reach for residents of certain areas due to race or ethnicity.
“These things that go all the way back to historical patterns of discrimination… that have had health implications that we’re only now really wrapping our heads around as a community and figuring out what needs to be done to make those things right,” Wessel said.
While the office works to correct the issues highlighted due to the Nox Crete fire and historical discrimination, their main undertaking is still completing the 22 action steps outlined in the Douglas County’s 2020 declarate that racism is a public health crisis.
This declaration said that the Douglas County Health Department would establish an Office of Health Equity which would include the people most affected by health challenges in decision making.
The department also needed to review the Health Equity policy for updated terms regarding racism as well as create specific activities to embrace diversity and educational efforts to dismantle racism for staff.
Other steps included advocating for policies in communities of color, developing routine racial equity impact assessments, promoting racially equitable economic and workforce development processes and reviewing all City and County ordinances through a racial equity lens.
While there are always going to be health crises in Douglas County that need solutions, Wessel said the Health Equity Office is better equipped to handle these situations than other public health agencies due to the information line, COVID-19 community advisory group and a refugee stakeholders group (that was initially organized to understand what their needs were during the pandemic) that the office has established.
These groups are in place to help the Health Equity Office better understand the needs of the community members and especially those who may be overlooked, Johnson said.
“We recognize that sometimes we are only hearing the loudest voices in the room,” Johnson said. “That does not mean that people who have a soft voice don’t have a lot to say. We needed to identify ways to create channels of communication for people who might have a softer voice to feel safe and free to share.”
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