Q&A with Tricia Tillman, Director, Office of Multicultural Health State of Oregon

What is your primary role as Director of the Office of Multicultural Health?

My role is to ensure that the Department of Human Services has a strong and strategic focus on bringing more diversity to the department by recruiting, hiring and promoting employees of color. Ensuring that DHS is an environment that is supportive and embracing of people of color. There’s also a focus on eliminating disparities across the different services provided by the State of Oregon. This includes public health services, access to the Oregon Health Plan (OHP), and the quality of care that people receive on OHP. Services also include Temporary Assistance for Needy Families (TANF), child welfare services, and services for seniors and people with disabilities. Across all those different areas, there are racial and health disparities. My role is to make sure that the State of Oregon has a plan and commitment to addressing and eliminating those disparities.

What is your top priority in your first year?

My first priority is to build a strong and functional team to work across all the divisions within the Department of Human Services. I want to make sure that we have the best and brightest on board to move forward our agenda of addressing disparities. Historically, the office has only focused on public health, and it has now expanded to ensure diversity and inclusion is a priority in delivering services. Our team is shifting to include people from Human Resources whose focus is on diversity, affirmative action and cultural competency. We have team members who are focused on building partnerships with different communities on issues related to public health.

We also want to strengthen partnerships with community-based organizations, and to empower the community to hold DHS responsible for addressing disparities in ways that are strategic and relevant to those communities impacted the most.

Right now, we are just starting to have conversations about where we are and what kinds of issues the communities are seeing. We’re listening to communities about their experiences with the Department of Human Services. In the near future, what I’d like to do is to convene an advisory to look closely at the issues. This will help us develop a strategic plan that we will ultimately be accountable to. My vision is that the community must guide and direct the work of our office.

What was your career path leading up to your current role?

In some ways I’m the most unlikely director for an Office of Multicultural Health, and in other ways, my background really fits the position. My father is African-American – he was born in the Ninth Ward in New Orleans. He served the military and lived the rest of his life in Los Angeles until he passed away from a heart attack.

I was raised by my Mom who is white and Native American. It’s fairly common for Native American families not to engage and understand their Native American culture. There was a whole period of time when the goal of the federal government was to assimilate Native Americans into the mainstream society, causing people to lose their language, traditions and culture. There’s a part of my family that has been struggling with that loss for generations.

After getting my undergraduate is in international relations, I spent five years in Tucson, Arizona, where I was introduced to public health, social services and child welfare issues. In grad school, I decided to focus on public health, particularly interested in health disparities. My other graduate degree is in political science.

Why are health disparities an important focus of your work?

There are lots of personal and professional reasons. When I look back at my family’s experiences, I can see how racial oppression has definitely impacted the health and well-being of my family. In my community, I’ve been to many funerals where people say, “They died so young.” We lose a lot of assets in our community by not paying attention to health issues. It takes a huge emotional, social and economic toll.

What are some of the most important lessons you’ve learned?

Humility and courage are the two most important lessons I’ve learned: they continue to make up a lot of the conversations I have with myself. To me, humility means that I don’t know the answers. I have my life experiences, but they’re unique and different. I need to extend that same understanding to everybody that I meet, and be willing to ask the important questions. People bring so much knowledge to the table.

Courage is particularly important. In Oregon, there are a lot of situations where people around the table are completely bought in to a way of doing things. But that way may not work for me as a woman of color, and it may not work for other people of color. Being able to step up, challenge people’s thinking and interrupt the momentum. It’s hard to challenge people’s assumptions, and still hold on to their willingness to collaborate.

What do you foresee is the most challenging aspect of the work?

There’s a culture here in the State of Oregon that dictates the way business is done. Most people are not aware that it exists. There’s not a lot of reflection on why we do it this way – who it includes or excludes, whose power is maintained, who does not have power. Creating a climate for reflection is going to be a big challenge.

