The day after Buffalo experienced the largest mass shooting in its history, teams of emergency volunteers and mental health counselors arrived on the scene, offering emotional support and distributing food.
The response was robust and swift, but there was one big problem.
“The community didn’t feel comfortable coming up the stairs to the center because what they saw was a large group of White people,” said Kelly Wofford, Erie County’s director of health equity.
A White gunman had deliberately opened fire at a predominantly Black neighborhood’s only grocery store, a Tops supermarket, on a busy Saturday in May. Eleven of the 13 people shot were Black, including the 10 killed. Authorities called the shooting racially motivated.
“In any other kind of tragedy, like a hurricane or flood, anyone offering resources would be gladly welcomed, but this was different. This tragedy had a face and a hatred for a certain group of people,” said Thomas Beauford Jr., president and CEO of the Buffalo Urban League, which was one of the community organizations on site the day of the shooting.
“They completely rejected it,” said Beauford, adding, “The immediate reaction to the counselors was, ‘We need to see counselors that look like us.’”
By Monday, the problem was addressed. Wofford, who grew up down the street from the Tops, tapped her network to ensure there were more Black counselors on site, that Black people were the ones handing out flyers on the street about available services, and that Black people greeted folks at the help center.
“We made sure the community affected felt comfortable seeking the services they need,” Wofford said.
Her response efforts – and the spotlight the May 14 shooting put on the community’s existing disparities – exemplifies the role Erie County’s newly formed Office of Health Equity is meant to play in the community: ensuring that health services are equitably distributed across disadvantaged and marginalized populations.
Within Erie County, there is a significant disparity between the health outcomes of White residents and residents of color, which became even clearer as Covid-19 disproportionately affected Black and brown communities there, as well as across the country.
Even before the pandemic, the life expectancy of Black Buffalo residents was 12 years shorter than White residents, according to a report published by the Buffalo Center for Health Equity in 2015, the most recent data available.
Erie County’s Office of Health Equity was launched to help address those disparities. It was established in January by county law, and the funding was made possible by a major federal pandemic relief package known as the American Rescue Plan that distributed money to states, counties and cities across the country.
Erie County allocated roughly $1 million of the nearly $179 million it received from the American Rescue Plan for the creation of the Health Equity Office. It is using the remaining funds on a variety of needs, including economic assistance for small businesses, water treatment infrastructure and restoring jobs and spending that were initially cut due to the pandemic.
While issues of health equity were addressed prior to the formation of the office, the law formalized the efforts and put funding behind them, ensuring it can work to address long-term solutions. With Wofford at the helm, the office has nine staff members, including two epidemiologists.
“The Office of Health Equity – which did not exist and would not have existed without the funding we received from the American Rescue Plan – immediately became an integral partner in the response to the Tops shooting on May 14, by being in some ways the boots on the ground and the coordinator between third-party agencies and the county’s delivery of these services to the community,” said Erie County Executive Mark Poloncarz.
“It was unlike any experience we’ve ever had,” Poloncarz added, “and I’m very grateful that we had the Office of Health Equity in place because it would have made our job a lot tougher without it.”
Addressing health disparities is something communities across the country are grappling with, and while the pandemic caused illness and death for millions, it also has helped spur some momentum.
State and local health equity offices are far from being as prevalent as water departments, for example, but they are having a moment – due in part to the influx of money from the federal government meant to help communities recover.
“The pandemic really highlighted the gross differences in our ability to keep people healthy, related to race and ethnicity,” said Lori Tremmel Freeman, CEO of the National Association of County and City Health Officials.
The group hasn’t tracked how many formal equity offices have opened, but the number is growing, Freeman said. Philadelphia hired its first chief racial equity officer earlier this year.
In the past, some communities have not had the political will or the resources to formalize their health equity efforts, she added.
High-profile killings of Black people by police, notably the murder of George Floyd in Minneapolis, gave rise to a number of communities declaring racism as a public health crisis, laying the groundwork for some of the offices opening now. In April 2021, the US Centers for Disease Control and Prevention also declared racism a serious public health threat.
Resolving health inequities will take time and requires tackling the social determinants of health. These are the factors that contribute to someone’s health that they don’t have control over themselves, like access to clean water and healthy food and other conditions where they live, work and play that can affect their health.
“You’re really trying to create the same opportunity for health for every single person in the community, no matter what their economic status is, where they live or whether they have a job,” Freeman said.
In mid-July, the Tops grocery store reopened to mixed reactions from the community.
Without the supermarket, those without a car may have lacked convenient access to nutritious food. For others, it was emotionally difficult to reenter the store.
Migdalia Lozada, a crisis counselor with the Buffalo Urban League, spent one August morning offering support to shoppers. Lozada took one woman by the hand as she walked into the store for the first time since the tragedy, feeling the woman’s tears fall onto her arm.
The Buffalo Urban League’s community resource center, located just two blocks from the Tops, continues to serve the traumatized neighborhood. People can walk right into the space and speak with a crisis counselor. Some people are regulars who come in nearly every day. Others may have been triggered by an event like a shooting elsewhere or movement in a court case against the shooting suspect.
“We just try to give the person some space to open up in a safe, confidential place,” said Lozada.
While the Buffalo Urban League’s crisis counselors had already been serving the community for months, its leaders wanted a physical space nearby the Tops store after the shooting. The group found an open space down the street that had once been a neighborhood bar known as Pixie’s and opened a resource center there within days after the tragedy. The building intentionally looks and feels much more like a local watering hole than a health institution.
The center also serves as a place that connects people with other resources to address a wide range of social determinants of health, like employment, housing and education.
The Buffalo Urban League plans to work closely with the county, especially with the new Office of Health Equity, to help drive long-term change going forward.
The county office is first working on training people in the Mental Health First Aid national program, so that the county can deploy counselors throughout the community – like at Bible studies and community centers – to meet people where they already may be. A recent nationwide study found that while the share of US adults who received treatment for mental health grew throughout the Covid-19 pandemic, people of color are less able to access mental health services.
The office is also working on a survey that, in part, will show what problems members of the community would like addressed – it could be the high prevalence of diabetes or high blood pressure, for example.
“When you look at the social determinants of health, there are inequities across all of them, so you can pick whichever one you want,” Wofford said.