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Urban policy -- Oregon -- Portland -- Periodicals, Portland (Or.) -- Politics and government -- Periodicals, Portland (Or.) -- Social conditions -- Periodicals


The Health and Welfare Subcommittee of the City Club's Study of Racial and Ethnic Relations in Portland focused on two areas: the major income maintenance programs administered by the State of Oregon Department of Human Resources (welfare) and health care provided through the Medicaid program and some community-based agencies.

Contrary to stereotype, the overwhelming majority of welfare clients is white. However, because disproportionate numbers of minorities are poor, a correspondingly disproportionate number of minority persons relies upon the meager support offered by public assistance.

In the welfare system:

  • The Subcommittee was unable to obtain information on complaints filed with Adult and Family Services Division, and is therefore unable to ascertain if there are complaints of discrimination in the welfare system.
  • Present and former welfare clients as well as welfare workers told the committee that subtle discrimination persists on an individual basis in welfare. Whether labeled racism or cultural insensitivity, this bias is a barrier to full access to services.
  • An additional bias exists—a prejudice against poor people. While this affects clients of all races, it is a special burden for minority clients when racial and ethnic discrimination is layered on top of poverty.

In health care:

  • Medicaid benefits, as measured by the dollars spent per recipient, demonstrate a clear bias in favor of white clients. The disparity appears across, all age groups. It is most pronounced in elderly clients, where white patients receive 40%-180% more care dollars than minority patients.
  • Studies done by the State Health Division on the African-American and Native American communities show startling facts of higher death rates, inadequate prenatal care, and higher infant mortality rates.

In both welfare and health care, cultural and language barriers impede access to services. Improved cultural training and greater emphasis on hiring and promotion of minority staff and management are needed in virtually all of the public agencies studied.

Published in City Club of Portland Bulletin Vol. 72, No. 21

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