Other Sections of the Report
You can find the rest of the report in the following links:
Extreme Heat Extreme Cold Air Quality Communicable Diseases Mental HealthLand Acknowledgment and Actions
Multnomah Clackamas and Washington county exist on the stolen homelands of the Multnomah, Kathlamet, Clackamas, bands of Chinook, Tualatin, Kalapuya, Wasco Tumwater and Molalla peoples. Signers of the Willamette Valley Treaty of 1855 were removed from their homelands to the Grand Ronde Indian Reservation. Today their descendants are tribal members of Grand Ronde and Siletz tribes, carrying on the traditions and cultures of their ancestors.
We acknowledge and express gratitude for the ancestors of this place and recognize that we are here because of the atrocities endured by indigenous communities. In remembering these communities, we honor their legacy, their lives, and their continuation in our community. Please reflect on the role the government has played in the painful colonial history and reflect as well on the resilience and healing of the Indigenous land and communities. We would like to invite everyone to collaborate and work together with the tribes to take care of the land and water and the people who inhabit these spaces.
While land acknowledgements are intended to be respectful, they can oversimplify complex tribal histories and can fail to recognize the ongoing impacts of colonization that tribal communities continue to live with to this day.
In addition to a land acknowledgement, we request that you join us in the following actions to support Indigenous communities.
- Give land back to Indigenous communities.
- Protect the environment.
- Insist the United States respect tribal sovereignty and uphold its trust responsibility to tribes which includes appropriate levels of government funding to support tribal needs.
- Elect officials and judges that understand tribal governments, relationships and law.
- Invest in tribal economies.
- Challenge and reject all stereotypes about indigenous people.
- Insist that children are taught accurate information about histories, cultures, and contemporary lives of indigenous peoples in your school system.
- Inform yourself about issues impacting indigenous communities and speak up.
Tri-County Region Overview
The tri-county metro area (Clackamas, Multnomah, Washington) is Oregon’s most populous region, home to 1.8M + people (43% of the state). Its diverse landscape includes urban, suburban, and rural communities, with residents frequently crossing county lines for work, school, and recreation.
Climate Challenges:Population growth (12% since 2010)
Projected climate impacts: More extreme heat, wildfires, floods, and landslides.
Multnomah County (Primarily Urban with Suburban and Some Forest)
800K+ residents; dense urban core with heat islands with low tree cover.
Communities Most Impacted: Low-income communities, communities of color, unhoused populations.
Protective Factors: Significant investment in the City of Portland from the Portland Clean Energy Fund, long history of climate change planning.
Risks: heat-related illness, wildfire smoke, flooding, ice storms.
Washington County (Mixed Urban/Suburban/Rural)
600K+ residents; diverse land-use.
Communities Most Impacted: low-income communities, communities of color, farmworkers, unhoused populations, older adults living alone, people living with a chronic condition.
Protective Factors: More green space, newer housing stock.
Risks: Rapid development contributing to canopy loss and heat islands, wildfires, air pollution.
Clackamas County (Primarily Rural/Forest with Suburban and Smaller Cities)
423K+ residents; largest county by geography, half live in unincorporated areas.
Communities Most Impacted: farmworkers, non-English speakers, and rural communities.
Protective Factors: More green space, fewer heat islands.
Risks: Wildfires, poor air quality.
Systemic racism has created unequal access to housing, jobs, and healthcare, worsening climate impacts for marginalized groups.
Black, Indigenous, Latine/x, and other communities of color are most affected.
Solutions must center equity and involve most impacted communities in climate planning to address root causes (e.g., housing, worker safety)
Contact
This data story/report was prepared by:
Kate Bennett MPH, Clackamas County Climate and Health Epidemiologist
Lauralee Fernandez PhD, MPH, Washington County Public Health Emergency Preparedness and Environmental Epidemiologist
Blanca Perez Castaneda MStat, Washington County Public Health Emergency Preparedness and Environmental Health Data Analyst
Sarah-Truclinh Tran PhD, MPH, Senior Environmental Epidemiologist, Multnomah County Health Department
Dan Trifone Multnomah County Health Department, Climate & Health Program Specialist
Acknowledgements
We thank the following reviewers who helped improve this report:
Kirsten Aird - Public Health Director - Multnomah County
Ryan Ames - Data Science and Informatics Supervisor - Washington County
Rachael Banks - Health Department Director - Multnomah County
Russ Barlow - Epidemiologist Senior - Multnomah County
Janine Delaunay - Disabilities Advocacy Coordinator - Oregon Department of Human Services
Leah Fisher - Built and Natural Environment Analyst - Clackamas County
Brendon Haggerty - Manager Health Homes and Communities - Multnomah County
Andrea Hamberg - Environmental Health Manager - Multnomah County
Hannah Hamling - Administrative Analyst Senior - Multnomah County
Afiq Hisham - Public Health Communications Coordinator - Washington County
Aly Hoffman - Health Department Program Communications Coordinator - Multnomah County
Armando Jimenez - Public Health Program Manager - Clackamas County
Kathleen Johnson - Sr Program Coordinator, Community Environmental Health - Washington County
Kimberly La Croix - Interim Public Health Director - Clackamas County
Larry Lake - Assistive Technology Instructor - Oregon Commission for the Blind
Madeline LeVasseur - Epidemiologist - Oregon Health Authority
Tim Lynch - Sustainability Program Specialist Senior - Multnomah County
Sara McCall - Communicable Disease Manager - Multnomah County
Meagan McLafferty - Senior Syndromic Surveillance Epidemiologist - Oregon Health Authority
Abe Moland - Research Evaluation Analyst Senior - Multnomah County
Alyssa Mooney - Emergency Medical Services Epidemiologist - Clackamas County
Scott Moshier - Environmental Health Program Communications Coordinator - Multnomah County
Emily Mosites - Epidemiology Manager - Multnomah County
Sarah Present - Clackamas County Health Officer/Family Physician Deputy/Multnomah County County Health Officer
Kathleen Rees - Communicable Disease and Data Modernization Supervisor - Washington County
Kimberly Repp - Public Health Deputy Division Manager - Washington County
Jairaj Singh - Climate and Health Program Specialist Senior - Multnomah County
Jennifer Snarski - Program Communications Coordinator - Multnomah County
Lindsey Snyder - Population Health Epidemiologist - Clackamas County
Amy Sturgeon - Sr Program Coordinator Health and Human Services - Washington County
Levi Zahn - Vector Control Program Supervisor - Multnomah County
Notes for Readers
Data for emergency room and urgent care center (ED/UC) visits from ESSENCE and hospitalizations from Oregon Health Authority Health Policy and Analytics Division are “visit-centric,” meaning they lack personal information to be able to link visits to the same individual. Therefore, these counts may represent multiple visits from a single individual for the same complaint. In addition, while all non-federal and non-specialty Emergency Departments report visits, urgent care participation is not robust and can vary over time. Non-urgent outpatient settings do not participate (e.g., community health clinics), so the visit counts presented here are likely an underestimate of the true burden of climate-related morbidity.
To track disparities in cause-specific ED/UC visits, we compare their characteristics to those for all-cause visits. This approach controls for the varying number of ED/UC reporting facilities in the source data over time and the fact that not all facilities participate in syndromic surveillance reporting.
ED/UC visits, hospitalizations, infectious disease vector borne cases are reported by place of residence, whereas deaths are reported by place of injury.