What We Do

Community Powered Change...

...is lifting community voices to build the future we want to see.

...is defining health equity for ourselves.

...is transforming the ways in which communities engage with institutions and organizations that create policy in our county.

...is creating healthy communities by dismantling racism at every turn.

...is creating a space where health equity is valued and practiced by everyone.

We do this work through different approaches. We begin by transforming planning processes to integrate the voices of those experiencing the greatest inequities. Our communities of color hold knowledge and experience that best influence the policies affecting our daily lives. We also focus work with partners in health, housing, education, jobs, transportation, food systems, and neighborhood development, as well as others, including government.

Theory of Change

By engaging our communities, we build capacity of community to identify the issues most affecting us and lift up the community voices least heard. These voices inform leadership within the OHEA coalition - where the work of Community Powered Change lives - and influence a policy agenda at both the state and local levels.

OHEA's Theory of Change in Action

(Click to enlarge) Image description: Titled OHEA Theory of Change, this graphic has hands at the bottom representing the community. Arrows around the border show the continuing work: Bridging a gap /serving as convener; Remove barriers to health equity through public policy; Education and implementation; Shifting balance of power, Building capacity in community; All participants have goal of advancing health equity, Supporting and organizing those most affected, and Lifting community voice. On the left within the circle of arrows, there are three boxes representing OHEA Membership (Health Equity and SDOH Partners), OHEA Executive / Advisory Committee (EDs & Organizers), and Community Health Improvement in Action (Community Voice) - community determined planning - community engagement. Each of these boxes has a line to community, as well as to a circle representing OHEA Policy Agenda. OHEA Policy Agenda then flows through to State / County / Local Public Agencies, as well as community and the continuing work of Education and implementation and Shifting balance of power.

VALUES, Guiding Principles, & frameworks


The values of Community Powered Change were established by community members, organizational partners, and the local health department. The image here reflects broad values of inclusion and empowerment; community leadership and participation; community-oriented approach to strategies; understanding the current and historical context of health disparities; and prioritizing health-related determinants.

Our Values.png


Three main principles support Community Powered Change.

1. We are community-led and transparent.

Our work centers community knowledge and experience. Everything that has been developed is a result of partnerships between community members, organizations representing communities of color, and the county health department.

2. We use the most current evidence or best practices and strategies to address health equity.

As much as possible, we pull from information that describes community level conditions.

3. We use feasible recommendations and strategies.

These strategies involve and build on the existing, hard work of key stakeholders who have the ability to influence effective implementation of strategies recommended by community members.

our frameworks

social determinants of health

Wherever possible, Community Powered Change focuses on social, environmental, and economic determinants of health. This aligns with an upstream approach to addressing health.

The concept of moving upstream is a public health analogy shared by social epidemiologist John McKinlay in an address to the American Heart Association in 1974. Imagine a rapidly flowing river where people continuously fall in. Members of this community work so much to rescue those who have fallen in, they become exhausted and are also drowning. They are not able to learn the reason why people continue to end up in the river in the first place. When community members are finally able to walk upstream to identify the reasons people are falling in the river, they see an opportunity for systemic change to improve health.

(Click to enlarge) Image description: Five concentric semi-circles show social determinants of health. The outermost semi-circle lists social, economic, & political factors: racism; social cohesion; political participation; segregation; inequality; and poverty. Moving inwards, the second semi-circle lists living & working conditions: housing; access to food; disease vectors; air, water,& soil quality; working environment; jobs; wages & benefits; and noise. The third semi-circle lists public services & infrastructure: parks; education; community centers; transportation; economic dev; and health care. The fourth semi-circle lists individual behaviors: exercise; diet; addiction; and coping. The fifth and innermost semi-circle lists individual factors: age; gender; and genetics.


Health equity means everyone has what they need in order to be healthy and thrive. Achieving health equity requires valuing everyone equally so that we consider ways to prevent inequalities, address injustice, and eliminate healthcare disparities.

Community Powered Change applies a health equity perspective when considering health determinants — the circumstances and conditions affecting people’s health behaviors and health outcomes — as a means to end the systematic creation of health inequities.

Health equity connects the equitable distribution of power and resources, empowered people, healthy community conditions, and quality healthcare as structural drivers that lead to healthy environments and behaviors that decrease illness and gain health equity for all.