People are used to moving things forward in a certain way. Asking people to stop and reflect changes the momentum and requires more time, which is often our most valuable commodity.

Another challenge is coming in as a new person. In my past work, a lot of my effectiveness comes from the relationships I have built.

What do you look forward to?

I’m really excited about meeting communities of color outside the Portland Metro area. The challenge for me is to get a more thorough understanding of the diverse communities of color in Oregon. We started a series of road trips to various cities and towns in Oregon. Our first one was at a migrant health center and saw how the State is providing services to migrant farm workers. We’re also planning to visit tribal health centers.

I grew up in the city, although my family maintained their traditional ways. Becoming more in touch with rural Oregon – especially from the perspective of people of color – is one of the learnings I’m most excited about.

How does your cultural background impact your leadership?

Because I am multiracial, I tend to think about things from multiple perspectives. While I am not wedded to one particular outcome, I am wedded to a particular process – one that is inclusive. I feel like I’ve always been comfortable about things not being “all lined up” or having the one right answer. I’m comfortable with starting out with a blank sheet and brainstorming to come up with different solutions.

Part of the reason that we’re in this position in the first place was that a particular group of people who had the power at that time – whether they knew it or not – got to decide the rules for everybody. I understand that people’s lives are challenging in different ways, but certain groups have always had more privilege and power. So now the rules are set without consideration for the life experiences and perspectives of other communities. I think that really is the essence of what needs to be “undone” – we need to step back and really look at how we consider multiple perspectives and come up with rules that are fair and equitable for everyone.

What accomplishments are you most proud of?

I had the opportunity to work on environmental health issues in Multnomah County, as part of the county health department. We worked with community groups: mainstream environmental groups, some environmental justice groups, and advocates for low-income people, particularly those in low-income housing. Listening to the community, we determined that what people wanted was an environmental health agenda that reflected their daily life. They wanted to talk about the trash that wasn’t getting picked up regularly from the housing development. Many shared that their concerns are largely ignored by property management.

Because we listened, the Health Department was able to engage in housing policy, which made an impact in the lives and environmental health of mostly people of color living in low-income housing.

What that experience taught me is that it is possible for institutions to step out of the norm, and change the way they’ve done business. It’s possible for institutions to work in partnership with community. It’s possible for institutions to hear and understand what the community is saying. It’s possible for communities and institutions to work together on solutions that make sense to the people we’re trying to serve. To me, that is the “soul food” that has helped me to continue the work.

What do you enjoy most about the work that you do everyday?

My favorite thing is the people. I really love that I meet and the people that I work with. My story tends to be a mix of professional and personal experiences. It seems that people who want to work in health disparities bring a personal passion to the issue. That fuels them in making a difference.

The people engaged in this work have a commitment to social justice: they’re not in it for the money, or work from 8 to 5, then go on about their lives. They tend to be in it for the purpose of making their families and communities better. It’s really nice to work with people who have a deep sense of purpose and passion for their work.

My goal is to help them be more successful. We’re only a small office, and there’s only so much we can do. But if we can invest in supporting and nurturing other community groups, we can have a huge multiplier effect and have a bigger impact.

What’s on your wish list?

In a practical way, my wish is to have enough money to hire and work with the best people so we can support community organizations to help them realize their hopes and dreams.

In a more idealistic way, my wish is that when children come into this world, that they develop a sense of themselves as good people, as worthy people. That their families would be healthy, safe and nurturing places. That people would feel connected in an emotional and heartfelt way to their family, neighborhood and community. I wish that people wouldn’t have to struggle so much to achieve a decent life, that there will be enough supports for them in our society.

Fall 2009 Colors of Influence

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"When I look back at my family’s experiences, I can see how racial oppression has definitely impacted the health and well-being of my family."

"To me, humility means that I don’t know the answers. I have my life experiences, but they’re unique and different. I need to extend that same understanding to everybody that I meet, and be willing to ask the important questions."




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