Racial justice is about ensuring people of all races are treated fairly within our systems and institutions and have the same opportunities to thrive and be well. The racial justice work of Community Powered Change begins by centering communities of color, their knowledge, and experience and moves across access to different systems and institutions and the policies affecting our daily lives.


establishing community priorities

In 2016, Community Powered Change connected with approximately 225 residents of Multnomah County through a robust community engagement effort. Conversations with these community members elevated five community priorities:

  • Addressing racism and discrimination*
  • Access to a culturally responsive healthcare system
  • Affordable housing and houselessness issues
  • Access to essential community resources related to jobs, education, transportation, and food
  • Supporting families and communities of color

* This became the number one priority in 2017 with conversations around increased discrimination and intolerance, particularly racist behavior, and anti-Muslim and anti-immigrant sentiments. It also became clear that addressing this priority will make it easier to achieve the other priorities.

collaborating on strategies

In addition to the priorities, community members provided hundreds of recommendations for different approaches to improving health. In 2017, Opportunity Teams came together to develop strategies for implementing these approaches recommended by community. These Opportunity Teams consisted of organizational partners and community members.


In the first year of Community Powered Change, five priority areas were identified by community members. The original set of priorities has remained the same; however, in 2017, community members raised their thoughts around changing the order of priorities, given the increased racist behavior observed within Multnomah County. These are presented here in their adjusted order.

Transformative Change Toward Equity and Empowerment

Transformative Change Toward Equity and Empowerment

Oregon was legally founded as a state that excluded and discriminated against communities of color. As a result of such laws and policies, Multnomah County has a deep history of discrimination against its communities of color. Acts of racism and violence against these groups of people are increasing as this behavior has become accepted and even supported in the highest institutions of this country. Multnomah’s population has been changing steadily for the past 20 years, with growing numbers of people of color, immigrants, and refugees. The work of Community Powered Change seeks to ensure the policies of our institutions and programs support our growing communities of color.

Access to Culturally & Linguistically Specific and Responsive Healthcare

Access to Culturally & Linguistically Specific and Responsive Healthcare

Too often our communities of color are made to feel unwelcome or unsafe in our healthcare institutions. This can mean not having signs available in our own language or information we can understand in simple terms. It can also mean working with doctors and nurses who don’t look like us. This unfriendly, unwelcoming environment does not allow our communities to engage fully in our own health and this can have serious health consequences. Our work lies in ensuring healthcare systems are more accessible to our communities of color.

A Neighborhood Home for All

A Neighborhood Home for All

All people deserve access to safe and affordable housing. Yet for many families of color, there are multiple barriers that make this dream nearly impossible, including discriminatory policies. In addition, families and communities are being forced to leave their homes and neighborhoods due to rising costs and increased no-cause evictions. Unstable housing affects physical and mental health and increases the risk of homelessness, which in turn can make recovery from illnesses more difficult. The work of Community Powered Change addresses issues including overall housing policies, affordable housing, and houselessness.

Essential Community Resources

Essential Community Resources

Essential community resources encompass what affects our health and daily living, beyond hospitals and housing. This category includes transportation, education, jobs, and food. There are notable differences in access to these services among communities of color. Our work identifies areas of policy change and investment in work supporting communities of color.

Supporting Family and Community Ways

Supporting Family and Community Ways

Families and communities of color must often balance living in the mainstream world while finding ways to bring opportunities and resources back home that support our own traditional and cultural practices of health and healing. This includes access to foods and healing medicines, land to connect to physical activity and nature, and space and opportunity for ceremonial, religious, cultural, educational, and celebratory community gatherings. The work of Community Powered Change includes ensuring investment in the organizations that support our communities of color.


There are many organizations and institutions doing equity work now. These organizations are our partners and we recognize the very important work they do, as well as the support they need to do the work in a more coordinated way so it can have the strongest impact on people within Multnomah County. | Learn about becoming a partner

(Click to enlarge) Image description: Titled Community Powered Change Implementation Framework, this image has icons representing each one of the five priorities of Community Powered chnage. Below this are two triangles; the one on the left represents partners and lists MCHD, Metro, Portland Fire & Rescue, and Coalition of Community Health Clinics as examples. The text reads, "Start with where organizations are to support implementation of strategies within own channels." The triangle on the right represents projects and lists Community Investment, Pathways to a Culturally Diverse Workforce, and Community Health Equity. The text reads, "Facilitated collaboration between cross-sectoral partners on shared strategies."


Organizations do equity work in different ways according to their organization’s vision, mission, and values. We see how important it is to ensure our partners include a health focus in their equity work. More importantly, we see how valuable it is to start where our organizations are at in their process. This in turn impacts the community members they serve.


Community members brainstormed hundreds of ways they believe health could be improved. Their recommendations, what we refer to as strategies, range from free gym memberships to investment in culturally specific, community based organizations. Sometimes we see a shared focus of equity work between partners from different fields of work, as well. Supporting collaboration between these organizations is an opportunity to coordinate existing efforts and make sure our efforts come from distinct perspectives.